For my fifteenth birthday, my parents gave me a copy of Arno Karlen’s book Plague’s Progress: A social history of man and disease. This is, as the title suggests, mainly concerned with the history of epidemics and pandemics, and how they occur (principally through a disease that is well-established in an animal species jumping the species barrier). It is prescient reading, and so I’ve just whipped through it again in a couple of evenings. Having read and inwardly digested the central message of the book twenty-five years ago (i.e. LOOK OUT), some small part of me coiled itself up to wait, wondering when the next pandemic was going to be. A mere seven years later, the SARS outbreaks occurred, followed by swine ’flu shortly afterwards. The latter prevented me from going to China that year, but otherwise came as no surprise whatsoever. I read a sensible, well-researched book. Based on the evidence, the book predicted a thing; the thing came to pass. Why, then, is the current pandemic such a shock to the system?
One reason, and the idea I want to explore in this post, is the lack of a more meaningful connection between scientific research and policy. Here is a passage from Plague’s Progress in which Karlen explores an outbreak of hantavirus pulmonary syndrome in the Four Corners area in 1993:
a New Mexico biologist, Robert Parmenter, had just finished a ten-year study of local rodents. Heavy rain and snow the previous year had caused a rare abundance of piñon nuts and grasshoppers, staples of the deer mouse diet. When the animals’ food supply expands, they have bigger, more frequent litters and their population grows. From May 1992 to May 1993, deer mice had multiplied tenfold. As result, people were exposed far more than usual to the mice and their wastes. Late in the summer of 1993, the mouse population started to fall, and the hantavirus epidemic in humans waned.Arno Karlen, Plague’s Progress (London: Victor Gollancz, 1995), p.172.
Notice four important things here. One, somebody (Dr. Parmenter and/or his funding body) decided that deer mice were interesting – so interesting, in fact, that they were prepared to study the little blighters for a decade. Two, somebody (Dr. Parmenter and/or his research team) noticed the explosion in the deer mouse population. He and his team had probably written at least one paper on the subject, including lots of meticulous stats and several photos of whiskery-faced mice looking both cute and harmless. Three, somebody – quite a few somebodies this time – knew that hantavirus was linked to human/mouse contact and it seems reasonable to suppose that this may even have been one of the reasons these mice were being studied in the first place. Stephen Porter devotes two entire pages of The Great Plague to speculating about rat populations in the 1660s, and while his various suggestions are convincingly argued, he has no rat-based data with which to support them. Similarly, Roy Porter makes it clear in his medical history of humanity that one of the reasons we can’t say anything substantial about the rat populations in plague years is that ‘no-one had any reason to suspect rats’. Karlen makes it very clear in the preceding pages that, in the case of hantavirus, the link to mice was known and the virus was sufficiently well understood that it had been placed into the correct family, alongside Bolivian haemorrhagic fever, which he describes as appearing in 1960 and ‘like the Argentine fever, but even deadlier.’ Four, notice how keen we are to pin these diseases down to a specific location in the way we name them. This nasty pox can’t have originated here, in our nice clean homes, we imply, but somewhere else, where people are less clean, less responsible and less white (although we might note in passing that there are infestations and infections, from nits to polio, that thrive on cleanliness). This is an attempt, I think, to shift the blame. Rather than focusing on (say) idiotic, irresponsible behaviour here (e.g. the delivery driver who yesterday tried to hand me his telephone, a thing he literally holds up to his face to make it work), it allows us to focus on there: some unfamiliar, barbaric place, where no doubt they do things differently and more dangerously. It is an attempt to make these diseases sound external, invasive, foreign and other. The obvious examples are of course Spanish ’flu (of which more later), German measles and various names for syphilis. Karlen notes that,
People around the world named it for the nations they thought had infected them; in France it was the Italian disease … the Spanish disease in Holland, the Castilian disease in Portugal, the Polish disease in Russia, the Russian disease in Siberia, the German disease in Poland, the Christian disease in Turkey, the Turkish disease in Persia, and the Portuguese or Chinese disease in Japan. [Syphilis] became the most disowned infection in history.Karlen, p.124. I am also reminded of Flanders and Swann at the end of the Song of Patriotic Prejudice: ‘it’s not that they’re stubborn or naturally bad/It’s knowing they’re foreign that makes them so mad.’
