Today, when humanity is grappling with the deadly impact of the coronavirus pandemic, which has so far claimed over 30 lakh lives globally, it becomes important to look back at yet another pandemic, which took place nearly 100 years ago during the First World War and is said to have killed up to 5 crore people and infected 50 crore out of a total world population of 150 crore.
Yes, I am talking about the deadly 1918 influenza epidemic, also popularly known as the ‘Spanish Flu’. The pandemic was also Indian subcontinent’s most deadly epidemic that killed an estimated 1 crore Indians in the erstwhile British India. And over a century later, we are once again at the same point and in the same situation, with India clocking more than 3 lakh cases of infection every day and more than 3,000 people succumbing to the disease in a day.
The ‘Spanish Flu’ is a misnomer because it did not originate in Spain. The influenza outbreak is believed to have originated in Kansas, United States, in March 1918 from where it spread to France, Germany and the United Kingdom, carried by American forces fighting in the First World War. All countries involved in the First World War suppressed the news of the outbreak to maintain the morale of their fighting forces and Spain being the neutral country was the only nation that did not censor the news of the outbreak and hence the pandemic came to be known as the ‘Spanish Flu’.
The pandemic came in four successive waves, from 1918 till 1920, of which the second wave caused by mutated strain of the influenza was most deadly that killed people of all ages, especially the young. The second deadly wave of Spanish Flu spread to different countries as troops moved. The mutated strain spread to entire North, Central and Southern America, all of Africa and Europe. From Europe, the disease travelled to the Russian empire and then entered Asia. From Central Asia, it finally entered the Indian subcontinent where it caused humongous devastation.
In British India, the influenza flu came to known as the ‘Bombay Fever’ because it first hit the shipping yard of Bombay that received returning British-Indian soldiers from Europe after the end of World War I. The outbreak then soon spread to entire British India, both princely states and British-ruled territories. As per conservative estimates, nearly 1 crore Indians succumbed to the disease—the pandemic affected a large section of the young population as well as women.
It is said that such was the scale of deaths that neither enough land was available for burial nor enough wood was available for cremation, because of which families simply immersed bodies of their loved ones in the rivers. Nearly all rivers were choked. British India lost nearly 5 per cent of its population and this was the only period when population growth was in the negative in the recorded history of India, which saw a low population growth of 1.2 per cent during 1911-1921.
There are no clear-cut reasons and explanations for the high mortality rate of the influenza epidemic. Due to less advancement in medical and biological science at that time, it is not clear if such large number of deaths were caused by more virulent mutated strains of the influenza. It is, however, believed that malnourishment played a great role in making people, both armed forces and civilian population, vulnerable to severe illness due to their much weaker immunity. This is also believed to be true for British India, where general population was underfed, physically weak, and by and large malnourished.
Just like the current coronavirus pandemic, most deaths during the outbreak of Spanish Flu were caused by bacterial pneumonia, a common secondary infection associated with influenza, which impacted human lungs by causing massive haemorrhage in the lungs, triggering a cytokine storm or overreaction of body’s immune system leading to multi-organ failure.
The most surprising aspect of the Spanish Flu epidemic has been its rather inconspicuous mention in modern history. Given the scale of deaths, it is very unusual that there has been very little human remembrance of this catastrophic event. Historians, epidemiologists and medical researchers are surprised as to why the tragedy of such volume was forgotten so soon and virtually erased from the human memory and history books till the current wave of coronavirus pandemic hit the world a year ago, after an outbreak in the interior Chinese city of Wuhan.
The coronavirus pandemic has revived people’s interest in the Spanish Flu. Unfortunately, given the time lag and the fact that most people who remembered the period are long gone, it is very difficult to do any meaningful research on the pandemic of 1918. Most historical accounts of the influenza pandemic come from the newspapers published at that time. The news about Spanish Flu in these newspapers, however, is not detailed as the world was more occupied with the events of World War 1. There were some medical experiments done decades after 1918, by taking samples from bodies of patients buried in frozen lands of Europe and some medical studies were also published. But most historical, anecdotal and medical information regarding the catastrophic events of the Spanish Flu remains sketchy.
The Spanish Flu, the coronavirus pandemic and some other deadly epidemics like the SARS outbreak of 2002, the Swine Flu epidemic of 2009 or the Ebola outbreaks in Western Africa tell us that the more humans interfere with the sensitive and delicate balance of nature, the more it exposes the humanity to dangers of many yet-unknown viruses, some of which may have the potential to wipe out the entire human race. The overarching message from the Spanish Flu and coronavirus pandemic is that humans must respect the boundaries of the nature and must not disturb the natural ecosystem; failing to do so may unleash many potentially dangerous diseases upon the mankind.
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