A 432-year-old manual on social distancing | Hacker News Reader

A 432-year-old manual on social distancing

bbc.com

166 pointsThevet45 comments

It should be noted that social distancing is an ancient practice even before 1500. For example before 1400 years back, the Persian Islamic scholar Muhammad al-Bukhari recorded the following 7th-century hadith : “If you hear of an outbreak of plague in a land, do not enter it; but if the plague breaks out in a place while you are in it, do not leave that place.”

Quarantine is nothing new. The medieval trading republic of Ragusa had an island in their harbor specifically for quarantining new arrivals. It’s a shame that people even contest the logic today when wholly uneducated people were fine with it hundreds of years ago.

There is a difference between "Quarantine when you cross a border" and "Shut down all commerce and tell people they can't leave their homes for months on end"

There's a difference between the death rates in those plagues and this pandemic, too. There's a difference in the amount of information we have compared to Ragusa. There's a difference between how globally connected the world was then. There's a difference in the technology we have now that allows us to continue to facilitate some sort of economy from our homes.

conclusion: this is a very contrived comparison

Indeed lockdown and quarantine are different things. The countries that have had proper quarantine eg Vietnam, NZ, Thailand have mostly done rather better with covid than those who have not eg. the UK and USA.

Quarantine when you cross a border requires a meaningful border.

Had governments actually shut down all commerce and told people they can't leave their homes, this would have been over in a month.

True. But I mention this to my fellow Canadians and they have very little interest when I say it (I live in Vietnam currently). And yet at the moment they are going through the worst lockdown I've heard of: curfew at 8pm and lifted at 5am. Unheard of. Surely if they thought about it, they would have preferred to have closed the borders and waited it out. That's what COVID successful Asian countries have done.

> this would have been over in a month

Yea. Because everyone would have starved to death.

I believe they had a quarantine island in Marseilles. In one instance lack of observation of this by a trading ship led to an outbreak of the plague in southern France.

Indeed rich merchants lobbied for skipping the quarantine for a ship carrying stocks of cloth. When the plague broke out they ran away, something like 30% of people in Marseille died

TBH harbor-based city states that are similar to old Ragusa (Singapore, Hong Kong) did quite well in Covid pandemics as well.

Big continental empires were always the ones to be most vulnerable.

Yep - the word quarantine itself comes from the Italian "quaranta giorni" (forty days). This was the amount of time that ships arriving in Venice from infected ports were required to sit at anchor before landing, so as not to infect the Venetians.

Ibn Sina (Avicenna) wrote in his medical encyclopedia published in 1025 to isolate for 40 days (Al-Arba'iniyah in Arabic) to prevent the spread of certain diseases. According to some this is where the Italian word was translated from.

Yep. Republic of Ragusa, is present-day Dubrovnik, Croatia (not Ragusa, Italy).

Republic of Ragusa was the first official place in the world to issue a decree for quarantine.

More info about it is here: https://www.amusingplanet.com/2020/03/the-quarantine-quarter...

Also, the pictures of Dubrovnik do not do it justice. The walled old town is incredible on a sunny day. For some reason, if you view Dubrovnik’s old town (stari grad) on Google Earth on a VR headset, the rendering of the walled old town is very messed up, as in flat as a pancake.

It is quite hilly! Walking the walls is a hike. I was there 10 years ago, and it was surprising just how much of that country remained scarred from the war in the 90s. Especially in the countryside it was common to see shot up old concrete buildings. Painful reminders, but a lovely country where even middle class travelers like myself could afford to eat excellent fresh local seafood and wine with every meal, and it was lovely to have my cousins from Bosnia stop by for a day in Dubrovnik.

> It’s a shame that people even contest the logic today when wholly uneducated people were fine with it hundreds of years ago.

I'm not familiar with that place's history. Are we really sure that (a) that people was uneducated, and (b) all of them were okay with that policy?

Academically uneducated, yes. Intimately familiar with deadly and disfiguring pathogens, yes.

Younger generations in developed countries today are wholly unfamiliar with how destructive an unrestrained pathogen can be.

People are approaching retirement without being able to remember polio, smallpox, tuberculosis or tetanus being endemic.

I suppose younger generations haven't seen measles, mumps, rubella or hepatitis either, but it's not just the young who have little familiarity with pathogens.

