Quarantine for Covid19
A little bit of history can help us to understand why quarantining is important and what does the word quarantine mean. The term was first used in Europe during the bubonic plague in the 14th century. Even though the process of isolation dates back thousands of years to the biblical times.
The bible book of Leviticus has many verses that describe the process of isolation during leprosy or other infections. “He shall remain unclean all the days during which he has the infection; he is unclean. He shall live alone; his dwelling shall be outside of the camp.” Leviticus 13:46
Some legends, that I could not confirm due to time it happened (14-15 century), say that the priests, who were the doctors at that time, were having a hard time to control the black plague (or bubonic plague) that decimated one-third of Europe. Either they looked at the bible verses and found the idea of isolation there, or they looked to the Jewish people who appeared to had controlled the epidemic on their villages by practicing isolation. In any case, they started isolating sick people and ultimately were able to control the epidemic.
One documented historical event in Europe clarified the process of quarantine. Officials from the city of Ragusa (now Dubrovnik, Croatia) passed laws to establish 30 days of isolation for ships arriving from infected areas (similar to our passenger screenings at our airports for affected Covid19 areas). At first, people in the ships needed to wait for 30 days and later it was expanded to 40 days, which is called “quarantino” in Italian – the root of the English word ‘quarantine.’
They also developed special places for quarantined people separated from the city. As time passed the period of isolation became dependent on the incubation period for the disease, but the term quarantine was kept. After years of dealing with global epidemics, quarantine became one fo the main methods to control diseases that are transmitted by contact or human discharges such as hepatitis, pneumonia, tuberculosis, flu, SARS, and now the Covid19 pandemic that is affecting the whole world.
Therefore, in your case or mine, with the Covid 19, we must follow the same procedure; isolation and social distance as much as possible. I remember when I was in Hong Kong during the SARS (Severe Acute Respiratory Syndrome) epidemic caused by a coronavirus more deadly than Covid19, that one infected person entered a hotel in the city and took the elevator. All the people on that elevator were infected and died later on.
On that epidemic of SARS, the death rates were about 10% and not respecting age but 55% of deaths were above 60 years old. The 1918 influenza that affected 1/3 of the world population had a death rate of 2% and it was more common among 20-40 years old. The seasonal flu has a death rate of 0.1% and also is more deadly to old folks or those with other health complications. The Covid19 rates of death are 3.4%, even though in some areas it is less than that. However, the risk is higher for older people or those with underlying health conditions.
As we do not have a specific treatment either a vaccine for it yet, still the best preventive action is social distance and isolation. South Korea was the country that was able to manage and control the disease better than any other country, with death rates lower than 1%. One of their main strategies was making faster identification of infected people, tracing their contacts and isolation. And they were very efficient at it and could provide tracing to where the positive people were, which stores they went, and even which buses they took with specific times of those activities. Therefore, people could check if they were closer to those contagious people at any of those times.
Back to isolation, that is what I am doing now as I am 65 years old. I hope I will survive it, but nobody knows! In any case, our best shot is isolation if a person is sick. If a person is not sick, he or she should stay home if possible. If not, he should avoid agglomerations, wear protective gear, wash hands thoroughly and frequently and do not touch the face with hands. When we have Covid19 free testing for all, it will help to identify infected people and lead to more specific isolation. This will lead to more efficient control of the epidemic; until then, use the precautions.
And trust in the Lord. He guided the Israelites during their epidemics in the desert, he guided the priest doctors during the middle ages, and he will guide our doctors and ourselves today. Stay safe in His hands!
Hildemar Dos Santos, MD, DrPH
Associate Professor at Loma Linda University School of Public Health
Director of the Preventive Care DrPH Program and Drayson Center Office of Preventive Care
References:
bostomglobe.com - accessed on March 30, 2020
healthline.com – accessed on March 30, 2020
time.com – accessed on March 30, 2020
A little bit of history can help us to understand why quarantining is important and what does the word quarantine mean. The term was first used in Europe during the bubonic plague in the 14th century. Even though the process of isolation dates back thousands of years to the biblical times.
The bible book of Leviticus has many verses that describe the process of isolation during leprosy or other infections. “He shall remain unclean all the days during which he has the infection; he is unclean. He shall live alone; his dwelling shall be outside of the camp.” Leviticus 13:46
Some legends, that I could not confirm due to time it happened (14-15 century), say that the priests, who were the doctors at that time, were having a hard time to control the black plague (or bubonic plague) that decimated one-third of Europe. Either they looked at the bible verses and found the idea of isolation there, or they looked to the Jewish people who appeared to had controlled the epidemic on their villages by practicing isolation. In any case, they started isolating sick people and ultimately were able to control the epidemic.
One documented historical event in Europe clarified the process of quarantine. Officials from the city of Ragusa (now Dubrovnik, Croatia) passed laws to establish 30 days of isolation for ships arriving from infected areas (similar to our passenger screenings at our airports for affected Covid19 areas). At first, people in the ships needed to wait for 30 days and later it was expanded to 40 days, which is called “quarantino” in Italian – the root of the English word ‘quarantine.’
They also developed special places for quarantined people separated from the city. As time passed the period of isolation became dependent on the incubation period for the disease, but the term quarantine was kept. After years of dealing with global epidemics, quarantine became one fo the main methods to control diseases that are transmitted by contact or human discharges such as hepatitis, pneumonia, tuberculosis, flu, SARS, and now the Covid19 pandemic that is affecting the whole world.
Therefore, in your case or mine, with the Covid 19, we must follow the same procedure; isolation and social distance as much as possible. I remember when I was in Hong Kong during the SARS (Severe Acute Respiratory Syndrome) epidemic caused by a coronavirus more deadly than Covid19, that one infected person entered a hotel in the city and took the elevator. All the people on that elevator were infected and died later on.
On that epidemic of SARS, the death rates were about 10% and not respecting age but 55% of deaths were above 60 years old. The 1918 influenza that affected 1/3 of the world population had a death rate of 2% and it was more common among 20-40 years old. The seasonal flu has a death rate of 0.1% and also is more deadly to old folks or those with other health complications. The Covid19 rates of death are 3.4%, even though in some areas it is less than that. However, the risk is higher for older people or those with underlying health conditions.
As we do not have a specific treatment either a vaccine for it yet, still the best preventive action is social distance and isolation. South Korea was the country that was able to manage and control the disease better than any other country, with death rates lower than 1%. One of their main strategies was making faster identification of infected people, tracing their contacts and isolation. And they were very efficient at it and could provide tracing to where the positive people were, which stores they went, and even which buses they took with specific times of those activities. Therefore, people could check if they were closer to those contagious people at any of those times.
Back to isolation, that is what I am doing now as I am 65 years old. I hope I will survive it, but nobody knows! In any case, our best shot is isolation if a person is sick. If a person is not sick, he or she should stay home if possible. If not, he should avoid agglomerations, wear protective gear, wash hands thoroughly and frequently and do not touch the face with hands. When we have Covid19 free testing for all, it will help to identify infected people and lead to more specific isolation. This will lead to more efficient control of the epidemic; until then, use the precautions.
And trust in the Lord. He guided the Israelites during their epidemics in the desert, he guided the priest doctors during the middle ages, and he will guide our doctors and ourselves today. Stay safe in His hands!
Hildemar Dos Santos, MD, DrPH
Associate Professor at Loma Linda University School of Public Health
Director of the Preventive Care DrPH Program and Drayson Center Office of Preventive Care
References:
bostomglobe.com - accessed on March 30, 2020
healthline.com – accessed on March 30, 2020
time.com – accessed on March 30, 2020