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Thursday, June 20, 2024

Untouchability

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Untouchability

Untouchability is a form of social institution that legitimises and enforces practices that are discriminatory, humiliating, exclusionary and exploitative against people belonging to certain social groups. Although comparable forms of discrimination are found all over the world, untouchability involving the caste system is largely unique to South Asia.

The term is most commonly associated with treatment of the Dalit communities in the Indian subcontinent who were considered "polluting". The term has also been used to refer to other groups, including the Burakumin of Japan, the Baekjeong of Korea, and the Ragyabpa of Tibet, as well as the Romani people and Cagot in Europe, and the Al-Akhdam in Yemen.Traditionally, the groups characterized as untouchable were those whose occupations and habits of life involved ritually "polluting" activities, such as pursuing a career based on killing (e.g. fishermen) or engaging in common contact with others' feces or sweat (e.g. manual scavengers, sweepers and washermen).

According to the religious Hindu text, untouchables were not considered a part of the varna system. Therefore, they were not treated like the savarnas (Brahmins, Kshatriyas, Vaishyas and Shudras).

Due to many caste-based discriminations in Nepal, the government of Nepal legally abolished the caste-system and criminalized any caste-based discrimination, including "untouchability" in 1963.

Untouchability has been outlawed in India, Nepal and Pakistan. However, "untouchability" has not been legally defined. The origin of untouchability and its historicity are still debated. A 2020 study of a sample of households in India concludes that "Notwithstanding the likelihood of under-reporting of the practice of untouchability, 70 percent of the population reported not indulging in this practice. This is an encouraging sign."

Origin

B. R. Ambedkar, an Indian social reformer and politician who came from a social group that was considered untouchable, theorized that untouchability originated because of the deliberate policy of the Brahmins. According to him, the Brahmanas despised the people who gave up the Brahmanism in favour of Buddhism. Later scholars such as Vivekanand Jha have refuted this theory.

Nripendra Kumar Dutt, a professor of history, theorized that the concept of untouchability originated from the "pariah"-like treatment accorded to the indigenous people of India by the early Dravidians, and that the concept was borrowed by the Indo-Aryans from the Dravidians. Scholars such as R. S. Sharma have rejected this theory, arguing that there is no evidence that Dravidians practised untouchability before coming into contact with the Indo-Aryans.

Austrian ethnologist Christoph von Fürer-Haimendorf theorized that untouchability originated as class stratification in urban areas of the Indus Valley civilisation. According to this theory, the poorer workers involved in 'unclean' occupations such as sweeping or leather work were historically segregated and banished outside the city limits. Over time, personal cleanliness came to be identified with "purity", and the concept of untouchability eventually spread to rural areas as well. After the decline of the Indus Valley towns, these untouchables probably spread to other parts of India. Scholars such as Suvira Jaiswal reject this theory, arguing that it lacks evidence, and does not explain why the concept of untouchability is more pronounced in rural areas.

American scholar George L. Hart, based on his interpretation of Old Tamil texts such as Purananuru, traced the origin of untouchability to ancient Tamil society. According to him, in this society, certain occupational groups were thought to be involved in controlling the malevolent supernatural forces; as an example, Hart mentions the Paraiyars, who played the drums during battles and solemn events such as births and deaths. People from these occupational groups came to be avoided by others, who believed that they were "dangerous and had the power to pollute the others". Jaiswal dismisses the evidence produced by Hart as "extremely weak" and contradictory. Jaiswal points out that the authors of the ancient Tamil texts included several Brahmanas (a fact accepted by Hart); thus, the society described in these texts was already under Brahmanical influence, and could have borrowed the concept of untouchability from them.

British anthropologist John Henry Hutton traced the origin of untouchability to the taboo on accepting food cooked by a person from a different caste. This taboo presumably originated because of cleanliness concerns, and ultimately, led to other prejudices such as the taboo on marrying outside one's caste. Jaiswal argues that this theory cannot explain how various social groups were isolated as untouchable or accorded a social rank. Jaiswal also notes that several passages from the ancient Vedic texts indicate that there was no taboo against accepting food from people belonging to a different varna or tribe. For example, some Shrauta Sutras mandate that a performer of the Vishvajit sacrifice must live with the Nishadas (a tribe regarded as untouchable in later period) for three days, in their village, and eat their food.

