© Reuters / Jeenah Moon

Comment: Note that this article was published March 21st, before the current situation in the US erupted, and that is fast spreading throughout the Western world.

What's happening around the globe is both new and old. While SARS-CoV-2 is new, pandemics and the effects of infectious disease are as old as mankind. And when we think about how to grapple with the situation in front of us, we should be looking to the past for guidance - because this is about far more than a pandemic, it's about humans. Specifically, human behavior.

One of the greatest challenges facing leaders today is determining just how to control the spread of a virus, while not having control over millions (globally billions) of autonomous individuals. Local, state, and federal government are having to make decisions daily (even hourly) about how many restrictions to place on the American people. And if you've been following the news, you know that states and cities are taking very different approaches. But as they consider strong restrictions and forced quarantines, it is important to look back at what has happened in the past when those in power place their constituents on lockdown.

How can leaders balance the destruction of viral transmission, without destruction of the human spirit and liberties?

A quarantine is "a state, period, or place of isolation in which people or animals that have arrived from elsewhere or been exposed to infectious or contagious disease are placed." Quarantines are something that is imposed on you and done to you. It is not voluntary and, in most mass quarantine cases, those in quarantine are not consulted or engaged in the decision-making process.

And history has taught us that whether it's caused by fear, frustration, or the helplessness that comes with imprisonment, human beings do not respond well to forced lockdowns. These feelings are often exacerbated by sentiments that the vulnerable are being taken advantage of. There is also outrage that accompanies the gained knowledge that in almost all cases, the resources needed are not available - as it is difficult to prepare for the unknown.

But what happens to the human brain - and subsequent behavioral responses - when placed on lockdown, much like imprisonment, is very predictable. Adrenaline and stress hormones like cortisol kick into an acute stress response (hyperarousal). This is what leads to the fight or flight response we often refer to. What that means is that your sympathetic nervous system (the involuntary regulation of things like blood pressure, heart rate, pupil dilation) kicks in so rapidly many people don't realize it's happening - and it tells you you're now in survival mode. At this point you'll have an almost uncontrollable response that either tells you to stand your ground and fight, or turn and run from the danger.

Given that we no longer are facing down lions on a day-to-day basis, our survival triggers can be activated by things like being locked down. And they can be exacerbated by many of the factors that are present during a pandemic such as lack of trust in government or authority, geographic proximity to others in a similar situation, and a shared purpose and intensity. That is to say, riots are not a mindless mob as often depicted. And when we know that forced confinement triggers all kinds of sensory responses that result in stress systems firing on all cylinders, lockdowns should be a last resort.

Riots Are A Predictable Part Of Quarantine

When Italy signed an unprecedented containment decree less than two weeks ago, the details were leaked hours before the announcement. The result, thousands of Italians packed up and fled. Taking the virus with them, and highlighting how much people did not want to be locked in place, no matter the national crisis. Further, following the announcement overcrowded prisons saw multiple prisoners die after riots broke out. Those already stripped of their freedoms believed they were being locked in to die. The same happened last week in Beirut, Lebanon.

During the 2014-2015 Ebola crisis, riots carried on for days in the West Point neighborhood of the Liberian capital of Monrovia. About 70,000 people woke up one morning to find themselves blockaded into their poor area - including checkpoints and a buffer zone according to NPR reporters on site. But to make matters worse, a government official was escorted out of the zone, causing an eruption of outrage, violence, and inevitably - the spread of Ebola. Their rage was both predictable and reasonable as they saw it. Injustice was being done, and others were likely deciding who lived and died.

In the 1700's the Russian plague ravaged Moscow and the city found itself in a quarantine that resulted in many deaths including the murder of the Archbishop. Throughout the 1800's cholera pandemics (there were seven) led to no less than 70 riots across the globe, as people were unsure of the source of the infectious disease, but believed city and national government officials were withholding the truth from them and leaving them to die. In Milwaukee, Wisconsin and Laredo, Texas, there were protests and riots around the start of the 1900's due to smallpox isolation. Prisoners in Mexico rioted during the H1N1 (Swine Flu) outbreak as recently as 2009. The examples go on and on.

The lessons learned from history should not be forgotten today. Human beings do not do well in prison - and in the face of real or perceived inequality, are quick to enter into a fight or flight response. Many will predictably view lockdowns and quarantines as punishment and imprisonment. And without the comfort of knowing if they will be able to provide for themselves, provide for their families, be able to pay their bills, and have access to plenty of food and water, you can expect that 2020 human beings will behave no differently than their ancestors.

Nicole Fisher is the founder and President of Health & Human Rights Strategies, a health care and human rights-focused advising firm in Washington, D.C.