A tale of two pandemics, 100 years apart

PT Jyothi Datta | Updated on April 05, 2021

Legacy of care: Founded in 1902, Masina was Mumbai’s first private charitable hospital   -  IMAGE COURTESY: MASINA HOSPITAL

The Spanish flu (1918) devastated a port city like Mumbai. Could the lessons help as we brace for a second wave of Covid-19?

Last year, when the World Health Organization labelled the rapidly spreading novel coronavirus a ‘pandemic’, the top brass of Mumbai’s Masina Hospital were clear about one thing. They would play a part in battling the virus this time too.

In 1918, when the ‘Spanish flu’ came to India and Mumbai bore the brunt of its entry through the ports, Masina Hospital — then just 16 years old — had treated patients with the flu. “There is evidence that patients were treated at a nominal cost,” says Dr Vispi Jokhi, Masina Chief Executive Officer, relying on sketchy notes from the past.

Since there were no detailed medical records then, the information available was that the hospital was flooded with Spanish flu patients. And their symptoms included chills, body-ache and fever. “The treatment was symptomatic,” he says.

With 200-plus beds, Masina is Mumbai’s first private charitable hospital, started in 1902 by Dr Hormasji Manekji Masina.

The one thing they learnt from the previous pandemic experience was to not be “reactive” to a crisis, says Dr Vispi. “We were proactive, but of course the magnitude of this crisis was not envisaged,” he adds.

During the 2020 pandemic, as well, many of the city’s and indeed the country’s private hospitals were roped in by State administrations to treat Covid-19, along with the Government-run hospitals.

“The more you look into the archives, you realise that some things were the same,” says Dr Sanjay Agarwala, Medical Director at the Hinduja Hospital. Internationally, it was seen that cities that clamped down on congregations saw a decrease in the number of infected, while a couple of places where the mayors went ahead with previously planned parades saw the infection spike, he says. But then, there was little knowledge of masks and super-spreader events, he adds.

Doing it differently

Masina approached Covid-19 differently. As international reports came in on the high ICU (intensive care unit) mortality, Dr Vispi says they decided against having one where the Covid-19 patients were treated. That was left to hospitals that had the resources, he says, adding, “we worked harder to keep patients from reaching that stage”. They found that high-flow oxygen (where it’s given at high speed and volume to a patient) prevents people from going onto a ventilator, he says.

In addition to Masina’s consultants and staff who helped tide through 2020, he says, the other features that worked in their favour included having separate air-conditioned rooms with exhausts, which curbed the flow of infection.

Also, being an old building they had different access points, so it helped keep non-Covid-19 services running after some early hiccups. And they brought in “portas” (portable cabins) — shipping containers redesigned as an isolation facility, complete with a bathroom.

Lethal second?

As the country braces for the second wave of the pandemic, Dr Vispi agrees that in 1918 the second wave was more “devastating”.

This time, he is hopeful that the vaccines, among other things, would help control the spread. Masina has restarted its Covid-19 facilities and would go up to 50 beds (given that 80 per cent cases were asymptomatic), he said. During the peak last year, they had over 100 beds.

This time, Dr Agarwala points out, people can be careful and not get the virus; and doctors have tools to work with, including steroids and anti-virals. There are people who were infected and now have the antibodies, and then there are the vaccines, he says, adding that during the Spanish flu there were just the masks.

He clocks back to 1889, the Russian flu pandemic. The virus could be a precursor of the common cold, he says. Viruses have existed in the past and survive for the future by mutating, he says, adding ominously that it’s unclear if the present virus will hover around or just disappear.

Published on April 04, 2021

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