Ebola – BLDGBLOG

[Image: Dressed in 21st-century personal protective equipment (PPE), I am standing next to Dr. Luigi Bertinato, wearing period plague doctor gear from the time of the Black Death, inside the library of the Querini Stampalia, Venice. Photo by Nicola Twilley.]

Long-time readers of this blog will hardly be surprised to hear of my interest in quarantine, a topic I’ve been posting and lecturing about since at least 2009. The Landscapes of Quarantine exhibition at Storefront for Art and Architecture, curated with Nicola Twilley back in 2010, was the beginning of a much larger project that we eventually returned to, several years ago, for a book on the subject.

Originally titled—and sold to our editor as—The Coming Quarantine, we had to change the book’s name when COVID-19 hit. Surreally, we ended up finishing a book about quarantine while in a state of medical detention—indeed, at one point late last spring, more than half the world’s human population was in some state of quarantine or lockdown.

Our book’s hypothesis and prediction was, in fact, that we would all be quarantining more in the future, not less, relying on this seemingly medieval tool of spatial isolation to protect ourselves from emerging diseases for which we had no natural immunity, no available vaccination, and no cure. Why quarantine? It is the use of space and time to overcome uncertainty, creating a buffer between ourselves and a potentially infectious other until that suspected threat can be proven safe.

[Image: An arch inside the abandoned lazaretto, or quarantine hospital, on Manoel Island, Malta; photo by Geoff Manaugh.]

Until Proven Safe: The History and Future of Quarantine—the book we have been traveling for, reporting, and working on since summer 2016—finally comes out tomorrow, July 20th. I am unbelievably excited about this book, for millions of reasons. On one level, it combines so many of the long-running interests here on this blog, from quarantine itself to architectural ruins, mythology & horror, science fiction, space exploration, the Army Corps of Engineers, agricultural landscapes, strange animal diseases, extraordinary engineering controls, the ethical dangers of smart homes, even nuclear waste.

Having posted little to nothing about this book over the past few years—indeed, having posted almost nothing about COVID-19—it’s also immensely relieving to finally release this thing into the world.

[Image: Inside the lazaretto at Ancona, Italy; photo by Geoff Manaugh.]

Some highlights that I think would appeal to BLDGBLOG readers include Nicky’s and my travelogue around the Adriatic and Mediterranean seas, exploring ruined lazarettos in the footsteps of 18th-century British prison reformer—and quarantine critic—John Howard. We climbed locked fences into ruins on Malta, took a night ship across the Adriatic to disembark near the extraordinary pentagonal lazaretto in Ancona, and we got to tour the then-closed Lazzaretto Nuovo in Venice, Italy, with the local man intent on preserving it. (His original plan, he admitted, was to turn the island into a martial arts dojo.)

In other parts of the book, we sit down with the head of the Disinfected Mail Study Circle, based in North London. That group collects rare pieces of mail sent to and from sites of quarantine; like characters in a Thomas Pynchon novel, their postal archaeology has revealed previously forgotten outbreaks and odd geopolitical details about the formation of international borders.

We also visited the first federal quarantine facility, then under construction, in the United States in more than a hundred years, mere months before COVID-19, and we spoke with the former head of the Army Corps of Engineers about plans for retrofitting hotels, convention centers, and stadiums, as well as the prospect of pop-up home quarantine kits in the near-future. We visited the Ebola high-level isolation unit at the Royal Free Hospital in London—where Nicky climbed inside.

[Image: Nicola Twilley inside the high-level isolation unit’s Trexler Ebola system; photo by Geoff Manaugh.]

In the latter half of the book—primarily dedicated to nonhuman quarantine, or quarantine applied to the plant, animal, and mineral kingdoms, capped off by a look at “planetary protection” and the risk of alien microbes—we were able to see a brand-new high-level animal-disease research lab in the middle of U.S. cattle country. This is the nation’s replacement for the aging facility on Plum Island, subject of countless conspiracy theories.

Elsewhere, we went deep into WIPP—the Waste Isolation Pilot Plant—outside Carlsbad, New Mexico, to see nuclear waste being buried and isolated from the Earth’s biosphere for a federally-mandated time periods of at least 100,000 years. We got to see the Apollo moon rocks and learn about the history of lunar quarantine, and even sat down with two of NASA’s Planetary Protection Officers—and their counterpart at the European Space Agency—to discuss the quarantine challenge of bringing Mars geology back to Earth. Along the way, we got to see Perseverance, the Mars rover, before its long (and successful) journey to Mars.

[Image: Walking inside the Waste Isolation Pilot Plant, a salt mine 2,150 feet below the surface of the Earth, where the United States is permanently burying nuclear waste; photo by Nicola Twilley.]

