We All Fall Down by Daniel Kalla

This is a novel about a black death outbreak in modern day Genoa. By absolute coincidence I recently read up on the plague, why it was that the in the middle ages it killed so many, and yet while the plague still exists (unlike say Smallpox which has been eradicated), while there are still outbreaks, they are never so deadly. It turns out that the plague is like the flu in that there have been different variants. Most flu doesn’t become a deadly pandemic, but in 1918, the Spanish flu was just that, killing millions. The same is true of the plague. The variants around today are not the same as those which ravaged Europe and much of the world in the middles ages, which has disappeared for reasons unknown. We All Fall Down imagines a scenario where this, far deadlier plague, returns. As the text on the cover reads: Centuries ago the plague killed millions. Today it might kill billions.”

Dr Alana Vaughn, the novel’s protagonist, is an infectious disease specialist who in the past has worked for the World Health Organisation (WHO). She now works for NATO and her job is to watch out for signs of germ warfare, as well as natural outbreaks which might threaten order in the societies of member nations. When she hears about the plague outbreak she flies to Italy to check it out. She quickly discovers the outbreak to be of the deadlier variety and together with the WHO team on the ground, and local Italian doctors, they try to contain the rapidly spreading outbreak. As part of their efforts they try to discover the source of the outbreak and this entails detective work.

Their efforts lead them to multiple potential suspects. Is it a bioweapon? Both the Soviet Union and the United States weaponised plague virus during the cold war. Whether or not it is, has it’s release to do with terrorism? Has it been released accidentally? Or has the plague come from a natural source? Just as in the middle ages, the virus itself, and the deaths it causes, is only part of the problem. People’s fear and their associated need to find a scapegoat leads to social tensions and it isn’t long before immigrants are being blamed for the outbreak.

We All Fall Down is compared on the cover to Contagion meets The Da Vinci Code, and without giving away spoilers, while I can see why it has been compared to the latter, it is far more the former. At heart this is a novel about the reemergence of the plague, a medical thriller rather than a religious-conspiracy novel. The author, Daniel Kalla, is himself a doctor practicing emergency medicine and this shows. Nor is this his first novel about pandemics (in fact one of his previous novels, titled Pandemic, is about a deadly outbreak of flu). It is not too heavy on the medicine and science but he clearly knows his stuff and writes with authority.

Dr Alana Vaughn and her supporting cast of characters are compelling and well drawn and the novel presses the right buttons, the narrative moving along at a fast pace that kept me turning the pages. The plot itself holds together and resolves itself satisfactorily. All in all this is an enjoyable novel and one that posits a frightening scenario, all the more nightmarish because a global pandemic is far from the realm of fantasy and could well occur some day.

3 out of 5 stars