Milan talks to author Chinmay Tumbe about India's three forgotten pandemics—cholera, the plague, and influenza— and what we might learn from them.
Although this history has largely been forgotten today, India was the epicenter of three major pandemics throughout the 19th and early 20th century.
A new book by the economist Chinmay Tumbe, The Age of Pandemics: 1817-1920—How They Shaped India and the World, takes readers on a tour of three previous pandemics—cholera, the plague, and influenza—that ravaged India and highlights what we might learn from this past trauma.
This week on the show, Chinmay speaks with Milan about India’s “Age of Pandemics” and why this dark chapter in Indian history has been glossed over. Chinmay and Milan also discuss the parallels between pandemics past and present, how pandemics have shaped politics, and why the flight of internal migrants is one of the most stylized facts of pandemics in history.
Episode notes:
Milan 00:11
Welcome to Grand Tamasha, a co-production of the Carnegie Endowment for International Peace and the Hindustan Times. I'm your host, Milan Vaishnav. Imagine this: a deadly pandemic breaks out across India. Politicians debate the role of religion and religious pilgrimages and spreading the virus. Migrants flee disease by abandoning the big cities, where they've taken up residence in the tens of thousands. Measures announced by the government meant to allay citizens' fears end up stoking them instead. Well, this disruption might fit India's Coronavirus dilemma in 2020. It also captures the realities of India in 1817, or even 1917. A new book by the economist Chinmay Tumbe, The Age of Pandemics, 1817 to 1920: How They Shaped India and the World, takes readers on a tour of three previous pandemics that ravaged India and highlights what we might learn from this past trauma. Chinmay is a professor at the Indian Institute of Management and author of the fabulous 2018 book, India Moving: A History of Migration. I'm pleased to welcome him to the show for the very first time. Chinmay, thanks for coming on.
Chinmay 01:09
Thank you so much for having me.
Milan 01:11
So, let's start with a question about the motivation for the book. You began, before the first chapter, with an exchange between you and your son in which he asked you kind of very innocently whether there had been pandemics in the past. Tell us about how this conversation moved you to put pen to paper.
Chinmay 01:32
Yeah, it's really strange. If you [told] me in January, you know, that I'd have a book on pandemics by the end of the year, it was highly unlikely, and yet a series of events happened after that, and one of them was my son asking me about past pandemics. And just the fact that the word pandemic was in his vocabulary at such a young age is, of course, striking, but then when I started talking about something like influenza, he said, "I've heard this word influenza," pulled out his Tintin comic, and pointed out the word influenza in one of these editions. That got me really thinking as to how diseases are represented in popular culture, media, and so on over time. And then when he asked me specifically, "Tell me something asked pandemics, especially about India," I felt both happy and uneasy, happy in the sense that I knew a little bit about it because I had actually collected a lot of statistics on the influenza even before COVID struck - I had a plan to write on the influenza even before the WHO declared this was a pandemic - and also uneasy because I did not really know what to tell him because there really is no book or no major account of what I call the "age of pandemics" of this period. So, that really got me thinking that maybe this book has to be written, and that's precisely what I set out to do. The closest equivalent is David Arnold's book, which is an academic book on health, but that's 19th century. That covers cholera, plague, and smallpox, but the bulk of the action really happens in 1900s and 1910s. And there's no influenza in that, which is really the biggest demographic disaster, I argue, that ever took place in a two- or three-months’ period, and in which India was the most affected. So, all of this put together told me that this is a book waiting to be written, and so I think since March I've just been working nonstop on this book project. And I really wanted to get it out in 2020, and now, the last month of the year, I managed to get it just in time.
Milan 03:36
And so, just for a second before we move on - you had the idea of writing about the influenza even before the COVID-19 pandemic. What moved you and motivated you to think about that even before this struck?
