How Quarantine Has Shaped Buildings, Streets, and Cities?
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The implementation of quarantine and isolation has always been a stimulus for creatively rethinking the built environment.
Geoff Manaugh and Nicola Twilley. 2021. Until Proven Safe: The History and Future of Quarantine. Farrar, Straus & Giroux.
Source:
https://bldgblog.com/2021/07/until-proven-safe/
https://www.nytimes.com/2021/07/26/books/review-until-proven-safe-quarantine-geoff-manaugh-nicola-twilley.html
https://www.wsj.com/articles/until-proven-safe-review-nicola-twilley-geoff-manaugh-quarantine-covid-pandemic-11626450804
The COVID-19 pandemic has forced humanity to adopt an old practice that originated in the 14th century-quarantine. Quarantine is our most powerful response to uncertainty: it means waiting to see if something hidden inside us will be revealed. It is also one of our most dangerous, operating through an assumption of guilt. In quarantine, we are considered infectious until proven safe.
Until Proven Safe tracks the history and future of quarantine around the globe, chasing the story of emergency isolation through time and space—from the crumbling lazarettos of the Mediterranean, built to contain the Black Death, to an experimental Ebola unit in London, and from the hallways of the CDC to closed-door simulations where pharmaceutical execs and epidemiologists prepare for the outbreak of a novel coronavirus.
Geoff Manaugh and Dr. Luigi Bertinato wearing plague gear from different eras: Manaugh in 21st-century personal protective equipment and Dr. Bertinato in the costume of a Black Death-era physician.
But the story of quarantine ranges far beyond the history of medical isolation. In Until Proven Safe, the authors tour a nuclear-waste isolation facility beneath the New Mexican desert, see plants stricken with a disease that threatens the world's wheat supply, and meet NASA's Planetary Protection Officer, tasked with saving Earth from extraterrestrial infections. They also introduce us to the corporate tech giants hoping to revolutionize quarantine through surveillance and algorithmic prediction.
Quarantine can be lifesaving; it can also be dangerous, an exercise of extraordinary power in the name of disease control, a presumption of guilt instead of innocence. Any exercise of such formidable power also opens up the possibility of abuse. The book includes historical examples of disease control measures getting mapped onto existing prejudices. In 1900, a cordon sanitaire in San Francisco's Chinatown zigzagged around white-owned businesses; during World War I, under the auspices of protecting men who might be called to fight overseas, local American officials were empowered to quarantine young women "reasonably suspected" of having a sexually transmitted disease. In 1991, an "H.I.V. prison camp" to detain asylum seekers was set up by the attorney general William Barr—the same William Barr, the authors helpfully remind us, who refused to quarantine himself following a potential exposure to the coronavirus in October 2020.
The origin of quarantine
Quarantine—from the Italian word quarantena, shorthand for quaranta giorni, meaning "forty days"—is one of humanity's oldest and most consistent responses to epidemic disease. In theory, quarantine has always been minimal—it works by separating people suspected of sickness from those known to be well—but making this seemingly simple distinction opens up entire worlds of philosophical uncertainty, ethical risk, and the potential abuse of political power.
The logic behind quarantine remains straightforward: there might be something dangerous inside you—something contagious—on the verge of breaking free. The space and time you need to see whether it will emerge is quarantine. Quarantine can be an effective medical tool, but it is also an unusually poetic metaphor for any number of moral, ethical, and religious ills: it is a period of waiting to see if something hidden within you will be revealed.
For hundreds of years, quarantine has been used to create a buffer between the known and the unknown; it delays our contact with something we do not understand and against which we have no natural immunity. It is an inherently spatial solution, with surveillance at its core.
When architects and engineers design spaces of quarantine, whether those are purpose-built hospital wards, modified Airstream trailers, converted motels, or airtight greenhouses, they are attempting to remove risk from our interactions with others. For this exact reason, quarantine historically most often occurs at sites of encounter, at ports of entry, at places of meeting between one culture, even one species, and another. In fact, some of today's existing geopolitical borders are where they are because of quarantine: dividing lines that have persisted where nation-states and empires once grew nervous about protecting themselves from an approaching threat. If there is something dreadful, even potentially fatal, on its way, it is not surprising that we might want to find a way to delay its arrival. That delay is quarantine.
Formally speaking, humans have been quarantining themselves and one another since at least the fourteenth century, in response to the Black Death. In July 1377, the maritime city of Dubrovnik, on the coast of the Adriatic Sea, instituted what are thought to be the world's first mandatory public health measures with specific provisions for quarantine.
A regulation approved by the city's Major Council at the time stated that "those who come from plague infested areas shall not enter Dubrovnik or its district unless they previously spend a month on the islet of Mrkan (St. Mark) or in the town of Cavtat, for the purpose of disinfection." Rather than close the city's gates in the face of disease, sacrificing all the economic benefits of exchange, Dubrovnik's elders created a buffer, delaying the arrival of potentially infected people and goods into the city until they were proven safe.
Quarantine is thus a tool from an earlier era reclaiming center stage in our modern world, but it arrives bearing an unexpected religious pedigree: initially limited to a period of just thirty days, the eponymous forty days of quarantine gave the experience theological weight. By adopting the number forty, quarantine became conceptually backdated to biblical times. From then on, quarantine was a period of cleansing that explicitly referenced Christ's forty days in the desert, the forty days of Christian Lent, the forty days of rain that compelled Noah to build his ark, even the forty days that Moses spent waiting atop Mount Sinai for the Ten Commandments.