Scholars such as Suvira Jaiswal, R. S. Sharma, and Vivekanand Jha characterize untouchability as a relatively later development after the establishment of the varna and caste system. Jha notes that the earliest Vedic text Rigveda makes no mention of untouchability, and even the later Vedic texts, which revile certain groups such as the Chandalas, do not suggest that untouchability existed in the contemporary society. According to Jha, in the later period, several groups began to be characterized as untouchable, a development which reached its peak during 600–1200 AD. Sharma theorizes that institution of untouchability arose when the aboriginal tribes with "low material culture" and "uncertain means of livelihood" came to be regarded as impure by the privileged classes who despised manual labour, and regarded associated impurity with "certain material objects". According to Jaiswal, when the members of aboriginal groups were assimilated into the Brahmanical society, the privileged among them may have tried to assert their higher status by disassociating themselves from their lower-status counterparts, who were gradually branded as untouchables.

According to the Dharmashastras which are ancient legal codes from various kingdoms in ancient India, certain peoples grouped either by ethnicity or profession were not considered a part of the varna based society. Therefore, they were not treated like the savarnas (Brahmins, Kshatriyas, Vaishyas and Shudras).

Characteristics

According to Sarah Pinto, an anthropologist, modern untouchability in India applies to people whose work relates to "meat, and bodily fluids". Based on the punishments prescribed in The Untouchability (Offences) Act, 1955 the following practices could be understood to have been associated with Untouchability in India:

Prohibition from eating with other members
Provision of separate cups in village tea stalls
Separate seating arrangements and utensils in restaurants
Segregation in seating and food arrangements at village functions and festivals
Prohibition from entering places of public worship
Prohibition from wearing sandals or holding umbrellas in front of higher caste members
Prohibition from entering other caste homes
Prohibition from using common village paths
Separate burial/cremation grounds
Prohibition from accessing common/public properties and resources (wells, ponds, temples, etc.)
Segregation (separate seating area) of children in schools
Bonded labour
Social boycotts by other castes for refusing to perform their "duties"

Government action in India

India is home to over 200 million Dalits. At the time of Indian independence, Dalit activists began calling for separate electorates for untouchables in India to allow fair representation. Officially labeled the Minorities Act, it would guarantee representation for Sikhs, Muslims, Christians, and Untouchables in the newly formed Indian government. The Act was supported by British representatives such as Ramsay MacDonald. According to the textbook Religions in the Modern World, B. R. Ambedkar, who was also a supporter of the Act, was considered to be the "untouchable leader" who made great efforts to eliminate caste system privileges that included participation in public festivals, access to temples, and wedding rituals. In 1932, Ambedkar proposed that the untouchables create a separate electorate that ultimately led Gandhi to fast until it was rejected.

A separation within Hindu society was opposed by national leaders at the time such as Gandhi, although he took no exception to the demands of the other minorities. He began a hunger strike, citing that such a separation would create an unhealthy divide within the religion. At the Round Table Conferences, he provided this explanation for his reasoning:

I don't mind untouchables if they so desire, being converted to Islam or Christianity. I should tolerate that, but I cannot possibly tolerate what is in store for Hinduism if there are two divisions set forth in the villages. Those who speak of the political rights of the untouchables don't know their India, don't know how Indian society is today constituted and therefore I want to say with all the emphasis that I can command that if I was the only person to resist this thing that I would resist it with my life.

Gandhi achieved some success through his hunger strike however Dalit activists faced pressure from the Hindu population at large to end his protest at the risk of his ailing health. The two sides eventually came to a compromise where the number of guaranteed seats for Untouchables would be increased at both central and provincial levels, but there would be a common electorate.

The 1950 national constitution of India legally abolished the practice of untouchability and provided measures for affirmative action in both educational institutions and public services for Dalits and other social groups who lie within the caste system. These are supplemented by official bodies such as the National Commission for Scheduled Castes and Scheduled Tribes.

Despite this, instances of prejudice against Dalits still occur in some rural areas, as evidenced by events such as the Kherlanji massacre.

Social distancing

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Social_distancing

In public health, social distancing, also called physical distancing,is a set of non-pharmaceutical interventions or measures intended to prevent the spread of a contagious disease by maintaining a physical distance between people and reducing the number of times people come into close contact with each other. It usually involves keeping a certain distance from others (the distance specified differs from country to country and can change with time) and avoiding gathering together in large groups.

By minimising the probability that a given uninfected person will come into physical contact with an infected person, the disease transmission can be suppressed, resulting in fewer deaths. The measures may be used in combination with others, such as good respiratory hygiene, face masks and hand washing. To slow down the spread of infectious diseases and avoid overburdening healthcare systems, particularly during a pandemic, several social-distancing measures are used, including the closing of schools and workplaces, isolation, quarantine, restricting the movement of people and the cancellation of mass gatherings. Drawbacks of social distancing can include loneliness, reduced productivity and the loss of other benefits associated with human interaction.

