Until Proven Safe: The History and Future of Quarantine

by Nicola Twilley, Geoff Manaugh

Overview

Geoff Manaugh and Nicola Twilley have been researching quarantine since long before the COVID-19 pandemic. With Until Proven Safe, they bring us a book as compelling as it is definitive, not only urgent reading for social-distanced times but also an up-to-the-minute investigation of the interplay of forces–––biological, political, technological––that shape our modern world.

Quarantine is our most powerful response to uncertainty: it means waiting to see if something hidden inside us will be revealed. It is also one of our most dangerous, operating through an assumption of guilt. In quarantine, we are considered infectious until proven safe.

Until Proven Safe tracks the history and future of quarantine around the globe, chasing the story of emergency isolation through time and space—from the crumbling lazarettos of the Mediterranean, built to contain the Black Death, to an experimental Ebola unit in London, and from the hallways of the CDC to closed-door simulations where pharmaceutical execs and epidemiologists prepare for the outbreak of a novel coronavirus.

But the story of quarantine ranges far beyond the history of medical isolation. In Until Proven Safe, the authors tour a nuclear-waste isolation facility beneath the New Mexican desert, see plants stricken with a disease that threatens the world’s wheat supply, and meet NASA’s Planetary Protection Officer, tasked with saving Earth from extraterrestrial infections. They also introduce us to the corporate tech giants hoping to revolutionize quarantine through surveillance and algorithmic prediction.

We live in a disorienting historical moment that can feel both unprecedented and inevitable; Until Proven Safe helps us make sense of our new reality through a thrillingly reported, thought-provoking exploration of the meaning of freedom, governance, and mutual responsibility.

Product Details

ISBN-13:	9780374126582
Publisher:	Farrar, Straus and Giroux
Publication date:	07/20/2021
Pages:	416
Sales rank:	1,038,303
Product dimensions:	5.40(w) x 8.30(h) x 1.00(d)

About the Author

GEOFF MANAUGH is the author of the New York Times-bestseller A Burglar’s Guide to the City, as well as the architecture and technology website BLDGBLOG. He regularly writes for The New York Times Magazine, The Atlantic, The New Yorker, Wired, and many other publications.

NICOLA TWILLEY is co-host of the award-winning podcast Gastropod, which looks at food through the lens of history and science, and an award-winning contributor to The New Yorker.

They live in Los Angeles.

Table of Contents

Maps vi

Part I Encountering Uncertainty

1 The Coming Quarantine 3

Part II Building Quarantine

2 The Quarantine Tourist 47

3 Postmarks from the Edge 80

4 An Extraordinary Power 116

5 Alone Together 153

Part III Animal, Vegetable, Mineral, Alien

6 Biology at the Border 193

7 A Million Years of Isolation 244

8 All the Planets, All the Time 270

Part IV Distance Assistance

9 Algorithms of Quarantine 309

Epilogue: Until Proven Safe 343

Authors' Note 351

Sources 353

Acknowledgments 379

Index 381

Editorial Reviews

★ 05/10/2021

BLDGBLOG blogger Manaugh (A Burglar’s Guide to the City) and Gastropod host Twilley take a riveting and timely look at how humanity has protected itself by isolating segments of its populations. Quarantines, they write, have “always been a stimulus for creatively rethinking the built environment,” and while the authors cover the response to Covid-19, they also survey the ways animals avoid infecting others, agricultural safeguards against diseases that could decimate food supplies, precautions taken by NASA to not contaminate other planets, and how radioactive nuclear waste can be safely stored for tens of thousands of years. Manaugh and Twilley cull their research into a concise and logical series of recommendations for future public health crises, grounded in a deep appreciation of the human impact of quarantining. Though technological advances in tracking, testing, and containment offer promise for more effective quarantining, the future will likely see more quarantines, and thus will require “a politics and culture of collaboration.” The way forward, they write, will require design creativity, legal reforms that ensure “that the authorities making... promises will deliver on them,” and imaginatively thinking about quarantine as an experience that allows agency. This thoughtful study couldn’t arrive at a better moment. Agent: Nathaniel Jacks, InkWell Management. (July)

Publishers Weekly

[Manaugh and Twilley] bring an impressively wide range of interests to bear on a subject that involves not only infectious disease but also—in their ambitious yet seamless narration—politics, agriculture, surveillance and even outer space.”
—Jennifer Szalai, The New York Times Book Review

