Is pandemic history repeating itself in India?

• If things are going out of control at present, look at the past – Indian adage

By Jai Kumar Sharma, New Delhi

The influenza pandemic of 1918, also known as Spanish flu, was an unusually deadly pandemic which lasted from February, 1918 to April, 1920. It infected 500 million people, about a third of the world’s population at the time. The estimated number of deaths ranging from 20 million to a possible high of 100 million makes it one of the deadliest pandemics in human history.

There are stories in the pages of history from the Spanish flu era which can still be referred to for a lesson or two. On September 28, 1918, the Liberty Loan Parade was organised in Philadelphia, USA, to economically support soldiers who fought in World War I. Intellectuals opposed the event; they were of the opinion that since the Spanish flu was still going strong; a crowded event might result in new series of disasters. Ignoring such objection, the local administration allowed the event. It was a matter of patriotism, so more than 200,000 people gathered. What followed was along the expected line. Within the next few days, 47,000 fresh cases were reported and 12,000 people died. By October, 1918, over 195,000 people had lost their lives in the US alone.

The tragic Indian chapter

Spanish flu struck India at the same time and 10 to 20 million people, then three to six per cent of the population, died. The major damage was caused in a short period from June, 1918, to early 1919. The second wave of the pandemic lasted for less than three months – but was most devastating.

One of the famous Hindi poets and writer of the era, Suryakant Tripathi Nirala, wrote about his personal experience of the 1918 pandemic in a book. The writer famously known as Nirala received a telegram which read: “Come back urgently, your wife is seriously ill.” He was in Bengal and he took the next train to his hometown in Uttar Pradesh. When he reached his hometown on the banks of River Ganga, he observed that the river was “swollen with bodies”. By the time he reached home, his teenage wife was dead. In the days that followed, all other family members got the infection and died. Reports from government documents made the observation that “all rivers across India were clogged with bodies because of shortage of firewood for cremation.”

History repeating itself

Looking at images and reports in Indian media this week, it seems nothing has changed even after a century. Locals in Buxar District of Bihar Province reported about floating bodies in River Ganga on May 9. Similar was the sight in Ghazipur District in Uttar Pradesh Province the following day.

The bodies were suspected to be those of COVID-19 patients, revealing the scale of the virus in India. Locals said following the Hindu cremation rituals, people either burnt their dead or dumped them in the river due to the lack of firewood at the crematoriums owing to the rise in COVID-19 related deaths.

These are stray cases and not a common sight across India, but even these isolated cases put a big question mark on the progress of medical science and human development. Such incidents depict a real picture of the catastrophe this planet is going through at present.

Social media feeds are full with videos of COVID-19 funerals at crowded cemeteries, wailing relatives of the dead outside hospitals, long queues of ambulances carrying gasping patients, mortuaries overflowing with bodies, and patients, sometimes two to a bed, in corridors and lobbies of hospitals.

What went wrong?

In early March, politicians and parts of the media believed that India was truly out of the woods. While customary guidance on COVID-19 appropriate behaviour was issued, it was policymakers and elected leaders who tacitly encouraged crowding in festivals, election rallies and religious congregations. In less than a month, things began to unravel.

The second wave of COVID-19 has come a few months after the second wave in other countries. There was no reason to believe it would be any different in India or in any other country.

More than ventilators and ICU beds, what was essential was an adequate supply of oxygen in hospitals to treat critically ill patients. Nonetheless, when the second wave of the pandemic arrived, India’s medical oxygen supply network collapsed.

Availability of hospital beds was nowhere close to meet the sudden demand. WHO standard is 30 hospital beds per 10,000 people; India has only 5.3, much less compared to even smaller countries like Fiji 20, New Zealand 25.7 and South Korea 124. Nigeria also has 5 hospital beds per 10,000 population.

India recorded a worrying Test Positivity Ratio (TPR) of 22.36 per cent at the end of the second week of May, which is way above the five per cent TPR needed to control the pandemic, India’s testing numbers seem to be dipping instead of keeping pace with the rate of transmission.

Battle far from over

Experts are raising concerns that inoculation is not helping turn the tide in some places. Seychelles, Israel, the UAE, Chile and Bahrain, the world’s five most vaccinated countries, only Israel is not fighting to contain a dangerous surge in COVID-19 infections.

Seychelles which has vaccinated more of its population against COVID-19 than any other country, saw active cases more than double at the end of the first week of May.

Maldives, where over 35 per cent of the population had received two shots of vaccine, is also struggling with new cases which jumped to 12,000 plus on May 12.

The world is at war with COVID-19; more than three million people have lost their lives so far. But while some countries move forward with vaccination campaigns and businesses reopening, a resurgence in India and South America is a stark reminder of the pandemic’s severe and ongoing toll. Society’s staggered return towards “normal” also begs the question of what we will learn when this once-in-a-century pandemic is finally over and how the three million lives lost (and counting) will be remembered.

Sharma is a Consultant Editor of Daily Trust based in New Delhi, India.