Social distancing measures are most effective when the infectious disease spreads via one or more of the following methods, droplet contact (coughing or sneezing), direct physical contact (including sexual contact), indirect physical contact (such as by touching a contaminated surface), and airborne transmission (if the microorganism can survive in the air for long periods). The measures are less effective when an infection is transmitted primarily via contaminated water or food or by vectors such as mosquitoes or other insects. Authorities have encouraged or mandated social distancing during the COVID-19 pandemic as it is an important method of preventing transmission of COVID-19. COVID-19 is much more likely to spread over short distances than long ones. However, it can spread over distances longer than 2 m (6 ft) in enclosed, poorly ventilated places and with prolonged exposure.

The term "social distancing" was not introduced until the 21st century. Social distancing measures have been successfully implemented in several epidemics. In St. Louis, shortly after the first cases of influenza were detected in the city during the 1918 flu pandemic, authorities implemented school closures, bans on public gatherings and other social-distancing interventions. The influenza fatality rates in St. Louis were much less than in Philadelphia, which had fewer cases of influenza but allowed a mass parade to continue and did not introduce social distancing until more than two weeks after its first cases.

The World Health Organization (WHO) has suggested using the term "physical distancing" instead of "social distancing" because it is physical separation which prevents transmission; people can remain socially connected by meeting outdoors at a safe distance (when there is no stay-at-home order) and by meeting via technology.

Definition

The American Centers for Disease Control and Prevention (CDC) have described social distancing as a set of "methods for reducing frequency and closeness of contact between people in order to decrease the risk of transmission of disease". During the 2009 swine flu pandemic the WHO described social distancing as "keeping at least an arm's length distance from others, [and] minimizing gatherings". During the COVID-19 pandemic, the CDC defined social distancing as "remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately six feet or two meters) from others when possible".

Social distancing, combined with the use of face masks, good respiratory hygiene and hand washing, is considered the most feasible way to reduce or delay a pandemic.

Measures

Several social distancing measures are used to control the spread of contagious illnesses. Research indicates that measures must be applied rigorously and immediately in order to be effective.

Avoiding physical contact

Social distancing includes eliminating the physical contact that occurs with the typical handshake, hug, or hongi; this New Zealand illustration offers eight alternatives.

Keeping a set physical distance from each other and avoiding hugs and gestures that involve direct physical contact, reduce the risk of becoming infected during outbreaks of infectious respiratory diseases (for example, flu pandemics and the COVID-19 pandemic of 2020.) These distances of separation, in addition to personal hygiene measures, are also recommended at places of work. Where possible, remote work may be encouraged.

The distance advised by authorities varies. During the COVID-19 pandemic, for example, the World Health Organization recommends that a distance of 1 m (3.3 ft) or more is safe. Subsequently, China, Denmark, France, Hong Kong, Lithuania and Singapore adopted a 1 m social distancing policy. South Korea adopted 1.4 m (4.6 ft). Australia, Belgium, Germany, Greece, Italy, Netherlands, Portugal and Spain adopted 1.5 m (4.9 ft). The United States adopted 6 ft (1.8 m), and Canada adopted 2 m (6.6 ft). The United Kingdom first advised 2 m, then on July 4, 2020 reduced this to "one metre plus" where other methods of mitigation such as face masks were in use.

The WHO's one-metre recommendation stems from research into droplet-based transmission of tuberculosis by William F. Wells, which had found that droplets produced by exhalation, coughs, or sneezes landed an average of 3 ft (0.9 m) from where they were expelled.Quartz speculated that the U.S. CDC's adoption of 6 ft (1.8 m) may have stemmed from a study of SARS transmission on an airplane, published in The New England Journal of Medicine. When contacted, however, the CDC did not provide any specific information.

Some have suggested that distances greater than 1–2 m (3.3–6.6 ft) should be observed. One minute of loud speaking can produce oral droplets with a load of 7 million SARS-CoV-2 virus per milliliter that can remain for more than eight minutes, a time-period during which many people could enter or remain in the area. A sneeze can distribute such droplets as far as 7 m (23 ft) or 8 m (26 ft). Social distancing is less effective than face masks at reducing the spread of COVID-19.

