‘Until Proven Safe’ a Timely Tour of Quarantine Past and Present

It’s been almost exactly three years since COVID hit the U.S., and large swaths of that time feel dreamlike, like it took place in some liminal place that regarded time as a suggestion, not an invariable dictation of things.

Quarantining during COVID was an unprecedented event for most of us, but it’s hardly unusual in the span of human history, as authors Geoff Manaugh and Nicola Twilley point out in Until Proven Safe: The History and Future of Quarantine, and even more common for common items most of us have lying around the house.

In terms of human disease, Manaugh and Twilley trace lazarettos, essentially walled-off little housing complexes for quarantining the ill or potentially infected, from their start in the 1500s, when Italy, then still the beating heart of the Western world, needed a solution other than shutting down trade or letting everyone die in the throes of the bubonic plague. In the centuries since, countries have sought myriad ways of containing and controlling disease among their population, including banning the sale of goods that hadn’t been themselves quarantined, quarantining and/or lightly toasting mail to make sure no germs traveled on letters, and containing traders and other non-residents until it was certain they weren’t bringing illness as well as riches. Today, our efforts to quarantine are both unimaginable to those 16th-century Italians and not all that different from what people have done for five hundred years or more.

While “quarantine,” at least in this day and age, immediately and almost exclusively brings to mind humans sheltering from disease like COVID (or Ebola, or Spanish Influenza, or cholera, or, again, the actual plague), Manaugh and Twilley examine the concept further, such as the global effort to stop agricultural blights. Swine Fever, for example, can wipe out whole farms worth of pigs, and the pathogens responsible can’t be cooked out of the meat. Foot-and-mouth disease from contaminated pork transported from Asia and made into improperly sterilized swill for pigs in the U.K. resulted in a year-long outbreak in the 2000s that brought about six million livestock deaths and at least sixty farmer suicides, as well as plummeting tourist numbers and incalculable losses to farmers and the broader livestock and meat market. Cacao plants are quarantined for years to ensure they don’t have a deadly and pervasive blight. Those irritating checkpoints at the border of California where you have to stop and fess up if you’re carrying so much as an apple with you are to prevent or delay plant and bee diseases from devastating the state’s massive agricultural industry.

And, of course, what to do with nuclear waste? Or samples brought back from the moon or Mars? And how do we stop ourselves from contaminating other celestial bodies when we send out probes or robots—or, eventually, ourselves?

The cover of Until Proven Safe, all in light and dark orange, with an old-looking illustration of a person in plague doctor robes and beak mask behind the text of the title.
Good news: the cover is not the only appearance of the plague doctor costume!

Because the subject matter is disease, there is somewhat of an ick factor now and then. My partner cringed most at a passage about the animal waste disposal practices of an older quarantining and testing facility, which the book describes with words like “tissue digester” and “dissolve[d] animals in an alkaline soup” that is eventually sterilized to the point where it is disposed of through the municipal sewer system in a “slug” late at night to avoid overwhelming the system. But for hundreds of pages of talking about disease and dying (or trying to avoid that fate), Until Proven Safe is a remarkably un-gross book. It’s clear that Manaugh and Twilley have intentionally kept their view clinical, steering away whenever possible from material that might affect the weak-stomached.

Until Proven Safe isn’t a short book, and it’s dense besides. There’s a lot to pack in, after all, talking about quarantining everybody and everything in our past, present, and future. Manaugh and Twilley’s writing, though, does keep it from being a slog. This is definitely not a nonfiction book that can be accused of “reading like a novel,” but it is one that holds interest well. Manaugh and Twilley have not provided an exhaustive look at all types of quarantine, but it is comprehensive and cohesive enough to fascinate, or squick out, anyone at a cocktail party who makes the mistake of asking what you’re reading these days.

Authors Manaugh and Twilley had the remarkable good luck, if you will, to be working on a book about quarantining before, during, and after the height of the COVID pandemic, making Until Proven Safe a more timely book than it might have been. At least in my circles, it seemed like there was a bizarre resistance to small steps of communal safety. The rhetoric that masks were somehow un-American, for example. It’s impossible to tell the emotional response to past quarantines and whether ours was worse or about par for the course, and not even Manaugh and Twilley’s obviously extensive research can answer that for us. But they do point out how so many other parts of COVID were, if not predictable, then anticipatory. We were overdue for a blight; we have known disease victors in airports and other transportation hubs; a world as interconnected as ours has to weigh grinding the economy to a halt with slowing or stopping disease.

It is chilling how often these choices have had to be made before, likely even before the lazarettos of Italy, and how new technology will almost certainly force us into better compliance in the future. We can’t totally predict what will come with the next blight, whether it targets us, our livestock, or our candy bars. But we can see the ways disease spreads, and the hundreds of ways we have tried to stop it—and how successful, or unsuccessful, that has been.

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