This is a tale as old as plagues themselves. Stephen Porter tells us that,
When the chronicler Henry Knighton described the origins of the Black Death in the 1340s, he noted that it had begun in India, spreading from there to Asia Minor and then infecting the Christian and Jewish populations.Stephen Porter, The Great Plague (Stroud: Sutton Publishing, 2003), p.1.
Donald Trump’s idiotic label for this latest form of the coronavirus as ‘the Chinese virus’ is, therefore, entirely of a piece with the racism and othering that has been applied to infectious disease for centuries. However, as the syphilis example shows, the origins of a disease are rarely captured accurately or helpfully in its name. Karlen suggests, with reference to polio, that ‘officials responded … as they often do to puzzling new challenges by refighting their last war’ and perhaps we can read the current situation in the light of Brexit and other sources and/or expressions of racial tension around the world. British exceptionalism will not save us, as we blunder off into the night, mumbling ‘keep calm and something something’. I’m also getting pretty tired of the situation being described as a war or in warlike terms, given that what is currently required is calm, compassion and good sense (qualities not usually sought out or rewarded in wartime). Again, I read this as othering: wars are, after all, almost always fought against other nations.
We can find a whole load more racism in the efforts made to fight (by which I mean find someone to blame for) previous outbreaks of various diseases. For example, in her review of John Henderson’s book Florence Under Siege, Erin Maglaque speaks of Jews being ‘locked in the ghetto’ during the 1629 outbreak of the plague in Italy; Roy Porter of Jews being ‘penned up in a wooden building and burnt alive’. In the many polio epidemics in the twentieth century across Europe, doctors, public health officials and parents were basically just guessing at how to prevent and treat the disease, and naturally turned on those they already viewed with hatred and suspicion. Karlen describes
a belief that dirt, and polio, were spread by the poor and foreign-born. Scientists and laymen alike feared that hordes of dirty, ignorant immigrants with primitive hygiene were infecting clean-living society. … polio was rare among poor blacks. Yet official attention stayed fixed on ethnic and racial slums.Karlen, p.152.
In 1916, there was no test for polio, no vaccine and no effective treatment. There was also no idea of how it spread from one person to another. Polio appeared to strike at random (Karlen describes it as ‘evil lightning’) and thus as well as People From Forn Parts, suspected causes included fomites (objects, door-handles, railings and so forth), dogs, cats, dirt, insects, Jews and swimming. In fact, polio is caused by a virus that occurs naturally in the intestines, and that only becomes troublesome when spread (via the fecal-oral route) into the mouth. In some people it will cause a mild infection; in others, the spinal cord will be affected, leading to lifelong paralysis. This explains why polio thrives in clean, warm places: in dirty homes, children are far more likely to be exposed to the virus at an early age, experience a short illness and thereafter immunity.
To return to my comment that the relationship between research and policy is a problematic one, here is Karlen again, on the aforementioned Bolivian haemorrhagic fever:
When the epidemic peaked, in the mid-sixties, there were a thousand cases a year and hundreds of deaths. In one village, the ecological source of the disease became obvious. Spraying with DDT to prevent malaria had wiped out the village’s cats; mice multiplied, and human illness followed. Destroying the mice ended the epidemic in precisely two weeks, the virus’s incubation time.Karlen, p.162.
