How I wrote the pandemic. Not the current one, but the one in Bombay over 100 years ago

I define 2020 as sustained déjà vu.

We never really know the present, do we? In the infinitesimal lapse between awareness and event, the present has already escaped us.

We live caged by the past.

Still, I feel compelled to rattle those bars, if not bend and snap them clean. Particularly now, when this pandemic seems to be living out all pandemics past.

I’ve constantly had to remind myself I’m not stuck somewhere between 2005 and 2015 – or in 1896-97.

As familiar signposts reappear, I realise hotshot predictions are based only on these. We think these predictions are based on experience. More correctly, they are based on the memory of experience. And how selective is this recall?

I spent the years between 2007 and 2015 writing up the Bombay Plague of 1896. In public memory, it is called the Third Pandemic, and its standard narrative, practically cut in stone, has advised our approach to COVID-19.

The writing on the wall has never interested me, and I was not concerned with the Third Pandemic. My interest was the Bombay Plague. It was more than local, it was parochial to the point of asking: What was the plague like right here, beneath my feet?

I remember the moment I vocalised this question. I had just emerged, dusty and cobwebbed, from the crypt of the Bombay Archives. Sunlight slapped my cheek hard. The question jolted my benumbed brain into a startled wakefulness. I had read myself blind over three months, but none of that had conveyed 1896 to me. I needed something more immediate and tactile. How could I possibly find that a hundred years after the event? How could I even have a memory of the Bombay Plague?

I discovered that I did.

My memory was, very literally, a shut door. I had walked past it every day as an undergraduate.

Behind that locked door, Waldemar Haffkine had prepared the plague vaccine.

That was the sum of information anybody at all had about that room.

I had asked around, energetically, because its name intrigued me: Room 000.

It seemed a logical point to begin.

I expected it to be still locked, but when I got there, I found Room 000 in ecdysis. Its old neglected shell was being dismantled. Very soon it would be, in popular parlance, “repurposed”.

As I stood ankle deep in debris, I realized there was an ocean of memory trapped within that old shell. All I had to do was listen.

Back on the street, that ocean was no longer a memory. It was here, all around me.

It was 18 September 1896, and I was sharing a carriage with Dr Accacio Viegas, hurtling towards Vor Gaddi where a woman lay dying.

At the journey’s end, his diagnosis would make history. I watched him view the patient and perceive the first flare of suspicion. Could it be – I felt his doubt, his quick denial, his near superstitious dread of saying the word aloud. Dr Viegas had never seen a case of plague before. Bombay had never seen plague before.

I felt his clinical conviction as surely as if it were mine: Here is the plague.

This was no imaginary journey.

I coaxed Dr Viegas to climb down from his pedestal in Dhobi Talao. True, I didn’t have a carriage waiting, but half an hour at a brisk trot brought us to the patient. Despite the hoardings and the new façades, I had no difficulty recognising the place.

How does walking the talk restore a memory? The landscape is populated. Faces emerge from crowds. Scraps of conversation complete the story. Life, glimpsed through a half-open window, finds a parallel life in recall.

“How did you research Room 000?” is a question I usually duck, because the honest answer sounds rude, but I’ll risk it now.

How does it matter? Research is irrelevant. It is the mere accumulation of information. A plodding, mole-like activity, scavenging the public domain or raiding private hoards. Like an embarrassing body function, tedious, but inevitable. And now, by digitisation, happily democratised.

Isn’t it time we uncoupled information from thought?

But it is always a joy to acknowledge sources. Room 000 got written through the generosity of friends and strangers who opened libraries, records, letters, and above all, their thoughts and hearts to me.

My greatest source was the city itself. Matched against landmarks, archived anecdotes became accounts in real time. Most exciting of all were hospital records. I was able to compare them with quoted cases and published statements. They didn’t always tally. The public account was always more optimistic, sometimes misleadingly so.

The heroes of the Bombay Plague were many, forgotten today, but celebrated in their lifetime. But it was that unnamed commoner, the plague patient, who taught me what a pandemic is all about, and prepared me for the pandemics yet to come. The patient is the only one who knows the disease, and the only one whose experience one can count on, when the next pandemic hits.

In 2015, Brazil saw the beginnings of a devastating tragedy.

The Zika Congenital Syndrome, as it’s called today, was first noticed as a sudden increase in the number of babies born with small heads. A connect was quickly made with the Zika virus, an old acquaintance, and for seventy years thought to be harmless.

Pediatric surgeons are familiar with odd-shaped skulls, and though far away from Brazil, I found myself deeply involved as the disease unfolded in South America. Yes, a mosquito transmitted it, but beyond that, ignorance. A quick check showed me how clearly this manifestation could have been anticipated. It had been noticed in the 1960s. But now, confronted with the awful truth, there was no Dr Viegas to spell it out loud and clear: Cut down a forest and find a new disease.

