Changes

The concept of distancing from sick or infected individuals is ancient and texts speak of isolating people who had developed some form of infection. This could have influenced or even affecting affected class or social distancing based on class. In fact, clothing and even fashion markings were used to keep people away from each other. Infections were often higher in those in lower classes, mainly due to their exposure to poorer living conditions. However, over time we see in Europe and much of Eurasia the use of clothing as social markets markers that kept people away from each other. This became extreme by the 19th century, particularly for women using their large skirts as a way to keep unwanted attention away. In the Medieval period, there is evidence some social distancing was practiced during the Black Death. However, public policy was not developed to the point where public health officials made this a wide-scale practice. It was only in the 1916 polio outbreak and more widespread in the 1918 flu pandemic do we see the development of mass social distancing, although only after very painful lessons such as from Philadelphia, which had among the highest death rates in US cities.