As a yachtie, I raised and lowered quarantine flags punctiliously in new ports for years and woe betide any of us on the ocean sailing routes who did not observe, to the letter, the rules to protect borders against cholera, yellow fever and plague.
I’m also old enough to have a wired-in respect for not only the heart-breaking effects on farmers but also the rigour it takes to contain contagions like mad cow disease and of the brutal infectious diseases in hot-climate countries.
I was born in Malta – that sun-blasted rock in the middle of the Mediterranean about the size of Waiheke that has been a maritime linchpin in Western civilisation since the Phoenicians and where measures to prevent the introduction of infection were recorded 400 years ago.
A quarantine station was established first in Marsamxett Harbour and, after the foundation of Valletta in 1566, in Grand Harbour.
Regulations in those times required 40 days’ isolation for people and goods arriving from countries reported to be infected – that being the period of time then thought necessary for goods to become non-infectious by exposure to air and sunlight.
In 1643, the Knights Hospitaller of the Order of St John acquired Manoel Island in Marsamxett Harbour and built accommodation for the reception of patients and contacts – including the crowned heads of Europe and their retinues – when they came to their great medieval hospital on the headland between the two deep-water harbours.
The order’s still-mesmerising Sacra Infermeria was the foremost hospital of Europe at that time.
The astonishing architecture includes two vast halls 155 metres long; high, light, airy and opened onto a colonnaded cloister and what was then a walled orchard. Every well-spaced bed had a separate sanitation alcove. Flags still stir in the rafters and there are remnants of decoration and ancient pomp on the walls.
Forty days of quarantine at purpose-built and well-guarded Manoel Island was mandatory for king or commoner.
Quarantine is hard and fast separation of travellers arriving from countries of high-risk and, like Gordon Campbell in a Scoop comment this week, I believe we need a reset on our border procedures if we are to keep our edge against Covid in the face of a stream of arrivals from countries with rogue strains. Campbell suggests Waiouru or Ohakea military bases for purpose-built facilities that must be a more wholesome option for both those being accommodated and for taxpayers’ dollars.
We have all been disturbed by the numbers arriving, and that there have been so many positive Covid cases among them that chain hotels were never an ideal option. And it’s got less so. Air conditioning, lack of airy outdoor access and minimal room-space are obvious weaknesses. An apparent clamour for exemptions which weakens the rigour around exercise, basic and continued segregation of daily arrivals, inner city locations and perhaps a fundamental incompatibility of staff skills all argue against the necessary rigour and management protocols once secured by quarantine which went out of fashion 40 years ago.
The first international organisation for the control of infectious disease, the International Office of Public Health, was established early last century and remained until 1947, when it was absorbed into the World Health Organisation (WHO), together with the Health Organisation of the League of Nations. The International Sanitary Conventions were then replaced in 1952 by the WHO International Sanitary Regulations.
The speed and volume of international passenger traffic and the extent of air travel increased dramatically after World War II. Consequently, infected travellers could arrive from most parts of the world within the incubation period of the major infectious diseases. Furthermore, the enormous number of travellers made control measures at ports almost impossible, said WHO officials in 1968. The existing International Sanitary Regulations were no longer practicable and a new approach was needed.
The change, developed by the WHO, recognised that disease control by quarantine measures was “likely to be ineffective and might even give rise to a false sense of security”. Instead, the more active approach of epidemiological surveillance was introduced.
The more permissive International Health Regulations came into operation in 1971 and the control of imported communicable disease now depends primarily upon its early detection by epidemiological surveillance, swift control measures and the communication of information worldwide.
That was then. Ask anyone with family in the US, Britain or Brazil how well that is going now. The WHO is already getting criticised. The dogma is flawed, the virus is a jump ahead of us, international tourism is suspended indefinitely, vaccines are probably generating a false sense of security in officialdom and we have nothing to lose by being more thorough. • Liz Waters