13 ms·

A 432-year-old manual on social distancing

166 points by Thevet 6y ago

anoncake 6y ago
> 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.
- TT3351 6y ago
  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?
  - anoncake 6y ago
    No, it just means they are rarely worth it.
  - war1025 6y ago
    > 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.
    - sellyme 6y ago
      > 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.
      - war1025 6y ago
        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.
  - scoot 6y ago
    No, just worth less.
  - bpodgursky 6y ago
    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-hospitalization-rates-dropping/ https://www.washingtonpost.com/outlook/2020/12/07/covid-hosp...
    - toast0 6y ago
      When hospitalization rates are above capacity, it's pretty hard to argue doing less would have gotten better results.
      - bpodgursky 6y ago
        For sure, I'm just saying there are plagues, and then there are plagues.
JacobiX 6y ago
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.”
- asdff 6y ago
  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.
  - war1025 6y 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"
    - Timpy 6y ago
      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.
      - JoeyBananas 6y ago
        conclusion: this is a very contrived comparison
    - tim333 6y ago
      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.
dddddaviddddd 6y ago
Link to the original, in Latin and Italian (starts page 26): http://bdh-rd.bne.es/viewer.vm?id=0000056943 http://bdh-rd.bne.es/viewer.vm?id=0000056943 If I understand correctly, the manual's step 1 is to pray for mercy.
- schoen 6y ago
  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=PA99#v=onepage&q&f=false 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!
  - Bayart 6y ago
    It is Catalan. Alghero was and is a Catalan-speaking town.
spodek 6y ago
> 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.
m0llusk 6y ago
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.
- GoOnThenDoTell 6y ago
  Do you have some sources
  - cthaeh 6y ago
    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-pandemics-according-to-legendary-epidemiologist-and-smallpox-eradicator-donald-henderson/ 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/PIIS0140-6736(20)31422-7/fulltext?dgcid=raven_jbs_etoc_email&fbclid=IwAR1-5xn77qdOXm4AdEMm5xdNfjnFIIdMpsDNW8_t0XAQXoZQ_wMXno-1sxo https://www.thelancet.com/journals/lancet/article/PIIS0140-6... https://www.washingtonpost.com/world/middle_east/virus-linked-hunger-tied-to-10000-child-deaths-each-month/2020/07/27/84d349ca-d059-11ea-826b-cc394d824e35_story.html https://www.washingtonpost.com/world/middle_east/virus-linke... https://macdonaldlaurier.ca/files/pdf/20201209_Rethinking_lockdowns_Joffe_COMMENTARY_FWeb.pdf https://macdonaldlaurier.ca/files/pdf/20201209_Rethinking_lo...

166 points by Thevet 6y ago

> 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.

TT3351 6y ago
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?
- anoncake 6y ago
  No, it just means they are rarely worth it.
- war1025 6y ago
  > 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.
  - sellyme 6y ago
    > 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.
    - war1025 6y ago
      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.
- scoot 6y ago
  No, just worth less.
- bpodgursky 6y ago
  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-hospitalization-rates-dropping/ https://www.washingtonpost.com/outlook/2020/12/07/covid-hosp...
  - toast0 6y ago
    When hospitalization rates are above capacity, it's pretty hard to argue doing less would have gotten better results.
    - bpodgursky 6y ago
      For sure, I'm just saying there are plagues, and then there are plagues.

JacobiX 6y ago

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.”

asdff 6y ago
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.
- war1025 6y 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"
  - Timpy 6y ago
    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.
    - JoeyBananas 6y ago
      conclusion: this is a very contrived comparison
  - tim333 6y ago
    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.

dddddaviddddd 6y ago

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

schoen 6y ago
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=PA99#v=onepage&q&f=false 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!
- Bayart 6y ago
  It is Catalan. Alghero was and is a Catalan-speaking town.

spodek 6y ago

> 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.

m0llusk 6y ago

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.

GoOnThenDoTell 6y ago
Do you have some sources
- cthaeh 6y ago
  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-pandemics-according-to-legendary-epidemiologist-and-smallpox-eradicator-donald-henderson/ 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/PIIS0140-6736(20)31422-7/fulltext?dgcid=raven_jbs_etoc_email&fbclid=IwAR1-5xn77qdOXm4AdEMm5xdNfjnFIIdMpsDNW8_t0XAQXoZQ_wMXno-1sxo https://www.thelancet.com/journals/lancet/article/PIIS0140-6... https://www.washingtonpost.com/world/middle_east/virus-linked-hunger-tied-to-10000-child-deaths-each-month/2020/07/27/84d349ca-d059-11ea-826b-cc394d824e35_story.html https://www.washingtonpost.com/world/middle_east/virus-linke... https://macdonaldlaurier.ca/files/pdf/20201209_Rethinking_lockdowns_Joffe_COMMENTARY_FWeb.pdf https://macdonaldlaurier.ca/files/pdf/20201209_Rethinking_lo...