Step Ten: “Lockdown” is not a “Quarantine” [Essay Three]
Dr Naomi Wolf
Essay Three:
Let’s look now at a massive euphemism that is allowing for the various power grabs we will explore, that the COVID-19 pandemic facilitates.
National leaders are using the term “quarantine” to refer to acts of closing down economic activity in entire states and even nations, and of restricting all citizens’ travel to and from entire states lines or across borders to countries. This “quarantine” has in turn shut down engines of economic activity. https://www.bbc.com/news/world-us-canada-52080119.
While this drastic set of constraints may indeed be valuable medically, my concern here is at looking at what we risk to lose forever in the heart of our medically valid fears.
So I do want to point out that this is a serious historical misuse of the term.
Though leaders have rolled out the messaging around restrictions of movement as if this form of immobilizing citizens is a “quarantine” and has precedent, it really can’t be said to. It’s quite novel to lock down the economic engine of a whole society. For western democracies, it’s a new social experiment on this scale.
Our global and nation by nation “lockdown” really doesn’t look much like any disease-related “quarantines” in history at all. The large-scale forced closure of businesses, and the cordoning off of complete societies, with movements of both healthy and infected citizens restricted by the state, is something other than historical “quarantine” altogether.
The “lockdown” — mis-labelled, “quarantine” — as we are experiencing it now, has actually happened before on this planet: just not in open societies or in the contemporary West. Totalitarian and fascist societies have indeed often used mass restrictions of movement, curfews, and other ways of restricting the free association and free movement of citizens.
North Korea and China have indeed utilized the cordoning off of entire regions and putting them under no-movement rules for everyone. The Chinese Communist party, long before the COVID pandemic, was among few modern societies to restrict citizens’ physical movements nationally and regionally. https://www.citymetric.com/politics/china-theres-no-freedom-movement-even-between-country-and-city-2697. As dissident escapees from North Korea report, North Korean nationals have also long been unable to move freely around the country without proper documentation, even for family visits. https://www.nknews.org/2020/07/ask-a-north-korean-how-restricted-is-movement-in-north-korea/.
Europe is not immune to this in the past — it has seen such regional and national “lockdown” too, but that was in countries that suffered from fascist leadership: In 1935-36, the passports of Jews in Germany were restricted. https://www.bl.uk/learning/histcitizen/voices/info/decrees/decrees.html. Eventually restrictions on leaving the country would keep Jewish Germans from escaping altogether. https://encyclopedia.ushmm.org/content/en/article/german-jews-during-the-holocaust.
From 1939 to 1941, laws imposing various increasing restrictions on the movements of Jews put members of the Jewish community into effective “lockdown” as citizens within the larger German society (“infection” was a frequent trope used by anti-Semitic literature about the threat of Jews intermingling with Aryans). These laws prevented Jews from entering certain neighborhoods, and from traveling on buses. Walled Jewish residential areas, called ghettos, were often traditional in European cities; but state-mandated restrictions during the Nazi occupations turned them into residential prisons.
On 16 November 1940, the gates were closed to the Warsaw Ghetto, a community of 400,000, thus making it impossible for the Jewish inhabitants to earn livelihoods; this closure and denial of the power of earning a living, was instrumental in the weakening of potential resistance on the parts of victims of this segregation. https://www.jhi.pl/en/blog/2019-11-15-the-closing-of-the-warsaw-ghetto
But large-scale totalitarian-style restrictions of citizens’ movements by the state are new to the postwar democratic West and unheard-of in actual open societies; even past pandemics past have not been excuses in such societies to venture into this drastic territory.
What is “quarantine”, understood correctly? Not this.
Medical quarantine itself, as the term is properly understood, has a long and often effective history. The Oxford English Dictionary defines “quarantine” as “[a] period (originally of forty days) during which persons who might serve to spread a contagious disease are kept isolated from the rest of the community; especially a period of detention imposed on travellers or voyagers before they are allowed to enter a country or town, and mix with the inhabitants; commonly, the period during which a ship, capable of carrying contagion, is kept isolated on its arrival at a port. Also, a period of seclusion or isolation after exposure to infection from a contagious disease” (Oxford English Dictionary, 2004). Society-wide shut-down and the closing down of all economic activity are definitely not part of this definition of “quarantine”.