Chinmay 03:50
So, this has been a long-running sort of area of interest, [although] I've not written a paper or something on the influenza. It started when I was doing my doctoral research back in the day on migration, and whenever I've done research on migration, when I've sat in libraries, archives, especially because I'm reading the history of migration, you will often come across epidemics because migration and epidemics went hand in glove back in the day. But the influenza was specifically in my doctoral thesis, actually. I had collected the population growth rates of India at the district level from 1901 to now, I also have these maps in my thesis, and the most stark map in that entire series was 1911 to 1921, where virtually all of India had negative population growth. And so that was a massive demographic shock, and I always looked at that map and said, "Look, there's much more waiting to be written on this particular decade, which had both the plague and the influenza," and so wherever I have gone in - whether it is in the British Library, you know, whether it is in the National Archives - I always had this side antenna on, saying that, you know, "If there's something on epidemics, pandemics, maybe I can collect it." So, an example at the British Library: I picked up a report on cholera, 1867, and so on. So, they are hanging there in my folders, and then the eight months ago, I got activated after years of, you know, lying out there. That's really how it happened. The influenza part I was really excited about. The plague and cholera part [involved] a lot of learning, which has happened over the past one year, and for that I looked at a lot of mortality statistics, a bunch of other memoirs, records, a lot of economic data - I think one of the things which medical historians have not done is really look at the economic fallout, and so with my training in economics, I thought I should get this economic angle out there. So, for all the three pandemics, I also pointed out what was really the economic fallout.
Milan 05:41
So, one of the major revelations of your book is the fact that in many ways India was the epicenter of these three major pandemics - cholera, the plague, and influenza - that stretched throughout the 19th century and the early part of the 20th century, and in this so-called "age of pandemics," as you call it, over 40 million people in India lost their lives. And what's so interesting to me is, you write in your book that a lot of this history has been, "wiped clean" from people's collective memory. Given the scale of the devastation, why do you think this is?
Chinmay 06:16
I think one part of it is - it did linger on in people's memories until about the 1950s, but as the generation died out, that intergenerational transmission was not there. And for collective memory to exist, you need books, you need memorialization, which has happened for the World Wars, for example - you know, countless movies, countless books on the World Wars - even on World War One in India, now, you have a fair amount of literature and so on. So, one, epidemics in general... I think the only pandemic in history that has been memorized is the Black Death of the 14th century, which really entered European consciousness because that devastated [them] - by some estimates, a third of Europe died - and so on. So, apart from that pandemic, infectious disease in history have not got the same sort of status accorded to them as compared to even famines, as compared to wars. They are the most costly sort of events. So, we know more about the 1876 Great Famine in India because that led to political battles and so on. Infectious disease slips through the cracks. Why? Partly, there's no clear enemy, so it's not like you're fighting the British or fighting a political state - it's coming from out of the blue. Second, also, this is a time where there are a lot of infectious diseases, so one way to look at it is that people themselves did not see this as something dramatically new because death rates were very high to begin with. But, as I pointed out, death rates, even from that high base, actually increased tremendously during the speech. So, the lack of memorialization... The freedom movement, interestingly - when we look at the spirit of Indian history, it's about the rise and fall of British rule, and yet oddly a common enemy for both Indians and the British was infectious disease. And if you look at day-to-day lives, I'm pretty sure more people were afraid of diseases than the British or the Indians fighting with each other. And, as I pointed in the book, each of the pandemics were very closely tied with the freedom movement - for example, the 1857 revolt and the cholera pandemic, the plague and the rise of the Congress, and 1918 and the rise of Gandhi later on. So, it's very interesting that, I think, the focus in political history has meant not looking at the history of science, medicine, and so on. And there's been no book - I think that's the fundamental reason, that's one of the rationales for writing this was to start this conversation.
Milan 08:42
So, let me ask you about cholera, which is the first of the three pandemics that you study now. Cholera broke out in eastern India around 1817. In the late 19th century, the mortality from cholera was increasing in India, you point out, even as it was declining in many other parts of the world - I think Bengal had a death rate of around three per thousand people before 1920. Why was India in particular so badly affected by cholera?