Yeah, I was thinking younger as in not geriatric. Im middle aged anybody my parents age and younger hasnt witnessed first hand the hell pathogens can bring.

There's a difference between "quarantine maybe sick people who come from outside" and "quarantine the general population including healthy individuals"

Social distancing is a modern mantra/meme meaning "stay 6 feet apart from others". I wouldn't call it an ancient practice.

"Next up was the six-foot-rule, in which Angelerio instructed that – as translated by Benedictow's team – "People allowed to go out must bear with them a cane measuring six feet long. It is mandatory that people keep this distance from one another."

"And Angelerio went further. He also specified that a large rail, or parabonda, should be added to the counters at shops in which foods are sold, to encourage people to keep their distance – and recommended that, during mass, people should be careful when shaking hands."

Sounds like social distancing to me.

True, but the original comment was quoting something that referred to quarantining and equating it with social distancing. Even if the original medieval author did explicitly endorse a six-foot rule, that original comment was wrong to blur the difference, and the parent was correct to call it out.

Link to the original, in Latin and Italian (starts page 26): http://bdh-rd.bne.es/viewer.vm?id=0000056943 If I understand correctly, the manual's step 1 is to pray for mercy.

This looks much more like Catalan than either Latin or Italian to me.

I was having a little trouble reading the handwriting, so I searched for a few of the words and found a printed text in Google Books [https://books.google.com/books?id=Sw9C_I_5h9YC&pg=PA99&lpg=P...] that includes a complete transcription (with some accentuation and punctuation modernized). That first paragraph is

> Primerament, a tal que Nostre Señor Déu sia servit haver misericòrdia y aplacar la yra de sa justa indignatió que té sobre la dita ciutat, procuraran los habitadors de aquella de emplear-se en fer dejunis, almoines, vots y exercitar-se en obres pies.

Thinking of this as Catalan, it should mean something like

> First, so that Our Lord God may be pleased to have mercy and assuage the wrath of his just indignation that he has against the said city, its inhabitants will try to employ themselves in making fasts, alms, vows, and engaging in pious works.

Google Translate can also interpret most of it as Catalan, so I'm gaining confidence in my Catalan theory!

It is Catalan. Alghero was and is a Catalan-speaking town.

> In the days before smartphones, streaming services, or even affordable books, people innovated ways to get around the total boredom of being confined to the house.

I suspect smartphones and streaming services lessen our ability to handle solitude and make us feel more miserable.

Lockdowns have been rejected by modern epidemiology for around a hundred years. The problem is that fast spreading contagions hop any bounds, so what you need are methods of minimizing infection while allowing people go to about their business. Social media driven ignorance is no excuse for embracing anti science methodologies.

Now we know that Vitamin D is critical to immune system function and that mucus membranes can be extremely effective barriers as long as they are kept moist, but people would rather bicker about masks than think about the full range of methods for countering contagion.

Do you have some sources

Heres polio eradicator Donald Hendersons influenza control guideline:

"Experience has shown that communities faced with epidemics or other adverse events respond best and with the least anxiety when the normal social functioning of the community is least disrupted. Strong political and public health leadership to provide reassurance and to ensure that needed medical care services are provided are critical elements. If either is seen to be less than optimal, a manageable epidemic could move toward catastrophe."

https://www.aier.org/article/how-a-free-society-deals-with-p...

There are issues with the paper- its 15 years out dated and influenza != covid, but the paper is still useful. Also interestingly enough, the paper also mentions the non-effectiveness of masks (Non N95 ones at least), which was likely why masks were not heavily pushed at the start of the pandemic.

Overall from what I have read, lockdown as we implemented is a solely 2020 idea. We are essentially running the grandest science experiment ever, with both our lives and our happiness.

Its consequences; we are only beginning to understand, and it may very well be true that the "solution" for covid is far worse than the virus itself. See:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

https://www.washingtonpost.com/world/middle_east/virus-linke...

https://macdonaldlaurier.ca/files/pdf/20201209_Rethinking_lo...

You say you need "methods of minimizing infection while allowing people go to about their business". Don't masks do exactly that?

> In reality, it's thought that the epidemic killed 60% of the city's population.