A couple of things leap out at the contemporary reader here, I think. Firstly, we might recall the oft-repeated story of villagers suspecting cats to be carriers of the Black Death and killing them, thereby leaving flea-bearing rats and mice to proliferate in greater numbers. Stephen Porter describes the public health measures suggested by Sir Theodore de Mayerne (the king’s physician) in 1630, which including widening the net of death to include dogs, rats, mice and weasels. Secondly, I notice that the people tasked with killing these creatures are (much like our teachers in certain parts of the gutter press) considered simultaneously vital and expendable here, especially since the dogs, cats and weasels that might have happily wiped out the rats had already been pointlessly executed. If we agree with Mayerne that rats needed to be killed (and from our modern perspective with the knowledge that rats carried the plague-bearing fleas, this seems like a sound idea), then being the person tasked with killing hundreds of hysterical rats seems like one of the crueller and more unusual death sentences: I’ve no idea how medieval rat-catchers killed rats, but I doubt it involved hand sanitizer or PPE. Thirdly, if it was established in the mid-sixties that deer mice could carry disease (and a very unpleasant, often deadly disease for which there was no treatment), why was the hantavirus outbreak in Four Corners thirty years later such a surprise, given that it coincided with a tenfold increase in the deer mouse population? Presumably, alarm bells rang for Dr. Parmenter as he documented the massive increase in the number of deer mice. “Gosh”, he probably said to himself, “all those mice rushing about the place is going to increase the possibility of humans catching hantavirus! Thank goodness my university and/or funding body employed me to monitor their population! I should tell someone!” I imagine he thought more or less exactly that, but there was no Deer Mouse Hotline with a big brown flashing handset and Bakelite mouse-ears. The paper I imagined earlier, probably called something like ‘Piñon nuts and grasshoppers: On the population of deer mouse (Peromyscus sp.) in the Four Corners area’ no doubt exists, but it doesn’t even make it into the references for Karlen’s chapter: the best I could do was a summary of the original paper. I wonder how many people read Parmenter’s paper before the outbreak of hantavirus. I wonder how many of those people understood what it meant for human health. Look up the deer mouse and you will discover almost immediately that it is a reservoir of both hantavirus and Lyme disease, and that Peromyscus is the most commonly-used rodent species used in scientific research. No wonder the hantavirus jumped the species barrier: the power of irony compelled it.
Thirdly, there is the reference to spraying (spraying, for God’s sake) with DDT, again, in the mid-sixties. Why in God’s name was anyone doing anything with DDT in the mid-sixties, given that Silent Spring was published in 1962? Silent Spring, in glassy, beautifully controlled prose, did not so much debunk the indiscriminate use of pesticides, fungicides and herbicides as hack it to pieces and hurl the mangled remains onto a fire, much as Damiens the regicide is dismembered in the opening pages of Discipline and Punish. Rachel Carson builds her (absolutely watertight) case with great skill and persuasion. One is both frightened and utterly convinced well before the end of the first chapter. Why, then, does Ernest Shackleton describe the book as ‘brilliant and controversial’? What could possibly be controversial about warning both the public and the policy-makers that substances being merrily used to hose down homes, gardens, people and crops were highly poisonous to both man and beast? The answer is, of course, that it was more convenient to pretend that it wasn’t so. This, too, is as old as time: Maglaque notes that in early modern Bologna ‘officials had forbidden people to discuss the peste, as it they feared you could summon death with a word’ (nope: that’s Candyman).
Silent Spring is riddled with the lack of connection between research and policy (or perhaps the failure of policy-makers to take research seriously). For example, in Chapter 8 we meet Professor George Wallace and his grad student John Mehner, who was doing a PhD on robins in 1954. Much like Dr. Robert Parmenter and the deer mice, Mehner was uniquely well-placed to comment on the almost total lack of young robins after the elm trees in which the robins lived were sprayed with DDT. DDT is incredibly poisonous to both worms and the things that eat worms (including robins: Wallace reports mortality of 86-88%); and even small doses of DDT destroy the reproductive capacity of those that survive, creating eggs that refuse to hatch at all, or eggs with shells so thin that they either break prematurely or cause the baby birds to bake to death under the warm bodies of their brooding parents. The Cranbrook Institute of Science (Michigan)
asked in 1956 that all birds though to be victims of DDT poisoning be turned in to the institute for examination. … Within a few weeks the deep-freeze facilities of the institute were taxed to capacity, so that other specimens had to be refused … sixty-three different species were included among the specimens examined at the institute.Rachel Carson, Silent Spring (London: Hamish Hamilton, 1964), p.89.