Chinmay 09:09
Cholera is very interesting because the whole debate of that was on transmission, and we can talk about that in a bit, but what the Europeans understood very early on - and by early, I mean the 1850s, 1860s - is that cholera is essentially a waterborne disease, and this changed the weight of opinion, and so they invested heavily in better sewage systems, better piping, water supplies, and so on, and that drastically curtailed cholera fatality, or even cholera incidence rates, in those spots. It was more of a prevention rather than a cure kind of thing because the real cure - that is, getting down case fatality rates - actually had to wait for the early 20th century. But they kind of figured out how to keep cholera at bay. In India, that investment in basic infrastructure of water supply systems did not take. Where it did take, like in Kolkata city, it had an immediate impact on death rates, and Kolkata's [death rates] started falling from when this was introduced in 1869. So, the crux is that the public health officials in India, strangely enough, did not believe that cholera was waterborne, and so this is a really fascinating debate or fight between two different schools of thought: the Indian medical schools - and these are mostly British officers - saying that cholera is not waterborne, it's from the environment, whereas these guys are saying, "No, no, it's waterborne." So, actually, while Britain did the correct thing of investing in better water systems, in India, that never happened. They should have done it either way - even if it was not waterborne, they should have invested. But the fact that they did not really delayed that aspect. But there's another aspect, which is that the late 19th century is really a sort of dark part of climatic history in India. If you look at India's rainfall history from the 1850s to now, the worst years of rainfall were in the 1870s and the 1890s. So, there was a real water scarcity situation India. Food production had slowed down. So, cholera kind of acted on the general nature of water scarcity because when you have scarce water, people start moving to places, tanks get contaminated, and that's the classic recipe for more cholera. And so cholera rates [in India] actually increased in the late 19th century just as they were going [down elsewhere]. And the two principal answers I would say are the lack of investment in public health, which was happening in Europe and not in India, and the other was a nutrition crisis brought about by these two massive drought periods in Indian history.
Milan 11:40
Chinmay, I want to go back to something that you talked about, which was this debate that broke out over the long, arduous search for what it was that was the ultimate disease-causing agent. You discuss in the book - and I'm wondering if this is linked to the issue of water - that there were two competing schools of thought, what you call the "sanitarians" and the "contagionists." What was this debate about, and who ultimately prevailed?
Chinmay 12:06
Something as fundamental as contagion, incredibly, in medical history, is a very recent sort of idea. Today, we take it for granted that diseases can pass across human beings and so on, but until the middle of the 19th century, the prevailing school of thought in medical systems in most parts of the world was that diseases are caused by what is known as miasma, or bad air. So, if corpses or bodies or any flesh is left to rot, it's that impure air which leads to diseases. It's a thought which prevails until the late 19th, early 20th centuries for many diseases. So, the sanitarians were the guys who argued that climate and environmental factors determine diseases and diseases do not get transmitted across human beings, and it was very easy for the guys in India to accept the theory because cholera did sort of display seasonality - it wasn't in all months of the year, it was in certain months of the year - so there were a lot of theories around [for] why it was in certain months of the year [claiming that] there must be environmental factors. Whereas the contagionists, on the other hand, said there's a transmission mechanism, but it wasn't very clear to them how it was transmitted. And both of them had their own arguments: the contagionists would point out that cholera would start in a new place only when a person with cholera came there, so it must be contagious, whereas [the sanitarians] would say, "Look, the doctors administering the cholera patients are not getting cholera." So, that's the classic counterargument to the contagionists' position: seeing there are two people in the same room, but he's still not getting cholera in the doctor's case. And this was finally solved in a huge way by John Snow in the UK, who pointed out that it's not just airborne transmission, it's what he calls a fecal-oral transmission system, where you are ingesting it in water systems, it's going into the body, it's coming out in the form of stools, the watery stools that cholera was infamous for. And those stools, as it goes into the sewage system, it contaminates the water system, and if you are drinking from the same system, that's how it comes back. So, this was kind of proven in a very nice way by these people. Very interestingly, in India, one of the rare British officers who was convinced it was water and not air - he had a map, very similar to John Snow, but he showed a caste-level map of an Indian village, and he showed that there is, on one side, the upper castes, and the other side is low-ranking castes, and it's only the upper castes in that particular village which got cholera because there were two contaminated wells, and because the segregation is so stark, these guys did not get it because they were not drinking water from the same wells. So, I found it very fascinating as to how they were trying to argue the validity of water transmission. But the guys in India were diehard sanitarians, they argued it was always the environment, and their guru was a German guy called Max von Pettenkofer, who was a great sanitary official and physician in Germany who had done a lot for improving public health systems in Germany, but he was a die-hard sanitarian, and he used to look down upon people who talked about contagion - most famously, he ingested the cholera of India to show that, you know, "Nothing happens to me, it is all about the environment." And the Indian guys believed that school of thought for a long time, and unfortunately, they were completely wrong, with huge consequences for those thirty years. So, just as it was going down elsewhere, it was actually going up. And what it tells you in the context of any pandemic is that, more than vaccination, understanding transmission is key. You see, [with] most pandemics, most infectious diseases, the key is to understand transmission. Yes, vaccination can help at a certain point, but if you don't understand transmission, that's it. We've seen that with cholera - it lingered for decades - and even the plague. For the first decade of the plague, people were just clueless about how plague was transmitted. So, this transmission debate was a huge part of the cholera circuit in the 19th century, and ultimately, the contagionists won. But what's interesting is what we now know about cholera with modern day research actually confirms some of the things that the sanitarians were saying. So, we now know that cholera is not entirely waterborne - it can actually go from some other [sources]. So, we say "fundamentally waterborne," but it can have certain other transmission [sources]. They're showing that it is actually partly based on environmental factors. So, it's remarkable because after a hundred years, some of the hypotheses of the first positions are being proved as well, though on balance one would have to say that the contagionists were much more right.
