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The History Of Quarantine: How Individual Actions Stopped Our Biggest Threats

Medical History | April 6, 2020

With many cities, states, and even countries issuing "stay at home" orders to stop the spread of COVID-19, now might be a good time to look back through history at just what exactly quarantine is, where it came from, and how successful quarantine has proven in the past.

Plague doctor mask. (Getty Images)

Quarantine Through The Ages

Yersinia pestis, A.K.A. the Black Death or bubonic plague, is a bacterium that spread throughout Europe during the mid- and late-1300s, killing over 30% of the entire continent. Within a few days of exposure, a victim of the bubonic plague experienced high fevers, body aches, and nausea that sometimes resulted in vomiting blood while the lymph nodes (those things that help fight off infections) of their necks, armpits, and groins swelled massively. Once the infection reached the blood, body parts began to die off, and the victim's skin turned black. Overall, not a fun or pretty way to go.

The bacterial infection was spread by the bite of fleas, which often resided on the rats that swarmed city streets and kept second homes in the well-stocked underbellies of merchant ships. Since rodents have no idea of their own consciousness, let alone the concept of self-isolation, they spread the bacterium all across Europe on their globetrotting adventures. Unfortunately, medieval Europeans—who were considerably more self-aware but roughly equally knowledgeable about germ theory—never got a clear understanding of how the plague manifested, either.

The people of Venice, however, did land on something at least marginally useful. As the Venetians controlled many points of entry for merchant ships, they decided to stop all ships at the ports and isolate them for 40 days before allowing them onto the shore. The Italian word quarantino, derived from the word for the number 40, eventually morphed into the English "quarantine" as the practice became popular throughout Europe. Although the Plague was already spreading, most historians believe the Venetian quarantine was beneficial.  

Cassell's Illustrated History of England, Volume 3. (Wikimedia Commons)

The Persistence Of The Plague

The Plague reared its ugly head again and again over the course of the following centuries. One particularly frightful episode occurred in London, when the Great Plague of 1665 killed around 100,000 people. Initially, London officials decided to conduct a house-by-house quarantine, but it wasn't very successful, as people often fled their homes if someone became sick or died. Since the surrounding areas were often unwilling to accept Londoners at this time, the poor were sometimes left to starve.

While tragic, refusing entry to the potentially infected is understandable, given what happened to the nearby town of Eyam after a London merchant visited. The fleas that hid in the merchant's cloth found residence on animals and humans alike, and the Plague took a quick and savage hold of the small town. The local reverend eventually declared a quarantine from the rest of England, and although a horrific 80% of the town died, his swift action undoubtedly saved the lives of thousands of people in the region.

Finally, in the summer of 1666, the spread of the Plague began to abate. It was eradicated completely that fall by the Great Fire of London, which carried the unfortunate side effect of burning nearly 400 acres of the city. It was really not London's year.

Yellow fever strain. (Wikimedia Commons)

Yellow Fever

In 1793, the city of Philadelphia was besieged by yellow fever, a deadly virus spread by mosquitoes that caused chills, vomiting, and severe liver damage resulting in jaundice, hence the name. The virus came to America by means of the African slave trade, and once it hit the shores of Philly, people began dropping like flies. With over 100 deaths per day, the city scrambled to take care of the sick and dying, sanctioning special hospitals as quarantine zones for yellow fever patients only. What proved most effective was the strategy employed by neighboring areas of restricting the travel of fleeing Philadelphians. Mercifully, the following winter wiped out many of the infected mosquitoes, and the city slowly recovered.

Fun fact: Philadelphia was actually the capital of the United States at the time, and 1793 was a time of great political unrest. According to John Adams, 10,000 Philadelphians had threatened to "drag Washington out of his house" if he continued to refuse to participate in the French Revolution. Fortunately for him, Washington was at his homestead in Mount Vernon, and the yellow fever distracted Philadelphians just enough to abandon the idea of overthrowing the fledgling government.

Chinatown, Honolulu. (Wikimedia Common)

Guess Who's Back

Did you think we were done with the Plague? Guess again. That cruel beast returned like an 86'd party guest in China in the late 1800s before landing Honolulu, Hawaii in 1899 on a rice ship that arrived with a mysteriously deceased crew member. The ship was rightfully quarantined, but like Italy, they failed to account for the rats. The ship's whiskery passengers made their way into nearby Chinatown, prompting the government to instate a military quarantine around the area. However, they lifted the quarantine much too soon. As cases of the bubonic plague began to rise, the government then attempted a controlled burn of supposedly infected belongings, but the fire quickly got out of hand and burned almost 40 acres of the neighborhood, leaving thousands homeless. The bubonic plague actually still exists today, but it turns out it's easily treated by antibiotics. Tough break for history.

1918 flu in Camp Funston, Kansas. (Wikimedia Commons)

The Spanish Flu

The 1918 flu pandemic, somewhat erroneously called the Spanish Flu, was a catastrophe on a global scale, with a death toll of 50 million people. To put that in perspective, World War I—the single most horrific war humanity had ever seen—killed less than half of that number of people.

So what do you do when the worst disease in recent memory comes knocking on your door? If you're American Samoa, you lock it, deadbolt, pull the chain, and close the blinds. Once word of the pandemic reached officials in American Samoa, they cut off all access to the land and quarantined everyone with symptoms on Navy medical ships. They suffered zero loss of life due to the flu as a result. Yes, zero.

In clear contrast, Western Samoa did absolutely nothing to control ships coming into their land. At this time, the region was controlled by New Zealand, and their appointed officials didn't take the threat seriously, prioritizing trade and travel over health. As a result, a whopping 20% of the island died within mere weeks of exposure. This callous disregard for life became a rallying cry of the Mau movement for Samoan independence, which was eventually accomplished in 1962. New Zealand formally apologized for the mishandling of the pandemic in 2002.

Tags: isolation | medicine | medieval europe | plague | spanish flu

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