Covid-19: Panic is dumb, but complacence is dumber

In late February, as the Covid-19 (coronavirus) panic rose across the world, Justice D.Y. Chandrachud of the Supreme Court announced that six of his colleagues had contracted swine flu. The swine flu virus, classified by the World Health Organization as H1N1/09, emerged in Mexico in 2009 (the “09" at the end of H1N1, like the “19" in Covid-19, signifies the year when the virus first made itself felt). Up to a billion people are estimated to have contracted swine flu since it first appeared, and somewhere between 150,000 and 600,000 have died. As the case of the Supreme Court judges demonstrates, the virus is still thriving.

The number of novel coronavirus infections and deaths is currently only a fraction of the figure associated with the H1N1 pandemic, yet the response to it seems more intense than anything witnessed in 2009. The travel industry is in severe contraction, capital markets have plummeted and each day brings news of cancelled conventions, postponed music tours, closed schools and even entire provinces in lockdown.

There are those who agree with Tesla and SpaceX CEO Elon Musk’s tweet that “the coronavirus panic is dumb". Among them are several political leaders. Donald Trump, an eye on November’s presidential election in the US, has been downplaying the threat for weeks. Yogi Adityanath, chief minister of Uttar Pradesh, suggested that flu is not a disease at all but an ailment caused by a change of seasons. Days later, he claimed yoga techniques could stave off the coronavirus. The Union health and family welfare minister, Harsh Vardhan, prematurely celebrated a victory over Covid-19, saying that “India’s robust health surveillance system has been able to stall novel coronavirus from entering the country". Soon after, a steady trickle of Covid-19 positive cases began turning up in different parts of the country.

The virus has now been identified in Indians recently returned from Wuhan in China, Milan in Italy, Qom in Iran, and Muscat in Oman. Cases have appeared from Kochi to Ladakh and there has been at least one instance of community transmission to a group with no recent history of travel abroad. It appears that the novel coronavirus is now entrenched in the country. While panic might be dumb given the low number of infections, complacence is even dumber.

This was illustrated in Iran, now among the worst-affected nations, alongside China, South Korea and Italy. The outbreak in Iran was centred in Qom, one of Twelver Shia Islam’s holiest cities and site of the shrine of Fatemeh Masoumeh, revered sister of the eighth Imam. The practice of thousands of pilgrims who visit the shrine each week, Indians prominent among them, is to crowd around Fatemah Masoumeh’s tomb, touching and kissing the protective grills of its enclosure. That is a recipe for passing on infections, yet Iran’s clerics refused to shut down pilgrimage sites after the first positive tests were recorded in Qom.

Iraj Harirchi, head of Iran’s task force against Covid-19, repeatedly wiped his sweaty brow at a press conference during which he dismissed fears the virus would spread widely. The next day, he revealed that he himself had contracted the disease. Industry, mining and trade minister Reza Rahmani and vice-president Masoumeh Ebtekar are among 23 deputies who have tested positive for the virus, while Iran’s former ambassador to the Vatican, Hadi Khosroshahi, and Mohammad Mirmohammadi, a confidant of the Supreme Leader Ayatollah Khamenei, have died. By placing faith above reason, Iran’s theocrats not only endangered the population but risked a kind of self-decapitation.

India appears to have learnt from Iran’s example and is now taking the virus seriously, with Prime Minister Narendra Modi himself reviewing plans to combat the threat. I fear, however, that the best intentions might not be enough, given the parlous state of the public health system. Consider the last major outbreak of H1N1 in India, which took place in 2015. According to official figures, 2,000 people died in that wave, out of 33,000 patients. Globally, H1N1/09 has a fatality rate of 0.01-0.08%. At those frequencies, between 2.5-20 million people would have had to be infected for there to be 2,000 fatalities. Was the mortality rate of H1N1 in India extraordinarily high, or were infection rates greatly under-reported?

While Delhi had a fatality rate well within the global range, mortality was massively higher in the four worst affected states of Rajasthan, Gujarat, Maharashtra and Madhya Pradesh. Such enormous discrepancies with respect to a disease that is well established lower one’s confidence in the system’s ability to identify and treat a novel virus.

What is clear is that Covid-19 presents a bigger danger than the 2009 swine flu. It spreads much more easily and is far deadlier, with an estimated case fatality rate ranging from 1-3.4%.

The high mortality rate puts Covid-19 in the same league as the worst pandemic in recent centuries, the 1918 H1N1 influenza, known as the Spanish flu. The origins of that flu are disputed, but it took hold in European battle trenches towards the end of World War I. Hitting in two waves, the first mild, the second savage, it infected one in every four individuals then alive, and killed an estimated 50 million people.

Indian soldiers serving in the British army brought the Spanish flu back with them once demobilized. By the time it subsided, one in every three victims of the virus was Indian, making for a total of 15-17 million dead, or around 5% of the population of undivided India. Astonishingly, there is no historical memory within the subcontinent of that epidemic. The effect of a similar virus today would be more moderate, given improvements in identification and in treatment of secondary bacterial infections, but could be devastating nonetheless.

A century after that dreadful pandemic, we are poised at an inflection point in the spread of a new virus. Will India’s anarchic democracy, with its disdain for rules, manage to contain Covid-19 as ruthlessly as the regimented societies of East Asia are doing? Can our economy afford to seal off cities and provinces where millions depend on daily wages for their hand-to-mouth existence? Will the virus, perhaps, weaken and disappear in the mysterious manner of the previous novel coronavirus outbreak, the Severe Acute Respiratory Syndrome of 2002-03? Will we, as a consequence, be spared the fate of Wuhan, Qom, Lombardy in Italy and Daegu in South Korea? In the absence of clear answers, it is wise to hope for 2003 while preparing for 1918.

Girish Shahane writes on politics, history and art.