Before they are shot into space, astronauts have to quarantine. This is in order to protect other planets from earthly contamination, and to make sure that the astronauts stay healthy (imagine re-entering the atmosphere with a sinus infection). But the suspended life of quarantine also allows for a transition between the jumble of Earth and the loneliness of space. The Italian astronaut Paolo Nespoli saw parallels between the isolation of the spaceship and of quarantine during the Covid-19 pandemic: space travel, he reflected, is “like lockdown in a certain way: you are quarantined, but you feel kind of free, because you are safe”. Safety guarantees freedom, and the freedom given to Nespoli was of the most outrageous kind, floating through the endless void of space, the moon whirling by the window. But what kind of freedom did our own isolation secure? In 2020, adults in the UK spent nearly a third of their waking hours watching TV and online video content.
In Until Proven Safe, Geoff Manaugh and Nicola Twilley provide a timely intellectual history of quarantine, from the 14th-century Black Death to the interplanetary quarantines overseen by Nasa’s planetary protection officer. The authors take us on a romp around the quarantine islands of the early modern Mediterranean, the International Cocoa Quarantine Centre outside Reading in the UK (cacao is especially vulnerable to disease), and the Waste Isolation Pilot Plant in the New Mexico desert, where radioactive waste is buried – quarantined, in a sense – more than 2,000ft underground, for the next 10,000 years. In each chapter, quarantine is the testing ground for critical questions: is it possible to totally contain risk? When is individual freedom superseded by collective safety? And who has authority to decide? If these questions were once abstract experiments in political philosophy, they are now problems that most of us navigate daily when we consider something as ordinary as whether to have dinner with friends.
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Manaugh, a writer on cities and the built environment, and Twilley, a host of a podcast on the science and history of food, finished Until Proven Safe during the first wave of lockdowns in 2020, when, as they tell us, nearly half of the world’s population was living in some form of medical isolation. And so their evidence, once historical curiosity, now prompts weary familiarity; it’s easy to sympathise with the Russian poet Alexander Pushkin, locked down during a cholera outbreak, complaining that he was “in a foul mood”, living on porridge and growing a beard. The artist Francis Hervé, quarantined on the Austro-Hungarian border in the 1830s, described the monotony of isolation: his friend went to bed at eight o’clock “to kill some portion of time”, only to lie awake for hours. Whether quarantine has improved over the centuries seems very much a matter of personal opinion. The 15 Americans who contracted coronavirus onboard the cruise ship the Diamond Princess in February 2020 were locked down in the brand-new National Quarantine Unit in Nebraska, and seemed cheerful enough. As one representative boasted, “they had access to Amazon, so they could pretty much order anything they wanted”.
“Quarantine” takes its name from the Italian quaranta giorni, or 40 days. The first quarantine is thought to have taken place in Dubrovnik in 1377 in response to the plague: the city’s council mandated that all ships spend a month docked on an island offshore. Venice soon did the same, creating lazzaretti – permanent quarantine islands – in its marshy lagoon. The forty days recalled biblical stories of cleansing and purification: Christ in the desert, Noah in the deluge. As Manaugh and Twilley write, quarantine is enforced in cases of potential infection, of possible risk, and therefore admits a degree of uncertainty. One of the striking continuities in their history is how this uncertainty has been exploited to deepen gendered and racialised inequalities.
The “American Plan”, implemented in the US in the aftermath of the First World War, empowered local authorities to quarantine any woman suspected of spreading venereal disease. These young women – with jobs, apartments in cities and casual sexual partners – were disciplined by the blunt threat of medical lock-up. In 1900 authorities in San Francisco established a quarantine that neatly clung to the borders of Chinatown, gerrymandered around white-owned businesses. In court, a judge found the quarantine to have been applied with “an evil eye and an unequal hand”, in contravention of the equal protections enshrined in the US constitution. Such measures aren’t relics of a more brutal past. George HW Bush and William Barr’s travel ban against non-citizens with HIV or Aids was only repealed in 2010.
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Manaugh and Twilley extend their investigation of quarantine into the non-human world, too, in order to think through the problem of isolation on a grander scale of space and time. In their most surreal chapter, they describe efforts to quarantine radioactive materials that have the potential to harm living things for millions of years. How to design a quarantine that will last beyond our own human civilisation? The problem is not only technological but communicative. Even if scientists can design a physical architecture of isolation, there remains the problem of informing future generations of its danger. The US Department of Energy’s “Human Interference Task Force” came up with proposals: surround the building with 50ft-tall concrete spikes; paste reproductions of Edvard Munch’s The Scream all over the region of radioactivity; or – quaintly – create a website with detailed instructions. Of course, the project of total and eternal containment is inevitably doomed; but its pursuit is a reminder of human hubris on a nuclear scale.
In October 2019 a group of representatives from international organisations, medical authorities and corporations gathered in New York to simulate their response to a pandemic of a novel coronavirus. It didn’t go well. Stock markets crashed, PPE was in short supply, conspiracy theories multiplied. As Marty Cetron, the director of global migration and quarantine at the Centers for Disease Control and Prevention, tells Manaugh and Twilley, authorities are “always fighting the previous pandemic”: our epidemiological data comes from the last catastrophe, the last wave, and so the public health response is always already obsolete.
In future, data-driven forms of medical surveillance offer the possibility of a predictive or anticipatory pandemic response, and so a more sensitive and sophisticated quarantine. This form of medical isolation would target at-risk individuals based on personal data agglomerated from our smart homes, Google searches, or even from coughs picked up by Amazon’s Alexa. Data surveillance is already an uneasy reality. The data aggregation firm Palantir signed a £23m contract with the NHS in March 2020 to analyse health information in order to guide the response to the pandemic. (On the walls of the Palantir offices there is a portrait of the French philosopher Michel Foucault, the patron saint of surveillance.) If sophisticated data technology offers a glimmer of a life beyond lockdown, it is at the cost of entrusting our freedom to Silicon Valley corporations.
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And yet despite the inequalities of its past and the intractable ethics of its future, Manaugh and Twilley believe that quarantine can be reformed. The future of quarantine, they argue, relies on “cooperation and self-sacrifice”, on becoming “good neighbours” who privilege the collective over the individual. Their call for civility makes this book as much an artefact of the Donald Trump era as of Covid-19: their frustration at anti-maskers is conspicuous in their wish to reframe quarantine as an act of personal, neighbourly responsibility. But toggling between the history of quarantine charted in Until Proven Safe and our own, too-fresh experience of lockdown, I am not sure that civility is enough to secure an exchange of freedom for safety. I found the most compelling argument in the book to be Cetron’s – that anyone asked to submit to quarantine in order to protect the public is owed a duty of care by the public. This is not a matter of personal sacrifice or of being nicer to each other, but of guaranteed, publicly funded food, shelter and healthcare in exchange for constrained freedom. In his words: “There’s no control without care.”
Erin Maglaque is a historian of early modern Europe at the University of Sheffield and the author of “Venice’s Intimate Empire” (Cornell University Press)
Until Proven Safe: The History and Future of Quarantine
Geoff Manaugh and Nicola Twilley
Picador, 416pp, £25
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This article appears in the 29 Sep 2021 issue of the New Statesman, Spirit of the Age