No lessons learnt from Spanish Flu

It would have better prepared India for the second wave of COVID-19

In a single day in October 27, 1918, Hyderabad lost 464 people to the Spanish Flu. The killer pandemic had roared into India as soldiers from the battlefront of First World War began returning to their native places. By the end of the pandemic, during the 1921 census there was a 20% dip in the population of Hyderabad provinces. Census officials calculated that on a conservative estimate, about 35,000 persons had died in the Nizam’s territory within the short span. But the tragedy of the Spanish Flu more than 100 years ago was that no lessons were learnt from the first wave, known as herald wave by epidemiologists. In the first wave, the crude mortality rate shot up from the normal 7.5 to 12 per thousand persons. In the second wave, it reached an unprecedented 36 per thousand before the mortality rate returned to the pre-war average of 7.5. The Nizam’s Dominion and the medieval walled city of Hyderabad were no strangers to deaths due to infectious diseases. In one year of 1921, as many as 3,411 persons died due to cholera, 31 died due to smallpox, 78,976 died due to malaria, 187 died due to influenza and 3,824 persons died due to plague. Hyderabad in the 1920s was considered the fourth largest city in the Indian Empire with a population density of 7,925 persons per square mile. As these successive diseases played havoc, the wealthier citizens used to emigrate to their farmhouses or move in with their friends in the suburbs. The 1914 map created by Leonard Munn and his associates shows dozens of plague camps, where healthy citizens would move in to survive the epidemics. There were pioneering non-pharmaceutical interventions in the city which helped the city fight these seasonal health disasters.