Until Proven Safe

Title: Until Proven Safe

Author: Nicola Twilley

Completed: Sept 2021

Overview: An interesting look at many different aspects of quarantine. I probably wouldn’t have picked up this book (or heard about it) except that I listen to Nicola’s podcast, Gastropod. It was fun to think that most of it was written before Sars-Cov-2 and the global lockdown it created. So much of what was discussed started as obscure knowledge when the experts were interviewed, but quickly became common knowledge as the pandemic progressed.


  • Skepticism about U.S. quarantine capabilities was, in fact, warranted: as cases of the virus began to grow in number, the nation’s permanent federal quarantine infrastructure consisted of just twenty inspection stations at international airports around the country and a brand-new, twenty-bed unit in Omaha, Nebraska. This, the nation’s only federal quarantine facility, barely opened in time for COVID-19: after a lengthy construction process, it became operational on January 29, 2020.
  • In Japan, so-called virus vigilantes took quarantine into their own hands, dumping thumbtacks on the street to pop the tires of potentially infected cyclists attempting to bike through neighborhoods where they didn’t belong, and scouring cities for cars with out-of-town registration details.
  • By the end of March 2020, a mere three weeks after King County health authorities painted over an Econo Lodge sign, fully 20 percent of the Earth’s population was living in a state of isolation or quarantine—an estimated 1.7 billion people. Within a week, that tally would more than double, with Agence France-Presse estimating that “half of humanity” was now undergoing some form of medical detention.
  • one of the primary ways that humans have responded to something we do not fully understand—whether that be the Black Death, Ebola, or, several years after our meeting, COVID-19—is to develop protocols and procedures, ritual behaviors whose performance reassures us as we encounter and attempt to triumph over the unknown. From scented herbs to hand sanitizer, and from Venetian lazarettos to high-level containment facilities, these measures curtail contact and constrain exposure, keeping an unfamiliar threat at bay.
  • Asma goes on to suggest that what it means to be human is often defined by our degree of separation from what we think we are not. As part of the rich cycle of myths that developed after the death of Alexander the Great, one story of isolation stands out. “Alexander supposedly chased his foreign enemies through a mountain pass in the Caucasus region and then enclosed them behind unbreachable iron gates,” Asma writes. Beyond this wall was what Asma calls a “monster zone”—a “prison territory”—in which Gog and Magog, enigmatic creatures that play an almost Godzilla-like role in the biblical book of Revelation, were locked away in a realm of grotesquerie and violence. The Caucasus Mountains being the supposed site of origin of the Caucasian people—a pseudoscientific term used by white, Enlightenment-era Europeans to classify themselves in opposition to other races—it is striking that the story of these gates suggests that the very idea of the West required an act of isolation against a monstrous other that lurked somewhere in Eastern darkness.
  • 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 borderlands were also ground zero for alleged vampire sightings, triggering a literary mania that swept Europe. This quarantine threshold, a zone of suspicion and uncertainty, whose inhabitants were neither healthy nor sick, neither citizen nor soldier, and constantly under threat from plagues both real and imagined, proved the perfect hunting ground for the similarly liminal living dead.
  • one of the central ways in which the United States pursued its colonial ambitions was through disease control, using concern about the return of yellow fever to its shores as an excuse to intervene in, influence, and eventually, in some cases, administer its southern neighbors. “In a whole lot of places like Cuba, and eventually Panama, Puerto Rico, and even Guam, the first U.S. inroads were around quarantine and infectious disease measures,” Bashford told us. “Unsurprisingly, this was followed pretty quickly either by territorial acquisition of those places or by transnational agreements and other extensions of influence.” Under the cover provided by quarantine, the United States was able to pursue an expansionist foreign policy by other means; later, U.S. president John F. Kennedy would employ the term’s useful ambiguity to order a naval blockade of Cuba without committing to a definitive act of war against the nuclear-powered Soviet Union.
  • quarantine “differs from a measure of criminal police in this respect: That it assumes every person to be capable of spreading disease until he has proven his incapacity; whereas the law assumes moral innocence until guilt is proved.” That reversal, explained Krista Maglen, an Australian historian of medicine, makes quarantine one of the singular instances in today’s liberal democracies in which a state can detain someone without having to demonstrate their guilt—merely their potential for causing future harm.
  • a federal structure in which public health powers reside at the local level will, by design, respond to a pandemic in a fragmented and uncoordinated manner. “A legal system that emphasizes the protection of individual rights and restricts governmental powers to impinge on such rights,” Fidler added, is also one in which quarantine and other social distancing measures are destined to fail. “In such a system, the citizenry is always wary and skeptical of governmental incursions on its rights, creating a climate of distrust that works against governmental efforts to contain an epidemic.”