Various alternatives have been proposed for the tradition of handshaking. The gesture of namaste, placing one's palms together, fingers pointing upwards, drawing the hands to the heart, is one non-touch alternative. During the COVID-19 pandemic in the United Kingdom, this gesture was used by Prince Charles upon greeting reception guests, and has been recommended by the Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, and Israeli Prime Minister Benjamin Netanyahu. Other alternatives include the popular thumbs up gesture, the wave, the shaka (or "hang loose") sign, and placing a palm on one's heart, as practiced in parts of Iran.

In this computer lab, every other workstation has been closed off to increase the distance between people working, and screens between workstations are also in place.
Floor markings can help people maintain distance in public places, especially when queueing.
Urinals adjusted in a way close contacts are less likely

School closures

Mathematical modeling has shown that transmission of an outbreak may be delayed by closing schools. However, effectiveness depends on the contacts children maintain outside of school. Often, one parent has to take time off work, and prolonged closures may be required. These factors could result in social and economic disruption.

Workplace closures

Modeling and simulation studies based on U.S. data suggest that if 10% of affected workplaces are closed, the overall infection transmission rate is around 11.9% and the epidemic peak time is slightly delayed. In contrast, if 33% of affected workplaces are closed, the attack rate decreases to 4.9%, and the peak time is delayed by one week. Workplace closures include closure of "non-essential" businesses and social services ("non-essential" means those facilities that do not maintain primary functions in the community, as opposed to essential services).

Canceling mass gatherings

Cancellation of mass gatherings includes sports events, films or musical shows. Evidence suggesting that mass gatherings increase the potential for infectious disease transmission is inconclusive. Anecdotal evidence suggests certain types of mass gatherings may be associated with increased risk of influenza transmission, and may also "seed" new strains into an area, instigating community transmission in a pandemic. During the 1918 influenza pandemic, military parades in Philadelphia and Boston may have been responsible for spreading the disease by mixing infected sailors with crowds of civilians. Restricting mass gatherings, in combination with other social distancing interventions, may help reduce transmission. A recent peer-reviewed study in the British Medical Journal (The BMJ) also suggested it as one of the key components of an effective strategy in reducing the burden of COVID-19.

Travel restrictions

Border restrictions or internal travel restrictions are unlikely to delay an epidemic by more than two to three weeks unless implemented with over 99% coverage. Airport screening was found to be ineffective in preventing viral transmission during the 2003 SARS outbreak in Canada and the U.S. Strict border controls between Austria and the Ottoman Empire, imposed from 1770 until 1871 to prevent persons infected with the bubonic plague from entering Austria, were reportedly effective, as there were no major outbreaks of plague in Austrian territory after they were established, whereas the Ottoman Empire continued to suffer frequent epidemics of plague until the mid-nineteenth century.

A Northeastern University study published in March 2020 found that "travel restrictions to and from China only slow down the international spread of COVID-19 [when] combined with efforts to reduce transmission on a community and an individual level. ... Travel restrictions aren't enough unless we couple it with social distancing." The study found that the travel ban in Wuhan delayed the spread of the disease to other parts of mainland China only by three to five days, although it did reduce the spread of international cases by as much as 80 percent.

Shielding

Shielding measures for individuals include limiting face-to-face contacts, conducting business by phone or online, avoiding public places and reducing unnecessary travel.

During the COVID-19 pandemic in the United Kingdom, shielding referred to special advisory measures put in place by the UK Government to protect those at the highest risk of serious illness from the disease. This included those with weakened immune systems (such as organ transplant recipients), as well as those with certain medical conditions such as cystic fibrosis or severe asthma. Until June 1, 2020, those shielding were strongly advised not to leave home for any reason at all, including essential travel, and to maintain a 2 m (6.6 ft) distance from anyone else in their household. Supermarkets quickly made priority grocery delivery slots available to those shielding, and the Government arranged for food boxes to be sent to those shielding who needed additional assistance, for example elderly people shielding on their own. This was gradually relaxed from June to allow shielders to spend more time outside, before being suspended indefinitely from August 1.

Quarantine

During the 2003 SARS outbreak in Singapore, approximately 8000 people were subjected to mandatory home quarantine and an additional 4300 were required to self-monitor for symptoms and make daily telephone contact with health authorities as a means of controlling the epidemic. Although only 58 of these individuals were eventually diagnosed with SARS, public health officials were satisfied that this measure assisted in preventing further spread of the infection. Voluntary self-isolation may have helped reduce transmission of influenza in Texas in 2009. Short and long-term negative psychological effects have been reported.