Some historians of science refer to quarantine as a primitive “technology”: A A Conti, in “Quarantine Through History”, notes that “[q]uarantine is overall one of the oldest and most disseminated and, despite its limits, most effective health measures elaborated by mankind.” And in the centuries before germ theory was understood, and before vaccines, quarantine — physical isolation of the infected — was indeed among the few methodologies societies had, to manage terrifying outbreaks of suffering and of death.
“Quarantine” has virtually always meant the restriction of movement for those who are ill or possibly infected. But not of everyone.
The term has often meant isolating travelers until they can be guaranteed to be healthy, and then letting them pass into the larger society to which they wish to travel; it has often meant putting infected people on an island together or outside of camp, or in a “fever hospital”, until they either got better or else died. But “quarantines” in history overwhelmingly describe other kinds of much more specific restrictions than the wholesale restriction of movement and economic activity of healthy and ill, that we are experiencing.
This isolation of the infected members of a community has an ancient history. Ill people are isolated throughout the Hebrew Bible and the New Testament. Leviticus prescribes how to handle the dreaded contagion of leprosy in a member of the community: “His clothes shall be rent, his head shall be left bare, and he shall cover over his upper lip; and he shall call out, “Unclean, Unclean!” [Leviticus 13:45]. P J Grisar, writing in the Forward, adds the example of Moses telling the Israelites to place outside of the camp, “anyone with an eruption or a discharge.” [https://forward.com/culture/441195/what-does-the-bible-say-about-quarantine/]. Indeed, Leviticus 15:19 is remarkably detailed about how to avoid infection:
“When any man has a […] discharge, he is thereby unclean.
“Such is his uncleanness from this discharge, whether his body drains freely with the discharge or is blocked up from the discharge. His uncleanness is on him all the days that his body discharges or is blocked up from his discharge; this is his uncleanness.
“Any bed on which the man with the discharge lies is unclean, and any article on which he sits is unclean. Anyone who touches his bed shall wash his garments, bathe in water, and be unclean until evening. Whoever sits on an article on which the man with the discharge was sitting shall wash his garments, bathe in water, and be unclean until evening. Whoever touches the body of the man with the discharge shall wash his garments, bathe in water, and be unclean until evening…” [Leviticus 15:19]
(The admonition to “be unclean until evening”, meaning to consider oneself impure and not touch or interact with others, foreshadows guidance we are being given to distance socially and to avoid surfaces that have been recently handled by those who may be infected with COVID.)
It was understood that within the camp of the Israelites, people infected with contagious diseases could “defile” the rest of the community. Some analysts of ancient Jewish “kashrut” practices such as these, with their emphases on cleanliness, and on strict attention to what is “fit” and “unfit” to touch or eat, argue that some rules may have had to do with upholding sanitary practices in a time when infections swept through communities with devastating impunity.
The public nature of infectious illness in the pre-modern-medicine past, assigned people lifelong social roles. It made some people complete outcasts. The parable in the New Testament of the Woman with the Issue of Blood — Matthew 9:20-22 — is profound regarding the public aloneness of people with infectious diseases in the world before antibiotics or vaccines. The woman is described as having “an issue of blood” that had lasted twelve years. In that society, bleeding made one unclean. Thus, the Woman with the Issue of Blood, and everything she touched, were all considered unclean. So in the parable, the woman’s plight, as her contemporaries would have understood, was that she lived in deep and public social isolation as well as in a condition of physical illness. (Jesus’ welcome of her touch of his hem, was part of what made his conduct toward her, and his message about her social value, so very radical.)
The public nature of the management of COVID infection, and the many apparatuses that are being brought to bear on tracking and managing it, as medically valuable as they may be, once again risk stripping citizens of privacy; they risk creating the pre-modern specter of medical pariahs; that is, people whose antibodies or immunities will or will not eventually allow them to work or to travel. Illness in the modern, antibiotic-managed present is usually private; until now, in the modern era, we haven’t needed to disclose not-obvious illnesses to our neighbors, let alone to the state. That is one reason we can have the level of privacy that has been ours in the modern period. The commons could no longer kill us. My infection did not kill you; yours did not kill me.