“What makes [Until Proven Safe] compelling, besides [Manaugh and Twilley’s] extensive experience as journalists, is the depth of their research coupled with a firm conviction that quarantine, a mighty yet dangerous weapon, must be used ‘more wisely in the future’ . . . The informality of the authors’ engaging prose, bearing few scholarly trappings save for the source notes, more aptly resembles that of an article in the New Yorker . . . This is an exceptionally powerful book.”
—A. Roger Ekirch, The Wall Street Journal

"[Nicola Twilley and Geoff Manaugh] make a compelling case that we must continue to refine the use of quarantine, balancing the needs of public health with those of human rights."
—The New Yorker

“Until Proven Safe is uncanny in its prescience . . . Twilley and Manaugh see things that others don’t. Their insatiable curiosity reveals itself through all of their endeavors.”
—Allison Arieff, San Francisco Chronicle

“There is something counterintuitively comforting in a deeply-considered book that contextualizes and justifies the seclusion and uncertainty of the past 18 months . . . Fascinating.”
—Annalisa Quinn, NPR.org

"Maybe reading a book about quarantine sounds like the last thing you want to do this summer . . . but indulge me in a counterargument. Manaugh’s and Twilley’s extensive history of a concept we might otherwise take for granted is actually the perfect postpandemic read—an imaginative, layperson-friendly way to make sense of and contextualize what we just lived through."
—Arianna Rebolini, BUZZFEED

"As unapologetically delightful as a story about nation-eradicating fatal pathogens can be, Manaugh and Twilley travel from the site of the medieval-era hospitals anchored off the coast of Venice to keep the bubonic plague at bay, to the 2019 dress rehearsals for a then-hypothetical novel coronavirus pandemic, held in a ballroom of the Pierre Hotel on New York’s Upper West Side. As we prepare to unmask, there is perhaps no more reassuring summer read..."
—Alissa Walker, VULTURE

“[An] engrossing examination of protective isolation . . . An island near Dubrovnik, NASA, Nebraska, and Venice are a few destinations on the authors’ itinerary . . . Quarantine provides a buffer and a delay, offering space and time, between the known (healthy folks) and the dangerous (potentially contagious people). Its complicated nature is adeptly explored, including ethical concerns, legal and moral questions, and enforcement challenges . . . Fascinating reading.”
—Tony Miksanek, BOOKLIST

"A riveting and timely look at how humanity has protected itself. . . Manaugh and Twilley cull their research into a concise and logical series of recommendations for future public health crises, grounded in a deep appreciation of the human impact of quarantining. . . The way forward, they write, will require design creativity, legal reforms that ensure 'that the authorities making...promises will deliver on them,' and imaginatively thinking about quarantine as an experience that allows agency."
—PUBLISHERS WEEKLY (starred review)

"Captivating . . . Manaugh and Twilley meld a global view of a timely subject with vividly detailed accounts . . . But a larger charm of this smart book lies in their ability to bring potentially dry topics to life . . . An infectiously appealing overview of efforts to contain the potentially infectious.”
—KIRKUS REVIEWS (starred review)

“An engrossing study of the ways in which quarantines have changed social, emotional, and political life over hundreds of years, and a fascinating exploration of the perennial roles of fear, conspiracy theories, greed, and prejudice, to which we now add the threat of permanent digital surveillance in the name of public health. Perfect for our time and guidance for the future.”
—ELLEN ULLMAN, author of Close to the Machine and Life in Code

“As Twilley and Manaugh reveal in this timely but timeless, ambitious and flawlessly executed account, quarantines have shaped our history—shifting geopolitical boundaries, fomenting racial hatreds, facilitating authoritarian control. The struggle to protect ourselves from invisible and deadly contagions is waged daily and largely out of sight—along borders and spore superhighways, in biosecure piggeries and nuclear waste facilities a half-mile underground. Quarantine: boring to live through, unbelievably interesting to read about.”
—MARY ROACH, author of Stiff and Grunt

"Until Proven Safe is the book of our historical moment—a provocative meditation on how society uses quarantine to define the boundaries of self and other when faced with the terrifying unknown. Startlingly timely, authoritatively researched, and electrifyingly written."
—STEVE SILBERMAN, author of NeuroTribes: The Legacy of Autism and the Future of Neurodiversity