Stay-at-home orders

The objective of stay-at-home orders is to reduce day-to-day contact between people and thereby reduce the spread of infection During the COVID-19 pandemic, early and aggressive implementation of stay-at-home orders was effective in "flattening the curve" and provided the much needed time for healthcare systems to increase their capacity while reducing the number of peak cases during the initial wave of illness. It is important for public health authorities to follow disease trends closely to re-implement appropriate social distancing policies, including stay-at-home orders, if secondary COVID-19 waves appear.

Cordon sanitaire

In 1995, a cordon sanitaire was used to control an outbreak of Ebola virus disease in Kikwit, Zaire.President Mobutu Sese Seko surrounded the town with troops and suspended all flights into the community. Inside Kikwit, the World Health Organization and Zaire's medical teams erected further cordons sanitaires, isolating burial and treatment zones from the general population and successfully containing the infection.

Protective sequestration

During the 1918 influenza epidemic, the town of Gunnison, Colorado, isolated itself for two months to prevent an introduction of the infection. Highways were barricaded and arriving train passengers were quarantined for five days. As a result of the isolation, no one died of influenza in Gunnison during the epidemic. Several other communities adopted similar measures.

Other measures

Other measures include shutting down or limiting mass transit and closure of sport facilities (community swimming pools, youth clubs, gymnasiums). Due to the highly interconnected nature of modern transportation hubs, a highly contagious illness can achieve rapid geographic spread if appropriate mitigation measures are not taken early. Consequently, highly coordinated efforts must be put into place early during an outbreak to proactively monitor, detect, and isolate any potentially infectious individuals. If community spread is present, more aggressive measures may be required, up to and including complete cessation of travel in/out of a specific geographic area.

Communicating social distancing public health guidelines

Public health messaging, gaining the public's trust (countering misinformation), ensuring community involvement and two-way exchange of ideas can affect the uptake, adherence, and effectiveness of best-evidence social distancing approach to preventing disease spread. The communication approaches, messaging, and delivery mechanisms need to be flexible so that they can be changed as both the best-evidence social distancing measures change and as the community needs change.

History

Leper colonies and lazarettos were established as a means of preventing the spread of leprosy and other contagious diseases through social distancing, until transmission was understood and effective treatments invented.

The Lazzaretto of Ancona was constructed in the 18th century on an artificial island to serve as a quarantine station and leprosarium for the port town of Ancona, Italy.
Two lepers denied entrance to town. Woodcut by Vincent of Beauvais, 14th century
New York City parks and playgrounds were closed during a 1916 polio epidemic.
Passenger without mask being refused boarding of a streetcar amid 1918 flu pandemic. (Seattle, Washington, 1918)

1916 New York City polio epidemic

During the 1916 New York City polio epidemic, when there were more than 27,000 cases and more than 6,000 deaths due to polio in the United States, with more than 2,000 deaths in New York City alone, movie theaters were closed, meetings were cancelled, public gatherings were almost non-existent, and children were warned not to drink from water fountains, and told to avoid amusement parks, swimming pools and beaches.

Influenza, 1918 to present

During the influenza pandemic of 1918, Philadelphia saw its first cases of influenza on 17 September. The city continued with its planned parade and gathering of more than 200000 people on 28 September and over the subsequent three days, the city's 31 hospitals became fully occupied. During the week ending 16 October, over 4500 people died. Social distancing measures were introduced on 3 October, on the orders of St. Louis physician Max C. Starkloff, more than two weeks after the first case. Unlike Philadelphia, St. Louis experienced its first cases of influenza on 5 October and the city took two days to implement several social distancing measures, including closing schools, theatres, and other places where people get together. It banned public gatherings, including funerals. The actions slowed the spread of influenza in St. Louis and a spike in cases and deaths, as had happened in Philadelphia, did not occur. The final death rate in St. Louis increased following a second wave of cases, but remained overall less than in other cities. Bootsma and Ferguson analyzed social distancing interventions in sixteen U.S. cities during the 1918 epidemic and found that time-limited interventions reduced total mortality only moderately (perhaps 10–30%), and that the impact was often very limited because the interventions were introduced too late and lifted too early. It was observed that several cities experienced a second epidemic peak after social distancing controls were lifted, because susceptible individuals who had been protected were now exposed.

School closures were shown to reduce morbidity from the Asian flu by 90% during the 1957–1958 pandemic, and up to 50% in controlling influenza in the U.S., 2004–2008. Similarly, mandatory school closures and other social distancing measures were associated with a 29% to 37% reduction in influenza transmission rates during the 2009 flu epidemic in Mexico.

