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Susceptibility to infection such as SARS-CoV-2 may be influenced by host genotype. TwinsUK volunteers (n = 3261) completing the C-19 COVID-19 symptom tracker app allowed classical twin studies of COVID-19 symptoms, including predicted COVID-19, a symptom-based algorithm to predict true infection, derived from app users tested for SARS-CoV-2. We found heritability of 49% (32−64%) for delirium; 34% (20−47%) for diarrhea; 31% (8−52%) for fatigue; 19% (0−38%) for anosmia; 46% (31−60%) for skipped meals and 31% (11−48%) for predicted COVID-19. Heritability estimates were not affected by cohabiting or by social deprivation. The results suggest the importance of host genetics in the risk of clinical manifestations of COVID-19 and provide grounds for planning genome-wide association studies to establish specific genes involved in viral infectivity and the host immune response.
After the Italian declaration of war came the period of their short-lived ‘parallel war’, where they attempted to fight independently of Germany in the theatre. Chapter 2 highlights the great numerical disparity between the scarce British and Commonwealth forces spread from the Middle East to Gibraltar versus those of Italy. Despite this lack of resources, British theatre commanders recognised the need to make inroads into Italian sea communications, and they also received clear direction from Whitehall to pursue this objective. Consequently, the failure to do so was not for lack of will at any level of command, but a question of means. The scattered, incoherent efforts that were made are shown to have been completely ineffectual, with British success against the Italians in North Africa during 1940 instead being the product of a series of other factors. Nevertheless, this period set important foundations for an anti-shipping campaign in terms of the recognition of the vulnerability of Italian sea routes and the need for greater resources to prosecute it.
Despite the qualified successes of Operation ‘Crusader’, Britain was faced with a disastrous turn of events in early 1942. The entry of Japan to the war had compelled a redistribution of force to the Far East, while some key British losses and new in-theatre German commitments had further redefined the Mediterranean balance of power. Chapter 5 outlines how the British were forced to adopt a defensive posture throughout the theatre, as their gains from ‘Crusader’ were rapidly reversed. As the Axis then advanced into Egypt, Malta was subjected to an intense aerial siege and came perilously close to being starved into submission. The difficulties in conducting anti-shipping operations during this period were numerous. Yet in a reversal of the thesis advanced by historians such as van Creveld and Gladman, the chapter demonstrates that significant sinkings (of over 300,000 tons) were achieved during this period. The continued attrition was greatly troubling for the Axis, contributing to a shipping shortage that was to reach crisis point later in the year.
This book opens with a discussion of the importance of the Mediterranean to the British Empire, highlighting its role as a ‘vital artery’ of communication between the eastern and western worlds. By examining the changing position of the Mediterranean in British strategic policy from the construction of the Suez Canal through to the Italian declaration of war in 1940, it shows how important the Mediterranean would be in the event of another global war. However, British foreign policy in the late interwar period included numerous efforts to keep Italy neutral, allowing the Mediterranean to be denude of military assets in favour of their deployment against threats elsewhere. Consequently, these decisions led to a difficult context in which to plan realistically for war in the Mediterranean, and the subsequent paucity of British forces stationed there at the start of hostilities. It was this situation which set the foundation for early failures in the anti-shipping campaign. The pre-war planning debates did, however, see the British develop an appreciation of the importance of cutting Axis sea communications, even if they initially lacked the military power to do so and were initially restricted by legal criteria prohibiting attacks on merchant shipping in most cases.
Chapter 6 begins by illustrating the respective positions of each side by September 1942. It shows that while the Axis position can in retrospect be viewed as highly precarious, the British evinced real concern about a complete collapse in Egypt. It highlights the resurgent emphasis that was placed on the Mediterranean from Whitehall, and on anti-shipping operations by the theatre commanders. These attacks were pursued with a ruthless prioritisation; even after clear evidence that some Axis vessels were carrying British prisoners of war. This allowed anti-shipping operations to thrive, aided by the effective use of intelligence to target the most critical cargoes of fuel and ammunition. As a result, over the three-month period, ninety-five vessels of nearly 200,000 tons were sunk, with grave effects on the Axis. These sinkings helped curtail the final Axis offensive in Egypt and contributed to the vital British victory at El Alamein by depriving the Axis of essential fuel and ammunition. In contrast to arguments put forward by scholars such as van Creveld, Barnett and Gladman, the book uses a mix of Italian, German and British material to conclusively show that the supply shortages suffered by the Axis were primarily the result of seaborne sinkings.