But with COVID, illness can be messaged as a public matter again as in the pre-modern past; and certainly one that gives the state a central role, and thus a high status and a great deal of authority, in managing our bodies. From temperatures being taken in front of strangers after a flight, to announcements of the infections of public figures on social media, COVID’s lethality is being used to explain why, whether we are sick or well, we should all abandon any expectations of privacy and autonomy.
In the past, “quarantines” did indeed strip privacy and autonomy from infected people. But with the articulating of policy around COVID, we are all positioned as hypothetically ill; and continually told that we should act as if we are all “potentially infected.” As medically valuable as that may be, it also means that we are thus all expected, whether sick or perfectly healthy, to release our rights to privacy and autonomy.
The downside of this beyond its potential medical value, is that this can create a public category of second-class citizens whose bodies determines their potential in life; and all of us can be managed by the threat of our losing options due to what we do or don’t have in our bodies, whether it is the infection itself, which can be revealed on any track and trace database, or our antibodies, or the records of our medical treatment.
In several states, such as Massachusetts, elementary school students are being told that they can’t go back to school unless they have a flu vaccine; COVID research is the justification for this brand-new power grab by the state in usurping parents in managing the bodies of children with the rationale of avoiding a minor illness. The details will change; but once the state has succeeded in thus opening and closing opportunity for community – or for work or education — based on the makeup of one’s body, a Black Mirror reality in which one accepts intrusions by the state in order to have community – or to have work or education — is one step away.
Quarantines were in use by various communities in the Middle Ages of course, as the Black (or bubonic) Plague wiped out millions of people in Europe, in the 14th, the 16th and finally at the end of the 19th centuries centuries. [https://www.sciencemuseum.org.uk/objects-and-stories/medicine/bubonic-plague-first-pandemic]
The standardized process of quarantine in the European sense, dates from the 14th century. A A Conti describes how the Rector of Ragusa — today’s Dubrovnik — issued a decree in 1377, formalizing the ‘trentina’, a word derived from the Italian word for “thirty.” Ships had to isolate for 30 days if they came from areas suspected of having plague. Travelers by land had to isolate for forty days — hence “quarantina”. If these travellers fled the isolation before their time was up, they could be fined. Again though, in this accurate definition of “quarantine”, travelers were stopped in their tracks; infection was understood to be caused by contact; but as devastated as the economies of Europe were, they were not intentionally brought to a complete standstill in response to the plague.
The UK Science Museum calls the Black Plague probably the first recorded pandemic; it killed two thirds of the people of Europe. Most of its victims died within days. ‘Leave quickly, go far and come back slowly’ was the best advice authorities could offer. They provided medical inspections, and if signs of black plague were present, they would isolate the infected patients along with their families. Authorities removed sick people to “plague hospitals,” later called “fever hospitals”: “Hospitals were built throughout Europe and remained as fever hospitals for infectious patients up until the 1900s.” https://www.sciencemuseum.org.uk/objects-and-stories/medicine/bubonic-plague-first-pandemic.
Some of this isolation took place on islands of the infected. A mass grave on a Venetian island might be the earliest “disease-quarantine colony,” writes Maria Cristina Valsecchi in The National Geographic. https://www.nationalgeographic.com/science/2007/08/venice-mass-plague-graves-science/. The quarantine island was called a “lazaret,” and these islands were part of how Venice was able to recover between waves of plague. “When plague struck the town, everybody sick or showing any suspect symptom were restricted on the island until they recovered or died,” explains University of Padua anthropologist Luisa Gambaro. At the height of plague outbreaks, five hundred people a day would die on the island. This is a distressing and tragic way of handling a plague; but again, Venice as a whole did not stop its entire economic activity or keep healthy Venetians indoors alongside the ill.
