Geoff Manaugh and Nicola Twilley explore the history and future of quarantine, from the Black Death to Big Data.

Quarantine has shaped our buildings, cities, and borders for centuries, yet, as a concept, it remains both feared and misunderstood.

In Until Proven Safe, journalists Geoff Manaugh and Nicola Twilley climb through the ruins of quarantine hospitals in Venice, Dubrovnik, and Malta, don hardhats to visit a new federal quarantine facility in the heart of the United States, and attend simulated pandemics—one eerily similar to COVID-19—in New York and Washington D.C.

Although quarantine, at its heart, works by separating people suspected of illness from those known to be well, even this simple distinction leads to entire realms of philosophical uncertainty, ethical risk, and the potential abuse of political power. What if we don’t know we are infected? Quarantine has been an effective medical tool for 600 years, but it is also an unusually poetic metaphor for any number of moral and religious ills: it means waiting to see if something hidden inside you will be revealed.

You must remain in quarantine—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 to the hallways of the CDC, to the corporate giants hoping to disrupt quarantine today armed with surveillance technology and Big Data.

Yet quarantine is more than just a medical tool: the authors also drop deep into the Earth to tour a nuclear-waste isolation facility beneath the New Mexican desert, strip down to nothing but protective Tyvek suits to see plants stricken with a disease that threatens the world’s wheat supply, and meet with NASA’s Planetary Protection Officer, tasked with saving the Earth from extraterrestrial infections.

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.