Rachna Mehra, Ambedkar University Delhi, India
The COVID-19 pandemic across the world has reified the precarious transition brought about by a contagion which after colonizing a host of human bodies virulently spread beyond transnational borders causing a demographic and economic upheaval. While expeditious attempts are being made to discover the vaccine and find a cure for the disease, yet there is no alchemy that can serve as a panacea for the social turmoil which pre-existed the spread of the communicable disease and got exacerbated under the uncertain conditions produced by it. The syndrome may perhaps confound us for some more time but the response to it is unable to thwart some deep seated notions. This essay follows the bio-physiological trail of the pandemic alongside its sociological imputations and proposes that the imperceptible virus takes a more potent form when it permeates a corporeal being or is perceived to have emanated from a particular ethnic group, thus resulting in the effusion of inveterate prejudices whose containment is irremediable or beyond cure.
Living in a self assured age of retro futurism, one got accustomed to hearing the phrase ‘never before in history’ but today we are reminded of it in a rather misanthropic way while confronting the uncertainty produced by the COVID-19 pandemic the worlds over. The state discourse in India which some months ago propagated military prowess being indispensible for the nation’s survival has shifted gears to applauding and honouring the care givers donned in personal protective equipment (PPE) who remain at the forefront of this new kind of ‘battle’ against the virus. In addition to them, a barely acknowledged reality uneasily surfaced during the crisis as to who among the blue and white collared workers provide the essential services for continued existence. It is an auxiliary army of delivery boys, garbage collectors, street vendors, and grocery store workers who are inadvertently risking their lives to ensure that all basic services are in place and the supplies do not run dry.
In the meanwhile as the contagion spreads with varied outcomes, affecting some people more than the other, the virus has also reconfigured in many ways from its initial outbreak. The formidable adversary earlier touted to be an indiscernible virus later became more perceptible with an impulsive need to find ‘the other’ culpable for this misfortune. The otherwise invisible virus was easier to target when it evidently became corporeal; hence sometimes it was designated by its ethnic origin or according to its conversion to the creed of the host body. It is definitely an adaptable virus so chronicling its social imputation along with its biological mutation becomes imperative. If the victim of COVID-19 is also the aggressor and perpetrator, then the impaired body suffering malady and alienation is as much a matter of concern as the ordeal caused by the imposition of social ostracism. This essay will locate the biological trajectory of the disease vector alongside its sociological implications situating it in the backdrop of certain historical epidemics in India.
Playing the name blame game
The novel pneumonia COVID-19 was first reported in December 2019 in Wuhan, Hubei Province, China but within months the contagion spread to all parts of the globe and by the end of July the world corona meter showed 17,421,013 infected people with 675,545 dead, out of which India ranked third with about 1,638,827 cases (John Hopkins 31st July 2020). While the infection at present continues to spread with no imminent signs of abatement, the extent and the severity of the disease has fuelled speculation of all kinds.
The earliest infected persons were traced back to those who worked at or lived around the local Huanan seafood wholesale market, where live animals were also on sale. Hence, the aetiology of the disease gave rise to theories which ranged from possibility of it being a zoonotic disease to the more hyped yet unverified bio weapon conspiracy against the world order. But the immunologist and microbiologist analysing the genomic data of the evolution and spread of this pathogen concur that it is improbable that SARS-CoV-2 is a laboratory engineered virus. However, it is an ongoing debate whether it mutated in an animal and became more efficient in infecting the humans or it infected a human and then mutated to a more virulent form aggrandizing against its very own species. While the speculation regarding the pathogenesis of the disease is still ripening, there is no uncertainty about its physiological effects and even less ambiguity regarding its social fallout.
The transnational spread of the potent virus was met with grim resistance which did not prevent it from being monikered as ‘Chinese virus’ or designated as ‘Wuhan-Human-1 coronavirus’, etc. However, the nomenclature intentionally associating it with the place of its origin has still not been able to unravel the motives of the progenitor nation. At a scientific and global level, there are different procedural norms and rationale for naming a virus which is based on their genetic structure to facilitate the development of diagnostic tests, vaccines and medicines. The virus is named different from the disease they cause. For an outbreak of a new viral disease, there are three names to be decided: the disease, the virus and the species. The World Health Organization (WHO) is responsible for the first, expert virologists for the second, the International Committee on Taxonomy of Viruses (ICTV) for the third.