The failure of Italy’s ‘parallel war’ was followed by turmoil caused by a combination of German intervention in the theatre and the British decision to send aid to Greece. The shift in focus towards what would be a disastrous Greek expedition resulted in neglect of the Axis sea lanes with North Africa, and abortive efforts at interdiction were made in the Adriatic instead. Yet, as this chapter shows, there were also positive developments in the campaign. New types of more suitable equipment and weaponry were employed, accompanied by the beginnings of a learning process to develop new tactics and procedures and to incorporate new technologies. This offered the potential for greater efficiency in anti-shipping operations, but it was only from April onwards that significant attention was again paid to them. Sinking rates promptly increased and, although the overall required Axis supply quotas were generally met, the losses did cause logistical pressure in certain key areas. While anti-shipping operations had been relatively limited in terms of quantity and effect over the first year of the war in the Mediterranean, an important foundation was laid in terms of recognition of their importance, increasing priority and operational learning. This provided the platform for what would be become a decisive campaign within the Mediterranean war.
The final chapter opens with a discussion of the transformed nature of the war in the Mediterranean after the Axis surrender in Tunisia, where Axis maritime commitments had shrunk, yet remained substantial. The Allied focus on other in-theatre tasks, particularly the invasions of Sicily and mainland Italy, pushed anti-shipping operations into a side-line role. Yet there were times when they received greater focus, including the Axis evacuation of Sicily, and in the Aegean during 1943–44. An account of anti-shipping operations over the period in question shows that there were in fact very high quantities of sinkings at certain stages of the period in question. These contributed yet further to the overall shipping crisis, forcing the Axis to expedite the withdrawal from Sardinia, Corsica and many of their Aegean possessions. By late 1944, most of the territories reliant on maritime supply had been abandoned, and the anti-shipping campaign had been a key element in ensuring Allied victory in the Mediterranean.
On 10 June 1940, despite a distinct lack of enthusiasm from both the German and Italian military high commands, Benito Mussolini formally joined the war on the Axis side. That evening he gave a speech from the balcony of the Palazzo Venezia in Rome to an assembled crowd, informing them that their country was going to war to stop ‘the plutocratic and reactionary democracies of the west’.1 In reality, much of that ‘stopping’ had already been done by Germany: most of the British personnel had already been evacuated from the continent to a homeland faced with the prospect of invasion, while France would soon sign an armistice. What it did achieve was to transform the war by spreading it beyond the boundaries of Europe and igniting a long and bloody contest to control the Mediterranean. It was the ultimate ability of the Allies to prevail in controlling its waterways and thence strangle Axis communications at sea, which proved vital to securing victory. This forced the collapse of the Italo-German position across the broadly defined ‘Mediterranean theatre’, removed the threat to key British imperial possessions and ensured the defeat of Fascist Italy.
While El Alamein represented an important defensive victory at the eastern fringe of the Mediterranean, joint Anglo-American landings in north-west Africa caused a transformation of the theatre. This shift to a truly Allied venture, where the war in North Africa was fought on two fronts, had consequent effects on Axis supply requirements. Anti-shipping operations continued to receive high priority throughout this period, resulting in a devastating 477 vessels of over 700,000 tons being sunk in five months. This ensured that the minimum level of supplies required by the Axis forces were not received. In fact, the losses were so devastating that the Axis came to lack the necessary shipping to even attempt shipping the required amounts in the first place. The chapter then offers a revolutionary new argument: that the period around October 1942 represented a tipping point towards collapse for the Axis position in the wider Mediterranean. The consistently high rates of sinkings had greatly eroded the base of available tonnage, and efforts to improve construction had failed. The attempts to fill the void with seized French tonnage were inadequate, and by early summer 1943 the Axis were acknowledging that maintaining positions such as Sardinia and Corsica was no longer possible, while retaining the Aegean islands and even Sicily were tenuous aims.