Through a glass darkly

Have we been here before ?

Susie gave me Peter Frankopan’s The Silk Roads: a new history of the world for my birthday. It’s a dense book of 600+ pages, so I’m reading it one chapter at a time. I’ve just reached the mid-14th century. As Frankopan tells the story, the Mongols had rapidly overrun the ancient Middle East and vast swathes of Asia, and had spared Europe only because there were richer pickings elsewhere. The Mongols were militarily dominant and politically astute. Under the Mongols trade blossomed: slaves, silk and cotton, frankincense, ambergris, glass, pepper and all kinds of spices, silver and other precious metals all flowed down the trade arteries. But something else also entered the bloodstream: disease. 

The arid and semi-arid landscapes of the Eurasian steppe were the perfect breeding ground for the bacterium Yersinia pestis. Plague was most effectively spread by animal hosts, sometimes camels, but more often by rats. Transmission to humans is most often the result of fleas vomiting bacilli into the bloodstream before feeding. Bacilli flowed to the lymph nodes, in the armpit or the groin, and produced swellings [buboes]  the size of an apple. Other organs are infected in turn leading to internal haemorrhaging and death. During the 1340s the plague flowed out of central Asia through Persia, the Middle East, the Arabian Peninsula, Egypt and Europe. The trading routes that connected the rest of the world to Europe became lethal highways of infection. A Mongol army laying siege to the Genoese post of Caffa on the Black Sea were struck by the plague and lobbed their corpses into the besieged city, It was an early example of biological warfare.

There was a widespread sense of coming to the End Times. Three-quarters of the population of Venice were killed by the plague. A French chronicler reported that “it rained frogs, snakes, lizards, scorpions and many other poisonous animals”. The King of England, Edward III, turned to prayer and fasting, and ordered his bishops to follow his example.  It is estimated that a third of the population of Europe died, some 25 million out of a population of about 75 million.This plague, commonly known as the Black Death, is sometimes labelled the worst single disaster to befall mankind since the Flood. 

Just over 30 years ago, as an Anglican ordinand, I was asked to write an essay: ‘AIDS is a manifestation of God’s wrath on present moral standards.’ Discuss. As a virus previously unknown, manifesting itself in previously obscure, opportunistic diseases, for which there was [then] no known vaccine or cure, AIDS was a phenomenon tailor-made for conspiracy theories. The Globe, an American tabloid, ran a lengthy cover-story in 1983 solemnly claiming that AIDS was part of King Tut’s curse, having followed a tour of Tut’s treasures to the United States in the late 1970s. Less fancifully we now think that AIDS was the product of a hitherto unknown virus from central Africa. As such it was not an unprecedented phenomenon. The American historian William McNeill has surveyed the history of infectious disease,, demonstrating the dramatic consequences of a ‘new disease’ circulating in human affairs. Writing at the end of the 1960s McNeill offered a prescient warning: “even without mutation, it is always possible that some hitherto obscure parasitic organism may escape its accustomed ecological niche … and expose the dense human population to some fresh and perchance devastating mortality”. Within a decade of his writing that, Dr Grethe Rask, a Danish surgeon came home to Denmark to die after working for four years in the primitive hospital of Abumonbazi in northern Zaire. She died of PCP in December 1977; almost certainly the first European to die of AIDS.

Are there lessons to learn from history ? About isolation ? The first public regulations for controlling the Black Death were only issued at Reggio in 1374. Only in 1383 did Marseille introduce a 40-day quarantine period; a period chosen for Biblical reasons. When the AIDS virus struck in North America, everyone said that “of course the gay bath-houses should have been closed earlier … of course the blood banks should have tested for blood sooner”. But by the time everyone agreed this, it was far too late. And about transmission ? The Black Death was carried by infected fleas and rats on a network of shipping throughout Europe. Improvements in ship design had made all-year-round sailing normal for the first time. The AIDS virus most probably originated in central Africa, as a mutant of an animal retrovirus. Its rapid global spread thereafter was made possible by the growth of inter-continental air travel. As Anthony Burgess noted at the time: “the world’s airlines are the great carriers of the disease”. Air travel is not only bad for the environment. It can have fatal consequences both for the passengers and for those with whom they come into contact.

Perhaps we do learn lessons from history. But, as Eric Morecambe famously said in another context: “not necessarily at the right speed or in the right order”.