The naming ceremony of this unplanned novel virus was not an easy task. On Jan 7, 2020 it was detected by the Chinese Center for Disease Control and Prevention (CDC) who identified it with the family of coronaviruses, named due to the crown-like spikes on their surface (Latin: corona = crown). On 12 January 2020, WHO provisionally named the 2019 novel coronavirus disease “2019-nCoV”and it became the seventh coronavirus known to infect humans. The crown fame however was a far cry from its ethnic nickname. ICTV who on the other hand is concerned with the designation and naming of virus taxa (i.e. species, genus, family, etc.) announced 'severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)' as the name of the new virus. By 11 February 2020, WHO officially renamed the '2019-nCoV' as 'COVID-19', with ‘CO’ implying ‘corona’, ‘VI’ ‘virus’, ‘D’ ‘disease’, and ‘19’ referring to 2019.
While the scientific community, WHO and ICTV were at work to identify the strain and give a name to the virus and disease which was defying the international boundaries, the flippantly coined sobriquet of its ethnic origin was in contravention to the WHO guidelines issued in 2015 laying down ethical principles in naming new human infectious diseases. In a public statement Dr Keiji Fukuda (WHO) had decried the practice of naming infectious diseases in a way which could stigmatise particular religious and ethnic communities. It was observed that disease names should avoid geographic locations, people’s names, species of animal or food, and other references that could incite fear or place blame. e.g., Spanish flu, swine flu, bird flu, monkey pox, Rift Valley fever, Creutzfeldt-Jakob disease, Middle Eastern Respiratory Syndrome, Chagas disease etc. It was observed that even adjectives or terms that incite undue fear (e.g. unknown, fatal, epidemic) should be carefully avoided to prevent panic (WHO 2015).
The best practices of WHO state that a disease name should consist of generic descriptive terms based on the symptoms that the disease causes (e.g. respiratory disease, neurologic syndrome, watery diarrhoea), etc. If the pathogen that causes the disease is known, it can be partly used in naming disease (e.g. coronavirus, influenza virus). On the contrary, the past few months have witnessed a growth of stigmatised monikers, which have found their ways in daily communication and contributed to the backlash against the people of China and Chinese diaspora. It has led to an unwarranted 'infodemic' where the information regarding an epidemic is mixed with misinformation, fake news, and rumours (David J. Rothkopf 2003).
The scientific taxonomy despite being inscrutable and distant to a lay person has a more pragmatic approach to the disease. Nonetheless the flawed convention of naming the virus based on its geographical location was not a new practice but it can be misleading as in the case of 1918 influenza pandemic which in common parlance came to be known as ‘Spanish flu’. The christening of the flu was a misnomer because the disease did not originate in Spain. Although there is no consensus about its beginning, the earliest victims of the influenza (later known as H1N1 virus with genes of avian origin) were found in the military base of camp Funston, Kansas in the United States in the spring of 1918. It is estimated that from 1918 to April 1920 about 500 million people or one-third of the world’s population became infected with this virus. In fact, more US soldiers died from the 1918 flu than were killed in battle during the World War I.
While the disease was causing a demographic havoc, its political and social implications were not far behind. Since the flu broke out in the shadow of the war, neither the Allies nor the Central Powers wanted to admit to additional loss of life and suppressed the reports of its spread. Spain was neutral in the war and had no wartime censorship so it reported the casualty of the unknown disease forthrightly and the European and US allies nicknamed it as Spanish Flu creating a false impression about the place of its origin. Moreover, it has become a legend as to how the influenza altered the decision-making abilities of President Woodrow Wilson who was stricken with the flu when he was in Europe to attend the Paris Peace Conference. His illness prevented him from diplomatically driving a hard bargain with Britain and France to ensure a fair deal at the end of the War. The Treaty of Versailles, signed on 28 June 1919 proved to be a harsh settlement for the defeated Germans and shaped the post war global order. It became one of the leading provocative factors in the run up to the next world war. Nonetheless Woodrow Wilson did not publicly acknowledge either his illness or the worsening situation at the home front lest it averted attention from the war effort (Steve Coll 2020).
