Until Proven Safe

Until Proven Safe: The History and Future of Quarantine
by Geoff Manaugh and Nicola Twilley
MCD × FSG, July 2021

Hardcover | 5-3/4 x 8-1/2 inches | 416 pages | English | ISBN: 9780374126582 | $28.00


Quarantine is our most powerful response to uncertainty: it means waiting to see if something hidden inside us will be revealed. It is also one of our most dangerous, operating through an assumption of guilt. In quarantine, we are considered infectious until proven safe.

Until Proven Safe tracks the history and future of quarantine around the globe, chasing the story of emergency isolation through time and space—from the crumbling lazarettos of the Mediterranean, built to contain the Black Death, to an experimental Ebola unit in London, and from the hallways of the CDC to closed-door simulations where pharmaceutical execs and epidemiologists prepare for the outbreak of a novel coronavirus.

But the story of quarantine ranges far beyond the history of medical isolation. In Until Proven Safe, the authors tour a nuclear-waste isolation facility beneath the New Mexican desert, see plants stricken with a disease that threatens the world’s wheat supply, and meet NASA’s Planetary Protection Officer, tasked with saving Earth from extraterrestrial infections. They also introduce us to the corporate tech giants hoping to revolutionize quarantine through surveillance and algorithmic prediction. 

Geoff Manaugh and Nicola Twilley have been researching quarantine since long before the COVID-19 pandemic. With Until Proven Safe, they bring us a book as compelling as it is definitive, not only urgent reading for social-distanced times but also an up-to-the-minute investigation of the interplay of forces–––biological, political, technological––that shape our modern world. The result is part travelogue, part intellectual history, an exhaustively researched trip that could not be more urgent or timely—and a book as compelling as it is definitive.

Geoff Manaugh is the founder of BLDGBLOG, one of the most popular architecture sites on the Web. Nicola Twilley is co-host of the award-winning podcast Gastropod, which looks at food through the lens of history and science, and an award-winning contributor to The New Yorker. She lives in Los Angeles.


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Back in November, architecture and design critic Edwin Heathcote rounded up the "Best books of 2021: Architecture and design" at the Financial Times, putting Geoff Manaugh and Nicola Twilley's book about quarantine alongside books about life on outer space, architect Sigurd Lewerentz, neoliberalism in architecture, and London pubs. Overall, what struck me about the list was the way the majority of the titles appeared to skirt architecture and design, with the monograph on Lewerentz and Douglas Spencer's Critique of Architecture firmly within the bounds of architecture but the other three books more on the field's margins. I don't see a problem with this, per se, but I do find the list encapsulating how numerous authors today view architecture and design well beyond the bounds of disciplines; humanity's impact on the built environment — both terrestrial and beyond — is what's considered to be architectural, not necessarily the work produced by architects.

Even though Until Proven Safe covers aspects of quarantine — a subject now familiar to billions given COVID-19 — that are scientific, technological, historical, and political, as well as spatial, contemporary architecture does enter the picture, in the form of the National Bio and Agro-Defense Facility (NBAF) in Manhattan, Kansas. The new federal facility is located on the campus of Kansas State University, which happens to be my alma mater, though it is at a bit of a remove from the main campus that I traversed in architecture school decades ago. This distance (about a mile and a half) makes some sense, given that the NBAF was created to meet Biosafety Level 4, the highest level of containment for pathogens. As Manaugh and Twilley quote the CDC: BSL-4 microbes are "dangerous and exotic, posing a high risk of aerosol-transmitted infections." Ebola is one such pathogen — not something students want to be near on any regular basis.

