Musings on a plague year in Stratford upon Avon

When in disgrace with fortune and men’s eyes,

I all alone beweep my outcast state,

During an outbreak of the bubonic plague in 1592, when London theatres were closed for 6 months, Shakespeare used the time to write two long narrative poems and quite possibly this Sonnet XXIX.

And trouble deaf heaven with my bootless cries,

And look upon myself and curse my fate,

Could those be the words of man fed up with lockdown? Shakespeare’s whole life was overshadowed by the plague. A few months after he was born in April 1564, a serious outbreak swept through England and killed nearly a quarter of the people of Stratford upon Avon. The plague was again rife in the 1590s and Shakespeare’s only son Hamnet died in 1596 aged 11; the cause of his death was not recorded but the plague was not ruled out. The plague returned in force to London in 1603 and again in July 1606 when theatres, including Shakespeare’s Globe, were once more closed; in fact, London playhouses were intermittently closed for 78 months of the following decade (60% of the time). A preacher at that time thought that “The cause of plagues is sin, and the cause of sin is plays”; fortunately we now know better: if was fleas, not sin. Theatre-goers today, perhaps, should take heart from the fact that Shakespeare’s company managed to keep the show on the road throughout those troubled times. 

Wishing me like to one more rich in hope,

Featured like him, like him with friends possessed,

He certainly sounds as though he’s “got the hump” as my mother used to say, although during  her low moments she was more like a nervous sheep than a camel. The currrent pandemic is so widespread across the world, afflicting “all conditions of men and women”, that it is hard to think  with envy of anyone “more rich in hope”. Perhaps our son who now lives in London might wish he were back in New Zealand again, or I can feel grateful for another son who lives in Japan’s northern island of Hokkaido and has not seen a single case of covid-19 in his coastal town of Shiranuka.

Desiring this man’s art and that man’s scope,

With what I most enjoy contented least;

Among the diversions of my years of retirement, I have noticed recent changes in “what I most enjoy”. For example, I have stopped drinking and watching films. Living alone since the pandemic began has made me realise these are social activities and no longer so satisfying in my outcast state. All my life I have struggled for inspiration with the tricky art of watercolour, but the muse has lately completely deserted me. My small local group of fellow greying artists has started meeting again (in the garden, of course) but now seem to gas as much as draw. I have enjoyed Zooming or WhatsApping to stay in touch and have dug up old friends from home and abroad, I have also enjoyed keeping this blog alive with commentary on the pandemic and cryptic crossword clues. I get a weekly Mindbender for the Quarantined from the New York Museum of Mathematics and spend hours writing small programs to search for solutions; off and on I append a new paragraph to my memoir (for family consumption only, I hasten to add).

Yet in these thoughts myself almost despising,

Haply I think on thee, and then my state,

Aha, at last, a welcome change of mood, a happy memory, a ray of light to banish his gloom. Begone dull care! There have been better days and there will be again. Put way introspection and melancholy, stay “Looking on the bright side” as my old maths teacher called his memoir.

Like to the lark at break of day arising

From sullen earth sings hymns at heaven’s gate;

Praise be the Lord! Heaven is not entirely deaf to his bootless cries; the lark has interceded.

For thy sweet love remembered such wealth brings

       That then I scorn to change my state with kings.

Yes, I can relate to that. For the past three months my wife has been locked away in Penzance, without a pirate in sight as far as I know. But we will soon be braving public transport to meet up in London to celebrate four family birthdays. Things are not so bad after all, for me, and even for Stratford. Sure, the RSC is closed, but they have been streaming their past productions, and their cast of actors, hopefully only temporally out of work, have been reading Shakespeare’s sonnets. Anthony Sher reads Sonnet XXIX and this reminds me that only a year ago I watched him and John Kani give an outstanding performance of Kani’s moving South African play, Kunene and the King. They will be back, the RSC will return, and then I shall scorn to change my state with kings.

The Hammers

During my early childhood in Derbyshire I was an enthusiastic follower of the local soccer team, Derby County ("The Rams") and was very proud when they won the Football Association Cup in 1946, beating Charlton Athletic 4-1 after extra time.   Much later in life, when I moved to the Midlands, I occasionally went to watch Coventry City ("The Sky Blues"), but they fell on hard times, dropping two leagues below the Premier, and I lost interest in the game. (These days I confine my watching to brief random TV broadcasts while standing in the queue at my local fish and chip shop.) 

I had therefore not been aware that the Premier League Club, West Ham United ("The Hammers"), had forsaken their 100-year-old home at the Boleyn Ground in Upton Park in favour of the London Stadium, built originally for the 2012 Olympic Games in the Stratford district of east London, until I saw this brilliant crossword clue (due to Russell Henwood in his puzzle in The Telegraph  on July 10th):

 The new stadium designed for West Ham United, perhaps? (7, first letter A).

T for Thymus!

After answering questions about my age, health and lifestyle for a covid-19 mortality calculator on this UK website, I was given a 1-in-20 risk of becoming infected and a 1-18 risk of dying if infected. It has become well-established that the risk of succumbing to a bout of covid rises dramatically with age, from essentially zero for the under-20s up to around 6% for reasonably healthy over-80-year-olds like me. The reasons for this disparity are not fully understood, but a decline in the effectiveness of the human immune system with advancing years is likely to be a significant factor. To give a readable account of the amazing complexity of this system is well beyond my knowledge and the scope of a short post, but I have managed to isolate one important component relevant to these statistics, namely the role of the T-cells

The Enemy

Pathogens are microbes that invade your body and make you ill. They include bacteria, viruses, pollen and fungi. A bacterium is a single cell organism that can independently reproduce in your body and may sometimes cause damage. In contrast, a virus, which  is much smaller, can only replicate by entering one of your cells and taking over a normal cell function to make copies of itself.