In the 1620s and 1630s, the British Parliament sought to keep ships at harbor long enough to make sure that they were free of infectious diseases, in response to outbreaks of plague in Italy. This too was accurately called “quarantine.” But once again: 17th century Britain did not bring its marketplaces to a standstill or keep healthy people inside with those who were sick. [Hickey, Talei ML, “Arrival From Abroad: Plague, Quarantine, and Concepts of Contagion in Eighteenth-Century England” (2014). https://digitalcommons.tacoma.uw.edu/history_theses/6]
Plague was severe in Britain several times in the 17th century: in A Journal of the Plague Year, which is an account of the “Great Visitation” of plague to London in 1665, journalist and trader Daniel Defoe describes London slowly realizing that “plague” or “distemper” was stalking the city. At first the authorities closed off neighborhoods when rumors of plague circulated; there was a mad rush of wealthy people to the provinces – folks who chose to “shut up” their “house[s] and flee,” as he put it (foreshadowing today’s flights of the wealthy to the Hamptons, the Cotswolds, and other elite rural enclaves). Defoe reported the progression of the plague as starting at one end of town at first, then spreading with the hot weather.
Defoe described the “bills” of deaths, much like our own COVID bulletins, showing escalating numbers, as “really frightful.” And he described checkpoints much like today’s, recently mandated by Gov Cuomo in New York State: “it was rumored that an order of the Government was to be issued out to place turnpikes and barriers on the road to prevent people traveling, and that the towns on the road would not suffer [allow] people from London to pass for fear of bringing the infection along with them.”
Defoe depicts the downtown of the city as a ghost town, the Inns of Court shut down, and the face of London altered by this mass flight. The Justices of the Peace began to shut up the parishes where there were infected citizens; “the power of shutting people up in their own houses was granted by an Act of Parliament”; the houses in question were shut down in 1665 and sick people transported away from town: “some people being removed to the pest-house beyond Bunhill Fields.” Orders of sequestration were sent out: if a person was found to be sick, his house would be shut up for a month. None was allowed to move out of a shut-up house or to enter into it. Even bedding and furniture were forbidden to be taken out of an infected house or sold. Some understanding of pathogens seems to have informed the orders of the London leadership: as with the instructions in Leviticus, one was to leave surfaces an infected person had touched, alone for a while: hackney coaches that transported the sick to “pest-houses” were to be well aired and left uninhabited for five or six days. Group gatherings were understood to communicate the plague: plays, “feasting” and taverns were all limited. But the engine of London’s economy, again, did not shut down. The whole city, healthy inhabitants and ill, did not shut down.
Quarantine practices arrived in America in the same form they had taken in Europe: isolation of the sick, not “lockdown” of everyone. Thousands of people died of waves of yellow fever in the United States in 1793 and 1798; in response, Philadelphia’s town fathers create what they called, from the Italian, a “lazeretto”: a hospital where the infected were taken to isolate together. Though the cause of yellow fever — mosquitoes — was not yet understood, the hospital with its seclusion of the infectious from everyone else, was effective. Ships too were isolated further away from the city. https://whyy.org/segments/americas-oldest-quarantine-hospital-tied-to-philadelphia-yellow-fever-history/. But in this example of “quarantine,” all of Philadelphia’s economic activity was not shut down and the movements of all citizens, healthy along with infected, were not restricted.
The nineteenth century was the breakthrough century for managing infectious diseases. The cholera and typhus epidemics of London in the 1830s and 1840s — which Londoners attributed to “miasmas” or “bad air” — felled thousands, who died in swift, grotesque ways. Physician John Snow was able to prove in 1854 that cholera was spread by infected water. This led to a major municipal effort: the building of an underground network of sewers, a huge public health triumph. But this innovation, when the state stepped in to manage infectious material (in this case human waste and infected water) and to regulate the commons, is influential to this day in ways both good and bad. In Outrages: Sex, Censorship and the Criminalization of Love, I trace how this formative public health victory left us with assumptions about the power and scope of the modern state. We assume from this history, I argue, that the modern state has the primary role of managing and “cleansing” the commons, the networks and thoroughfares that connect us. And we still think of the ways in which we are connected in terms of vulnerability to infectious diseases: ideas and influences can “infect” the young or vulnerable. With this public health triumph, it became common to legislate based on the metaphor of “infection” of the community by way of people and even of words and ideas.