Milan 16:44
That's a nice segue, Chinmay, for what I want to ask you about. There were several times when I was reading your book when there was this kind of uncanny resemblance between debates that were going on hundreds of years ago and challenges the world is confronting today. For instance, during the cholera pandemic, you described a debate that broke out over the role that religion and religious pilgrimages might have played as acting as a conduit for the disease. Of course, our listeners will be aware that in the early days of the Coronavirus, a similar argument broke out centered on this Islamic gathering that took place in Delhi, which was seen as a kind of super-spreader event, and it led to lots of communal overtones in discussing COVID and so on and so forth. Tell us about what the controversy was about back then.
Chinmay 17:34
So, the idea was again about how cholera was transmitted, and one of the big theories was that cholera went from India outside to the rest of the world through pilgrimage routes. So, it transmitted within India through pilgrim routes, and it got transmitted outside India, also. So, in a way, the villains for the British were the Hindu pilgrims within India and the Muslim pilgrims going to Mecca. Now, was it accurate in terms of the actual transmission? To a certain extent, yes. Clear time series show you that, for example, the famous Kumbhe Melas in India coincided with large cholera outbreaks across North India, and there were certain practices - for example, this practice of taking water from the holy rivers and taking it to your home places and, in fact, sprinkling it in your ponds there - now, this is the classic recipe for fecal-oral transmission. And so once this cholera activated from 1817, pilgrimages were actually deadly sites. It was also interesting because it was a point on which both the sanitarians and the contagionists agreed. Sanitarians would say that these are dirty places, and so you get diseases, and the contagious say that there's water and hence you're getting cholera. But the difference of opinion between the Indians and the British was that Indians said, obviously, "This is part of our culture, and you need to invest in better public health facilities, better arrangements at our pilgrim sites, rather than doing nothing," whereas the British sort of cited oriental fatalism and other factors, saying this will never change. But what it did was - just like we have Chinese wet markets today as a sort of point of all blame - it was the Indian pilgrimage sites which became this massive point of blame back then, so much so that there were these international conferences (in fact, the intellectual precursors to the World Health Organization - the World Health Organization, really its origin is 1948, but its actual origin, if you trace out how it started, is in 1851), and they actually met to understand cholera in the world, and so these conferences always looked at pilgrims in a very negative light, and you had quarantines, you had vaccination programs for pilgrims, but in this, of course, there was a lot of victimization of the pilgrims as well, which is also what we see today. So, to some extent, it is true that the pilgrimage routes did transmit cholera to a certain extent, but the response was outsized, and the officials were never really listening to what the pilgrims themselves were saying. The worst parts of the quarantines were actually in the Middle East. So, if you had to go to Mecca, there's an island called El Tor - in fact, the new cholera variety nowadays is actually named after that quarantine station, it's called the El Tor cholera variety - and this was a landing station for all pilgrims to go to Mecca. And so it kind of reframed commercial relations, it kind of reframed trading relations between countries, and the sort of sole villain was this pilgrim. This pilgrim became this huge outcast, and the fact that it was not just the pilgrims - in fact, one of the huge transmitters of cholera within India was the British military - that was never picked up fully enough by the British.
Milan 20:42
I want to ask you a little bit about the plague, which was the second pandemic you studied. Some of the numbers that you quote are just kind of mind-boggling. Bombay had a case fatality rate of over 70%. Half of the city's population, around 400,000 people or so, at one point or another left the city in the late 1800s. You write that the plague claimed about 12 million lives on the subcontinent between 1896 and 1918. The year 1907 saw a million deaths in just that one year alone. What was very interesting - you alluded to this earlier, and I want to ask you if you could kind of dig a little deeper - you mentioned that the plague played a crucial role in political movements in India at that time. It threw the spotlight on new leaders, it helped to build the kind of sense of organizational capacity, it created a sense of solidarity through volunteering and coming together. How exactly would you relate the awful things which happened as part of the plague with the kind of development and evolution of Congress party politics at that time, the kind of evolution of the freedom movement?