The 2009 swine flu pandemic caused social distancing to rise in popularity, most notably in Mexico, with the country's Ministry of Health advising people to avoid handshakes and kissing as ways of greeting people. A mandatory nationwide school closure enacted in Mexico, which lasted for 18 days from late April 2009 to early May 2009, was a form of social distancing aimed at reducing the transmission of Swine flu. A study from 2011 found the mandatory nationwide school closure and other forms of social distancing in Mexico were effective at reducing influenza transmission rates.

During the swine flu outbreak in 2009 in the UK, in an article titled "Closure of schools during an influenza pandemic" published in The Lancet Infectious Diseases, a group of epidemiologists endorsed the closure of schools to interrupt the course of the infection, slow the further spread and buy time to research and produce a vaccine. Having studied previous influenza pandemics including the 1918 flu pandemic, the influenza pandemic of 1957 and the 1968 flu pandemic, they reported on the economic and workforce effect school closure would have, particularly with a large percentage of doctors and nurses being women, of whom half had children under the age of 16. They also looked at the dynamics of the spread of influenza in France during French school holidays and noted that cases of flu dropped when schools closed and re-emerged when they re-opened. They noted that when teachers in Israel went on strike during the flu season of 1999–2000, visits to doctors and the number of respiratory infections dropped by more than a fifth and more than two fifths respectively.

SARS 2003

During the SARS outbreak of 2003, social distancing measures were implemented, such as banning large gatherings, closing schools and theaters, and other public places, supplemented public health measures such as finding and isolating affected people, quarantining their close contacts, and infection control procedures. This was combined with the wearing of masks for certain people. During this time in Canada, "community quarantine" was used to reduce transmission of the disease with moderate success.

COVID-19 pandemic

During the COVID-19 pandemic, social distancing and related measures are emphasized by several governments as alternatives to an enforced quarantine of heavily affected areas. According to UNESCO monitoring, more than a hundred countries have implemented nationwide school closures in response to COVID-19, impacting over half the world's student population. In the United Kingdom, the government advised the public to avoid public spaces, and cinemas and theaters voluntarily closed to encourage the government's message.

With many people disbelieving that COVID-19 is any worse than the seasonal flu, it has been difficult to convince the public—particularly youth, and the anti vaxx community to voluntarily adopt social distancing practices. In Belgium, media reported a rave was attended by at least 300 before it was broken up by local authorities. In France, teens making nonessential trips are fined up to US$150. Beaches were closed in Florida and Alabama to disperse partygoers during spring break. Weddings were broken up in New Jersey and an 8 p.m. curfew was imposed in Newark. New York, New Jersey, Connecticut and Pennsylvania were the first states to adopt coordinated social distancing policies which closed down non-essential businesses and restricted large gatherings. Shelter in place orders in California were extended to the entire state on 19 March. On the same day Texas declared a public disaster and imposed statewide restrictions.

These preventive measures such as social-distancing and self-isolation prompted the widespread closure of primary, secondary, and post-secondary schools in more than 120 countries. As of 23 March 2020, more than 1.2 billion learners were out of school due to school closures in response to COVID-19. Given low rates of COVID-19 symptoms among children, the effectiveness of school closures has been called into question. Even when school closures are temporary, it carries high social and economic costs. However, the significance of children in spreading COVID-19 is unclear. While the full impact of school closures during the coronavirus pandemic are not yet known, UNESCO advises that school closures have negative impacts on local economies and on learning outcomes for students.

In early March 2020, the sentiment "Stay Home" was coined by Florian Reifschneider, a German engineer and was quickly echoed by notable celebrities such as Taylor Swift, Ariana Grande and Busy Philipps in hopes of reducing and delaying the peak of the outbreak. Facebook, Twitter and Instagram also joined the campaign with similar hashtags, stickers and filters under #staythefhome, #stayhome, #staythefuckhome and began trending across social media. The website claims to have reached about two million people online and says the text has been translated into 17 languages.

Impact on mental health

There are concerns that social distancing can have adverse affects on participants' mental health. It may lead to stress, anxiety, depression or panic, especially for individuals with preexisting conditions such as anxiety disorders, obsessive compulsive disorders, and paranoia. Widespread media coverage about a pandemic, its impact on economy, and resulting hardships may create anxiety. Change in daily circumstances and uncertainty about the future may add onto the mental stress of being away from other people.

Psychologist Lennis Echterling noted that, in such social distancing situations, using technology for "connection with loved ones...is imperative" to combat isolation, for the sake of one's well-being. Social worker Mindy Altschul noted that the concept of "social distancing" ought to be reframed as "physical distancing", so as to emphasize the fact that being physically isolated need not, and should not, result in being socially isolated.