The massive troop movements during World War I hastened the transmission of the disease to different parts of the world. India being the colony of Britain was inevitably drawn into the war and hence received its own share of booty in the form of 1918 flu. While the mortality in India was estimated from 13.88 to 17.21 million people, the colony countenanced the outbreak of many other epidemics during the British rule with varied outcomes. Epidemiological studies from the colonial period reveal that between 1896 and 1921, over 30 million people had fallen prey to diseases – bubonic plague, cholera, malaria, smallpox and influenza. It would be interesting to now turn to the colonial state response to such grave crises (Lone, 8 April 2020).
Civic hype of a biotype
Vibrio Cholerae or the rather maligned ‘Asiatic Cholera’ also referred to as ‘Indian Cholera’ was not only a serious public health concern but also a polemical issue of debate due to its seasonal visit. As per the records from the nineteenth century, it was predominantly the rural population in the Indian context and the poverty stricken workers in Europe who fell under the scourge of this recrudescent pandemic. David Arnold who has looked at the interplay between the cultural framework and the political milieu of the disease describes it as 'a continuing and shifting relationship between two different, often antagonistic value-systems, the one Indian, the other European' (Arnold 1986).
The religious pilgrimages and troop movements were identified as two critical determinants for the spread of cholera in India. The source of the disease - the cholera vibrio or comma bacillus - entered the body through oral induction by drinking water contaminated with infected human faeces. It was transmitted through tanks and watercourses which were used for drinking water as well as for washing and bathing. The immersion of Hindu pilgrims in a sacred tank or river during the kumbh melas (twelve-yearly festivals) at Hardwar and Allahabad on the Ganges and the sipping of the water as part of the ritual of worship and religious purification provided ideal conditions for the rapid transmission of the water-borne vibrio. The disease spread when pilgrims brought back Ganges water infected with cholera for relatives and friends to drink as it was considered pure or having special medicinal and protective powers (Arnold 1986).
While on the one hand, the colonial government carried out scientific research to unearth the biotypes of Cholera, on the other an 'Orientalist' assumption was established that India’s climate, physical environment and socio-religious behaviour was responsible for the disease. The problem intensified when in the ninth conference held in Paris in 1894, the French participant Henri Monod in a diatribe against the British delegates claimed that 'The factory of cholera is to be found in British India. Europe did not know cholera before India became a British possession'. Hence the persistent international reproach along with impending plague of 1896 prodded the British government to intervene, formulate policies and strengthen public health measures at large.
The bubonic plague which engulfed the city of Bombay in 1896 re-ignited the controversy between the ‘contagionist etiology which focussed on the human body as the carrier of disease to the localist framework which emphasised on the environmental factors as a predisposing cause of the plague’ (Kidambi 2007). However before one discusses the spread of the disease, one cannot overlook its possible origin. The plague epidemic is said to have originated in the Chinese mainland during the early 19th century, spread to Hong Kong in 1894 and eventually entered India via naval trade routes especially the Bombay port in the summer of 1896. Initially the British authorities kept the ports functional so that global trade networks were not disrupted. They ascribed the outbreak to habits and local customs, blaming the living spaces of Indians for being filthy and unsanitary, deliberately overlooking extraneous factors such as the arrival of trading ships which were believed to be carrying the flea-infested rodents into the ports. Instead the government shifted its focus towards sanitising the 'locality' (slum) through disinfection operation in order to contain the disease.
