Isolation

Seamus Heaney (1939–2013) Irish Poet and Nobel Prize Laureate. Pascal’s aphorism has probably been written by journalists and media people more frequently in the last few months than at any time since his death. Isolation means different things to different people. Today, in the COVID19 pandemic, most people think of self-isolation rather than isolation of the virus for the purpose of laboratory investigation Fig. 1. When I was training in HCT at the Fred Hutchinson Cancer Research Centre in the early 1980s, some patients were isolated in Laminar Air Flow (LAF) whereas others were in single, ensuite, positive-pressure rooms with highefficiency particulate air-filtered rooms. LAF rooms are extremely expensive to install and maintain and the difficulties in entering a LAF room served as a deterrent to examining patients. Since then, LAF rooms have gone out of fashion and Yokoe et al. [1] stated that LAF was not recommended for newly built rooms in HCT centres. The EBMT carried out a survey of HCT units [2] and found that less than one third of HCT centres used LAF rooms, but somewhat surprisingly, up to a quarter of centres reported that no isolation procedures were used in patients colonised or infected with highly transmissible pathogens. They concluded that recommendations for infected or colonised patients following HCT are poorly known or applied in many HCT Centres. Although Ignác Semmelweis, in the mid-19th century, demonstrated that hand cleansing prevented the spread of puerperal sepsis it took the medical profession many years to heed his recommendations [3]. Interestingly the universal recommendations to delay/prevent the spread COVID-19 infection are careful hand-washing, self-isolation and mass testing, free at the point of entry. So, in spite of all our modern interventions, careful hand-washing is the critical modality. When I was in charge of our National HCT in Dublin I found that the most difficult task was to convince health-care workers that hand-washing was of paramount importance in preventing the spread of disease. Personal protective equipment is recommended for all health-care workers who are dealing with COVID-19 infected patients. Hopefully we will not have to revert to the type of clothing worn by so-called ‘Plague Doctors’ Fig. 2 but it is remarkable how similar the strategy is. Individuals and communities may suffer severe mental distress from being isolated for long periods and ingenuity is needed to ameliorate this sense of frustration. The Division of Psychiatry at University College London, UK, are developing a network to investigate loneliness and social isolation in mental health. The most well-known and poignant tale of isolation is in the Diary of Anne Frank when she hid in an attic for 2 years to avoid the Nazis. The Dutch version is available on line. Perhaps it is a good time to read all the books for which you said you never had the time. Is isolation important in wine making? Probably yes. Viticulturists, like infectious disease experts and microbiologists, usually think of isolation as the identification of infectious agents which can have a devastating effect on vine yield. However, some wine growing areas are geographically isolated and this may be advantageous. Certain parts of Chile are so remote that the vines escaped the phylloxera epidemic [4] which devastated many vineyards * Shaun McCann shaunrmccann@gmail.com

or infected with highly transmissible pathogens. They concluded that recommendations for infected or colonised patients following HCT are poorly known or applied in many HCT Centres.
Although Ignác Semmelweis, in the mid-19th century, demonstrated that hand cleansing prevented the spread of puerperal sepsis it took the medical profession many years to heed his recommendations [3]. Interestingly the universal recommendations to delay/prevent the spread COVID-19 infection are careful hand-washing, self-isolation and mass testing, free at the point of entry. So, in spite of all our modern interventions, careful hand-washing is the critical modality. When I was in charge of our National HCT in Dublin I found that the most difficult task was to convince health-care workers that hand-washing was of paramount importance in preventing the spread of disease. Personal protective equipment is recommended for all health-care workers who are dealing with COVID-19 infected patients. Hopefully we will not have to revert to the type of clothing worn by so-called 'Plague Doctors' Fig. 2 but it is remarkable how similar the strategy is.
Individuals and communities may suffer severe mental distress from being isolated for long periods and ingenuity is needed to ameliorate this sense of frustration. The Division of Psychiatry at University College London, UK, are developing a network to investigate loneliness and social isolation in mental health. The most well-known and poignant tale of isolation is in the Diary of Anne Frank when she hid in an attic for 2 years to avoid the Nazis. The Dutch version is available on line. Perhaps it is a good time to read all the books for which you said you never had the time.
Is isolation important in wine making? Probably yes. Viticulturists, like infectious disease experts and microbiologists, usually think of isolation as the identification of infectious agents which can have a devastating effect on vine yield. However, some wine growing areas are geographically isolated and this may be advantageous. Certain parts of Chile are so remote that the vines escaped the phylloxera epidemic [4] which devastated many vineyards vines at high altitudes exposes them to more sunlight and may reduce the incidence of pests. Malbec wines from Mendoza will be known to many of you. The grape originated in Cahors in France where it is called Auxerrois or Côt and probably came to Argentina in the 19th century. Prior to the phylloxera pandemic it was one of the most widely grown grapes in Bordeaux. High-altitude vineyards are also being planted in China and India as well as Bolivia and other parts of South America. Eradicating nematodes from soil is extremely important in isolating vines from nepovirus infection causing fanleaf degeneration [5].
Believe it or not there is a vineyard in Australia called Isolation Ridge Vineyard, a vineyard of the Frankland Estate in the Frankland River wine region in Western Australia, known particularly for its Riesling wines. As the owners say: perhaps one of the most isolated vineyards in the world it seemed only fitting that we called our site 'Isolation Ridge Vineyard'.
The good news is that 'virtual' wine tastings are proliferating and wine sales, at the moment of writing, 'on line' continue to operate.
As the days roll on in this surreal atmosphere perhaps a glass of wine will help to alleviate the sense of isolation? SRM.

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