Warm beer causes plague!
Mediæval responses to plague had a lot in common with how the world has tried to manage the Covid pandemic, says Mark Greener
Plagues, Pandemics and Viruses From the Plague of Athens to Covid-19 Heather E Quinlan Visible Ink Press 2020 Pb, 397pp, £19.99, ISBN 9781578597048
Lockdowns. Social distancing. Fake news. For all our medical sophistication, a mediæval physician would recognise our responses to Covid-19.
During the waves of plague that swept across Europe during the Middle Ages and Enlightenment, physicians used personal protective equipment, such as plague suits. When the Black Death reached Ragusa (Dubrovnik), the authorities introduced 30-day isolation and patrolled the borders. During the 1636 London plague, the Royal College of Physicians recommended banning public and private gatherings.
As the Treasury struggles with Covid-19’s economic fallout, Quinlan recounts that a plague outbreak in AD541 brought the “near-collapse of the economic system” supporting the Byzantine Empire. Covid-19, like the London plague, tends to hit the poorest the hardest.
Fake news “plagued” previous pandemics. Some “experts” suggested that drinking beer in an overheated room or eating cucumbers caused the London plague. Some suggested avoiding boiled cauliflowers, peaches and sweet plums among other fruits and vegetables. Inevitably, some persecuted Jews for spreading the Black Death or regarded disease as divine punishment. In an excellent chapter summarising the US response to Covid-19, Quinlan tells of a US pastor who “described Christians who use hand sanitiser as having ‘fake faith’ and ‘no balls’”.
Forteans have seen it all before. Back in 1976 a mysterious outbreak at a Philadelphia hotel led FT to comment that the response “is a classical scenario of clashing experts, contradictory theories, inefficiency, bungling, scaremongering and general ineffectiveness of the various kinds of establishments … caught with their collective pants down by the unknown” ( FT20:10-11). Over four decades later, it’s, for me, a perfect encapsulation of the response to Covid-19. A Soviet paper even “speculated that a secret Pentagon chemical warfare experiment had gone wrong” in Philadelphia, shades of the blame placed on the Wuhan laboratory. We now know a bacterium caused the outbreak of “Legionnaires’ disease”. But the similarities with Covid-19 are striking.
Quinlan’s easy-to-read, accessible and humane historical overview of humanity’s struggle with pandemics resonates across the years and casts a wide net. She covers, for instance, prescription opioid misuse and addiction. The chapter is excellent, sympathetic and the risks need highlighting. The discussion jarred a bit with the book’s microbiological focus; but I understand and totally sympathise with her motives. I’d willingly sacrifice narrative focus to save a life or even a single case of addiction. Visible Ink should commission a book from Quinlan on opioid misuse and addiction: it could be excellent.
Her explanations are generally clear, concise and, given that she aims at a popular audience, accurate – even when she discusses immunology, a notoriously complex area of biology. Occasionally, however, I felt that the simplifications went a step too far. Discussing Homo sapiens’s early medical history, she notes that Palæolithic people were “the world’s first pharmacists; herbs were discovered in Shanidar cave in today’s Kurdistan”. The remains are actually associated with Homo neanderthalensis not H. sapiens. I believe the herbs suggest the burial is that of a Neanderthal healer or patient. But Quinlan doesn’t point out that the suggestion that the presence of the flowers was deliberate, let alone that the herbs were placed
because they were medicinal, is controversial. (For an excellent summary of the excavations, see
Antiquity 2020;94:11–26.)
She describes Yersinia pestis, the bacterium that causes plague, as being covered with “a layer called ‘biofilm’, which is really just a clinical term for slime; this slime prevents Y. pestis from being eaten by other cells”. Biofilms certainly help Y. pestis evade immune defences. But biofilms are more than protective slime. They’re complex, integrated microbiological communities that, for example, encourage
Y. pestis’s transmission by fleas, drive the bacterium’s growth, reproduction and disease-causing pathogenicity, and are central to the bacterium’s ability to cope with environmental changes, such as resistance to our immune systems and antibiotics. Biofilms are an important reason why certain bacteria (not just Y. pestis) are so often deadly and increasingly difficult to treat.
It’s hard to find the silver lining in the Covid-19 cloud. But plagues can force social change. Quinlan notes that an economic boom followed the Black Death. The limited number of workers increased wages, reduced rents and hastened the end of feudalism.
I just hope some good comes out of our current mess. ★★★★