Briefly juxtaposing the Spanish Flu of 1918 in India with COVID-19 of 2020 reveals key lessons and how much, and how little things have changed.
As the world helplessly watches Coronavirus claim lives, batter economies, and throttle businesses, one is prompted to look back at another pandemic, the Spanish Flu of 1918, the deadly influenza outbreak that killed at least 50 million people worldwide. Long abandoned in collective memory, the flu pandemic languished in the quasi-obscurity of immediate post-World War I history, notwithstanding the severity with which it raged in 1918 and 1919. Until now.
A few weeks ago, the Union Human Resource Development (HRD) Ministry asked research institutes and universities to study how the then colonial government handled the influenza pandemic. While this indicates the need for us to learn lessons from that flu, it also sadly implies that it has taken another lethal viral outbreak for us to realize the need to learn a thing or two. Though it may be imprudent to draw a comparison between the two pandemics, briefly juxtaposing the Spanish Flu of 1918 in India with COVID-19 of 2020 will reveal how much, and how little things have changed. And of course, highlight key lessons.
The Flu that wasn’t Spanish
The Spanish flu was first observed in the summer of 1918 in Europe, where the Allied forces and Central powers were still locked in battle. However, within months, it had spread to nearly every part of the world. Spain, neutral in the war, became the first to report deaths since news in the country was not subject to wartime censorship. This led to the assumption that the flu started there, and the name stuck. Spanish flu most likely entered India through a ship of returning troops that docked in Bombay (now Mumbai). But it soon swept through the subcontinent even as Bombay, the overcrowded metropolis, remained the epicenter of the infection.
1918 influenza outbreak is believed to have killed up to 18 million people in India, a figure that exceeded the number of casualties in World War I.
Even Mahatma Gandhi, who was then in Gujarat battling an acute stomach infection, lost his daughter-in-law Gulab – wife of eldest son Harilal Gandhi – to the dreaded influenza.
Watch: Why Spanish Flu of 1918 matters in India’s COVID-19 fight
Starkly Differing Realities
102 years may be the blink of an eye in history, yet India and the world have changed in irreversible ways since the Spanish Flu struck in 1918. The 1918 pandemic happened at a time when there were no antibiotics, no electron microscopes, and little to no protective equipment for health care workers. Besides, most Indians largely relied on indigenous medicines at the time. Though there’s still no cure for Coronavirus, scientists have successfully mapped its genetic make-up and are hard at work, testing anti-viral drugs and trying to develop a vaccine. The Spanish flu came at a time when doctors – an overwhelming number of them, British – were posted on the war front. Although India continues to face a shortage of doctors, the situation is infinitely better than what it was in 1918.
Unlike COVID-19, which disproportionately affects older people and those with underlying health conditions, the Spanish Flu mostly infected adults in their prime, aged between 20-40 years. Researchers believe that a less lethal version of that virus had struck a few decades earlier, which meant that the elderly living in 1918 had already been exposed to it, and in all likelihood developed antibodies. Though both are respiratory viruses, there are differences. In contrast to coronaviruses, influenza viruses are more prone to mutating, leading scientists to attribute the virus’s eventual disappearance by 1920 to its mutation into a weaker strain.
Twin Catastrophes, Born 102 years Apart
Despite the differences, several traits link the two cataclysms. The outbreak of the 1918 pandemic was exacerbated by the failure of the south-west monsoon, which led to famines in rural areas, compelling people to move to densely populated cities. This further contributed to the terrifying rapidity with which the flu spread across villages and cities. The frail healthcare system quickly collapsed and a disaster, unparalleled in scale or intensity, unfolded. There were corpses in the streets, in drains and rivers; mournful wails rent the air across India’s hamlets and towns. Though the consequences of reverse exodus – from cities to villages – of India’s migrant labour force are yet to fully unravel, experts haven’t ruled out the odds of an outbreak in rural India – an event which may prove catastrophic, given the abysmal state of medical infrastructure in villages and small towns.
Another striking similarity is the chasm between the haves and have-nots.
The British, most of whom lived in sprawling garden homes and employed a retinue of servants, were scarcely affected by the flu and remained largely indifferent to the plight of the poor common Indians. Among Indians, more women died than men, presumably because they were relatively undernourished.
For every 1000 people who succumbed to the flu in Bombay, 61.6 were ‘low caste Hindus’, 19.2 ‘Mohammadans’, 18.9 other caste Hindus, and just 8.3 ‘Europeans’.According to a British report from 1919
A British health officer in Calcutta is said to have remarked on the high incidence of the disease among the city’s poverty-stricken coolie population in Kidderpore, an area home to densely populated slums comprising dank, squalid tenements. Today, the emergence of Dharavi – Asia’s largest slum cluster – as one of India’s most difficult COVID-19 challenges harks back to the same hideous reality, one that the passage of a century couldn’t change. There is also not a scrap of doubt that our disadvantaged groups – all of whom continue to be overwhelmingly Dalit, tribal, or Muslim – have been disproportionately hit by the COVID-19 lockdown.
The colonial authorities responded to the flu-induced pandemonium with characteristic insouciance and resignation, eventually inviting volunteers to help. At the peak of the outbreak, newspapers reported how several officials remained in hill stations. The Indian Government may not have the luxury of dispensing with the pretense of being concerned, but its failure in reaching out to vulnerable sections and announcement of an economic package woefully inadequate in terms of actual fiscal stimulus clearly indicate apathy – cold and cruel.
What History Taught
Watch: Lessons from the Spanish flu 2018
Spanish Flu underlined the importance of having a sound health infrastructure, but it was a lesson unheeded. Similar to the colonial government, successive Indian governments since 1947 have continued to allocate the lion’s share of the Union Budget to military expenditure, and ignore investment in human infrastructure i.e. health and education. The financial year 2019-2020 saw just 1.29% of GDP spent on healthcare, making India the least to spend on the sector even among BRICS countries. The consequences of following such a trajectory are already visible on a severely strained medical infrastructure as it grapples with an unprecedented health emergency.
Eventually, it was citizens’ groups, volunteers, and grassroots activists who came to the rescue in 1918. It was they who diligently went about treating patients, arranging cremations and burials, setting up makeshift dispensaries, distributing food and aid, and raising funds for relief efforts. This serves as a reminder that while the government may or may not fully discharge its duties, ordinary civilians will play a crucial role in containing the virus’s spread and providing help and relief. This is already happening today; and will only increase as time passes.
Watch: Good samaritans offer food to workers walking home
A Watershed Moment
The year 1918 marked a watershed moment in the history of the Indian freedom struggle. The economic fallout of the War – food scarcity, galloping inflation – compounded the devastation wrought by the pandemic, fuelling mass resentment against British rule in India. The following year, the Jallianwala Bagh massacre acted as the catalyst, triggering widespread outrage which Gandhi duly harnessed for his Non-cooperation movement launched in 1920.
As we gingerly step into the post-lockdown phase, we must cling to the emaciated hope of the coronavirus apocalypse prompting Indians to dare to seek sweeping changes, as so many Indians back then sought.