Tuesday 04 August 2020

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History of Quarantine & significance of 40 days (By Cleofato Almeida Coutinho)


Why the isolation period was changed from 30 days to 40 days is a mystery . It may be that the thirty days was not effective enough at a time when there was not much of advancement of science and medicine

sanitizing at quarantine facility

 Our national ‘lockdown’ completes 40 days 0n 3/5/20. Isolation separates person infected with a contagious disease from those who are not.  Quarantine separates and restricts the movement of people who were exposed to such a disease, to test if they become sick.  Quarantined are the ones who are exposed to the disease but the infection is not confirmed. If we accept that distinction, we have been quarantined for past forty days. Though the lockdown has been claimed to be extended, the relaxations for the green and orange zones actually means a phased exit. The Prime Minister does not want to say that it is a calibrated exit The quarantining a country is called it a ‘national lockdown’. Unlike ours, the U.S. lockdown does not restrict people’s movements.

When U.K. will lift their lockdown is not confirmed .Italy and Spain which locked down on 9th and 14th March respectively are likely to   lift it  in the first week of May while France which imposed shutdown on 28th April  has decided to open by 11th May. The main epicenter of Covid -19 Wuhan in china was shut down for ten weeks. There are no WHO protocols for shutdown of provinces or countries. A shutdown is to deal with the rate of increase of out breaks, though the transmission chain does not break.

The Indian lockdown is effective from 25th March and extended till  3rd May  completing the forty days of quarantine of the country. The two  weeks extension is actually an exit. The Chief Ministers wanted the lockdown till 30th April but the Prime Minister made it forty days. It is said that various CMs having unilaterally announced extension, the PM was left with no option. Some say it hardly mattered as 1st to 3rd May were holidays. Whatever the reason, there is great significance over 40 days which  is always considered a important time period in the Christian world

Isolation of people with contagious diseases from those not infected is centuries old method of dealing with malady. All most one third of Europe’s population was wiped out by the plague called ‘black death’ (bubonic plague) which swept Europe in the fourteenth century. The disease is supposed to have its epicenter in Asia and entered the west through Sicily in 1347. The main disease control measure was isolation of the infected. At a time when science had had not advanced to understand virus or bacteria, they understood that person to person contact had to be avoided and the disease could get transferred through  any surfaces(goods). They put in place a public health measure which we today call ‘social distancing’. It is seen as a great barrier to infection in 2020, such measures were thought of in the   fourteenth century. A Mediterranean port city Ragusa( now in Croatia) was the first to bring in the ‘contagion strategy’ where those infected of ‘black death’  would be  treated outside the city. They were aware that isolation was not enough.  Ragusa had the first plague Hospital, a temporary one. Venice had a permanent plague hospital in an island which doubled up as quarantine   facility.

For over six centuries quarantining has been used as a strategy to deal with pandemics and epidemics. The length of quarantining time and the methods used to enforce have different for different countries. The quarantining regulations have been brutal and resisted by people. Europe had grapple with cholera riots as the European countries were dealing with waves of cholera pandemics in the nineteenth century.

The great council of Ragusa port city passed a law, in 1377, of isolating  all incoming ships  and any boats   for thirty days(trentino). Why the period of thirty days was fixed is not known. Possibly it was felt that a calendar month was considered enough. The order  said ”those who come from plague infested areas shall not enter Ragusa  or it’s district unless  they spend a  month on the islet of  Mrkan (an uninhabited rocky island) or in the town of cavtat (at the end of the caravan road) for the purpose of disinfection” The period was used to screen  the sailors for infection . Similar laws came to be passed   by Marseilles, Venice, Pisa, Milan and Genoa, but the isolation period was increased to 40 days changing from ‘trentino’ to ‘quarantino’ which comes from the Italian word ‘Quranta giorni’ for forty days. Venice was an important port and ships arriving at  Venice     had to  anchor for 40 days before the passengers  or goods were brought offshore This practice came to be called  ‘quarantine’.  

Why the isolation period was changed from 30 days to 40 days is  a mystery . It may be that the thirty days was not effective enough at a time when there was not much of   advancement of science and medicine. Dave Roos claims that forty had great symbolic and religious significance to medieval Christians. It is accepted  that  forty days came because the period is considered as holy length of time   in keeping with the ‘lent’ period of 40 days of abstinence by Christians. In the Judean desert in East Jerusalem Christ retreated to be alone with god for forty days and forty nights in wilderness being tempted by Satan.  40 days and 40 nights is the period between resurrections of Jesus at Easter his ascension to heaven. Forty days after birth of Jesus, he  was presented to the temple of Jerusalem for his legal purification. Flood of Noah lasted forty days. Moses spent 40 days and forty nights at Mount Sinai on two separate occasions. When god destroyed the earth with water, he caused it to rain for 40 days and forty nights. Elijah walked 40 days and nights to reach Horeb Mount. He fasted during 40 days before to begin his public ministry and remained 40 days on Mount Carmel. The biblical significance of forty   is actually a long one in so far as the old  testament.   Dr. Jane Stephen Crawshaw of the Oxford University claims that even before the arrival of plague, the biblical notion of 40 days period of purification had crossed into health practices. After childbirth, a mother was expected to rest for 40 days. Thus forty days got firmly entrenched in the into contagion strategy

It is said the corona virus has 14 days incubation period. Our first phase of national lockdown was 21days.Why the PM opted for 40 days is not known. It could be a coincidence but we have met the requirement of quarantino. The significance of forty in various cultures is very noticeable. We also meet the Greek doctrine of “critical days” which holds that a contagious disease will develop within 40 days after exposure. They impose 40 days of isolation. Will that forty be lucky for us in India