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Quarantine
What does quarantine mean?
By Kimberly Hickok - Reference Editor
Reference article: Definition
and history of quarantines.
Medical
quarantine requires that a patient be isolated from others so as to prevent the
spread of contagious diseases.
Quarantine
is a state or place of isolation for a person or animal who may have come in
contact with contagious diseases.
The
period of isolation lowers the chance that person or animal could transfer
illnesses to others.
Quarantine
isn't reserved for sick people only.
People
who appear healthy could spread a pathogen without ever knowing they were
carriers, which is why travelers who appear healthy may still be quarantined,
depending on where they are visiting from.
Novel
coronavirus quarantine (in the U.S.)
For
the COVID-19 pandemic, the CDC has recommended voluntary self-quarantine for
individuals exhibiting symptoms and social distancing for everyone else, but a
government-mandated quarantine is not in place.
Many
public and private institutions have taken the CDC's advice to heart and
voluntarily cancelled events and issued work-from-home mandates in an effort to
keep the rate of disease spread to a minimum.
If
enough people participate in self-quarantine and social distancing, the number
of COVID-19 cases is likely to remain at a manageable level for medical
services.
Health
professionals call this "flattening the curve," because it keeps the
number of cases over time below the maximum capacity of medical providers
throughout the duration of the outbreak (see the graph below).
At
the time of publishing this article, the coronavirus pandemic is in full-force,
and it remains to be seen if the U.S. can keep its 102-year streak of no
government-mandated quarantines.
Flattening
the curve refers to community isolation measures that keep the daily number of
disease cases at a manageable level for medical providers.
Flattening
the curve refers to community isolation measures that keep the daily number of
disease cases at a manageable level for medical providers.
Brief
history of quarantines
The
concept of putting a sick person in isolation has been around for a very long
time.
One
of the earliest examples is found in the book of Leviticus, which recommends
isolating people with leprosy.
That
evidence suggests that although people at that time had no knowledge of
bacteria or viruses, they recognized isolation as a way to stop others from
getting sick, according to a review published in The Virginia Tech
Undergraduate Historical Review.
The
practice of a quarantine as we're familiar with it likely began in the Middle
Ages, according to the Centers for Disease Prevention and Control.
In
the 14th century, ships arriving in Venice from areas struck with the Black
Death (bubonic plague) were required to anchor away from port for 40 days
before docking.
The
Italians called it "quaranta giorni," or "40 days," which
evolved into "quarantino."
The
40-day quarantine was so effective that it became standard practice in Europe
for the next 300 years.
In
the United States, the Commonwealth of Philadelphia opened a quarantine station
on the Delaware River in 1799 after the yellow fever epidemic of 1793 that
killed around 5,000 people.
In
the 1830s, the mayor of New York City issued a quarantine for all ships and
vehicles entering the city in an attempt to protect the city from a cholera
pandemic.
That
quarantine wasn't too effective because numerous immigrants managed to find
their way around the quarantine barriers and entered towns and cities
throughout New England anyway.
.
During the Spanish flu of 1918 (the deadliest pandemic in history) health authorities in the U.S. and Europe recommended social isolation because they knew the flu-causing pathogen was spread through the air by coughing and sneezing.
.
During the Spanish flu of 1918 (the deadliest pandemic in history) health authorities in the U.S. and Europe recommended social isolation because they knew the flu-causing pathogen was spread through the air by coughing and sneezing.
As
such, several agencies banned public gatherings and closed public institutions,
but how strictly the bans were enforced varied depending on the power of local
health departments and perceived severity of the outbreak, according to a
review published by Stanford University.
The
Illinois and New York State Health Departments both issued mandatory
quarantines for all ill patients, but that was also difficult to enforce.
Entire
military training camps were quarantined, which was a bit easier to enforce.
At
the same time, the American Public Health Association recommended that only
patients with the most severe symptoms seek medical attention and those with
mild symptoms remain at home.
Modern
quarantines
Quarantines
can be effective at minimizing the spread and risk of disease, but they're not
always the best solution.
The
severe acute respiratory syndrome (SARS) epidemic of 2003 led to quarantines in
many countries, sometimes when it may not have been necessary.
For
example, Canada quarantined about 100 people for every confirmed case of SARS,
NPR reported.
Toronto
had only 250 probable cases, but 30,000 people were confined to hospitals or
their homes — about the same as the number of people quarantined in Beijing,
where there were 2,500 cases.
And
quarantines remain difficult to enforce at a large scale.
During
the 2014 Ebola epidemic in Liberia and Sierra Leone, entire neighborhoods were
put on lockdown and people were told they couldn't leave their homes.
The
civil unrest that resulted meant the quarantines led to the quarantines being
lifted after three days.
Doctors Without Borders, the medical organization that
aided the fight against Ebola, later stated, "It has been our
experience that lockdowns and quarantines do not help control Ebola, as they
end up driving people underground and jeopardizing the trust between people and
health officials."
U.S.
government-mandated quarantines
The
Public Health Service Act enacted by the U.S. Congress in 1944 gave the federal
government legal authority to enact quarantines and respond to public health
emergencies.
(The
U.S. Department of Health & Human Services is the agency responsible for
declaring and responding to a public health emergency.)
The
CDC's National Center for Emerging and Zoonotic Infectious Diseases now
operates quarantine stations in 20 major U.S. cities and ports, with the goal
of preventing pathogens from other countries from entering the U.S.
The Division of Global Migration and Quarantine has
the right "to detain, medically examine, or conditionally release
individuals and wildlife suspected of carrying a communicable disease."
The
agency has a list of quarantinable diseases, which includes things like
cholera, plague, smallpox and SARS.
The
CDC also has the legal authority to issue mandatory quarantines at the state,
local and tribal levels if it wishes.
However,
the last time the U.S. federal government issued large-scale quarantine orders
was during the Spanish flu pandemic in 1918.
Kimberly Hickok
Reference Editor
Kimberly is the reference
editor for Live Science and Space.com. She has a bachelor's degree in marine
biology from Texas A&M University, a master's degree in biology from
Southeastern Louisiana University and a graduate certificate in science
communication from the University of California, Santa Cruz. Her favorite
stories include animals and obscurities. A Texas native, Kim now lives in a
California redwood forest. You can follow her on Twitter @kimdhickok.
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