Pandemic Flu, 1918: After hundred years, India is as vulnerable

COVID-19 and Informal Settlements - Implications for Water, Sanitation and Health in India and Indonesia

“…The Influenza pandemic of 1918 (Spanish flu) is considered to be the most lethal pandemic of the twentieth century. It resulted in the largest number of deaths in single countries; high mortality rates were seen in Indonesia and circa 10-20 million fatalities were reported in India 1 . At the time, vaccines, in combination with social measures at the individual, household and societal levels, proved to be effective public health interventions 1 .…”

“…It resulted in the largest number of deaths in single countries; high mortality rates were seen in Indonesia and circa 10-20 million fatalities were reported in India 1 . At the time, vaccines, in combination with social measures at the individual, household and societal levels, proved to be effective public health interventions 1 . Years later, COVID-19 poses a similar challenge globally, but the highly contagious nature of the disease and no currently available vaccine requires stringent physical distancing measures, with particular challenges in overcrowded areas.…”

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“…India had the largest number of deaths in any single country at that time (10-20 million) and the global death toll was 50 to 100 million. 5 Things have changed significantly over the past 100 years, but the basic infection control practices have remained the same. We need to learn from history and ensure that the same mistakes are not committed again.…”

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“…A mathematic model predicted that if similar severity of influenza pandemic would have repeated in 2004, the estimated mortality toll world over would have been 62 million, and with a similar trend as in the past, nearly 14.8 million deaths were estimated in India alone. [2,3] In the wake of a similar pandemic of COVID-19 causing chaos all around the world and claiming thousands of lives, we need to introspect our current position and understand our capacity to "bend the curve" to minimize the magnitude of damage at every cost. [4,5] Fortunately, so far, the situation in India appears better in comparison to many other countries, but the balance is dynamic.…”

“…[1] Hence, to reduce the impact of COVID-19, it is our joint responsibility as oncologists to explicitly communicate our deficiencies, efficiencies, and the ongoing challenges in treatment delivery and come to a consensus as a multidisciplinary team on where we think is most appropriate to draw lines and decide on consistent treatment policies, which are in alignment with the international guidelines, organization's capacity, and safe practices. [2] The great inventions in the medical fields of public health, critical care, and emergency medicine such as vaccines, extracorporeal membrane oxygenation, several antibiotics, antivirals, and targeted therapy have failed to cure critical patients suffering from COVID-19, bolstering the ideology of "Prevention is still better than cure." [3] Prevention of infection can only be achieved with population-based interventions such as quarantine of the suspected, isolation of the infected, and social distancing to reduce the cross contamination and improving hygiene to eventually "Flatten the otherwise exponentially rising curve of the infected cases."…”