Chinmay 21:53
There's a historian, Ian Catanach, who documents some of these aspects, but let me just touch upon some of them, and especially what I found. We can talk of peak plague - peak plague was 1896 to 1918, so about twenty-odd years. [It had] a huge role to play. I mean, a lot of the Congress leaders really started off in the anti-plague movements. Gandhi himself was in the anti-plague movement both in Gujarat and in South Africa, later on, where plague also struck. Vallabhbhai, Sardar Patel Vallabhbhai from Ahmedabad, his first sort of big role in life was as the sanitation committeeperson in the municipality, fighting plague. You had Tilak in Maharashtra, where - this is a well-known incident - Talak was sent to jail because of his sort of anti-official stance during the harsh plague containment measures, and when he is released from jail, he's a national hero. There's Gokhale, who's a moderate [member of] Congress, who also becomes a staunch champion of plague relief committees. So, just a wide range of some of the stalwarts of the Indian Congress are in them. But I talk about one year, 1907, which is less known in Indian history. This is, in a way, the year where the Congress splits, and the backdrop of that is those million deaths. And there's a lot of turmoil in Punjab, especially, where plague had kind of devastated Punjab, about how one should sort of look at plague and how one should be countering the British. And one thought said, "Well, the plague is kind of God-given, and there's not much the British can do," and the other said, "This is completely a sort of British-driven problem." And this also became sort of reflected in the policy. So, many things happen in 1907 - it was also a bad crop - that play a huge part in setting the backdrop of turmoil and eventually a famous split in the Congress Party. But that entire decade was very eventful. The other part, which you mentioned, is the cooperative movement. I mean, even today, some cooperatives in India are very successful, like Amul for milk and so on. But the cooperative movement almost started out in the backdrop of the plague. What you really need for a good cooperative movement is leadership in organizing people, and that's what plague did. And one particular way in which plague sort of developed organizational capability was that after a lot of trial and error, they realized the best strategy to minimize deaths is to evacuate, and so there were these mass evacuations. So, whenever plague would come - again, it was seasonal - I estimate at least 30 million people must have evacuate at some time or the other. And you have memoirs, a lot of firsthand accounts of this. Basically, the minute that rats came out from the holes, you know, scurrying and falling dead, entire villages depopulate and basically encamped outside the village or outside small towns as well, and that required organizational capability. So, many of these guys in the cooperative movement, many of these guys in the political movement, like Gokhale, for example, they started off in plague relief measures. So, it was that big of an organizational event, which, of course, affected economic activity, there's no doubt about it, but what I'd like to highlight is that to start a nascent political movement, you need that leadership capability of organizing people, and I think plague sort of set the backdrop for this to happen in a spectacular fashion.
Milan 25:13
Just to stick with this period for a second: it was Lord Elgin, you point out, who was at the time the Viceroy, who first enacted the epidemic diseases act of '97, which is a law that still remains on the books. You know, it's funny - we often talk about colonial-era legislation. The police are still governed by the Police Act of 1861; until recently, of course, the Land Acquisition Act was that act of 1894. What is the relevance of the Epidemic Diseases Act of 1897 in the year 2020?
Chinmay 25:21
The fact that India is handling the COVID pandemic using literally the same act - there was one amendment this year, and that amendment was because a lot of people were attacking doctors, so they increased the penalties if you attack doctors. So, that's one change, which -
Milan 26:01
Wait, physically attack doctors?
