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Covid-19: When will this pandemic end?

Rutam V Vora | | Updated on: Dec 12, 2021
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Past pandemics teach us that it always ebbs and flows in waves, warning against any premature ‘celebration of defeat’

November 24, 2021: South Africa reports a new variant of SARS-CoV-2 (B.1.1.529) to the World Health Organization (WHO). It is shortly designated as a variant of concern (VOC), Omicron.

Stock markets crash globally, wiping off massive investor wealth amid fears of a return of 2020-like lockdowns. Unnerved, many asked just one question: When, after all, will this pandemic end?

The answer may lie in history. The three pandemics between 1817 and 1920 show they stay for a while and come in waves before dying down.

What’s needed is alertness and an ability to manage it well, to reduce mortality and the economic impact — the two core matrix that matter in a pandemic, says Chinmay Tumbe, an economics professor at the Indian Institute of Management, Ahmedabad.

His recent book, The Age of Pandemics (1817-1920): How They Shaped India and The World , chronicles cholera (1817), plague (1894) and influenza (1918), which collectively claimed over 72 million lives globally — 40 million in India.

About a century ago, influenza took a toll on India’s society and economy. The case fatality ratio (CFR) was about 10 per cent, and nearly 60 per cent of the population had caught the infection in 1918. The GDP shrank by 10 per cent and inflation surged to 30 per cent. The book notes that the pandemic brought renewed attention to the state of public finances and health — a focus area for the government today, too. “The inadequacy of medical facilities in India was also stressed to seek more budgetary allocations towards health,” it says, about the 1918 pandemic, but rings true with Covid-19, too.

On Covid-19, Tumbe’s research pegs the death toll at 3 million (2 million during the second wave) — a paper on this is under review. Ironically, the previous century marked record medical advances leading to better standards of living and life expectancy.

Is there a learning from past pandemics?

“If you had known the past pandemics, you could have anticipated the migration crisis, and the mortality crisis India witnessed during the first and second waves, respectively,” Tumbe says, pointing to pandemic management, which came like an “out-of-book question in exam on how do you deal with a pandemic?”. The inconsistencies by the authorities was ubiquitous across pandemics.

The 1918 influenza virus mutated too. Though India wasn’t much affected in the first wave, the second hit it hard. The third never came.

“From past experiences, the policy focus should have been on anticipating a mutation of the virus. What we didn’t do right during December 2020 and February 2021 was not tracking the mutations. A lot of other countries had moved on to that, we were very slow. We got to know about the Delta variant very late and didn’t act swiftly upon it. Hopefully, that has been rectified now,” says Tumbe, adding that the number of waves don’t matter. But history suggests a more stylised fact: “Pandemics come in waves”.

Plague terrified India, with its peak in 1907 claiming over one million lives and lasting 25 years in waves. Incidentally, it left us with the legacy of the Epidemic Diseases Act, passed on February 4, 1897. The legislation “would survive all the way to the present and be used in curtailing Covid-19 in 2020,” notes Tumbe.

Is Covid-19 showing signs of dying down?

There is currently no data that suggests it is dying down or moving to becoming endemic — that is, periodic in nature with limited presence.

The troughs dotted on the graph of daily infections could just be the starting point for another peak, Tumbe cautions. “The British had celebrated the end of the plague in 1897 but eventually it lasted for about 25 years. People who celebrated the end of the pandemic had to burn their fingers. The lesson from history is: anticipate the pandemic waves. Today it seems obvious after witnessing the second wave of Covid. Do not ever celebrate the pandemic ends, as you don’t know if it has ended,” says Tumbe, suggesting monitoring virus mutations and using the right matrix on mortality data to assess the intensity of the wave.

There is an urge to move on after each wave, we forget immediate past experiences, and end up inviting another wave.

“Today, we have vaccinations and natural immunity. So it is very unlikely that we will have anything like a second wave again. But that is not to let our guard down,” Tumbe cautions.

Trivia: Did you know?

1. Mighty or small, few were spared the pandemic's horrors

Mahatma Gandhi and Rabindranath Tagore were among the millions who grieved the loss of near ones when influenza ripped through the country in 1918. Popular accounts say that Gandhi had contracted the flu in the second half of 1918 and was seriously ill. His son Harilal lost his wife Gulab and son Shanti to the pandemic.

Nobel laureate Tagore, who too was afflicted by the influenza, saw a member of his extended family losing the battle for life.

2. The Ganga controversy -- then and now

In the cholera pandemic of 1872, pilgrims were seen as one of the most common conduits of the disease in Asia. The British, who ruled India then, perceived pilgrimage sites the way many viewed the Chinese wet markets in 2020 -- as places that generate pandemics. In North India, along the Ganga river, pilgrims traditionally took 'Ganga Jal' (holy water) back home to distribute to others. This contributed to the faecal-oral transmission of cholera.

In April-May 2020, hundreds of half-buried bodies surfaced in the riverbed of the Ganga as crematoriums over overrun due to the massive number of deaths from Covid-19.

3. Plague and Patel's leadership

Sardar Vallabhbhai Patel, as the chairman of Ahmedabad municipality in 1917, set an example of how an effective administrator can help lessen the blows of a pandemic. While many were fleeing the city, Patel stayed back and worked with the civic body's staff to enforce preventive measures. His ground work in Ahmedabad and Borsad (100 km away) during the plague pandemic helped identify serious inadequacies in the government's handling of the pandemic.

Published on December 12, 2021

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