Reporting the book also led us to a series of high-level pandemic simulations over the course of several years—all the way up to the incredible experience of sitting in on a simulation in October 2019, the premise of which was a global outbreak of a novel coronavirus. As we sat there, listening to government figures role-play what they would do, the very earliest cases of COVID-19 were likely circulating in China, undetected.

We also look at the limits of mathematical modeling, the encroachment of algorithms and Big Data into the future of quarantine, and the dystopian potential of involuntary medical isolation automatically enforced by today’s smart homes.

And, through all of that, one of our biggest coups, I think, was recording hours of interviews with the head of the CDC’s division of global migration and quarantine, visiting him in his office at the CDC and recording anguished, on-the-record discussions during the Trump Administration about the nation’s COVID-19 response.

A great way to get a flavor of the book would be to check out excerpts published in WIRED and The Guardian—and, tomorrow morning, The Atlantic—or to listen to the Gastropod episode we did on quarantine, agriculture, and threats to the world’s chocolate supply.

[Image: Until Proven Safe, with a cover design by Alex Merto.]

If you’re tempted, you can order a copy from Bookshop, Indiebound, Amazon, Barnes & Noble, or your local independent bookshop, etc. etc.

Note: This post contains affiliate links to Amazon and Bookshop from which I might draw a small percentage of any book sales.

[Image: Liberian security forces implement “a quarantine of the West Point slum, stepping up the government’s fight to stop the outbreak and unnerving residents.” Photo by Abbas Dulleh/AP, via Al Jazeera America].

Of Forcible Blockades and Military Isolation

A neighborhood-scale quarantine was forcibly imposed on the slums of Monrovia, Liberia, yesterday to help prevent the spread of Ebola.

Using makeshift roadblocks—consisting, for the most part, of old furniture, wooden pallets, and barbed wire, as everyday objects were transformed into the raw materials of a police blockade—authorities have forcibly isolated the densely populated neighborhood of West Point from the rest of the city.

Unsurprisingly, however, poor communication, over-aggressive law enforcement tactics, and general misinformation about the nature—even the very existence—of Ebola has led to local resistance.

Al Jazeera reports, for example, that “police in the Liberian capital have fired live rounds and tear gas to disperse a stone-throwing crowd trying to break an Ebola quarantine imposed on their neighborhood.” But they were perhaps simply trying to defend themselves against a badly communicated onslaught of police wielding batons and machine guns, and they would be doing so whether Ebola was in the picture or not.

[Image: Neigborhood-scale quarantine; photo by Abbas Dulleh/AP, via Al Jazeera America].

Ubiquitous Quarantine

But this is only one of the most recent—and one of the more extreme—examples of the spatial practice of quarantine reappearing in the news in recent weeks. At the end of July, for example, the Chinese city of Yumen was partially quarantined due to an outbreak of bubonic plague, as parts of the city were “sealed off” from the neighborhoods around them; and the ongoing Ebola outbreak has led to involuntary quarantines being implemented at nearly every spatial level, from the individual to the city to entire international regions.

In the latter case, recall that just last week a cordon sanitaire was enforced in the international border regions of Guinea, Liberia, and Sierra Leone to stop people possibly infected with Ebola from crossing the borders. As the New York Times described this action, “The Ebola outbreak in West Africa is so out of control that governments there have revived a disease-fighting tactic not used in nearly a century: the ‘cordon sanitaire,’ in which a line is drawn around the infected area and no one is allowed out.”

This spatial technique for managing the spread of microbiological life has “the potential to become brutal and inhumane,” the paper adds. “Centuries ago, in their most extreme form, everyone within the boundaries was left to die or survive, until the outbreak ended.”

[Image: Enforcing quarantine; Photo by Abbas Dulleh/AP, via Al Jazeera America].

Resisting Quarantine

Yet resistance to quarantine is nearly as ubiquitous as attempts to implement it. The very notion of involuntary quarantine is important to emphasize here: this is something that must be spatially imposed on people who have not chosen to bring this condition upon themselves.

Read this dramatic description from the Times, for example, depicting the moment at which involuntary government quarantine is revealed:

Soldiers and police officers in riot gear blocked the roads. Even the waterfront was cordoned off, with the coast guard stopping residents from setting out in canoes. The entire neighborhood, a sprawling slum with tens of thousands of people, awoke Wednesday morning to find that it was under strict quarantine in the government’s halting fight against Ebola.

The reaction was swift and violent. Angry young men hurled rocks and stormed barbed-wire barricades, trying to break out. Soldiers repelled the surging crowd with live rounds, driving back hundreds of young men.