Sex and love between men could “infect” the minds of the young, for instance; pornography was “filth” that had to be “cleaned” from public access; and so on. The fear of AIDS united with homophobia in the 1980s to whip up anti-gay hysteria and support for legislation in both the US and the UK that would keep positive images of same-sex relationships form “infecting” readers and students. The history of infectious diseases gave demagogues a potent scare vocabulary.
By the late 19th century, wealthy people with tuberculosis regularly exiled themselves to luxurious sanatoria or “rest homes.” Poet and critic John Addington Symonds, tubercular his whole adult life (he died of the illness at 53), made his home in Davos for just that reason; it was becoming a destination for well-to-do tubercular expatriates due for the good air and treatments in isolation. The Magic Mountain, of course, published by Thomas Mann in 1924, describes Hans Castorp’s visit to a cousin at a similar luxurious sanatorium for tuberculosis patients in Davos. https://www.newyorker.com/books/page-turner/to-the-magic-mountain
The need to isolate sick people for treatment and recovery, to keep them from infecting everyone else, and to give them the chance to recover, was so obvious by the end of the 19th century, state-funded “rest homes” and sanatoria were established for middle-class, working class and poor tuberculosis patients alike. Both D H Laurence and George Orwell self-isolated in such sanatoria. In 1947 a badly tubercular Orwell was advised to enter a sanatorium for four months, for “vitamins, fresh air and being confined to bed.”
We no longer have “rest homes” or “sanatoria.” These were closed after the age of antibiotics began.
Real (if benevolent) “quarantine” in “rest homes” is probably an idea that should be revived. In the United States, infections are rocketing skyward because there is nowhere to “rest” for many infected people. Lacking savings or health insurance, many infected people need to work among the general population in order to survive; if they get sick, they must be tended by family members, which spreads infection to them, or else they end up in actual hospitals, with those entities’ existing burdens.
But where will such sufferers now “rest”? Who will take care of them? A network of positive, state-funded “rest homes” where those who are ill can receive nutritious food, medical treatment, good ventilation, rest, and isolation from infecting others, is surely preferable to the unprecedented situation we have in which many sick people have nowhere to be taken care of that they can afford except to be home infecting families, and healthy people in turn can’t afford to avoid the sick; and in which all are forced to stay home together or go to work as essential workers together, in something that is not at all a “quarantine.”
But whatever national policies our leaders create in this pandemic, it’s important that we not be misled. Staying home, sick with well; and state-wide or nationally restricted movement; is not a time-honored medical practice, but a drastic social experiment which has been tried at scale only in closed societies.
Will it solve the problem of COVID infections? It doubtless – -medically – helps to contain the pandemic. But absolute medical safety is sometimes in a paradoxical relationship to the basic demands of a free society. We really should not be afraid to ask: how long, with what severity, based on what data, tolerating what intrusions and trackings of the body, and at what other set of costs?
As others have pointed out, there seems to be no exit strategy from this crisis, to regain the public spaces and processes in which real democracy takes place.
When will it be safe enough? What is that benchmark? Given how great COVID policies are for those who hate democracy and profit from its demise, I am warning that at this point it is unlikely ever to be deemed by our leaders safe enough to resume a full democracy, medical reality, and even a potential full recovery of our collective health from this pandemic, notwithstanding; not unless we do some hard independent thinking about how we make decisions as a community.
Surely we must start to discuss COVID-related policies in a free society that are predicated on prioritizing public health and respect for one another — but that do not subject citizens in unprecedented ways to violations of basic human rights of movement and association and privacy; policies that resemble decent policies used to manage other deadly epidemics in free societies in living memory, as we shall see.
Nationwide restrictions of all citizens, healthy and ill; restrictions of citizens’ movements; and suppression of all economic activity, have indeed been used in the past.
But these edicts on this scale have not been used in the past to solve the problem of infectious diseases.
Rather, they have been used in the past to solve the problem of democracy itself.
