In Time of Lockdown: Reflections on Locks, Lockdown, Isolation

Early Quarantines Erin Butler (MM Hu) In this period of frequent self-isolation and quarantine, it is easy to think that we live in unique times.

However, this is not the case. Formal systems of quarantine date back 600 years, to the time of the bubonic plague, and isolation dates back even further. The first official quarantine began in 1348 in Italy at the time of the Black Death, with the word quarantine originating from the Italian word quaranta - meaning forty – which was the length in days of this state-imposed isolation.

But what is quarantine? It is a form of restriction used to contain the spread of diseases, which often entails a separation of goods and people who have been exposed to a certain disease.

We commonly use the words isolation and quarantine in connection with each other, but it is important to distinguish between the two. Isolation (in the context of infectious diseases) involves separating the infected and quarantine involves separating those who may have come into contact with infected people. The earliest form of isolation recorded is in the book of Leviticus - in the Bible - where those with leprosy were isolated from society, ‘the priest is to isolate the affected person for seven days.’ Furthermore, in 541 CE the plague of Justinian came about, and the emperor of Justinian set out a series of laws against those he believed responsible for the epidemic, including Jews, Samaritans and homosexuals. Here we can see early discrimination and potential problems stemming from isolation and quarantine. However, this example cannot be regarded as a quarantine, as Justinian had no knowledge of what caused the disease to spread, and anyone who differed from the Christians of Constantinople was accused of being responsible for the plague. He attempted to halt people’s movements, but it was a complete failure. As we know, religion has nothing to do with carrying a plague.

The Bubonic Plague, which had originally started in the far east, reached Europe in the 14th century and was later responsible for the death of 30% of the population. It was caused by the Yersinia pestis, carried by rats predominantly, which spread the Black Death. Due to the detrimental effects of the disease and the 30 million deaths it caused, Italian states came up with strategies to reduce its spread and this is where we find the first official quarantine. This began in 1348, where a council in the republic of Venice gained power to detain ships in the Venetian lagoon for up to 30 days and turn others away. This was important as the plague was carried on rat-infested ships and as Venice was such an exposed city, this had to be monitored. As other ports in Italy, like Florence and Genoa, and those in surrounding coastal cities began to be infected, they too drew up restrictions and laws to help stop the spread of the disease.

In 1377, a decree was drawn up in the Venetian-controlled port, Ragusa, now Dubrovnik, Croatia, establishing a ‘trentino’. This stated that all ships coming from areas of infection or suspected infection must quarantine for 30 days outside of the harbour, while authorities inspected the ship. The law consisted of four parts: citizens from areas of the plague had to isolate for a month, no person could go to the isolated area, no one could bring food unless assigned by the Great Council, and anyone who didn’t follow this could be fined or made to isolate. Ultimately, the time extended to 40 days for reasons much debated, becoming a ‘quarantino’. Some argue it came from Hippocrates’ idea that after 40 days, diseases were no longer acute, but chronic. Other authors suggest that 40 days was selected for biblical reasons, such as the period of Lent or the great flood of Noah.

Whatever the reason, the extension to 40 days was beneficial, as scientists have now discovered the lifespan of the bubonic plague was about 37 days.

As well as quarantining ships, Italian states created a quarantine for infected people and their family on land. In Milan and Reggio, victims were left to die in their homes, and a law drawn up in 1374 meant that all those suffering must be taken out of the city into a forest or field, and left to recover or die. A few years later, in 1423, further steps were taken to avoid the spread of disease. In Venice, the first permanent plague hospital was created on the island of Santa Maria of Nazareth, on the Venetian lagoon. This hospital became known as a Lazaretto and so did all the other quarantine centres in Italy created in the years to come. The Lazaretto was commonly referred to as Lazarethum because of the links to Lazarus, a biblical figure and the catholic patron saint of leprosy. Lazarettos were located far enough from settlements to protect the healthy populations, but close 63