"The religious significance of the period for quarantine was not simply coincidental—it was chosen in order to bring comfort to those in need and to encourage those undergoing quarantine to look on it as a period of purification to be spent in devotion." This makes quarantine as much faith-based as it is medical, as much a purging of the soul as it is a cleansing of the body. To undergo quarantine is to distance oneself from the world in order to experience purification—then to reenter that world reborn, guaranteed free from its polluting contagion.
How Quarantine Has Shaped Buildings, Streets and City?
Venice is the perfect starting point for studying the history and future of quarantine. After all, quarantine may have first been mandated in Dubrovnik, but it was here, in Venice, that it was refined into an architectural and spatial science. Venice itself—a labyrinth of islands, canals, bridges, and docks—is a natural laboratory for experimenting with new forms of geographic control. As Jane Stevens Crawshaw writes, the city itself became an armature against the spread of disease—what she calls the "manipulation of urban space as a form of protection."
Venice in the fourteenth century was thus a city under siege: a mysterious, highly contagious disease had begun to infect people throughout Mediterranean Europe, imperiling both its inhabitants and their source of income, and it was not at all clear how to stop it. By the end of the pandemic, two-thirds of the Venetian population had been killed.
Keeping people and goods in a state of isolation, away from the city proper, allowed authorities to use urban form itself as a tool for field-testing this emerging medical hypothesis. Quarantine was a way to reveal a perceived connection between physical interaction, spatial proximity, and disease—proving that the plague might be best understood through an epidemiological lens, rather than an astrological or humoral one. The acceptance and implementation of quarantine is also an early historical bellwether for the modernization of medical practice, signaling at least a tentative trust in secular and scientific—rather than religious and supernatural—explanations for ill health.
The implementation of quarantine and isolation has always been a stimulus for creatively rethinking the built environment. For centuries, pandemic disease has inspired people to find new uses for old buildings or to invent new structures altogether.
In 1423 Venice constructed the first lazaretto—a large stone building designed to confine potentially infected individuals. Years afterward, Venice acquired a second structure—each was located on its own island—where food, water, and medical care were dispensed "for the public good."
In sixteenth-century England, following ordinances proclaimed by King Henry VIII, the houses of people in quarantine had to be marked with long white poles attached to the exterior walls, like the quills of a porcupine, with clumps of straw or hay attached to the ends. These functioned as highly visible warning signs as well as inconvenient physical obstacles, encouraging pedestrians and carriages to avoid certain streets altogether.
In Venice, Italy, toward the end of the 1500s, the houses of the quarantined were also marked and labeled with prominent warning signs, including wooden crosses, then boarded up and locked from without to prevent potentially infected inhabitants from breaking free.
Quarantine was often miserable for those subjected to it; conditions could be squalid and even cruel. As Byron recalled in his poem
"Farewell to Malta":
"Adieu, thou damned’st quarantine,
That gave me fever, and the spleen!"
Isolation and quarantine are thus early examples of political modernity and medical rationality, of both public spirit and evidence-based science.
This is not without irony: today, quarantine is often dismissed as medieval, even primitive, yet in the time of the Black Death it was, in many ways, a remarkably sophisticated and modern act.
For a tool so potent, quarantine has surprisingly few rules, yet its apparent lack of limitation is exactly what gives it such power and flexibility.
The most important rule of all—one that has defined quarantine since its inception and still underpins WHO and CDC guidelines today—is that quarantine requires uncertainty. In other words, if you know that you are infected with a communicable disease, and if you have been told to stay at home or in a hospital to avoid spreading that disease, then you have not been quarantined: you have been isolated. This means that, by definition, quarantine emerges from a state of suspicion: it is about potential infection and possible risk.
The two terms are often used interchangeably, even by medical professionals; they both involve detention in the name of public health and often appear identical in practice. Nevertheless, they refer to different things—a difference that is medically, legally, and philosophically consequential. Quarantined individuals are—for the time being—healthy. We simply have reason to believe that they may yet become sick.
Quarantine, at some point, must end. If you are in a state of permanent quarantine, then you are not, in fact, in quarantine. You have been isolated—imprisoned, even. Quarantine reflects the incubation period of the germ it is intended to contain. For some diseases, you need to wait mere days to determine whether you have been infected; for others it can be two weeks or more. Either way, you will, at some point, be freed from quarantine.
Over the past six centuries, quarantine has shaped the public health response to infectious disease around the world—but it has also shaped our streets, buildings, and cities, our borders, laws, identities, and imaginations. Quarantine has inspired the construction of great fortresslike facilities, built on the edges of civilization, as well as high-tech medical institutions in the very heart of the modern metropolis.
By examining what, where, and why we quarantine, we were not only exploring the limits of scientific understanding but also excavating our deepest fears, biases, and sense of identity. Quarantine reveals how we define and police the perimeters of self and other, as well as what we value enough to protect—and what we are willing to sacrifice. All too often, we discovered, quarantine is flawed and leaky, even deeply unjust. Almost always it has been designed simply as a buffer, rather than thought through as a lived experience. Sometimes it is the only thing that has saved us from death and devastation.
Today, quarantine is more relevant than ever, as we alter the environment in ways that have tipped the balance in favor of novel pathogens. Based on sheer numbers, not to mention the evolutionary advantage of faster generational cycling, bacteria and viruses hold the upper hand in their relationship with humans. As we disrupt ecosystems by changing the climate and by moving deeper into previously unexploited landscapes around the world, logging rain forest interiors and disturbing remote caves, we are also coming into contact with wild animals, and, in some cases, eating them, farming them, bringing them—and their diseases—back into our domestic lives. In the process, we are offering thousands of viruses and bacteria the chance to spill over, or jump hosts, unleashing new plagues. Quarantine is the best—sometimes the only—tool we have to protect ourselves against the new and truly alien. It buys us the time and space we need to respond.
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