One of the many criticisms levelled at doctoral research is that one spends four years researching and writing something that eight people will read and only five will care about (a criticism that is not without validity). In this case, however, Carson goes out of her way to make it clear that people did care about the dead robins, noting that citizens ‘show a keener understanding of the dangers and inconsistencies of spraying than do the officials who order it to be done.’ In other words, while the good people of Michigan might not have found the time to read Mehner’s thesis, they were certainly interested in the dead birds piling up in their gardens (‘one woman calling the institute reported twelve robins lying dead on her lawn as she spoke’) and they also knew that the appropriate thing to do with that information was to pass it on to a scientist. Not every thesis is as carefully situated in the wider context as it might be, but as we can see from the quotation above, it was perfectly clear that the problem was not robin-specific, and that none of the researchers working on it thought it was.
Karlen says, ‘[u]nderstanding ecology means not just sympathy for whales and owls but an appreciation of the entire biota, from humans to weeds to the smallest microscopic parasite’. Similarly, Shackleton writes in the Introduction to Silent Spring that the book is ‘not merely about poisons; it is about ecology or the relation of plants and animals to their environment and to one another.’ The remainder of Carson’s exposition of the DDT/robins example in Michigan is as follows:
The robins, then, are only one part of the chain of devastation linked to the spraying of the elms, even as the elm programme is only one of the multitudinous spray programmes that cover our land with poisons.Carson, pp.89-90.
She lays out over the next few pages the various species, from spruce beetles to screech owls, poisoned and rendered infertile by the spraying of elms against Dutch elm disease. Finally, we reach the devastating conclusion:
Spraying is killing the birds but it is not saving the elms … a drought year brought conditions especially favourable to the beetle [that carries a fungus that is the ultimate cause of Dutch elm disease] and the mortality of elms went up 1000%.Carson, p.94.
Carson then outlines how, with patience and rigour, scientists in New York established a programme of destroying infected trees and ‘beetle-breeding material’ that actually fucking worked, cost far less than spraying with DDT and didn’t kill anything other than the beetles. Three hundred years earlier, as the plague spread across Europe, Maglaque notes that Florentine officials ‘wrote anxiously to their colleagues in Milan, Verona, Venice, in the hope that studying the pattern of contagion would help them protect their city.’ It’s almost as if information is our best weapon against death and destruction, everyone.
If early modern Italians knew that knowledge was power, my question is this: why do we no longer believe this? If we no longer believe this, what the fuck is the point of research? What is the point of universities? Universities generate knowledge and pass it on. That is the whole reason they exist. Universities are often unclear about their own objectives, including what their top priorities should be: you may notice that institutions in the Russell Group like to describe themselves as ‘research intensive’, but whenever we ask for money, it is the young minds in our care that we wheel out, rather than the latest ugly capital building project or pointless HR initiative that has actually soaked up the funding. Nevertheless, for our purposes here, I am going to take universities at their word that research is somewhere near the top of a list of Things We Do. It seems clear to me that, as outlined above, relevant research is being done. Yet the information – important information, that took work and time to acquire – is frequently ignored, misunderstood, twisted or minimised. Karlen spends most of his introduction explaining the difficulty he had in getting his book published at all:
Almost twenty years ago [i.e. in 1975, for fuck’s sake], I told friends that I was thinking of writing a book about why so many new diseases were emerging. Most of my friends were puzzled. A few asked if I meant Legionnaire’s disease and Lyme disease, both of which had lately appeared. I said yes, those and many others … No publisher was interested. I was told this could only interest specialists.Karlen, p.2.