They also passed ‘The Epidemic Disease Act of 1897’ which empowered authorities to adopt all measures deemed necessary to prevent the plague from spreading. But the implementation of the Act did not go down well with the subject population. Soldiers were enlisted to conduct an intrusive door-to-door search, the ‘infected dwellings’ were demolished, arrangements were made to dispose dead bodies by sprinkling carbolic powder over the corpse before washing with a phenyl solution. These stringent yet inconsiderate measures of assaulting and humiliating people along with destroying public property triggered discontent leading to the assassination the plague commissioner W C Rand in Pune (Fernando Benita May 2020). So the question remains, if the social anxiety triggered by the act was so overwhelming 123 years ago, then what is its relevance today and why it is being applied to deal with the pandemic in India.
The Epidemic Diseases Act passed in 1897 was a short legislation consisting of four sections to prevent the spread of 'dangerous' diseases. The concerns included specifying special measures to control the outbreak and enable the state governments to take measures to contain it. While the act was precise in its content, it left much room for interpretation. It emphasised on the power of the government, but remained silent with regard to the rights of citizens. Most of the public health acts in the states are 'policing' acts, intended to control epidemics, but do not deal with coordinated and scientific responses to prevent and tackle an outbreak. In today’s scenario too, it is easier to apply the act as a punitive measure to control the spread of an epidemic but it absolves the government of their responsibility and accountability of ensuring sound public health (Rakesh PS 2016).
During the outbreak of the COVID-19 pandemic in India from March to July, there were several cases of social ostracism of the care givers reported throughout the country and racist attacks on the migrants from north east India. In some instances the medical personnel treating the patients were asked to ‘vacate’ their residential premises by landlords (Livemint 24 March 2020) or assaulted (spat and chased) publicly for doing their duty (ANI, NDTV April 9 2020). In separate yet related incidents, racial discrimination surfaced in Delhi and in Gurugram where young women from Manipur were racially abused as ‘corona’, allegedly spat upon (The Indian Express March 2020) and beaten up (May 2020) due to their mongoloid features. It is a fact that for years they have also been referred to as ‘Chinky’ in a derogatory way (ethnic slur used for Chinese in UK and US).
In the light of attacks on doctors and healthcare workers across the country, the central government, on 22 April, introduced an ordinance to amend the Epidemic Diseases Act, 1897 by recognising assaults on them as a cognisable, non-bailable offence punishable with imprisonment and financial penalty. While the Ordinance was an urgent response to contain the public paranoia, yet it simply added to another penalty feature of the Act. It is intended to strike fear among the public in the short term but does not ensure a change of demeanour towards the medical professionals or alleviate the social distress of people facing various prejudices. In a way, it is not a major departure from the 123 year old Colonial Act which employs punitive vocabulary but lacks government’s accountability towards strengthening public health system.
In a thoughtful article, Burton Cleetus mentions that diseases cannot be reduced to their bodily effects but 'dominant ideologies and religious beliefs, across time, have always had a major impact in shaping the meanings of diseases, and the manner in which they originate and circulate'. In its initial stages The COVID-19 pandemic was framed within a tepid bio phobic response when the infection was associated with bats, pangolin and insanitary conditions of Wuhan wet market. Once it snowballed into an insuperable health crisis drawing different countries into its vortex, the deep rooted socio-moral decrepitude began to manifest and outpace its biological origin theories in evident ways. According to the eminent virologist Stephen S. Morse, 'Viruses have no locomotion, yet many of them have travelled around the world' and in a similar vein when COVID-19 made landfall in various countries, it gained social currency of its own.
In the given scenario, succumbing to a virus is indicative of not only a physiologically compromised immune system but also a susceptible social microcosm which is cocooned in authoritarian and democratic regimes. While in a patronising political system, some bodies matter more than the others, it is ironical that COVID-19 disregarded this social norm by whimsically choosing its victims and claiming even the socially privileged lives around the globe. Till the prognostic treatment is underway, the virulent disease seems to establish a virtual democracy by continuing to undermine some social differences which festered under the garb of an egalitarian human existence.
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Dr Rachna Mehra is Assistant Professor in the Urban Studies Program (SGA) at Ambedkar University Delhi. Her research interests include studying the past and contemporary linkages of towns and cities and exploring the history of partition from the lens of refugee migration and gender relations in particular and the urban landscape at large.
The Viral Condition: Identities