An antigen is a small part of a pathogen, typically a specific protein on its surface, that is used by your immune system to identify, track down and destroy the invading microbe. You could think of it as a banner advertising the pathogen’s presence to your immune system.

Your Defences

T-cells have many important functions in the human immune system:

• They kill your own infected cells that have been hijacked by a virus to replicate itself
• They activate other immune cells that directly attack the invading virus or other pathogen
• They regulate the overall immune response, and
• They store memories of earlier infections in order to mount a pre-emptive strike if one of them tries to re-infect you. 

T-cells begin life as a type of stem cell made in your bone marrow. From there they are carried in our blood stream to other organs, in particular to the thymus, a small gland located in the upper chest behind the sternum and in front of the heart. There they undergo a selection process which many don’t survive. Those that do then circulate round the body’s peripheral lymph-organs ready to be activated when they encounter a specific antigen. Once activated, the T cells will proliferate and differentiate into effector T-cells, which further diversify into T-cells with a variety of different functions; among these are cytotoxic T-cells whose main function is to kill your virally-infected cells but which can also kill tumorous cells and cells invaded by bacteria.

The thymus continues to grow after birth and reaches maximum size and activity around puberty. Thereafter it decreases in size and function and continues to atrophy until old age, eventually  turning to fat and becoming very hard to detect even under a microscope. Surely SARS-Cov2 exploits this decline in our once-vigilant defences.

Special K

"Superspreaders" is a name given to individuals infected with the novel coronavirus who pass it on to a very large number of their contacts. Many examples have been reported. For instance 29-year-old man infected 101 people after visiting several nightclubs in Seoul, South Korea; a singer unwittingly infected 52 fellow singers at a choir practice in Mount Vernon in Washington State in early March. Most of these multiple transmissions have taken place in crowded, poorly-ventilated places where the spreader was expelling plenty of virus-laden breath, say by singing or talking loudly over background noise. 

We have heard much about the statistical parameter R, called the epidemic reproduction number; it is the average number of contacts an infected person will pass the virus on to. For the coronavirus SARS-Cov-2 in a fully-susceptible population, the value of R lies between 2 and 3 in urban settings. As a proportion of the population becomes immune and social restrictions reduce the number of contacts, the value of R declines, and when it falls below 1, the epidemic will start to retreat. There is another parameter epidemiologists use called K. The value of K represents the level of individual variation in R. When K is small (less than 1), there will be wide variation in the number of people one infected person will infect; in particular, there will be more so-called superspreaders. In the early stages of the outbreak of covid-19 the value of K was between 0.1 and 0.5 which meant that 10-20% of those infected probably generated about 80% of the transmissions. An increase in the value of K, to above 5 say, will reflect the fact that the number of transmissions generated by most individuals will be close to the value of R.

Imagine a group of 200 individuals in a large population and divide them into  say 50 who are shielded and at no risk, and the other 150 who are moving out of lockdown as now. Assume that the number of active infections has significantly fallen and that the reproduction number is just below 1. Just as it was at the initial outbreak, the value of K will be small and the risk of the return of superspreaders high; it will only need one or two of them among the 150 to send the R-number soaring. This is why an effective test-and-trace system is so important at this stage, to catch the potential superspreaders before they have a chance to set off a second wave.

Production of Mighty Marmite marred

An unlikely casualty of the pandemic is the supply of that famous metaphor love-it-or-hate-it Marmite, which now only available in small jars, A key ingredient is dead yeast cells, which are a healthy by-product from brewing beer, and with pints no longer being pulled in the pubs, the supply has dwindled.

Up close and dangerous

One metre or two? That is a question exercising politicians right now. Halving the current social distancing guideline of two metres would make a huge difference to the viability of the hospitality industry, which has taken a big hit during the lockdown.

Two metres is already not safe. The risk depends on many contingencies. Let’s assume your face is two metres from the face of someone already infected with the virus. Whether you catch it will depend on:

• How long you spend with them
• How infectious they are
• How many water droplets and aerosols they are expelling; in particular whether they cough or sneeze in your direction
• Whether you are facing each other and which way the air currents are moving
• Whether one or both of you are wearing masks

The transmission risk will be proportional to the time you are exposed. Evidence suggests there is a wide variation in individual infectiousness. It is higher if your contact is breathing heavily, speaking loudly or singing. It depends on what stage of infection they are at and how heavy their ‘viral load’ is. It will be much worse if you are in a crowded space with poor ventilation, such as a pub or night-club.

A recent meta-study - a study of studies - suggests that using one metre instead of two for your social distancing will double the risk of contagion, but that’s just an average and the confidence margins are wide. The real risk depends on the detailed circumstances of your encounter and these override the simplistic calculations derived from the meta-study.

Two More Free National Theatre Productions on YouTube

The Deep Blue Sea

Terence Rattigan’s devastating masterpiece contains one of the greatest female roles in contemporary drama, played by Helen McCrory.

Streaming from 7pm on 9 July, until 7pm on 16 July.

Find out more

Amadeus

Lucian Msamati plays Salieri in Peter Shaffer’s iconic play, directed by Michael Longhurst with live orchestral accompaniment by Southbank Sinfonia.

Streaming from 7pm Thursday 16 July until 23 July.

Find out more