I cannot grasp why a funding body would think it a good use of time and money to send someone out into the field to study mice for ten years without a coherent understanding of when and how that research might be valuable – and it could have been extremely valuable to the 32 people that died horribly in the Four Corners hantavirus outbreak, a disease with a mortality rate of 60%. Karlen is acutely aware of the need to research this stuff, learning from the past as we go (surely the task of both researchers and policy-makers). He has much to say here about influenza pandemics, primarily those in 1889 and 1918 (there were several earlier ones). The numbers are quite staggering. Here’s Karlen on the 1889 outbreak, which was ‘the first to move with the speed of trains and steamships, [and which] killed 250,000 people in Europe alone.’ Compare those figures to these from 1918. Humanity appeared to have learnt precisely zero about how to prevent or treat influenza in the intervening thirty years:
Influenza deaths reported in the United States numbered 550,000, ten times the nation’s death toll in World War I. Many cases went unreported; the real total may be as many as 650,000. One can only guess at how many died in such badly ravaged countries as India. The global mortality, usually given as 20 million, may have been 30 or even 40 million. World War I killed 15 million people in four years; flu killed perhaps twice that number in six months. Even bubonic plague did not kill so many people so fast.Karlen, p.144.
Notice that the Black Death is well-known to every schoolchild, even though a) influenza killed far more people; and b) influenza is far more likely to kill somebody known to that schoolchild than bubonic plague. Stephen Porter touches on the same idea, noting in the final pages of his book on the Great Plague of 1665-6 that
[t]he physical manifestations of plague [i.e. buboes, blotches under the skin, vomiting, delusions etc.] and the high levels of mortality among those infected made it one of the most feared of diseases, attracting attention in a way that other large-scale killers, such as influenza, did not.Stephen Porter, p.130.
Karlen recognises this, but I think what he’s really upset about here is the same thing that is bothering me: the failure of policy-makers to plan for the next epidemic.
[This was] was one of the worst disasters in history and it holds puzzles for virologists and historians today. Their questions are more than academic. If another such virus should emerge – and many researchers expect it will – we may be little better equipped to fight it than people were in 1918 … The 1918 flu pandemic continues to recede from memory. Curiously, medicine was not blamed for failing to prevent 50 million deaths from flu and typhus in the world’s last huge pre-AIDS pandemics…. It seems that, in the 1920s, the country saw its present and future not in the unsolved, lethal forces of typhus and flu but in the rescue of children from infectious diseases.Karlen, p.144 and p.147. The rescue he is talking about involved huskies dashing across Alaska to deliver diptheria antitoxin in 1925.
Now we come full circle, to the current pandemic (again, by way of early modern Italy). Here is Arno Karlen again, and again I remind the reader that he was writing twenty-five years ago:
in the middle of the fourteenth century came the worst disaster in human history, the second bubonic plague pandemic, the Black Death. It had the usual precursor, a Malthusian crisis of rising population, strained resources and environmental change.Karlen, p.86.
Note that phrase, ‘the usual precursor’. It should not be remotely surprising that fucking about with nature and squandering resources leads to new and exciting ways to die. Maglaque notes that ‘Florentines flouted the quarantine in ways that were both petty and risky … [they] understood the dangers, but gambled with their lives anyway: out of boredom, desire, habit, grief.’ Unlike Venice, where one in three people died from the plague, and Milan where it was nearly one in two, in seventeenth-century Florence, one in eight people died from the plague. The quarantine measures undertaken in Florence that saved so many lives are recognisable as what we now call ‘lockdown’, a term we have all started using as if it has been part of our vocabulary for years (see also ‘prorogation’). Medical advice is usually kindly meant and generously given, but that wasn’t always the case, and the public were just as reluctant to do as they were asked in early modern Florence as they are now in contemporary Britain.
The epigraph to Silent Spring is a quotation from Albert Schweitzer, which reads ‘Man has lost the capacity to foresee and to forestall. He will end by destroying the earth.’ I normally flinch at that use of ‘Man’ to refer to all of humanity, but in this case I think perhaps Rachel Carson intends us to read the gender as it stands. Virginia Woolf argues in Three Guineas (another controlled, raging piece of non-fiction) that one of the reasons the world continually lurches from crisis to crisis (she’s speaking specifically about warfare, but again I think the point stands) is that women aren’t at the decision-making table. Female politicians in the UK have been conspicuous by their absence since the pandemic began (so much so that Woman’s Hour recently asked where on earth they all were). I wonder if somebody somewhere decided that the general public would find it reassuring to see a load of exhausted men running the country, as if all the Men Who Always Sound Tired in The Archers had quietly conducted a coup d’etat.
