Covid-19 · Culture & Life · History of Medicine · Medicine & Doctors · Public health

COVID-19 in India – Society and Culture – March 22 Diary

For the previous posts in this series, see here & here.

[Throughout history epidemics have served as excellent windows into social and cultural beliefs and norms. While this contagion-catalyzed uncovering of a society’s thought processes helps historians understand past societies in better ways, for present societies it can potentially be utilized as a way to understand our hidden biases, prejudices, and even kindnesses. Besides, epidemics could make our anti-intellectual society finally start listening to intellectuals, activists, and academics who have always tried to drive our attention to fault-lines that we don’t take seriously before a crisis (like COVID-19) ultimately bares them open for all to see. My attempt here is to collate different media and personal narratives from the COVID-19 epidemic in India that throw light on the social and cultural aspects of how we have reacted (and will continue to react) to this crisis. There are a lot of lessons we can learn and implement, but whether we do that or not is, again, dependent upon what general direction our sociocultural norms take as the epidemic progresses and dies down.]

THE most important (not necessarily the most rational) event in India in the last few days was – wait for it – thousands of people banging plates and utensils to ostensibly express gratitude to healthcare workers. This was in response to an irrational call by the Indian Prime Minister for people to do the same. The call was made despite the very obvious fact that when carried out by thousands of people all over the country, it would quite simply provide hundreds of thousands of opportunities for the novel coronavirus to spread. I am personally very worried about how much damage the PM has caused today (of course in addition to what he has been doing over the past six years). Historians in the future will simultaneously be outraged and amused at how an entire nation could descend into such absurdity during a pandemic caused by a notoriously contagious virus.

You can see some (cringe-worthy) videos of people submissively following the PM here and here. These might also be important for epidemiologists in the future as content for courses on infectious diseases (or some course on authoritarianism and public health).

CONSIDERING the increased susceptibility of elderly persons to COVID-19, old-age homes in India have restricted entry of outsiders (it is important to remember that young people are not invincible, as the WHO recently said). Read this report by Vijayta Lalwani:

THREE persons were killed in clashes that broke out in a Kolkata prison following a ‘coronavirus clampdown’. The prisoners alleged that they were neither being produced in court nor being allowed to meet their family members.

THE historical intersection of religious congregations and contagion was emphasized in the story of Punjab’s first COVID-19 casualty. In the 1800s, British colonial officers routinely blamed Hindu religious gatherings for the spread of cholera.

With the latest set of cases, the number of confirmed novel coronavirus cases from Punjab has risen to 13. The Hola Mohalla is among the largest religious congregations in India. Sharma said between thirty five to forty lakh people normally attended the gathering in Anandpur Sahib, and that despite the ongoing public-health crisis, around twenty lakh people had still come for the festival. Given the scale of the gathering and the fact that Baldev is believed to have infected [a term I am not very comfortable with] his family members, it appears likely that the number of infections in Punjab is likely to increase further.

A QUIRKY consequence of the pandemic and social distancing was reported in Scroll recently:

The coronavirus crisis has rocked Bollywood. Releases have been delayed. Shooting for films, television shows and web series in Mumbai has been halted.. Cinemas and production companies have been shuttered, and celebrities are pursuing self-isolation. All of which means that the paparazzi have almost nobody to photograph. “There are hardly any celebrities around,” said Viral Bhayani, who runs one of the most well-known celebrity photography agencies. “While we were putting out 70-odd photographs on a daily basis, we are now sending two or three at best. Barely a couple of my 15 photographers are out in the field, and even that will stop over the next few days.” In the normal course of things, entertainment photographers would get their images by lingering outside restaurants, studios, five-star hotels and the homes of celebrities.

THE branding of persons with the virus or suspected of it has had interesting consequences (the ethical validity of this idea is extremely flimsy, though a strong case for it has been made from many quarters). A couple was asked to disembark a train after co-passengers noticed the ‘quarantine seal’ on the hand of one of them. Passengers in an airplane suffered quite an episode of panic after noticing at least five passengers in the plane with the quarantine seals on their hands.

The Chief Minister of Delhi announced a similarly controversial measure when he tweeted: “Delhi govt is marking all homes with persons advised to home quarantine. I appeal to all not to stigmatize such families. Please be empathetic and supportive towards them. The marking is aimed only at cautioning others for their own safety.”

AN important article on the website India Water Portal drew our attention to how the appeals to handwashing seem hollow for many millions of Indians considering the lack of access to clean water for them. Here are some excerpts from the piece:

The recent NSSO survey shows that only one in every five households in India has access to piped water connections. In urban India, only 41 percent of households have piped drinking water connections. In rural areas, the recent NRDWP data shows that just 18 per cent households receive potable water directly at homes. Around 58.3 per cent of households still rely on hand pumps, tube wells, public taps, piped water from neighbour, protected or unprotected wells, and private or public taps for their water.

AIR India is the only carrier in the country which has been engaged in bringing back Indian citizens stranded in other countries during this pandemic. The crew doing this, however, were in for a rude shock when their colleagues and communities started ostracizing them.

“We do not get our salary on time. We do not know when we will get the same. We do not think about ourselves whenever being called to fly to war zones and now corona hotspots to evacuate Indians. Our salary, which for months has not come on time, is being deducted and on top of this we are facing this ostracisation from our neighbours and RWAs. We are humans, don’t break us,” said a crew member on condition of anonymity.

HISTORICAL NUGGET:

Beginning in the early 1800s, cholera became perhaps the most deadly and frightening epidemic disease of India. It is only in the post-independence period that its prominence began gradually to recede. I reproduce here some excerpts from an interview of Dr Dhiman Barua, an expert associated with the World Health Organization who made immense contributions to helping devise appropriate management protocols for cholera. Read the full interview here.

In those days IV saline was made in glass bottles, as there were no plastic bottles, and a one-litre bottle was so heavy that to transport it by air was many times more expensive than the fluid itself. This made it impossible to provide, for example, tonnes of IV saline that were needed to meet demand in Africa, where 40 countries were affected by cholera in 1970. WHO was inundated with requests for IV fluid from African countries. One WHO consultant sent us a telegram from Guinea saying that he saw “children swimming in the cholera stools of their parents”. Such horrific conditions I could not have imagined. These circumstances obliged us think about alternatives to IV fluid in oral rehydration. But hospital-based clinicians were against allowing untrained people to use oral rehydration. (Former Director-General) Dr [Halfdan] Mahler was very supportive; we had long discussions about the use of oral rehydration in place of intravenous fluid. And ultimately he agreed with my proposal. He arranged for me to go to Africa to run five training courses in different countries. We were able to provide ORS packets that were much cheaper than IV fluid.

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