The History of Quarantine and Resistance to Public Health Measures

Rioters storming the quarantine hospital in 1858 in Staten Island. Image originally appeared in Harper's Weekly in 1858. (U.S. National Library of Medicine)

Italy, one of the countries most impacted by the coronavirus, has the distinction of having experience with quarantines for seven centuries. In the 1300s, merchants and sailors arriving on ships in Italian ports were required to remain onboard for forty days, to isolate themselves from the people on the shore and prevent the spread of disease. In fact, the word quarantine comes from the Italian word “quaranta” — forty — and this number could have been based on the Lenten period.

Quarantines have a long history, and the basic principle of isolating oneself, or groups of people, to prevent the spread of infectious diseases remains the same. Additionally, people in the past have been suspicious of and resisted quarantines, and today there is a growing movement to end the quarantine in parts of the country.

Different types of quarantines developed over history, according to Graham Mooney, a Professor at the Institute of the History of Medicine at Johns Hopkins University. One type involves the quarantine of ships, which is called maritime quarantine, and was used in Italian ports in the 14th century. More recently, immigrants arriving in New York harbor by ship were quarantined in a special quarantine facility if a passenger was found to have an infectious disease. Those quarantines could last up to six months.

Another involves the physical removal of people who had contracted the virus to a lazaretto — a quarantine site outside the city — where they would be unable to infect the general population. This type of quarantine took place during the 1916 polio epidemic, where some children were physically removed from their parents to stop the spread of polio. The physical removal of people to quarantine centers or hospitals in some cases generated controversy that would lead to violence.

A historical photograph of the Philadelphia Lazaretto, which was commissioned in 1799. The Lazaretto is the oldest surviving quarantine center in the U.S., and one of the oldest in the world. (Library of Congress)

The house quarantine is a type of quarantine which was used in Europe during the bubonic plague, in which if someone from a household contracted the disease, the whole household would go on lockdown and isolate from others, according to Professor Mooney. The self-isolation type of quarantine is what is largely being used across the world now, instead of forced quarantines of people to hospitals or blanket quarantines that force a group of people to remain in place, such as the quarantine seen in Wuhan.

Conspiracy theories, misinformation and resistance

In the long history, there are many examples of resistance to quarantine measures. On Thursday, armed protesters entered the Michigan state capitol to demand an end to the quarantine started by the governor. In the 19th century, there were a series of violent protests in both Europe, and North America in response to measures taken to combat the spread of infectious diseases such as cholera and yellow fever. In the U.S., it was the spread of cholera in the late 19th century that led the federal government to gain more authority and take a more active role in the establishment and implementation of quarantines.

Starting in the 1830s after the first widespread outbreak of cholera in Europe, riots occurred against hospitals, doctors, and government officials. The riots were fueled by misinformation and conspiracy that the doctors, the government and the elites were conspiring to kill off the lower class. The riots took place from the British Isles to Eastern Russia, but shared many features in common.

In Italy, riots took place during the first outbreak of cholera in the 1830s. During the last major outbreak in 1910 and 1911, in central Italy, in the town of Segni, a riot involving 3,000 broke out in 1911 in response to theories that the government and doctors were conspiring to kill people. The rioters attacked government officials and doctors and broke patients out of the hospital.

The conspiracies emerged because of lack of knowledge about the disease and the high death rate led to assumptions that the doctors had started the disease to kill people in the hospital, as few people left the hospital alive. Additionally, wealthier people were permitted in some places in Italy to still conduct proper burials of their relatives, while the lower classes were not, prompting outrage and riots.

The largest riots occurred in Russia. In 1892, in the city of Astrakhan, up to 30,000 people rioted when rumors began circulating that sick people were being buried alive after being forced into hospitals. The military had to be called in to put down the riot.

The removal of infected patients to hospitals and the lack of transparency around what happened to people in those hospitals helped to create the rumors that led to riots. Concerns that a quarantine hospital could be spreading diseases in the community that it was located in spurred riots in some cases. For example, in Staten Island in 1858, rioters burned a quarantine hospital to the ground out of fears that its presence was bringing infectious diseases and facilitating their spread through Staten Island.

The conspiracy theories and misinformation circulating among rioters in the 19th century is somewhat reminiscent of conspiracy theories that are circulating now. For example, a conspiracy theory that Bill Gates, and potentially other elites, is using the coronavirus as an opportunity to develop a vaccine that would insert a tracking device into people and make it easier for the masses of people to be wiped out. However, protests against quarantine in the U.S. have been peaceful, with nothing coming close to resembling the 19th century riots where thousands of people burned hospitals and killed doctors and government officials.

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