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August 5, 2014

How quarantine procedures have (and haven't) changed with time

Daily Briefing

Writing in The Atlantic this week, Adrienne LaFrance recounts the history of quarantine practices and how little has changed from the practice's earliest mention in the Old Testament to today's effort to control a deadly Ebola outbreak in West Africa.

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LaFrance traces historical mentions of quarantine practices:

  • The Bible's Old Testament notes that ill people were isolated from society.
  • European governments first established formal quarantine protocols during the 14th century plague outbreak.
  • During the 1730s smallpox epidemic, infected New York City residents were banished to Bedloe's Island—the same island where the Statue of Liberty would reside years later.
  • The colony of Kalaupapa on Pacific island of Molokai served as a settlement for people with leprosy from 1865 to 1969, where 8,000 people died.
  • "Typhoid Mary" Mallon—a cook who infected dozens of Manhattan residents in the early 1900s—was banished to North Brother Island for 24 years.
  • Astronauts in 1969 were quarantined in a trailer for three weeks after returning from the moon to ensure they did not carry moon germs. 

"Sickness-related isolation may carry the same stigmas and raise the same questions about civil liberties as it always did, and yet quarantine locations—the isolation spaces themselves—are far more integrated with the rest of society than they once were," LaFrance writes. People may not be sent to islands, but they are still cut off from society.

For example, a modern quarantine is in full effect in West Africa to combat Ebola, including masks, specially designed suits, and ventilation systems. The quarantine has extended to ambulance docking stations and jets as patients are moved to the United States to be treated.

Today, the United States has 20 quarantine stations—all in major cities such as Boston, Chicago, and Los Angeles—where CDC has the federal authority to detain any person believed to be carrying an infectious disease. (According to CDC, "isolation" is simply separating infected people to stop the spread of disease, while quarantining "involves restricting the movements of well people to see if they become sick.")

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Government-imposed quarantines—a fairly "archaic approach to disease management"—raise questions about freedom, says Geoff Manaugh, a writer who has written extensively on socio-architectural aspects of quarantine. 

With no imposed quarantine, people are reluctant to leave their families and submit themselves to government organizations that may not be considering the best interests of the individual patient, Manaugh says. "People are not necessarily very honest when it comes" to being quarantined and "[t]rying to break quarantine is kind of a strangely primal human instinct," Manaugh says (LaFrance, The Atlantic, 8/2).

More from today's Daily Briefing
  1. Current ArticleHow quarantine procedures have (and haven't) changed with time

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