Quarantine, a method that has its origins in the medieval times, perhaps, continues to be an effective public health strategy to control the spread of infectious diseases.
The term comes from Italian quanta and means forty (days). The term created panic and social stigma in the medieval times as a plague during the time decimated populations in flourishing cities like Florentine and Venice.
In modern times, with more knowledge about microbes and how they behave and cause diseases, the strategy has proved good globally to control new and emerging infectious diseases that spread from humans to humans.
In Kerala, the strategy had been effective earlier in controlling Nipah infection and now the novel coronavirus infection, both zoonotic diseases, with no known drug, except symptomatic treatment.
The new world has adopted the World Health Organisation guidelines for quarantine, though these measures are often debated and face the risk of people shunning them as they curtail individual rights and employ intrusive methods. However, experts opine that when public health is in danger, persons are to be placed under quarantine even though they show no symptoms, considering that the disease might manifest during the incubation period. During the period, a person’s movements in public space is limited so that he or she does not put the rest of the community at risk. Lack of information from the country of origin was a limiting factor in our knowledge about nCoV, said G.S. Praveen, Assistant Professor, Community Medicine, Government Medical College, Ernakulam.
Medical professionals from various countries and the WHO indicated an average incubation period of 14 days for nCoV, which was said to be spread through droplet discharge — direct or indirect contact. Incubation period was the time taken by the virus to show symptoms of disease in a person. Two methods of keeping infection under control was to place healthy people with risky circumstances under quarantine and moving people with symptoms to isolation in a hospital environment.
Given the unknown nature of the virus, double the incubation period has been decided as quarantine period. The quarantine period could be revised if and when there was more data available from virologists studying the disease.
For any public health strategy to be a success, it needed to be shared with the public so that quarantine became a voluntary act, said a public health expert.
People’s compliance with the directive, sacrificing their own comfort, would make the strategy successful. In case of Nipah, fear factor kept people away from the city of origin of the infection. The Health Department had worked overtime to trace the contacts and take protective measures and this helped in containing the infection. With such a precedent, the health team got into action to face nCoV with a definite action plan and appealed to people with a travel history to China for voluntary quarantine.
Health department representatives call everyone under quarantine twice a day and provide counselling and support for their needs.