Manaugh and Twilley, carrying out most of their research and travels for the book before COVID-19 entered the global picture, traveled to the "Little Apple" (yes, Manhattan, KS calls itself that) and spoke with Ron Trewyn, a former cancer researcher responsible for bringing the BSL-4 lab to KSU, and Eugene Cole, an architect who spent fifteen years working at the Department of Homeland Security as NBAF Program Technical Director. The authors did not speak with (or did not quote, at least) any architects at Perkins & Will or Flad Architects, the firms that collaborated on the project, which is documented in renderings on their respective websites but appears to be done, if not totally in use, per the photo (below) on the NBAF page on the USDA website. I'm not surprised by this omission, since Manaugh at least, in his many years of blog posts at BLDGBLOG and other writings, has long shown a preference for how buildings work over how they look. Sure, architects deal with function, not just aesthetics, as they design and lay out buildings, but there has always been a disconnect between their plans and the daily reality of buildings in use. Nevertheless, some of the most fascinating tidbits on NBAF come from Cole, who served as a client-side architect on the project and literally took the work home with him: he tested flooring with donated animal hooves so quarantined animals would walk on floors that are "cleanable, easy on the animal's feet, and completely nonslip."

National Bio and Agro-Defense Facility (Photo via usda.gov/nbaf)

Back in 2009, about a decade before Manaugh and Twilley visited Kansas to see the bio-lab — as well as their travels to a 500-year-old lazaretto (quarantine facility) in Dubrovnik, another lazaretto in Venice, the Waste Isolation Pilot Plant (WIPP) in New Mexico, NASA's Spacecraft Assembly Facility in California, and other site of quarantine — the couple curated Landscapes of Quarantine at the Storefront for Art and Architecture in the more familiar Manhattan. Described as "an exhibition exploring the spaces of quarantine, from Level 4 biocontainment labs to underground nuclear waste repositories" and coming out of an eight-week independent design studio directed by Manaugh and Twilley, Landscapes of Quarantine was the beginning of what would eventually become Until Proven Safe. At that early stage, born from the interests of its two protagonists, the exhibition illustrated the multifarious nature of quarantine that would continue through to the book, with spaces for the control of epidemics alongside broader "spatial separation between clean and dirty, safe and dangerous, healthy and sick, foreign and native—however those labels are defined."

Early in the book, in a chapter titled "The Coming Quarantine" but obviously written in the midst of it, the authors recount a pre-Covid evening spent with Dr. Luigi Bertinato, who would become the lead scientific advisor to Italy's national COVID-19 response team, in the library of the Querini Stampalia in Venice. After Manaugh donned contemporary personal protective equipment (PPE) and Bertinato the Black Death equivalent, the Italian doctor explained to the couple that the most important rule with quarantine is that it requires uncertainty. Testing positive for the coronavirus or some other pathogen leads to isolation, but being exposed to someone with the same but not knowing if you have it in your system means you need to quarantine. From early 2020, and the CDC's delaying of effective COVID-19 testing in the United States, to the present, with a three-day waiting period for accurate PCR tests (more accurate compared to relatively instant home tests), people have been directed to quarantine until a negative test — until proven safe. As such, this has meant turning our homes into spaces of quarantine, taking precautions from hospitals and other purpose-built quarantine sites into our own personal realms; this practice elevated the disjunction between rich and poor and between races, with many families unable to provide sufficient separation between people in one house.

Although few people are experts in quarantine, in early 2022 most of the globe is now familiar with it in some manner, be it personally, through people they know well, in comments from public health officials, or via the media. Not surprisingly, the information on quarantine is confusing as often as it is clear; it is as prone to mis- and disinformation as any other topic. So, while it's obvious to commend Manaugh and Twilley on the fortunate timing of their book, released last summer, and the foresight of their decade-plus interest and research on quarantine, I can't help think that the book would have been most valuable coming out in 2019, soon before our current pandemic situation. Of course, this means setting aside the realities of how they made the book, with some research, interviews, and travels taking place that year; but in a hypothetical scenario of an early release, the book's deep history of quarantine and wide net of its practices would have made its readers more knowledgable — and more open to public health officials promoting quarantine as a virus moved about the world. Book sales might not have been as strong, at least at first, but the intense appetite that Manaugh and Twilley have for the subject, and their skill in expressing it in an enjoyable and stimulating text, makes it an excellent read regardless of circumstances. Uncertainty is one reliable condition of the natural world, meaning quarantine will always be an aspect of our lives, at varying degrees at various times; by looking at the past and the present, Until Proven Safe provides a roadmap for how the future of quarantine could unfold.