Jacinda Ardern has implemented public health measures that have so far not so much flattened the curve as crushed it altogether: at the time of writing, the offical death-toll from coronavirus in New Zealand is one. In Britain, nearly a thousand people died (again, officially) yesterday alone. Let’s recall here the criticism of Hillary Clinton as ‘too prepared’; Elizabeth Warren’s famously meticulous and detailed plans, including one that she released to combat coronavirus in fucking January; and Stacey Abrams being shut out of the governorship of Georgia in favour of Brian Kemp. Kemp is a late entrant in the competition our male leaders seem to be having right now as to Who Can Be The Most Like Larry Vaughn (the mayor of Amity Island in Jaws), but Kemp might be ahead by a nose since he did just literally open some beaches. You may have missed Boris Johnson declaring Larry Vaughn to be the hero of Jaws and in the article I’ve linked to the writer urges us all to watch Jaws 2, in which Larry Vaughn is still mayor and still doesn’t believe in sharks. That’s not what happens in the original story, however: Peter Benchley’s Larry Vaughn is devastated by the deaths that are the result of his own hubris, losing weight, his fortune and his self-respect in rapid succession and eventually crawling quietly out of town a broken man. However, you shouldn’t watch Jaws 2. It’s terrible. Jaws 2 is not to Jaws as Exorcist II is to The Exorcist, but it’s not far off. Like Exorcist II, Jaws 2 attempts to lull the viewer into a false sense of security by recycling some of the same actors and characters as the original, but frankly that just makes it more painful. I also urge you not to watch Jaws 3-D or Jaws 4: The Revenge or Jaws 5: Cruel Jaws or Sharknado or Sharknado 2: The Second One or Sharknado 3: Oh Hell No or Sharknado 4: The 4th Awakens or Sharknado 5: Global Swarming or Sharknado 6: The Last Sharknado or Deep Blue Sea or Deep Blue Sea 2 or Three-Headed Shark Attack or Five-headed Shark Attack or Six-Headed Shark Attack or Bait 3-D or The Reef or Frenzy or Shark Night 3-D or 47 Metres Down or The Shallows or The Meg or Piranha Sharks or Toxic Shark or Jurassic Shark or Sand Sharks or Sky Sharks or Avalanche Sharks or Snow Shark: Ancient Snow Beast or Ghost Shark or Ghost Shark 2: Urban Jaws or any of the other fucking moronic Jaws rip-offs in this strangely crowded sub-sub-sub-genre. If you want to watch a film with a shark in it, try Jaws (spoiler alert: it’s not really about the shark).
It may seem that I have wandered off the point into a shark-infested backwater, but if you actually watch any of these films (and again, I don’t recommend that you do), you will see a set of familiar, tired stereotypes that are relevant here. Men, filled with rage and violence, but allowed in these oddly specific circumstances to unleash that rage and violence upon sharks, symbols of everything men both admire and fear. Women (by which I mean bikini-clad twenty-five-year-olds without surnames), screaming, taking their clothes off and falling into water for no good reason. Each of these braindead films has led in its own tiny, stupid way to the endangering of every species of shark; Peter Benchley spent much of his life attempting to undo the harm that he felt Jaws had done, but of course Jaws wasn’t the problem. These sub-Jaws films show sharks as huge, terrifying, voracious and unstoppable by any sensible means: generic serial killers, perpetually armed and with no tedious psychology to worry about. Just as the indiscriminate spraying of DDT to save a few elm trees as described above was a massive, disproportionate and destructive over-reaction, notice how these unfeasibly large film-sharks can only be killed by some kind of hastily improvised, highly unlikely and ultra-violent means: electrocution (Jaws 2), nuclear explosion (The Meg) or whatever (any and all of the Sharknado films). In short, we are back to the warfare metaphors I mentioned above, improvisation rather than planning, and narrow, shallow roles for women.