Chinmay 26:03
Physically attack doctors, yeah. So, that's one change which happened, they had to pass an amendment this year, but the structure is pretty much the same. There have been some amendments over time. And it's very useful for - I mean, for a state which really wants to impose its will very quickly, it's a great law. It's a draconian law in the sense that it curtails everything. Now, an epidemiologist might say that, you know, this is necessary, this is how you enforce lockdowns, but back then, this was a complete disaster. They enacted this law, they implemented it, and within a few months, they had to leave it. So, though they devised the law, they never went fully with the law because they realized very quickly that backfires, because the more you put pressure to curtail liberties, the more people counter it. But this is a big issue in public policy. How do you get people to change behavior quickly in a pandemic without going to what the British did? Because what the British did when the plague arrived was, you know - the counter-reaction was crazy. There's an assassination in Pune, guys killed off, Walter Rand was assassinated because these plague containment measures were seen to be very harsh, and all of them under the blanket cover of the Epidemic Disease Act. So, the Act came about in February 1897, so the timeline is, in effect - the plague really arrived in Bombay, roughly September or October 1896, and they're clueless for a few months, and then, as it's picking up, they take this decision: "You know what, let's just do this." And then it's literally a horribly cobbled law, which basically gives you power to shut down everything, you can do whatever you want, you can arrest whoever you want, you can have checkpoints anywhere you want. And that law is still there today, being used for COVID, and again, you saw the reaction against this wherever the state tried to overreach very quickly - there was reaction even today, but not as powerful a reaction as we saw back then in terms of an anti-state movement.
Milan 28:02
So, coming to the third plague of influenza, what is commonly referred to as the Spanish Flu, you note that somewhere between 40 and 60% of the population contracted the virus, but there has been this lingering historical puzzle over the variation within India when it comes to death rates. So, eastern and southern parts of India have fared relatively better than western and northern. Typically, we have thought about this variation as something that's has to do with per capita income, with wealth, but you actually point to another factor, which is the presence of drought. Tell us about the connection between these things.
Chinmay 28:38
So, my theory on this is that drought-linked price rise linked to a mortality impact. So, influenza acted on seriously malnourished bodies, and these bodies were malnourished because there was a severe drought in some parts of India, and that very neatly explains the regional variation. One, you can understand it in terms of food prices. So, food prices in eastern India actually fell, whereas the inflation of food prices in northern western India was 25 to 30%, so that's how dramatic price variation was within the country. And so my argument is more from an economic sort of sense - you know, what Amartya Sen [said] about famines, that often it is just lack of access because of, say, artificial scarcities which drove [famine-related deaths]. The other contending theories - I.D. Mills had a theory on climate, saying that it was colder up north and so, because influenza sort of created pneumonic conditions, a lot of pneumonia cases develop. So, that was a climatic argument. There is one argument of access to health facilities. But what I show in that chapter is that, if you look at the Indian Army, which was reasonably well-fed, or the European army, which was reasonably well-fed, there is no regional variation. So, if we look at north, south, eastern India, they all got influenza, and case fatality rates were pretty much the same across the board. It's only in the general population, where access to food is highly variable, that you've got this regional variation mortality. So, my argument is hinging on the drought. Now, when we say drought, we often think in India that, you know, there's a drought every five years, so I want to talk about the intensity. The three worst droughts in Indian history were in 1877, 1899, and 1980. So, climatically, this was a completely abnormal year. And the drought happened in June, July, August, and by September, you could see the problems of the drought coming. And it's in September, mid-September, that the second wave of the influenza virus, the killer wave, really unleashed itself. And I have a very nice snippet from a memoir, which is translated by Shanta Gokhale, by a lady called Lakshmibai Tilak who kept an account, it's called Smritichitre, and to the best of my knowledge, nobody has looked at that, no book, as a first-hand account of influenza because the word used for influenza is “manmori,” which is from a local language - I don't think the translator of the book knew that what they were describing in the book was influenza, but “manmori” was used for influenza back then. And it's a gripping three-page account in that book which tells you very clearly the sequence of events: first, the drought, people were literally starving, and then came influenza and demolished a lot of families. So, this seems to be more viable theory as to why so many people died in India, and why virtually nobody was really affected in Assam, for example, in eastern India, but it really hit large parts of western India. But that's a huge number, and my estimates actually are now taking the overall estimate higher than what previously people estimated because I've also looked at the princely states. Previous studies looked at only British India, but one of the things I'm finding is that in Rajasthan, Rajputana, and Islam-ruled Hyderabad, mortality rates were actually much higher, and so you find that when you add up those deaths, that number pushes it from roughly 15 million - what people were saying earlier - to about 20 million, which is huge because the overall influenza mortality is now about 40 million, so we're saying that about half of all deaths were in India. And, again, I just like to point out, there have been books on influenza, global histories, where India gets two or three lines, or in John Barry's best-selling book on influenza, India is one paragraph. So, what I find very interesting on even cholera - not so much on plague, but cholera and influenza - a lot has been written in the English language in Europe, in the US, but literally a paragraph or two on India. And yet, India was the epicenter in all three of these pandemics. So, that's the kind of imbalances this book is trying to address.