Yes, that is the kind of epidemic for which social isolation is an appropriate response.

432 years ago we didn't have nearly the scientific medical knowledge we do today; one might expect all outbreaks of disease to have vastly improved outcomes today than 430 years ago. Does that make further mitigation efforts worthless?

No, it just means they are rarely worth it.

> Does that make further mitigation efforts worthless?

Mitigation efforts are certainly worthwhile, but there are significant diminishing returns.

I would guess that 80/20 rule applies to mitigation efforts just as much as anything else. The vast majority of protection is provided by a fairly minimal set of precautions.

I think we see this borne out in the data. The places with the strictest lockdowns are doing better than the places with fewer restrictions. However, the numbers aren't so night and day different as to suggest that those additional lockdowns have been worth the price.

One thing I've wondered is how many "odd" social customs in various cultures (no singing / dancing, face coverings, etc.) could actually be explained by past epidemics. We've certainly adopted many of those restrictions in short order.

> I think we see this borne out in the data. The places with the strictest lockdowns are doing better than the places with fewer restrictions. However, the numbers aren't so night and day different as to suggest that those additional lockdowns have been worth the price.

This is complicated by the fact that the places who were willing to be the most strict would have enacted policies much earlier, and thus didn't actually need to be very strict.

I live in South Australia, where we've been extremely proactive in quarantining new arrivals since the start of the pandemic. We've only had two outbreaks ("outbreak" here meaning literally any locally-acquired cases) since March - the first one was ten cases over the course of about three weeks, during which we shut down almost every non-essential business and imposed very harsh maximum occupancy limits on essential ones. The second outbreak was ~30 cases, and we entered an immediate 6 day "stage 4" lockdown (that ended up only being 3 days) almost immediately after we found the first bulk of those cases.

Those measures are far more stringent than almost anywhere else in the world - the lockdown implemented at 18 local cases in November didn't even allow going outside to exercise, something places with thousands or even hundreds of thousands of cases allowed - but it means that we only had to lock down for 3 days in the entirety of 2021, and it means that for the majority of the last year our lives have been completely normal.

My experience has been that the speed at which you react to an outbreak is far more important than how strict you are in reacting to it, as long as you meet some minimum threshold of responsibility. Our initial outbreak in March was completely eradicated just by social distancing, enforcing maximum occupancy requirements, and working from home where possible. It's fine to have relatively loose restrictions as long as you're willing to ramp them up drastically the same day you find more cases than you expected.

I think Coronavirus is best thought of as a cancer.

It was easy to get under control in China. That was where it originated. It was centralized and easy to surgically target.

The spread to Europe and later the Americas was basically the virus metastasizing. Once something metastasizes, there is very little that can be done besides very heavy handed approaches that harm the surroundings as much as the thing you are trying to remove. That's basically lockdowns. And even when you make the largest effort you can manage, it is very often still not enough.

The reason island nations have been so successful is they by definition have strict borders, which means you can catch the virus before it has a chance to spread out to the point that you can never contain it again.

Coronavirus was beyond containment in the Western world by April.

Thankfully, we've learned that it's a much less deadly virus than initial impressions suggested.

I agree that initially, when the danger posed was unknown, a quick and temporary lockdown was justifiable. And indeed, you seem to be describing a sounder response taken in AU, overall.

However, somewhat in defense of the OP, now that we have a good idea of who is vulnerable, as well as the enormous relative health, social, economic, and personal costs that the lockdown has caused to many who don't have the luxury of a desk job, the claim that the lockdown is no longer justified (and hasn't been for some time) is very justifiable. Sadly, incompetence and political maneuvering have taken center stage.

This is not just true for epidemics. When reacting to any sort of situation, often the speed with which you react is much more important than just about anything else. You can always adjust later, especially if your adjustments are also done with alacrity.

https://en.wikipedia.org/wiki/OODA_loop

No, just worth less.

Sure, to a degree, but when hospitalization rates are < 5%[1], it's pretty hard to argue that medical science is preventing a 60% death rate.

[1] https://www.washingtonpost.com/outlook/2020/12/07/covid-hosp...

When hospitalization rates are above capacity, it's pretty hard to argue doing less would have gotten better results.

For sure, I'm just saying there are plagues, and then there are plagues.

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