People with autism also suffer impact from social distancing. Adjusting to a new routine can be stressful for everyone within the spectrum but especially for children who have trouble with change. Children with autism may not know what is going on or might not be able to express their fears and frustrations. They also may need extra support to understand what's expected of them in some situations.The adjustment to a new situation can lead to challenging behavior uncharacteristic of the autistic individual's true character. In some countries and demographics, teenagers and young adults within the autistic spectrum disorder (ASD) receive support services including special education, behavioral therapy, occupational therapy, speech services, and individual aides through school, but this can be a major challenge, particularly since many teenagers with ASD already have social and communication difficulties. Aggressive and self-injurious behaviors may increase during this time of fear and uncertainty.

Portrayal in literature

In his 1957 science fiction novel The Naked Sun, Isaac Asimov portrays a planet where people live with social distancing. They are spread out, miles from each other, across a sparsely-populated world. Communication is primarily through technology. A male and a female still need to engage in sex to make a baby, but it is seen as a dangerous, nasty chore. In contrast, when communication is through technology the situation is the reverse: there is no modesty, and casual nudity is frequent. The novel's point of departure is a murder: this seemingly idyllic world, in fact, has serious social problems.

Theoretical basis

From the perspective of epidemiology, the basic goal behind social distancing is to decrease the effective reproduction number, $R_{e}$ or $R$ , which in the absence of social distancing would equate to the basic reproduction number, i.e. the average number of secondary infected individuals generated from one primary infected individual in a population where all individuals are equally susceptible to a disease. In a basic model of social distancing, where a proportion $f$ of the population engages in social distancing to decrease their interpersonal contacts to a fraction $a$ of their normal contacts, the new effective reproduction number $R$ is given by:

R = [1 - (1 - a^{2}) f] R_{0}

Where the value of $R$ can be brought below 1 for sufficiently long, containment is achieved, and the number infected should decrease.

For any given period of time, the growth in the number of infections can be modeled as:

y_{n} = \sum_{i = 0}^{n} R^{i}

where:

$y_{n}$ is the number of infected individuals after $n$ incubation periods (5 days, in the case of COVID-19)

Using COVID-19 as an example, the following table shows the infection spread given:

A: No social distance mitigation
B: 50% reduction in social interaction
C: 75% reduction in social interaction

Number of infections after $n$ days for various values of $R$
Time	A	B	C
	$R = R_{0} = 2.5$	$R = 1.25$	$R = 0.625$
5 days (1 incubation period)	2.5	1.25	0.625
30 days (6 incubation periods)	406	15	2.5

Effectiveness

An empirical study published in July 2020 in The BMJ (British Medical Journal) analyzed data from 149 countries, and reported an average of 13% reduction in COVID-19 incidence after the implementation of social distancing policies. Another study found that four social distancing interventions combined resulted in a reduction of the infection rate from 66% to less than 1%.

Leper colony

From Wikipedia, the free encyclopedia

Spinalonga on Crete, Greece, one of the last leprosy colonies in Europe, closed in 1957

A leper colony, also known by many other names, is an isolated community for the quarantining and treatment of lepers, people suffering from leprosy.

M. leprae, the bacterium responsible for leprosy, is believed to have spread from East Africa through the Middle East, Europe, and Asia by the 5th century before reaching the rest of the world more recently. Historically, leprosy was believed to be extremely contagious and divinely ordained, leading to enormous stigma against its sufferers. Other severe skin diseases were frequently conflated with leprosy and all such sufferers were kept away from the general public, although some religious orders provided medical care and treatment. Recent research has shown M. leprae has maintained a similarly virulent genome over at least the last thousand years, leaving it unclear which precise factors led to leprosy's near elimination in Europe by 1700. A growing number of cases following the first wave of European colonization, however, led to increased attention towards leprosy during the New Imperialism of the late 19th century. Following G.A. Hansen's discovery of the role of M. leprae in the disease, the First International Leprosy Conference held in Berlin in 1897 renewed interest and investment in the isolation of lepers throughout the European colonial empires. Although Western countries now generally treat cases of leprosy individually on an outpatient basis, traditional isolated colonies continue to exist in India, China, and some other countries.

