Reading List: October 2021
The Russian Navy and smallpox mysteries
The Tsar’s Last Armada: The Epic Journey to the Battle of Tsushima (Constantine Pleshakov, 2003)
Following up on a Reddit thread, I picked up this book about the Russian navy’s journey around the world to confront the Japanese at the Battle of Tsushima, “[the] first and last decisive sea battle fought by modern steel battleship fleets” (Wikipedia). At 338 pages, it’s never dragged down, and the Russo-Japanese War begins only a few pages in.
A newly-promoted Admiral Rozhestvensky was tasked with this long journey. The Russian port in Manchuria (Port Arthur, now Lüshunko District) had already been besieged and decimated by the Japanese navy. If you’ve ever read about WW1’s deadliness coming from new, unrestrained technologies, this earlier war is another example. Ships and leaders were lost to mines and small skirmishes.
Ships, officers, and peasants who failed selection for the first round of the war were now sent off to this lost cause. Rozhestvensky divided the navy into three parts: his group rounding Cape of Good Hope, and others passing through the Mediterranean and Suez Canal.
The ships were constantly plagued with technical and crew problems. The Japanese had warned the British and French colonial ports that assisting the Russians would break their neutrality. The whole Russian diplomatic state was tasked with sourcing coal and supply orders along the journey (unfortunately revealing their moves to other navies). Communication between the Tsar and the Admiral was tense, and hampered by difficulties in radio and telegraph communication of the time.
Even before the first Russian ships finished passing through the English Channel, they attacked British fishing trawlers out of fear of a Japanese attack (a fear that continued in the Suez Canal, Madagascar, and in entering the Pacific through Indonesia). The British were allied with Japan and this almost pushed them into the war. Luckily for the Russians, war did not break out, the British and Egyptian authorities cleared the Suez Canal during their passage, and private companies continued to supply the fleet from British ports.
In the final month before the battle, experts in Moscow and also Rozhestvensk urged the Tsar to recall the fleet and make peace to prevent more ships, lives, and land from going to a lost cause. The Tsar insisted on the fleet continuing to Kamchatka (possibly due to an attack when he was a prince visiting Japan).
If you have a New Yorker subscription, also read the 1958 series: The Difficult Journey.
The Last Days of Smallpox: Tragedy in Birmingham (Mark Pallen, 2018)
Pallen, a professor of Microbial Genomics, reflects on the smallpox eradication story. With a popular science voice (detailed and understandable) he recounts the last few outbreaks and eradication efforts, before focusing on the final, perplexing lab leak in Birmingham.
Though I read House on Fire about smallpox eradication in 2020, this book’s introductory chapters added new information. I learned how scientists traced and incubated the closest relatives of smallpox (in African gerbils and camels, which met around the time the human virus emerged), and that Abraham Lincoln was in the incubation stage of smallpox when he delivered the Gettysburg Address.
In chapters about the last natural cases, it’s clear how a divided, pre-digital world could muster the resources to organize eradication. The disease was terrible, and any one souvenir or visitor from a distant smallpox-endemic country could start a new outbreak. In the 1960s the UK was repurposing or burning their old smallpox isolation hospitals (loss of institutional memory and resources) and many people went unvaccinated (loss of immunity / vigilance). New cases often went misdiagnosed, and no alarms rung until family members and other contacts were contagious.
Smallpox has a certain physics where infection is spread by being within 6 ft / 2m of the infected, or sharing contaminated items, and incubation creates waves 10–14 days apart. This made eradication possible. Foreshadowing the controversy around Birmingham, the author describes cases which challenged these rules. In West Germany, a patient infected nurses and a patient on another floor, despite decontamination measures: was smallpox airborne?
By the mid-1970s, cases were limited to a few countries. A UK program sent younger doctors to the smallpox frontline, to maintain practical knowledge. One of those doctors, Alasdair Geddes, was the smallpox expert on call to diagnose the lab leak case in 1978.
Here we get into some of the author’s own reporting. Pallen interviewed colleagues in Birmingham and used the UK equivalent of FOIA to view all testimony in the workplace safety trial. Experts were perplexed how the virus had spread to another floor, and the coincidence of a 1966 outbreak which had included someone working the same medical photographer position in the same building (but given strains of smallpox, it was quickly found to be new and not somehow dormant virus).
Despite theories about careless management or weaponized strains at the lab, the legal process decided that transmission occurred through a ventilation duct in a rare and unforeseeable accident.
After prodding the experts who are alive today, Pallen believes a different story — a rumor that Parker had visited the lab and would frequently order photo equipment for people (using the university supplier discount). After exposure to darkroom chemicals, it may have been easier for the virus to infect her through skin contact. The author continues on to say that with the concealed lab visits, the incubation time could be different, that the same situation likely started the 1966 outbreak, and that Parker’s health may have been weakened by an undiagnosed kidney problem. Ending the book with more routes of speculation was a bit frustrating, as I was digesting the main controversy / explanation, and then I’m given some other uncertainties. If I was talking about this book to someone, I would say it seems the unauthorized visit rumor must be true or else airborne smallpox would be a more frequent and persistent problem.
After the incident, labs improved their security and cleanliness, but also weighed the risks of future research. By 1980, only six labs held smallpox samples. South Africa agreed to destroy their samples in 1983 after being assured access to materials (they had feared researchers would lose access due to apartheid-era sanctions). And then there are the two labs with samples today.
Finally, I found it interesting that Pallen writes that guinea worm will ‘almost certainly’ be eradicated by the time the book was published, because three years later there are new setbacks. I do hope there can be a future ‘last days of guinea worm’ book, and in Jimmy Carter’s lifetime.
Updates on previous reads
- Dr. William Foege, of smallpox and CDC fame, was on the Theranos board. He might testify?
- There was a Twitter thread about White shoppers assuming the nearest Black person was an employee, and someone shared an anecdote about Justice Thurgood Marshall. I found a source:
Justice Douglas is also mentioned in the source because he would accuse Marshall of “wasting a lot of time and in a lot of idle talk and irrelevant conversation.”
