Atanu Dey On India's Development

Bird Flu Pandemic

October 17, 2005 by Atanu Dey

A terrible specter is haunting the world and it goes by the name H5N1, more commonly called the avian flu virus which cases influenza in birds. This avian flu high pathogenic virus mainly kills birds but has also killed a few dozen people since 2003. That is not the bad news. The bad news is that this virus could mutate after crossing with human flu strains and become highly contagious. If that happens—and some scientists believe that it is an almost certainty—then anywhere between 50 million to half a billion people would die from the pandemic.

Flu pandemics kill periodically. Spanish flu in the 1918-19 killed an estimated 50 million worldwide, for instance. (For a very readable account of flu pandemics, see the Centers for Disease Control and Prevention site.)

I have been worrying about the impact of the coming pandemic for a while. The poorer and developing economies of the world will suffer more than the rich economies, of course. The rich countries are not only less densely populated but they also have more resources to limit the damage by using anti-viral drugs and also by being able to implement public health measures more effectively.

India is both poor and densely populated. It is not unimaginable that India could see its population decimated (that is, reduce by a tenth, or kill one out of ten) by this pandemic. Of course one cannot really imagine 100 million dying in India. But it is possible. What would be the impact on the economy?

How will the course of India’s development be affected? I am reminded of a quote of Michael Bishop (which I had used before here):

The disruption wrought by microbes have repeatedly changed the course of human history. It was probably pestilence as much as any other single factor that accounted for the European conquest of the Western Hemisphere in the sixteenth century…

On the other hand, the Black Death may have fueled the burst of human creativity known as the Renaissance. At the time plague struck, medieval society had fallen into economic stasis, caused in large part by the “Malthusian deadlock” of dense population. The plague broke that deadlock by decimating the population, liberating land for diverse uses, creating the need for laborsaving devices, and unleashing the ingenuity of Renaissance society. The catastrophe of pestilence “gave to Europeans the chance to rebuild their society along much different lines … It assured that the Middle Ages would be the middle, not the final, phase in Western development. …

India will be changed. How I cannot guess. But it could be possible that the shock to the system may jolt it out of the rut it appears to have got stuck into for the last 60 odd years.

  • Pankaj

    I hope we don’t get this jolt!

  • Arun Anantharaman

    Wow, I can’t believe you even think along these lines. Disgracefuly distasteful.

    Atanu’s response: Yes, indeed, the idea of death — mega-death even — is disturbing. Disturbing things do happen, however. The Spanish flu did happen, and the Black Death happened. Sometimes it is caused by humans deliberately, as when tens of millions perished during the Great Leap Forward, or the Belgians slaughtering by the millions in the Congo (many have never heard of it), or the Pakistani Army killing about three million East Pakistanis in a few months, or the British policy causing the Bengal Famine of 1943.

    I quite agree that it is disgraceful that by now humans have not figured out how to not die or how to not kill in the millions. Quite distasteful.

  • http://blogontheweb.com/navin Navin

    Some people live in denial.. but there are already bad signs ..

    http://edition.cnn.com/2005/HEALTH/conditions/10/16/birdflu.europe/

  • Uday

    This is quite scary. So far among the few humans infected, the mortality rate has been 70% (compared to 10% for SARS). Many thought ‘Tamiflu’, a well known antiviral drug would help contain it, but supposedly, it was shown to be inadequate in a case in Vietnam. I am not sure on where the medical community stands on the status of this drug to combat the spread right now. Tamiflu (oseltamivir) is manufactured by Roche, and the US has only a few million in stock. With increased awareness, the prescriptions for Tamiflu in the US increased 800% compared to the same period last year :) And Roche has not yet licensed its manufacture in generic form(!!) which makes me think that ‘military-industrial complex’ is now passe. NY times just carried an article on how Cipla in Mumbai is ignoring Roche and going ahead with the generic:

    > “Right or wrong, we’re going to
    > commercialize and make oseltamivir,”
    > said Dr. Yusuf K. Hamied, chairman of
    > Cipla of Bombay

    Coincidentally, the 1918 Spanish flu you refer to also originated from birds.

  • http://kaisare.net/wlog Niket

    It is interesting how some people equate a matter-of-fact statement to saying that you want it to happen. I guess that is why Arun seems to think this is disgusting.

    No Arun, we hope that bird flu does not kill a million people.

    But we have to brace up for the possibility that it may.

    It has happened before, and it may happen again. Pointing out that the course of history changes due to such pandemics does not mean one wishes they happen. Saying that “system may jolt it out of the rut” does not mean Atanu hopes for this jolt. In fact, quite the contrary. I am sure he hopes the system gets out of the rut BEFORE the H5N1 mutates, so that we are in a better position to respond.

  • Prashant

    Even sarcastically, I don’t find anything distasteful about acknowledging a danger that lurks out there.

    Pankaj, I am not sure how far hoping and praying will get us when the pandemic strikes. I am sure though, that the right preparation will save millions of lives.

  • http://pithingcontest.blogspot.com greensmile

    Atnu: If the quote S Mitra Kalita has of you on her WaPo blog is indicative of the effect of globalization on India’s economy, that is an aggravating factor in the gloomy prospect of a pandemic. The sharp rise of prices as industrialization takes root in any formerly aggrarian economy has generally emptied the villages and filled the slums: folks need more money and more jobs are near the cities. Won’t the differential impact of this flu on rich and poor be amplified if the distribution of population begins to crowd toward the major cities?