Milan 32:52
The book ends with telling us about what are some of the lessons from these past pandemics for how we can think about the COVID era, and you make the point in that concluding chapter that democratic governance is ultimately very important for both government responsiveness and political accountability, and that the politics of pandemics, when you get down to the nuts and bolts, really kind of revolves around showcasing success. I wonder if you could reflect on this lesson for India, circa 2020. Of course, one of the arguments that many commentators as may have made is that there's been actually a de-linking of performance on the one hand - in terms of how the government has handled the pandemic and the economic crisis and the humanitarian crisis around it - and accountability [on the other]. Would you go so far as to say that this is a genuine puzzle?
Chinmay 33:48
I think, you know, it's a very interesting puzzle. I'm not a political scientist, so I'm always careful [when I] make any comment on this, but my sense is the communication of success in India, whether it's on economic growth or pandemic management, the communication - or you can call it marketing, campaigning, what you want - has been very good this year, so a lot of people think that these are the best decisions being taken. Many people think India is one of the best-performing countries in the world on these facts. And it is, of course, true that compared to our own past history in India, there are not 20 million deaths, thankfully, and early actions were taken. The Prime Minister of India did trust science for the most part, unlike, say, the Brazilian Premier and so on. So, there were good things done. But if you see the numbers, of course, India lags low on both deaths per million and economic growth rates, so even compared to South Asian countries, India is really not looking - India's probably the worst performing South Asian. So, what you're alluding to is if, for example, there is no political backlash, is there a delinking between the pandemic and this. I think it's very varied. I think the sort of ruling party is very smart to also project that some of these major issues which cropped up - for example, the migration crisis - that the central government had nothing to do with it. So, a lot of the responsibility for the crisis has been sort of passed on to the state governments. So, for example, you can ask about the Bihar election, the most recent, which the BJP did very well in. Now, it is a big surprise to me, right, because you've had this massive migration crisis - you'd have thought that there's some backlash, but clearly, this was not high on the people's [list of priorities]. And my sense is that, on the one hand, there's been good communication from the ruling parties about what's been done for the pandemic, but also sort of passing on the blame, [saying] that some of this migration crisis was beyond [the central government’s] hands, that it was in the state governments' hands. And that's one way to look at it. But I think we'll have to wait for a few more elections to make some sense of what people are thinking about, or whether there is this delinking between performance and [perception]. On the other hand, the opposition, I think, has not gone out forcefully saying a lot of this, or that India is standing very poor compared to our neighboring countries in both economic fallout and the pandemic fallout. And so it's a bit of both, probably.
Milan 36:15
So, this is a nice note to end on because it's a bridge between your previous work on internal migration and your new work on pandemics, and few people I know have studied internal migration India in greater detail than you have. In the conclusion of your new book, you note that this flight of internal migrants is a kind of stylized fact that gets repeated throughout the age of pandemics, and so it occurs to me as we think about the migrant crisis from earlier this year, which I'm sure you watched very closely, why do you think - irrespective of who gets the blame or not, put that to one side - why do you think it was missed or perhaps not anticipated by the government in advance of the COVID lockdown?
