In January 2020, just a few days before the first Covid-19-infected passengers landed in the United States on a flight from Wuhan, preparations were already being made in a converted car park in Omaha, Nebraska. By complete coincidence, after a decade of planning, the country’s first National Quarantine Unit opened its doors here on the eve of a global pandemic.
The timing couldn’t have been better. The need for such a place had been mooted ever since 9/11, followed by a series of anthrax attacks and Sars, all of which had raised fears in Congress over the prospect of bioterrorism and the increasing global threat of infectious diseases. Located roughly equidistant from both coasts, the city of Omaha declared itself to be the ideal place for isolating people potentially infected with deadly contagions, and received almost $20m from the US department of health to establish a state-of-the-art federal quarantine facility. Featuring negative-pressure en suite rooms kitted out with mini-fridges, TVs and exercise bikes, it was like a high-security, wipe-clean hotel. There was only one problem: it had just 20 beds.
When Geoff Manaugh and Nicola Twilley visited the facility under construction in 2019, its jovial director was optimistic about the scale. “We’ve gotten by for ever without any federal quarantine facility,” Ted Cieslak told them. “My gut feeling is, yes, it’s enough.” There just aren’t that many deadly diseases that are contagious and potentially transmissible before they cause symptoms to justify quarantine, he explained. A few days later, hundreds of people possibly infected with a novel coronavirus landed in the US from China and, soon, the whole country was in lockdown. Cieslak’s unit did eventually host some passengers from the Diamond Princess cruise ship, who had tested positive for Covid-19, but it was a droplet in a worldwide tsunami.
The fate of the Omaha facility is one of many striking stories in Manaugh and Twilley’s recent book, Until Proven Safe: The History and Future of Quarantine, which reads like a global safari of humanity’s best-laid plans being never quite enough. Just like the converted car park, their book has been a decade in the making, and has come out at an opportune time. Since the duo put on an exhibition, Landscapes of Quarantine, at the Storefront gallery in New York in 2010, they have toured 15th-century plague hospitals in Venice, descended into a salt mine used for storing nuclear waste in New Mexico, infiltrated the cleanest rooms in Nasa, and tracked down all manner of eccentric characters quietly engaged in personal quests to keep the planet safe.
They are well-placed to tell the tale, weaving the spatial, social and scientific facets of medical isolation into an entertaining adventure. Manaugh built a reputation for unearthing unlikely stories with Bldgblog a blog that gained a cult following in the 2000s for its sideways look at architecture, examining the built environment through the lenses of geology, crime, sci-fi, warfare and acoustics, among many other curious niches. Twilley took an equally original approach to the culture, science and landscapes of food on her Edible Geography blog and, more recently, as co-host of the Gastropod podcast. Their voracious interests mean the book leaps around somewhat, reading a bit like a collection of articles from the New Yorker (to which they both contribute); but the format also allows the reader to dip in and out as they please and make their own connections.
The intrepid duo begin by tracing the footsteps of John Howard, the eccentric 18th-century English prison reformer, who also took a keen interest in Europe’s network of lazarettos, or quarantine stations – a health infrastructure that, at the time, was entirely lacking in Britain. He was eager to experience the conditions of quarantine first-hand, so he intentionally boarded a ship with “a foul bill of health” and took the two-month voyage from Smyrna (present day İzmir, on the west coast of Turkey) to Venice, risking contracting an incurable illness along the way. His prize on arriving in Venice? “A very dirty room, full of vermin, and without table, chair, or bed,” he wrote. His overall verdict on the management of Venetian lazarettos was that “there is such remissness and corruption in executing [the] regulations, as to render the quarantine almost useless”.
Elsewhere, in a familiar echo of the recent rush to erect Covid-19 hospitals – many of which were never really used – the authors visit ambitious facilities that were either abandoned before completion or finished long after the threat had subsided. Ancona’s impressive lazaretto, for example, was designed as a pentagonal panopticon on an artificial island, but by the time it opened in 1743, the plague had long been over.
The Waste Isolation Pilot Plant in New Mexico seems like a similarly questionable endeavour, given that those in charge of the facility are dealing with a quarantine timeline of at least 10,000 years. Originally planned in 1979, it took another two decades of construction before the half-mile-deep salt mine began receiving its first shipment of nuclear waste – things such as clothing, tools, rags and soil that had been contaminated during the production of nuclear weapons. The plan is that, by 2033, the facility will be full (with enough waste to fill 100 basketball courts), at which point it will be permanently sealed, and the salt left to collapse around the containers, forming a crystalline tomb. The challenge of how to warn future generations of the dangers of what lies below remains ongoing. One suggestion, from the 1980s, is to establish an “atomic priesthood” to cultivate new folklore and superstitions extolling the radioactive horrors beneath the ground. Others have suggested a “landscape of thorns” – 50ftconcrete spikes that would make anyone flee in terror. Both would surely make any future archaeologist keener than ever to start digging.
A chapter on the travails of inter-planetary quarantine is equally surreal. Manaugh and Twilley get inside Nasa, where they meet a woman with the unenviable job title of Planetary Protection Officer. Her role is to guard the entire universe from human contamination – protecting “all the planets, all the time”, as international planetary protection policy puts it. As the authors write, her job is “the impossible art of modelling risk when your data is nonexistent but the stakes are existential”. It basically comes down to making sure that anything we send into space is very, very clean – decontaminated, baked and sanitised until any trace of territorial biochemistry is eliminated. All of which seems slightly futile, when people like Elon Musk then send an unsterilised Tesla into orbit. One grim quarantine detail to emerge from the original Apollo 11 mission to the moon is that, if the astronauts had returned contaminated with an alien contagion, the plan was to bury them alive under a mountain of concrete.
The authors’ other forays include meeting a group devoted to studying disinfected mail and visiting a greenhouse dedicated to protecting the world’s chocolate supply, but it is the final, future-focused chapter that is one of the most alarming. As we have recently witnessed, pandemics provide governments with the opportunity to debut programmes of tracking and confinement that would normally seem ethically unacceptable. The authors imagine a future where smart buildings and connected devices mean that we can be monitored and diagnosed all the time, informing the environment to respond accordingly. “At any moment, at the flip of a switch, your world will simply go into quarantine mode.” Running a high temperature and Googling certain symptoms? Your internet-connected home might simply lock you indoors.