“The people fleeing the affected zones are heading in all directions and taking the hysteria with them...Tetracycline, an antibiotic for plague treatment, has disappeared from chemist shops not only in Bombay but also in Delhi.”
This is an extract from a news report dated 25 September 1994 in The Hindu – and yet, is eerily similar to articles in 2020 on panic due to the COVID-19 outbreak in India and around the world.
Over 1,000 suspected cases, schools and businesses shut down, restrictions on Indian travellers flying abroad, and a crash in the stock market – the 1994 Surat plague was a major public health crisis of post-Independent India. As India reels under the impact of the novel coronavirus pandemic, what lessons can we learn from the past?
What Was the Surat Plague of 1994?
A pneumonic plague broke out in Surat in Gujarat in August 1994.
A pneumonic plague is a contagious bacterial disease, and the outbreak was reported to be carried by rats. At the time of the plague, Surat was a city marked with filthy streets littered with garbage and cramped slums.
As the disease spread, estimates show that as many as two lakh people fled the city. This led to the plague spreading to cities like Delhi, Mumbai (then, Bombay) and even as far-off as Odisha (then, Orissa.) According to official records, 52 people died in the plague, though the numbers belie the panic created by the plague.
Reports of doctors, along with residents fleeing Surat with the bacterial antibiotic Tetracycline for family, were common. Dr Vikas Desai, speaking to Patralekha Chatterjee reporting for Citylab, recounts,
“I was then with the public health department of the local medical college. Each night, I used to get phone calls from panic-stricken residents of the walled city. Doctors started leaving.”
The government’s initial response to the outbreak, and misinformation about the root behind the plague, are attributed as reasons behind the panic.
Fake News, Despite Lack of Social Media
When the plague broke out in Surat, it was initially informed to the public that it is a bubonic plague – which is much less infectious and easier to cure. Writing in an essay for the University of Montana, Godshen Robert Pallipparambil details how when the plague was at its peak, “the Chief Minister of Gujarat claimed that the plague in Surat was pneumonic and not bubonic, perhaps not realising that pneumonic plague is far more infectious and less curable than bubonic plague. To emphasise his point he quoted that “rat fall” in Surat was not very high.”
Daily statistics about the number of infected cases were also conflicting, with many cases of fever being counted as suspected plague cases. It has also been reported that there was an absence of statements made by the Union Health Minister to assuage anxieties about the plague.
In contrast, the COVID-19 outbreak in India has seen confirmed positive cases regularly updated by the Ministry of Health and Family Welfare on their website. Press briefings, addressed by Joint Secretary of Health, among other ministries, are also being held to inform the public about important protocols like “social distancing.” However, social media – which was missing in 1994 in India – has contributed to misinformation on COVID-19 symptoms, news updates and potential cures.
Businesses Hit
The COVID-19 pandemic has had a massive impact on the Indian economy. There has been a crash in stock markets and a slowdown in businesses like the 10,000-crore toy manufacturing industry that has taken a hit. As a result of the pandemic’s global impact, there are also fears of an impending recession and a slump in the job market in India.
The 1994 Surat plague had an economic impact, too. Agricultural exports were hit by the UAE’s decision to suspend all cargo shipments to India – leading to a dip in the share value of agricultural products. At the time, one way to tackle the plague in Surat was to kill all rats in the ports in the city, and fumigate cargo.
With the news of the plague, diamond-cutting markets, shops, industrial units, and banks were shut down, heavily impacting local businesses. According to an estimate, losses in business due to the plague amounted to Rs 816 crore (not adjusted for inflation).
Quarantine & Checking Within India
The Surat plague wasn’t confined only to the city. Due to panic, residents were fleeing to other Indian cities. In New Delhi, schools and places of entertainment were shut for five days and in Mumbai (then, Bombay), a few infected cases were reported.
So, checkpoints were established at railway stations and domestic airports to quarantine incoming Surat residents. In the ongoing COVID-19 outbreak, only Sikkim has taken steps to restrict the travel of domestic tourists to the state.
Travel restrictions were also placed on international travellers in 1994. Indians from plague-affected areas had to fill out special forms on arrival in the US, and travellers were fumigated on arrival in Italy. Currently, India has suspended all visas, barring a few categories, till 15 April to control the spread of COVID-19.
A Commissioner Who Turned the Plague Around & Sustained Investment in Public Health
The plague in Surat was controlled, and the city’s public health infrastructure revived over the years due to two essential factors – the work of municipal commissioners like SR Rao and sustained investment in public health.
Patralekha Chatterjee writes in Citylabs how Surat’s municipal commissioners like SR Rao and S Jagadeesan, who were appointed in mid- and late-1990s, “overhauled trash collection and street cleaning, enforced hygiene standards in food establishments and upgraded slums with paved streets and toilets.”
Dr Hemant Desai, Surat’s deputy commissioner for health in 2015, says, “Commissioner SL Rao took over in 1995 and initiated radical changes. He himself took eight to 12 rounds of the city inspecting if everything was in place.”
Surat now regularly features on the list of cleanest cities in India, ranking 18 in 2020.
After the plague, India strengthened The National Institute for Communicable Disease’s plague research unit. In Surat, the municipality’s Vector Borne Diseases Control Department strictly monitors for instances of diseases like malaria, and conducts door-to-door surveillance throughout the year. In fact, Surat now regularly features on the list of cleanest cities in India, ranking 18 in 2020.
As of 17 March 2020, India has reported three deaths, and almost 150 confirmed cases of COVID-19. With every passing day, increased shutdowns are being put in place. Can Surat’s lessons on misinformation and governance be scaled up nationally to deal with a nationwide pandemic?
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