    Atanu’s response: Greensmile, I am not sure what is meant by “sharp rise of prices as industrialization takes root”. As I see it, it is industrialization that lowers prices, and that that industrialization and the moving away from an agrarian economy is the same thing. In other words, as long as an economy is agrarian, the economy is poor (which is another way of saying that “the prices are high.”) It is inevitable that population pressures in the rural economy pushes people into the urban areas. It is the lack of adequate industrialization which cannot absorb this surplus population which leads to the slums you see in under-developed economies.

    The impact of the flu will be differential. In a sense, it may be a Malthusian instrument.

  • Vivek S

    “I have been worrying about the impact of the coming pandemic for a while”

    I dont think Atanu mentioned anything distasteful. He is worried and at the same time looks for something positive out of this.

    “But it could be possible that the shock to the system may jolt it out of the rut it appears to have got stuck into for the last 60 odd years.”

    Not 60 odd.. it is 1000 odd years..

  • Arun Anantharaman

    It is interesting how some people equate a matter-of-fact statement to saying that you want it to happen. I guess that is why Arun seems to think this is disgusting.

    Absolutely. If anyone else had made that post, I wouldn’t have made that inference. Have read enuf of Atanu’s writings on population to make me believe that he actually hopes that it will happen.

    Sure we have to brace up. I don’t see him much too concerned about the “bracing up” bit though.

    If you are just “worried” Atanu, my apologies for the over-reaction. When I read it, that’s not the impression I got.

    Atanu’s response: Death is a certainty and we may postpone but not indefinitely. In the ultimate analysis, we don’t have control over death — our own or of the billions. What we have control over is life. How we live, how we arrange our society, how we take care of those who need help — those are the important matters.

    The hundreds of millions in India who suffer daily is what matters to me. That is the greater tragedy. That is what needs our attention more than anything else. I would rather that we deliberately, humanely and consciously reduce our numbers so that it is more in balance with the resources we have, instead of depending on Malthusian processes to cut out hundreds of millions from our midst.

  • http://driveindia.blogspot.com/ Pranay Manocha

    Interesting comments. I must say though, that looking at it from a non-humane pov, whenever in history the balance is tipped excessively to either side of any situation, nature, economics or science interferes to set that right. As medicine advances to wipe out many diseases, the microbes that are responsible for those, get wiped out in turn (or significantly anyway)

    I’m sure there have been studies of the microbial ecosystem. Compare this to the most common one we study in school that aspires us to preserve our ecology. IF we kill all the deers, the grass will grow and grow. As lions cant eat grass and there are no deer, the lions will die too. Too much grass will use up a lot of the minerals in the soil, so the grass will begin to die too.

    Now consider that we wiped out the small pox virus, we’re on our way to wipe out the Polio virus. Do we have any measured effect that that would have on (for example) the bird flu virus?

    Of course I’m not making educated guesses – I’m just talking in general terms but I think you get the picture.

    Consider also, the mathematical implications of the growth of population. A virus that has little or no chance of causing an epidemic with a global population of 100 million – because 100 million might not be a critical number for it to affect and cause widespread and sustained communication from person to person – has a much greater chance with global population>6 billion.

    Also, diseases that are caused only when a certain critical mass in population is reached, are bound to be immensely more evolved in stength and complexity. There would also be a large number of ‘new’ strains that keep cropping up all the time.

    Bird Flu – we are compunding the situation many times over because not only has the human population risen exponentially over the past 200 years, but the population of birds (esp. chickens) has risen on an even more exponential scale.

    Figure it out – more chickens means more strains of bird flu can sustain themselves – more strains of bird flu that sustain mean that humans are at much greater risk. So this is just the beginning. (phew! long comment – hope its not all nonsense gibberish)

  • http://driveindia.blogspot.com/ Pranay Manocha

    “hope its not all nonsense gibberish” – Everyday my grammar hits new lows. Did I intend to mean here that it could be sensible gibberish? Haha.

  • http://kaisare.net/wlog Niket

    The following article on Bird Flu Histeria might be an interesting read
    http://www.gnxp.com/blog/2005/10/avian-flu-hysteria.php

    Atanu’s response: Niket, thanks for the link. The article is US-centric. It says that compared to 1918, today over-crowding is less, sanitary conditions are better, people have better access to drugs and medical care, etc. All of which is not applicable in overpopulated poor countries such as India and China.

    I found the comments following the article much more illuminating.

  • Anastacia Barlou

    God, Please Save Us

    This is perhaps one of the scariest things that may happen to the world. The support that confirms this is absolutely astounding, the facts that back the proposed event from taking place are significant and disturbing. Doctors and reknown scientists believe that this will happen for the most part and we should listen to them instead of submerging ourselves deeper into denial and our own private hyperrealistic world where we feel that nothing can touch us.

    The truth is well according to the postmodernists there is no truth. So i really can’t give u an answer, but what i can tell u is that the likliness of such an event is not impluasible. The fact that the bird flu could kill 1/3 of the population is sickening and the fact that bush has not haulted international flights is even moreso. We need to stock up on essentials and be aware. We are just as ill prepared as they were in the middle ages with the black death, see also the bubonic plague.

    If a human flu mixes with the bird flu it will create a deadly solution that might kill off such a large percentage of us. Imagine looking out your window and seeing bodies all over the street and knowing people that are among the heap. Imagine what the childen of our world will think. They say that every generation thinks that their generation is the worst but the children of ours may have really picked the most deadly apple out of the tree.

    I hope that i am wrong and out of my element. And that twenty years from now people read this and laugh histerically about how ridiculous i was being. I also pray and hope that i am here to laugh along with them.

  • Camel_J@radiks.net

    Is the spread of flu at least in 1918, any different in rural vs Urban areas? Is the death rate or numbers different?