A cordon sanitaire (, French for "sanitary cordon") is the restriction of movement of people into or out of a defined geographic area, such as a community, region, or country. The term originally denoted a barrier used to stop the spread of infectious diseases. The term is also often used metaphorically, in English, to refer to attempts to prevent the spread of an ideology deemed unwanted or dangerous, such as the containment policy adopted by George F. Kennan against the Soviet Union (see cordon sanitaire in politics).

Origin

The term cordon sanitaire dates to 1821, when the Duke de Richelieu deployed French troops to the border between France and Spain, to prevent yellow fever from spreading into France.

Definition

A cordon sanitaire is generally created around an area experiencing an epidemic or an outbreak of infectious disease, or along the border between two nations. Once the cordon is established, people from the affected area are no longer allowed to leave or enter it. In the most extreme form, the cordon is not lifted until the infection is extinguished. Traditionally, the line around a cordon sanitaire was quite physical; a fence or wall was built, armed troops patrolled, and inside, inhabitants were left to battle the affliction without help. In some cases, a "reverse cordon sanitaire" (also known as protective sequestration) may be imposed on healthy communities that are attempting to keep an infection from being introduced. Public health specialists have included cordon sanitaire along with quarantine and medical isolation as "nonpharmaceutical interventions" designed to prevent the transmission of microbial pathogens through social distancing. The cordon sanitaire is not used now in its most extreme historical form, mainly due to our improved understanding of disease transmission, treatment and prevention. Today its function is primarily to facilitate the identification of infectious disease and to prevent its transmission. In its more traditional role, the cordon also remains a useful intervention under conditions in which: 1) the infection is highly virulent (contagious and likely to cause illness); 2) the case fatality rate is very high; 3) treatment is nonexistent or difficult; and 4) there is no vaccine, or other means of immunizing large numbers of people (such as needles or syringes) are lacking. During the COVID-19 pandemic cordons sanitaires were imposed on geographic regions around the world in an attempt to contain the infection.

16th century

17th century

18th century

19th century

20th century

21st century

Ethical considerations

Guidance on when and how human rights can be restricted to prevent the spread of infectious disease is found in the Siracusa Principles, a non-binding document developed by the Siracusa International Institute for Criminal Justice and Human Rights and adopted by the United Nations Economic and Social Council in 1984. The Siracusa Principles state that restrictions on human rights under the International Covenant on Civil and Political Rights must meet standards of legality, evidence-based necessity, proportionality, and gradualism, noting that public health can be used as grounds for limiting certain rights if the state needs to take measures "aimed at preventing disease or injury or providing care for the sick and injured." Limitations on rights (such as a cordon sanitaire) must be "strictly necessary," meaning that they must: In addition, when a cordon sanitaire is imposed, public health ethics specify that: Finally, the state is ethically obligated to guarantee that:

In popular culture