Remember 1918? Covid-19 in India a fait accompli
The population of India in the first census of 1872 was 206,162,360. Meaning 20.61 crores on the subcontinent, including what is today Bangladesh and Pakistan. In 1881, this rose by 23 per cent to 25.38 crores. Some of this was due to an increase in population and some due to the increase in territory controlled by the British, which kept expanding over the years. In 1911, the population grew by seven per cent over the decade to 31 crores. However, in 1921, after 10 years it remained at 31 crores.
Why did the population not grow over an entire decade? The answer is an H1N1 virus which is called the Spanish influenza. This was an epidemic like the coronavirus and it killed off the entire population growth of a decade in India. Around 1.5 crore people and most likely more than that were killed by it.
The flu came to India from Europe, where it broke out in military hospitals towards the end of the First World War. We don’t know how it originated but it is possible that it was transferred from birds or animals being slaughtered for the armies’ messes. Indian regiments which fought for the British empire returned to Bombay after Germany surrendered in 1918 and the fighting ended. They brought the virus with them, just as those coming from abroad have brought the coronavirus.
Many nations had fought the war including the United States and so the returning soldiers took the disease around the world. It is thought that 25 per cent of the world’s population was infected and probably killed around 10 per cent of those infected.
These are very high rates of both transmission and of fatality and that is what we are faced with in the coronavirus. The problem with a new virus is that it has no cure. There is no medicine that can be taken and it has the ability to spread very rapidly as we are seeing in India today. Person A is infected and may or may not show symptoms, he passes them on to the people he has been near, and they pass the virus on to the people they come in contact with. And all this happens in the same day. There is no decrease in the lethality of the virus as it passes from one person to another and the virus does not dilute.
There are ways in which the chain of the spreading can be halted and that is to end contact between all people as far as possible. This ensures that those who are infected have the time for the disease to pass through their system. Some survive and others will not. But the isolation ensures that even those who are infected keep the disease to themselves. The point of isolation is not the benefit of the patient but the others around him.
China halted the spread of coronavirus through lockdowns of entire cities. People were banned from travelling outside their homes. The government ensured that food was supplied to each home by trained people. In Europe, it is not possible for democratic states to order or enforce absolute shutdowns like China. This is the reason that the spread of the virus in Italy and now Spain is faster and the death rate higher than in China. Of course Europeans have been practising social distancing and self quarantine as we have seen in the videos, but this is not as effective as a total lockdown.
On Friday, in Italy (which has a population of less than Gujarat) 627 people died and another 6,000 cases of coronavirus infection were recorded. Just in one day. And unless the chain is broken, or the virus itself mutates into something less infectious and less lethal, the infection spreads exponentially. We are familiar with exponential growth through the story of the man who asks the king to give him one grain of rice for the first square of the chessboard, then double it with each square. That sequence produces
1,2,4,8,16,32,64,128,256,512,1024 and
2048 by just the 12th square. Now assume that these are people and the 1 represents the first infected person entering the country. By the time you reach the 64th square, everybody has been infected except a few. This is what will happen with coronavirus.
The Prime Minister said we should break the chain of transmission for a few hours on one day, Sunday. This is not a solution. The fact is that India has no defence against coronavirus. One third of all Indians live in one room. Another one third lives in two rooms. They cannot self quarantine or isolate and if infected they will pass it on to others. It is impossible for India to control an epidemic. We do not have the state capacity of China to deliver food by trained and protected individuals to each home and order everyone to stay at home. That will not happen in India.
We also do not have the healthcare to save those who will be infected and can be saved medically because we do not have the capacity there either. India spends four times on defence what it does on health. Last year, the government gave only Rs 3,200 crores to Ayushman Bharat (what is called Modicare). We spent Rs 59,000 crores only on 36 Rafale fighters. India has 70,000 hospital beds and only a few ventilators.
Those infected who might be able to be saved in another country will die in India. This is a fact and we will learn of this very soon as we confront a disease that will kill not in numbers alone but a fraction of the population. The world will notice that India cannot spread the contagion and there will be consequences of that which we shall soon see and they will not be good for us.
The good thing about India, which perhaps no other country has, is our fatalism. We are so accustomed to extreme deprivation, misery and loss that there will be no revolution, no social upheaval as hundreds of thousands of people will die. Those of us that survive this plague will carry on just as the survivors of the Spanish influenza did a century ago.
The fact is that India has no defence against coronavirus. One third of all Indians live in one room. Another one third lives in two rooms. They cannot self quarantine or isolate and if infected they will pass it on to others.
Aakar Patel is a writer and columnist