Involuntary quarantine can inspire this type of reaction at any scale. Consider the panic-stricken family who forcibly raided a hospital in Freetown, Sierra Leone, in order to free an Ebola-stricken relative who, they had come to believe, was being held against her will; she later died, but not before passing her infection on to others. Or consider the Nigerian nurse possibly exposed to Ebola while caring for patients who nonetheless “skipped quarantine,” either out of a desperate sense of self-preservation or due to sheer ignorance of the dangers of her actions.

“Don’t Touch The Walls!”

Somewhat incredibly, though, the deliberate breaking of quarantine can also occur not out of survivalist panic or concern for one’s own medical safety, but simply for the purpose of looting. Some of the descriptions here are jaw-dropping, with raiders actually breaking into Ebola wards to steal “property like tents, tarpaulins, buckets, hospital beds, mobile phones and shoes among other things,” literally all of which could bear traces of Ebola and thus spread the contagion elsewhere.

The New York Times had a particularly chilling example of why not to steal from Ebola wards when it ran this haunting sentence two weeks ago: “‘Don’t touch the walls!’ a Western medical technician yelled out. ‘Totally infected.'”

Yet, even in the West Point quarantine zone, misguided acts of theft are rampant: “Residents stormed through” the quarantine zone, we read, also in the New York Times, “running off with a generator and supplies like mattresses, some soaked with the blood of patients who were believed to have Ebola.”

In a situation where even the hospitals are considered to be “death traps,” where the walls themselves are “totally infected” with Ebola, the designation of involuntary and militarily enforced quarantine boundaries is taken to mean the designation of a kind of urban sacrifice zone, a place where patients can be fatally off-loaded and the disease tragically but successfully contained. From this point of view, getting out of the quarantine zone becomes a top priority.

Residents of West Point have even protested that “their community, they believed, was becoming a dumping ground for Ebola patients,” and that quarantine was simply a spatial excuse for putting victims all in one place, uninfected neighbors be damned. “In all,” we read, “residents tried to break through the barricade three times on Wednesday, Col. Prince Johnson, the army’s brigade commander, said Wednesday evening by phone. His soldiers had fired in the air, he said, but he would not comment on whether they had also fired into the crowd.”

[Image: A “quarantine house” in Pennsylvania; courtesy of the U.S. Library of Congress].

Powers of Quarantine

Who has the power to quarantine? Where does this power come from—especially in a Constitutional democracy like the United States—and where exactly are this power’s limits? Does it have any?

Nicola Twilley and I explored these questions last week for the New Yorker, looking at, among other things, the Constitutional implications of quarantine powers. As we point out in that piece, there is an ethically troubling overlap between the notion of the quarantined subject, spatially isolated often against his or her will, and the liminal figure of the “enemy combatant” who potentially never faces the prospect of a legal trial whilst being indefinitely detained.

In both cases, extrajudicial detention can occur on the ground of suspicion alone—presumed guilt or infection—rather than legal or medical certainty.

In fact, writing as a coauthor on two Congressional Research Reports from 2005, legal theorist Jennifer Elsea commented on both of these categories: of the combatant held by the state without rights or legal access to resistance, and the medical subject unable to protest his or her segregation due to being held in a state of involuntary quarantine.

As we see massive international quarantine zones enforced at gunpoint throughout West Africa, and as suspected Ebola cases pop up everywhere from Johannesburg to California, it is well worth discussing where these spatial powers come from, who controls them, and when and where quarantine has reached its limit.

The Return of Quarantine

Indeed, as Twilley and I suggested back in 2010 during the “Landscapes of Quarantine” design studio and exhibition at New York’s Storefront for Art and Architecture, quarantine is a decidedly pre-modern spatial practice that is nonetheless experiencing a contemporary comeback.

Confronted with widespread antibiotic resistance and increased global air travel that can bring diseases like Ebola to every global metropolis in a matter of hours, quarantine is part of “a 14th-century toolbox” that ironically looks perfectly at home in the 21st century.

[Image: Quarantine station, Pennsylvania; courtesy of the U.S. Library of Congress].

Given all these examples of resistance, confusion, and the violence often necessary to impose spatial isolation on people only suspected of bearing a disease, we suggest in the New Yorker essay that quarantine becomes something of a spatial fiction, always and permanently on the verge of collapse. Its premise is a fantasy; the imaginary boundaries it seeks to defend are legally loose and physically porous.

Nonetheless, for all its apparent instability, quarantine offers a necessary fiction of separation and control at a time when the boundaries between health and contagion have become so vertiginous and blurred.

(Note: Parts of this post were co-written with Nicola Twilley).