Quarantine – not only about disease

Erlend Hem About the author
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The word quarantine was originally a medical term denoting the isolation of carriers of communicable diseases. Nowadays, the term in Norwegian is mainly used to describe completely different forms of exclusion.

Bjarne Håkon Hanssen withdrew from politics in 2009. He had six months of quarantine imposed on him and six months of restrictions on the cases he was allowed to handle (2). Photo: Dag W. Grundseth, Scanpix

When looking up the word quarantine in a modern Norwegian dictionary, we learn that this word has two meanings. One is «temporary isolation of (potential) carriers of communicable diseases», the other is «temporary exclusion from sports contests» (1). However, the term is also increasingly used for exclusion of people from other contexts, be it financial (bankruptcy quarantine) or about politicians who leave politics for business. One of the most widely publicised transfers of this kind occurred when Bjarne Håkon Hanssen, Minister of Health, jumped ship from politics after the elections to establish a communications agency (2).

Quarantine or waiting period?

In recent years, this type of transition has attracted a lot of attention, and a study of waiting periods and restrictions to be imposed on top-level civil servants and politicians who take other jobs was recently published (3). In his presentation of the report, Inge Lorange Backer, the commission’s chairman, stated that they had sought to avoid the term quarantine, since «this word may evoke associations with disease» (2). I frowned. Today, quarantine is only rarely used in a medical context, so what was the problem?

In its report, the commission devotes some space to terminology: «The term quarantine may communicate that the period should entail a «purification» and denote a distance in time between two different roles. It is nevertheless not completely befitting, since it may convey the impression that the politician is being isolated and barred from engagements in general and from accepting a new position. The commission therefore proposes to use another term, such as, for example, ‘waiting period’» (3).

In my opinion, this is far-fetched. In language, words often remain, even though their content may shift in pace with development (4).

Forty days

The oldest quarantine arrangements we know of date from the time after the Black Death at the end of the 14th century (5). Even though there has been perennial disagreement regarding the benefits of quarantine and its duration (5), this nevertheless remained an important measure to contain the spread of communicable diseases in Europe for more than 500 years (6). The Act relating to control of communicable diseases still contains provisions for quarantine, although Aavitsland already 15 years ago concluded that «in light of new knowledge about contagion, quarantine often appears to be irrelevant» (6).

The word quarantine is derived from the Italian quarantina (7). It reoccurs in several European languages: karantän (Swedish), karantæne (Danish), quarantine (English), quarantaine (French), Quarantäne (German), cuarentena (Spanish) etc. In Italian, quaranta means the number 40, and in the first provisions the exclusion lasted for 40 days (5). But where do these 40 days come from? Nobody knows for certain. Some claim that people knew that the incubation period for most communicable diseases would fall within a forty-day period (8), but we cannot tell whether this limit was chosen at random or had an empirical basis (9). Most likely, its background was as much religious as medical (10). Strangely enough, it appears that the quarantine originally lasted for 30 days, in Italian trentina (11).

The number 40 has occupied a special position in religion, tradition and culture (12). Moses wandered for 40 years through the desert, the fast could last for 40 days and Ali Baba was surrounded by 40 thieves. 40 was also one of the critical days in the Hippocratic texts (13), in perinatal care in many cultures (14) etc. Most likely, quarantine was pegged to a well-established number when insights and needs regarding prevention of epidemics arose (Torvid Kiserud, personal communication).

Conclusion

Some of the first measures introduced by public health authorities in Norway included provisions for quarantine and isolation as protection against the plague. Now, the term is used far more often in other contexts. There is no reason why it cannot be used when politicians go on to new jobs.

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