  • In reality, he told us, the restrictions that can control spread and reduce deaths in a pandemic such as COVID-19 have to be implemented earlier and be more stringent than seems reasonable, and they have to be sustained for a period that outstrips everyone’s patience. “We just didn’t have the grit for it in the United States,” said Cetron, with a deep sigh. “It’s quite humbling.”
  • The very first plant protection laws on record concern rust: in 1805, the principality of Schaumburg-Lippe, in present-day Germany, ordered the elimination of all barberry bushes; a German source mentions an even earlier anti-barberry law passed in the French city of Rouen in 1660. The barberry, a sturdy, thorny shrub whose bright pink berries are deliciously sour, plays host to rust after the wheat harvest and before the new season’s crop is sown. It was introduced deliberately into the United States for use in hedgerows, but, when a rust outbreak in 1916 destroyed about 40 percent of the nation’s wheat crop just prior to the nation’s entrance into World War I, the USDA decided barberry’s time was up. The University of Minnesota, where the Cereal Disease Lab is housed today, helped launch a comprehensive barberry-eradication campaign, recruiting schoolchildren and Boy Scouts to distribute flyers and help track down barberries in backyards and parks, and hiring teams of laborers to dig up the bushes and then salt the ground in which they’d grown, to prevent regrowth.
  • The number of alien species that have been imported into countries has increased dramatically over the past quarter century, an increase that correlates with the boost in global trade following the founding of the World Trade Organization in 1995. (WTO rules also legally require countries to use the least restrictive quarantine measures possible.) Researchers have found that you can calculate the rise in a European country’s GDP based solely on increases in the detection rate of newly arrived, nonnative spiders.
  • China, for example, has recently taken the first steps toward constructing its own permanent disposal site, excavating an experimental test facility—similar to WIPP—in deep desert rocks near Beishan, in Gansu Province, in the middle of the Gobi Desert. (Beishan lies near the Silk Road, the old trade route traveled by Marco Polo and other merchants—some of whom carried fleas infected with bubonic plague to Europe, thus prompting the very first architectures of quarantine.)
  • Among the many ideas put forward by the DOE’s research group were several that, in retrospect, seem so ill-considered as to appear frivolous. One such proposal suggested building a “landscape of thorns”—fifty-foot-tall concrete spikes—on the land above WIPP, under the assumption that large, geometrically aggressive shapes would be so menacing that anyone who saw them would simply flee in horror. Another called for the genetic modification of domestic house cats in order to produce a new species, the “ray cat,” whose skin would change color in the presence of radiation, possibly even emitting fluorescent light. Many thousands of years from now, the thinking behind this suggestion goes, humans passing through lands formerly known as New Mexico would notice that their cats were changing color, and they would conclude from this that radiation must be leaking from a long-forgotten underground repository. A place of safety would be anywhere their cats no longer glow.
  • Three days later, the crew reached Houston and transferred to the Lunar Receiving Lab, which was promptly declared an official quarantine area by the medical officer of Harris County, Texas. The next day, a small item in the Federal Register proclaimed a state of quarantine lasting from 0100 hours on July 21 to at least 0100 on August 11, 1969, “to prevent contamination of Earth by extraterrestrial life,” an understated admission that Texas was facing the risk, however tiny, of a celestial pandemic. In the event of an actual alien contagion, officials later revealed, the plan was to bury everyone in the laboratory alive under a mountain of dirt and concrete, sacrificing astronauts and NASA scientists alike. Technicians who worked in the lab had signed an agreement stating that their next-of-kin would not claim their bodies in case of their death.
  • Today, no matter where a disease emerges, public health professionals expect that, after just two or three acts of transmission, it will be detected in one of the world’s most connected transportation hubs.
  • the business leaders pointed out that, while collaborating to save both lives and the global economy was a nice idea, they had businesses to run. “The common good is all very well, but we have to go back to our companies on Monday,” said Adrian Thomas of Johnson & Johnson.
  • The patent drawings submitted by Amazon as part of its twenty-one-page patent documentation depict a woman saying, “Alexa, *cough* I’m hungry *sniffle*”; Alexa responds to the comment first by offering a recipe for chicken soup, then by suggesting an Amazon order of cough drops. Critics have rightly pointed out that there are serious ethical issues associated with such a service. The patent explicitly goes beyond detecting signs of ill-health: it also listens for indicators of sadness and depression. Serving up ads to customers whose voices—or perhaps out-of-character recent queries—suggest that they are feeling emotionally vulnerable or even suicidal raises obvious questions about corporate morality, medical responsibility, and, of course, user privacy. The patent does not address this. Instead, it cites the added potential of using a customer’s Amazon purchase history and recent “number of clicks” to determine the most appropriate commercial intervention. One such option, the patent says, is for Alexa to respond to sad customers by asking, “Are you in the mood for a movie?”