Why do we keep electing mediocre white men? Because so much of our culture tells us that mediocre white men are the answer to every problem. Why do we keep making excuses for them (see Brexit, pursued by a bear)? It’s as if the crew of a starship were offered a choice of Janeway or a semi-sentient potato to captain them through a series of unknown crises, and choose potato after potato because Janeway isn’t ‘likeable’. We could so easily have elected leaders that would been up to dealing with the pandemic. It’s neither fanciful nor unfair to say that our leaders could and should have made informed, well-researched contingency plans for this scenario: the fin has been slicing through the water for centuries. My colleague Prof. Gary Foster has been banging on about pandemics for decades, both in lectures and on Twitter. Literally everyone who studies infectious diseases knew this was coming. All their students knew this was coming. Arno Karlen knew this was coming and so did I. Our leaders did not.
 This meant taking a holiday from Clive James’s massive tome Cultural Amnesia, a book I have now been reading for several weeks. Even here, I have found ideas relevant to our current situation, including this rather lovely echo of social distancing in James’s essay on Georg Christoph Lichtenberg: ‘Lichtenberg’s innumerable observations add up to a single demonstration of his guiding principle: that there is such a thing as ‘the right distance.’’ Clive James, Cultural Amnesia: Notes in the margin of my time (London: Picador, 2012), p.380.
 Stephen Porter, The Great Plague (Stroud: Sutton Publishing, 2003), pp.126-127.
 Roy Porter, The Greatest Benefit to Mankind: A medical history of humanity from antiquity to the present (London: Harper Collins, 1997), p.125
 Arno Karlen, Plague’s Progress (London: Victor Gollancz, 1995), p.162.
 Fracastorius was both the first physician to describe the disease and the first poet to write about it in any detail. He did this with great enthusiasm in the poem Syphilis suve morbus gallicus (‘Syphilis, or the French disease’).
 Karlen, p.151.
 Erin Maglaque, ‘Inclined to Putrefaction’, London Review of Books, vol. 42, no. 4, 20th February 2020; Roy Porter, p.125. Porter notes that Jews were also accused to poisoning wells, an accusation levelled at ethnic Koreans in the aftermath of the 1923 Kantō earthquake in Japan. In reality, the wells were cloudy because of the turbidity caused by the earthquake, but as in the plague example, apparently any excuse to turn on one’s neighbours will do.
 Karlen, p.149.
 We think of polio as a child’s disease because distressing images of small children in iron lungs and callipers were used to raise money for treatment and research (such as in the March of Dimes campaign), but polio is in fact more likely to be dangerous in adults. Michael Flanders, for example, contracted polio as a healthy twenty-one year-old.
 Stephen Porter, p.15. Elsewhere in the book, Porter mentions pigs being killed rather than allowed to wander the streets, a medieval attitude to feral hogs that was new to me and that puts an interesting slant on those charming videos of boar roaming through deserted Italian streets.
 Peromyscus (‘the booted mouse’ in Greek) refers to the pattern of fur, in which the underside and feet are a pale colour, while the rest of the mouse is darker, giving the impression that the mouse is wearing boots (or possibly socks to modern eyes).
 Carson, p.93.
 Carson, p.89.
 Karlen, p.229.
 Ernest Shackleton, introduction to Silent Spring, p.xiii.
 Karlen, p.86.
 Carson, p.vi.
 Clearly, the only character in The Archers remotely qualified to act as benign dictator was Nigel. I’ve always hated The Archers, but ever since Nigel was pointlessly hurled to his death, nothing beyond the first three bars is tolerated in this house.
 Yes, I did completely ruin my YouTube search history adding in all those trailers for you. I regret nothing.
 Don’t waste your time on Bait (by which I mean the 2012 Australian horror film about a shark in a flooded supermarket). You might, however, enjoy Bait (by which I mean the 2019 film about Cornish fisherman finally having enough of all the fucking second-homers), even though it doesn’t have any sharks in it.