"Strap on your plague beaks and round up the loose women! In this intrepid, occasionally creepy jaunt through seven centuries of disease control, Twilley and Manaugh prove that the past is never dead; it’s just in quarantine."
—ALEXIS COE, New York Times Bestselling author of You Never Forget Your First: A Biography of George Washington

“Until Proven Safe combines history, geography, epidemiology, and the ethics of space exploration—how can this be? Because, as the authors explain in a very entertaining and wide-ranging way, quarantine, ironically enough, crosses borders of space and time to make a complex knot of stories. Timely, eye-opening, provocative—you will see the world differently after reading it.”
—KIM STANLEY ROBINSON, Hugo, Nebula, and Locus award-winning novelist, and author of Ministry for the Future

"What does it mean to isolate threats: people carrying diseases; the microbes, themselves; radioactive materials? For centuries the primary tool of isolation has been quarantine, and in this globe-trotting tale of history and today’s COVID-19 crisis, Geoff Manaugh and Nicola Twilley offer answers that will make your jaw drop. Nothing about “quarantine” is as simple or straight-forward as you think."
—LAURIE GARRETT, Pulitzer Prize-winning author of The Coming Plague: Newly Emerging Diseases in a World out of Balance

From the Publisher

07/01/2021

Authors Twilley (co-host of the podcast Gastropod) and Manaugh (A Burglar's Guide to the City) began their research on the practice of quarantine long before the start of the global COVID-19 pandemic, yet they always knew their book would be more than just a history of quarantine. They point out other instances of the practice, including in modern agriculture that depends on quarantine as a means of protection, especially as humans become more dependent on monoculture farming. Space exploration requires quarantine too, so that humans do not destroy other planetary ecosystems by transmitting Earth-based contagions. The global spread of COVID-19 and the subsequent viral flare-ups demonstrate a continuing need for separation and isolation; quarantine is still an effective tool in protecting public health, the authors say. Twilley and Manaugh argue, however, that quarantine's effectiveness must be balanced against historical knowledge and the conditions we see today around diseases like Ebola; they prove that quarantine, when used as a way to protect one's self, family, or society, can also allow the flourishing of racism, xenophobia, and oppression of targeted populations, including the revocation of personal freedoms. This book looks forward to new technologies and legal changes that may alter the way we travel and interact within our own homes to stay safe. VERDICT An informative account for readers interested in public health's impact on historical and current practices in medicine and science.—Rachel M. Minkin, Michigan State Univ. Libs., East Lansing

Library Journal

★ 2021-04-28
A captivating survey of the uses and abuses of quarantines, from the days of the Black Death to the lockdowns of Covid-19.

Journalists Manaugh and Twilley meld a global view of a timely subject with vividly detailed accounts of quarantines, whether of people or hazardous plants, animals, and chemicals such as nuclear waste. The authors show how—since the emergence of “lazarettos,” the quarantine hospitals of medieval Venice and other Adriatic ports—authorities have strived to contain dreaded hazards. Among many others, these have included the bubonic plague, yellow fever, tuberculosis, Ebola, and cholera. Yet some problems resist solutions. “Although the advent of advanced contagion modeling, location tracking, and data mining offer the promise of refining quarantine, rendering it so minimal and precise as to be almost imperceptible,” the authors write, “the use of those tools during COVID-19 has demonstrated that, in many ways, effective quarantine has changed remarkably little since its origins during the Black Death.” Persistent challenges include the tedium of isolation, the architectural rigors of designing suitable facilities, and the xenophobic use of quarantine “to obstruct the passage of undesirable immigrants at the border and stigmatize those who have already arrived.” For such risks, the authors propose fresh, sensible remedies such as a “bill of rights” for the quarantined. But a larger charm of this smart book lies in their ability to bring potentially dry topics to life. They profile the delightfully “obsessive” founder of the Disinfected Mail Study Circle (which tracks epidemics through postal evidence), and, after visiting a greenhouse near London, they note that cacao-plant diseases have contributed to a shrinking global chocolate supply that may lead to a “chocpocalypse.” Chocoholics, beware: One study found that in a decade or so, “a Hershey bar may well be as rare and expensive as caviar.”

An infectiously appealing overview of efforts to contain the potentially infectious.

Kirkus Reviews