Thread by @ClareCraigPath

New paper looks at the history of quarantine.

Many of the plague deaths were policy related too.

There is nothing new under the sun.🧵

https://twitter.com/sabhlok/status/1811381827996962916

"During the Great Plague of London in 1665, entire families with any symptomatic person were sealed inside their houses, with watchmen posted outside. Others could move around relatively freely, including leaving London, which is what the wealthy did."

Charles Maclean was a doctor who wrote extensively on quarantines and their effectiveness, producing several books and papers between 1796 and 1825.

The first ever cost benefit analysis is attributed to him.

His work on quarantines laid ground for modern public health.

He said "at least 3/4 of the mortality ought to be attributed to the restrictions..."

"...if they attempted to depart, they were driven back, vi et armis [by force and arms], by the inhabitants of the neighbouring villages and country;"

deaths could be attributed
"to irregularity and deficiency in the supply of-provisions, from the dread of infection; to the want of attendance upon the Sick; and, to the other evils occasioned by the belief in contagion."

He said,
"the belief [in person to person transmission] creates various adventitious causes of mortality and misery, where such calamities prevail, as restraint by quarantine, lazarettos, &c.; terror; ...

...a deficient supply of provisions; want of medical and other attendance; the abandonment of friends and relations; death from absolute starvation"

Nothing new about the effects of fear:

"The terror inspired during a pestilence, by the view of surrounding calamity, and by the apprehensions, whatever be its presumed cause, of being affected like others, forms an additional, and perhaps the most powerful cause of mortality."

"The destruction of lives, alone, depending upon the pernicious measures founded upon them, I roundly estimate at nearly a million of persons annually, throughout the world, since the period at which they began to operate, in 1547;...

not to speak of constitutions ruined, and the miseries of poverty and want inflicted upon many millions more."

Maclean cited an example from Gassendo (1658): "Gassendus relates, that, in a plague which affected Digne, in Provence, in 1619, out of ten thousand inhabitants, but fifteen hundred remained alive: and this mortality he imputes to the citizens having been so closely confined,...

...that they were not suffered to go to their country houses: whereas, in another pestilence, which broke out in the same place a year and a half-after, owing to the liberty being extended, there did not die above one hundred persons."

And an example from Prussia:
"In 1708, a sanitary cordon around Konigsberg erected by the Prussian government had to be removed in the face of local protests that it killed more people than the epidemic itself"

His thesis was backed up by the data,
"Thus, in eleven weeks, during which the Quarantine Laws were enforced, there was an increased weekly mortality of 7,291; and, in eight weeks, during which they were discontinued, a decreased weekly mortality of 7,392. This appears to me to afford a double demonstration of their injurious effects."