– Using a Tactic Unseen in a Century, Countries Cordon Off Ebola-Racked Areas (The New York Times, Aug 12, 2014):
The Ebola outbreak in West Africa is so out of control that governments there have revived a disease-fighting tactic not used in nearly a century: the “cordon sanitaire,” in which a line is drawn around the infected area and no one is allowed out.
Cordons, common in the medieval era of the Black Death, have not been seen since the border between Poland and Russia was closed in 1918 to stop typhus from spreading west. They have the potential to become brutal and inhumane. Centuries ago, in their most extreme form, everyone within the boundaries was left to die or survive, until the outbreak ended.
Troops began closing internal roads in Liberia and Sierra Leone last week. The epidemic began in southern Guinea in December, but new cases there have slowed to a trickle. In the other two countries, the number of new cases is still rapidly rising. As of Monday, the region had seen 1,848 cases and 1,013 deaths, according to the World Health Organization, although many experts think that the real count is much higher because families in remote villages are avoiding hospitals and hiding victims.
Officials at the health organization and the Centers for Disease Control and Prevention, which have experts advising the countries, say the tactic could help contain the outbreak but want to see it used humanely.
“It might work,” said Dr. Martin S. Cetron, the disease center’s chief quarantine expert. “But it has a lot of potential to go poorly if it’s not done with an ethical approach. Just letting the disease burn out and considering that the price of controlling it — we don’t live in that era anymore. And as soon as cases are under control, one should dial back the restrictions.”
Experts said that any cordon must let food, water and medical care reach those inside, and that the trust of inhabitants must be won through communication with their leaders.
The phrase cordon sanitaire, or sanitary barrier, appears to date from 1821, when France sent 30,000 troops into the Pyrenees to stop a lethal fever raging in Spain from crossing the border.
In Sierra Leone, large sections of the Kailahun and Kenema districts, an area the size of Jamaica, have been cut off by military roadblocks. Soldiers check the credentials and take the temperatures of those trying to go in or out. In Liberia, similar restrictions have been imposed north of the capital, Monrovia.