Names

In medieval Latin, a place for the isolation and care of lepers was known as a leprosaria, leprosarium, or leprosorium, names which are sometimes used in English as well. The Latin domus leprosaria was calqued in English as leper house, with leper colony becoming by far the most common English term in the 1880s as the growing number of leprosy cases were discussed within the context of European colonialism. Less common synonyms include leper asylum, leper lodge, and leper hospital. Other names derive from the figure of Lazarus in one of Jesus's parables, treated by the Catholic Church during the Middle Ages as a historical figure and as the patron saint of both lepers and the Crusader Order of Saint Lazarus, who administered the leper colony in Jerusalem before spreading to other locations. This caused leper colonies to also be known as lazar houses and, after the leper colony and quarantine center on Venice's Sta. Maria di Nazareth, as lazarets, lazarettes, lazarettos, and lazarettas. The name leper or leprosy villageis sometimes used for colonies in China, a calque of the Mandarin name máfēngcūn (t 麻風村, s 麻风村).

History

Abandoned nun's quarters at the leper colony on Chacachacare Island in Trinidad and Tobago

Although not all of the skin diseases (kushtha) discussed in the Indian Vedas and the Laws of Manu were leprosy, some of them seem to have been, with the disease appearing in the subcontinent by at least 2000 BC. The Indian religious texts and laws did not organize formal leper colonies but treated those afflicted with the disease as untouchable outcastes, forbidding and punishing any marriage with them while they suffered from the disease, which was considered both contagious and a divine punishment for sins of the sufferer's current or former life. In legend, even kings were removed from power and left to wander in the forests while suffering from leprosy, although their position could be restored in the event of their recovery, whether through divine intervention or Ayurvedic herbal remedies such as chaulmoogra oil. Similarly, the ancient Persians and Hebrews considered certain skin diseases to render people unclean and unfit for society, without organizing any special locations for their care; it seems likely, however, that the references to "leprosy" in the Old and New Testaments of the Bible are the result of a misunderstanding produced by the Septuagint's Greek translation and subsequent Latin translations like the Vulgate and originally referred to a variety of conditions such as psoriasis before becoming associated with leprosy centuries later. This confusion of terms—and the related divine opprobrium—was then translated into Islamic medicine in the 9th century. The introduction of leprosy to southern Europe was blamed on the armies of Alexander and Pompey; ancient Greek and Roman doctors did not blame divine punishment and advocated various treatments but still usually advised that lepers be kept out of cities. Some early Christians sought to emulate Jesus's example by personally ministering to lepers or communities of lepers, activity recorded in hagiographies like St Gregory's life of St Basil.

Leprosy seems to have reached the rest of Europe during late Antiquity and the early Middle Ages, with the imperial Church reducing formal restrictions on lepers while setting aside funds for leprosaria where clerics would treat the afflicted. Such leper houses are documented at St-Oyen in 460, Chalon-sur-Saône in 570, and Verdun in 634; their management was often provided by monastic orders. The area of modern Belgium alone may have had as many as 700 or 800 prior to the Crusades. Christian folklore misunderstood the parable of Lazarus and Dives as a historical account and took the sore-covered beggar in the story as St Lazarus, patron of lepers; the military order St Lazarus was established to care for lepers in Crusader Jerusalem and subsequently operated other leprosaria around Europe. Some colonies were located on mountains or in remote locations to ensure isolation, some on main roads, where donations would be made for their upkeep. Others were essentially hospitals within major cities. In 1623 the Congregation of the Mission, a Catholic society of apostolic life founded by Vincent de Paul, was given possession of the Priory of St. Lazarus, a former leper house in Paris, due to which the entire Congregation gained the name of "Lazarites" or "Lazarists" although most of its members had nothing to do with caring for lepers.

Debate exists over the conditions found within historical colonies; while they are currently thought to have been grim and neglected places, there are some indications that life within a leper colony or house was no worse than the life of other, non-isolated individuals. There is even doubt that the current definition of leprosy can be retrospectively applied to the medieval condition. What was classified as leprosy then covers a wide range of skin conditions that would be classified as distinct afflictions today. Some leper colonies issued their own money or tokens, in the belief that allowing people affected by leprosy to handle regular money could spread the disease. Today leper hospitals exist throughout the world to treat those afflicted with leprosy, especially in Africa, Brazil, China and India.

Political aspects

In 2001, government-run leper colonies in Japan came under judicial scrutiny, leading to the determination that the Japanese government had mistreated the patients, and the district court ordered Japan to pay compensation to former patients. In 2002, a formal inquiry into these colonies was set up, and in March 2005, the policy was strongly denounced. "Japan's policy of absolute quarantine... did not have any scientific grounds." The inquiry denounced not only the government and the doctors who were involved with the policy, but also the court that repeatedly ruled in favor of the government when the policy was challenged, as well as the media, which failed to report the plight of the victims.

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Thursday, June 20, 2024

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