Chinmay 37:09
It's really beyond my thinking as to how this was not anticipated, especially the lockdown speech. He ought to have had something for migrants. If you're going to shut down the Indian Railways with a four hours' notice period - I mean, this should have been in the overall planning process. Maybe this lack of knowledge about past pandemics was a handicap. Maybe people thought, "This is the first time, let's try it out." Maybe there was a thinking that in past pandemics, it spread precisely because people went back, and hence let's not allow them to go back. But either way - I mean, I'll tell you why I was surprised. There was a report in 2016 which told you the scale of circular migrants, there was a working group report on migration in 2017 which argued for portable social security, that migrants actually cannot live in cities for too long without some basic formal income support. So, really, it's a puzzle as to why this was done. In fact, we had more planning in shutting down our airspace internationally - it was at least a few weeks of planning for that. And what I'm arguing in the book is, obviously there has to be some curtailment of movement - I think that's a no-brainer - but the question is about how and when and how do you sequence it. And international mobility is easy to shut down, you just shut down the airports and say, "You can't come," but you can't do that with internal mobility. You can't shut down the trains and expect people not to move - people will walk. And they did that 100 years back. So, it's purely from a feasibility perspective that having a strong shutdown, saying, "You stay where you are for a few weeks," is just not [realistic]. What really failed this year was no credibility in the timeline. And because it started off with three weeks, some people said, "Okay, we'll stay here for three weeks." The minute [the government] started saying, "One more week, one more week," that's when the crisis really intensified. So, I think the learning from this is, whatever decision you're going to take, the biggest fallout of the lockdown is going to be on migrant workers. And Indian migrant workers have a highly circular nature - that is, they keep one foot in both sides. There's also psychological damage. That is, if there's a crisis, the first reaction is to go home, and it's been documented in this pandemic a lot. But even during the plague, the voices on the radio stations back then in the 1890s, [were saying], you know, if you want to die, might as well die back home. And there's a very, very strong psychological and cultural imperative to go back. So, I think hopefully the lessons will be heard, learned in a very stark manner this time around, and hopefully there's better documentation. One of the things I also argue in this book is we need to have some sort of a commission on this whole COVID pandemic. For all their faults, the British, after every one, they would have report. (They didn't do it for influenza, [which was] very smart because that was really a big disaster.) But for cholera and plague, they had annual reports, and over time, they helped - that incremental knowledge kind of help them understand cholera and plague. So, hopefully something of that sort.
Milan 40:02
Well, those of us in the United States believe that we need one of those after-action reports, as well. Let me just ask you one final thing on the migrant issue. What is your sense - we know there has been this big movement out of cities like Bombay, Delhi, where people have gone back to their homes, and there is a big concern right now about, you know, if a large percentage of them stay behind, what is that going to do for the economic recovery? What is that going to do for dynamism, the restarting of industry in urban centers, and so on and so forth? What's your sense about the timeline? Do you think that migrants that you've studied are looking to go back to cities, or do they still not have this sense of certainty, of social security, of safety, that they're going to be looked after if they if they do, in fact, return to the big city?
Chinmay 40:58
I think the first. That is, most will actually return - most are looking to return for the simple reason that why they came to the city in the first place hasn't vanished. That is, they're getting much higher wages than what they would get back home. And so, I think if you ask me now, in December, what's the position - a lot of migrant labor has come back to Indian cities. There will obviously be a few people who've been frustrated by the whole experience of earlier this year, and some surveys are showing some reluctance, but it's a small number - as a percentage, it's a small number who make up their minds never to go back to the cruel city again. But I think for most people, it's a hard economic reality, and they'll come, and that's why what we need to do at the city's end is that the employers, basically, or the government, has to pick up the tab to ensure safety. In the case of the COVID pandemic, health checkups, testing is probably the most important thing to do, so it's an incentive for actually people to come back faster. Because I think a lot of construction projects are still stalled because of a lack of certainty about when the lockdown in some parts of India will be lifted and so on. So, that should be done, and if that's done, I think workers will stay. I don't see this as a permanent sort of impact or that it will stop mobility. What might change is, of course, that new destinations might emerge. So, if you look at past shocks to migration corridors, often migrants choose a new destination. They say, "No, Delhi treated me very badly, I will try out Bangalore. I heard good stories about Bangalore, I'll try out that city." So, you might see some switching of migration corridors rather than a full stop.
Milan 42:36
My guest on the podcast today is the economist Chinmay Tumbe. He is the author of the brand-new book The Age of Pandemics, 1817 to 1920: How They Shaped India and the World. It's a tour de force of three previous pandemics and what they can inform us about India's challenge with the Coronavirus. Chinmay, thanks so much for coming out. Congrats on the new book. And I think you could not have asked - unfortunately or fortunately - for better timing with the release of your book. We wish you all the best.
Chinmay 43:02
Thank you so much.
Milan 43:04
Grand Tamasha is a co-production of the Carnegie Endowment for International Peace and the Hindustan Times. This podcast is an HT Smartcast original. It's available on htsmartcast.com, India's fastest-growing podcasting producing club. You can also find us on Apple Podcasts, Spotify, Stitcher, or wherever you get your podcasts. Don't forget to rate and review - it helps others find the show more easily. For more information about the show, and to find the writing we referenced on this week's episode, visit our website, grandtamasha.com. Production assistance comes from Jonathan Kay. Tim Martin is our audio engineer. Maya Krishna Rogers is our executive producer. Thanks for listening. We'll see you next week.