Venetians Invented Quarantine in 1348 and They Managed It Better than We Do Today
Even with No Clue About Contagion
On March 20, 1348, the Venetian Republic invented quarantine.
In the 14th century, it was routine for large merchant ships to come and go into Venice, Italy. Venice had built its Republic as a trading economy, and Venetians were the most successful global traders on earth at that time. They were not out to claim land, only ports for purchasing “exotic” goods such as salt, spices, and silk cloth and then transporting everything to some other port. The ships also sometimes sailed home to the bustling markets of the city and the option of taking good to trade fairs across Europe. Because of its trading fever, this unusual water-bound republic also became a hub for social interaction among travelers from all over the world.
Venice was a cosmopolitan place.
That economic mercantile success also came with a cost. Because of the comings and goings of ships from all over the world, Venice was an epicenter for disease transmission. This was a time before anyone had conceived of a germ theory of contagion (that was first proposed in 1546 by Venetian physician Girolamo Fracastoro) before there was any sort of explanatory science of pathology, epidemiology, microbiology, or infectious disease. But when travel and trade are your lifeblood, it doesn’t take a genius to see that the arrival of a ship often preceded the outbreak of the plague.
As a small, iconoclastic, and well-run city, Venice also had the governmental infrastructure to act. At first, suspecting that disease rode in on a foul miasma of air that hovered over ships, they placed a thirty-day hold on any vessels entering the Venetian lagoon in 1348. The ships, crew, passengers, and everything on board had to just remain there for a month. Who knows why they chose 30 days, but in 1403 that law was extended to 40 days, or quaranta in Veneziano, the language of Venice, and in Italian, from which we get the English word “quarantine.”
Venice opened the first of three “plague islands” in 1423 by conscripting a nearby islet from an order of nuns and building a massive complex to house those showing signs of disease as well as the doctors and caretakers necessary to tend the dying and dead. The name of the island was changed from Santa Maria Nazaret (Saint Mary of Nazareth) to Lazaretto presumably referring to Lazarus. The island is easily seen today by standing on the southeast shore of the city and looking across the water. A high brick wall circumvents the island and gives it the look of a floating prison; if you didn’t know what it was, you might wonder, especially given the openness and beauty of the city at your back. But on two weeks every September, it’s possible to take a small boat from the Lido across from Venice and have a guided tour of the six restored compounds and the administration building of what is now known as Lazaretto Vecchio (old lazaretto). There are carved inscriptions by bored patients on some of the building stones and messages from the past in red ocher scribbled on the walls. Walking through the vast brick now empty compounds with light from the lagoon streaming in through windows punctured in the outside walls makes it easy to imagine daily life here, including the pain and sorrow of gazing longingly at Venice while quietly dying. And even with death, those victims would not leave. Their bodies are interred here as well.
In 1456, Venice upped its quarantine game by taking over another island, called Lazaretto Nuovo (new lazaretto) and turning it into a holding facility for those exposed to the plague but not showing any signs, yet. That island was part of a comprehensive public health plan laid out to protect the city from itself, as well as others. It began with the first-ever active “maritime cordon.” Ships carrying plague had to signal with a flag as they entered the lagoon and there was always someone up the bell tower in Piazza San Marco watching for these flags. A small boat then rowed out to the ship and collected the captain who was interviewed through a glassed-in window in the offices of the health department in the city. He had to prove that the ship was free of disease and receive a bill of good health, otherwise, everything and everyone was “quarantined” on Lazaretto Nuovo for 40 days. Turning inward, any Venetian citizen with a sick family member was also forced to move with all their goods to Lazaretto Nuovo for the same 40 days until they either came down with plague or were spared.
That second Lazaretto lies off the northeast of Venice and it’s a longer boat ride away from central Venice than Lazaretto Vecchio. There, each sequestered individual or family had a small private compound with a garden; all the passengers and crew from one ship were housed adjacent to each other in a section that had a private chapel. This housing plan made sure there was no mixing among different ships or between Venetian citizens and those arriving by boat. Every day an on-sight doctor checked every person, even passengers who had been on ships with no signs of disease. If those signs appeared, the victims were moved to Lazaretto Vecchio but if not, they were released at the end of the 40-day quarantine.
Today, Lazaretto Nuovo is open on weekends in summer for guided tours. The main attraction is the Tezon Grande, a restored and massive building which was the storehouse for the piles of offloaded personal and trade goods. In this building, Venetians also tried to kill whatever it was with smoke fires laced with herbs, berries, and resinous woods. Health workers also made bonfires with those mountains of trade goods and set them alight which was like burning money. Lists of these disembarked goods and who they belonged to decorate the walls of the Tezon Grande and they graphically demonstrate how well this early public health policy was organized and run.
It’s impossible to know how many lives were saved by these initial Venetian steps to stop contagion, but we know now, with centuries of battling quickly spreading diseases under our collective belts, that quarantine is the most effective way to stop a pandemic. We are also lucky enough at this point to understand contagion, parasites, and viruses, and able sometimes to halt further outbreaks with vaccines. But the first line of defense today is the same one Venetians used 672 years ago — isolate the people carrying the germs, give the disease no more hosts, and there is nowhere for the virus to go and it dies out.
Today, the offloading of confirmed cases of COVID-19 and those exposed to the virus from cruise ships, letting people go home without proper testing, the insistence of governments such as the United State in repatriating exposed citizens (even in the face of C.D.C. warnings), and allowing anyone from the infected epicenter into other countries simply empowers the virus and opens up many possible paths for it to spread globally.
We know better. Even Venetians in the 14th century knew better. Just because we have airplanes and cruise ships doesn’t mean we can’t learn from Medieval public health policy that has, over centuries, saved millions of lives.