The fall guy was the mosquito. Swat! Or, as we do here, spray yourself giddy with toxic chemicals while away flits the mosquito, all blood and insousciance..

I spent all of 2016 tracking the Zika outbreak. The Secret Life of Zika Virus gave me a longer view of how we change the behaviour of microbes, by the stupid things we do. Surely these stupidities must also change the way our own bodies behave?

The answer lay in the silent pandemic that affects every third person on the planet. Obesity. Because medicine chose to ignore it, and victims could not, it stayed a cosmetic problem for fifty years before it was finally acknowledged as a disease. Today, its damage is particularly frightening as an unreasonable number of COVID-19 deaths are linked with obesity.

Unlike complicated viral illnesses, obesity is easily and successfully treated – once it is addressed as the killer disease it is. I wrote Fat: The Body, Food & Obesity by dividing my time between street and kitchen. The most useful research came from my own plate.

Apart from dread and physical suffering, the patient’s response to the Bombay Plague was – resistance.

The British plan to contain the plague was magnificent, on paper. In practice, it did not work. As “Plague Control” grew more severe and punitive, the death rate escalated. The patient’s verdict was: Nothing works.

My journey through the 1896 plague concluded at the turn of the 19th century. The Antibiotic Era was just beginning. The ideas that fired the early researchers on plague didn’t take us anywhere towards combating or controlling the disease. Yes, we learned a lot about it, but we didn’t know how to remedy or prevent it. Haffkine, the epitome of scientific integrity, produced a vaccine that didn’t work.

I finished writing Room 000 in 2015 with an uneasy feeling. If Bombay were to see a plague outbreak now, we would be just as clueless as we were in 1896. We would unload tonnes of antibiotics, but they might not work. The bubonic plague in all its frightful forms had kept its head down for a century, but for how long?

In 2015, as in 1896, we were oblivious of how we precipitated the emergence of disease through our faulty environmental decisions. In 2020, in the present pandemic, we still are.

The Bombay plague was managed without any understanding of the disease process. Its strategy was based on the old European model introduced in 1348 at Ragusa in Crimea during the Black Death We are using the same model now to contain COVID-19. It didn’t work in 431 BCE [Athenian Plague], nor in 542 CE [Justinian plague], nor through the many iterations of the Black Death, nor in the Plagues of London, nor in the Bombay Plague and the Third Pandemic, and it certainly is not working now.

Its logic is irreproachable, but only from a very ancient standpoint. Isolate, segregate, quarantine, and eventually, this cup too shall pass. If people rebel, get punitive every which way you can. As deaths increase, point out how many more would have died without these measures. Disease, outbreak, epidemic or pandemic is a historic condenser for power. The State has a captive population which it can impoverish and render helpless, for their own good.

Is it possible to think outside this black box in which we have been trapped for the past eight months? Of course it is. The unasked question is: Do we want to?

Nothing frightens me as much as the phrase “the new normal”. Our passive terror-stricken condition is nothing short of species decay. We can live like this, and love it, because it validates what we have already long become: disengaged from life around us.

Isolation is, literally, the creation of an island. We’ve living out the fantasy of a breezy existence on a climate-controlled island where supplies are air-dropped twice a day and there’s always Netflix. We grow, we age and we die on this island, unnoticed, alienated, safe.

Do we have a choice? We certainly do, but it will rattle the bars with a deafening din.

This pandemic, like the 1896 plague, like any other, is the outfall of human greed and destructiveness. As I write this [on September 13, 2020] the figures are 922,441 dead, with 28.8 million infected and potentially sick. When you read this, the numbers will be many more.

All lives matter, even mine. But, that’s only 1% of the story, for we make up even less than that proportion of life on the planet.

All life matters, and that’s the truth of COVID-19. And, if at this point, you should ask a bewildered Why?, it tells how selective your information has been.

Writing Room 000 helped me discover my own responsibility towards events today. Isolation is self-destructive. We are, today, as never before, a planet under threat – 68% of species have been lost over the last 50 years. The skies over California have been red for a week from 2 million acres of blazing forests, yet on a normal winter morning, the air over New Delhi is scarcely any better. East Africa will soon be transected with a super-heated pipeline, the Himalayas are being blasted apart, Mumbai’s coastline is a wasteland of concrete. Pandemic after pandemic after pandemic after pandemic –

The land is ripe for burning, and we are the spark.

Surgeons Ishrat Syed and Kalpana Swaminathan write together as Kalpish Ratna. Their newest book is A Crown of Thorns: The Coronavirus & Us.

This series of articles on the impact of the coronavirus pandemic on publishing is curated by Kanishka Gupta.