Mask up

The spread of H1N1, or swine-flu infections, in Delhi and Karnataka reflects India’s suboptimal hygiene standards, which enable zoonotic diseases to recur with seasonal regularity. So far, 2,300 cases have been confirmed in Delhi and  over 4,000 in Karnataka, with Bengaluru emerging as a hotspot. Fortunately, the Indian Council of Medical Research has confirmed that this is not a new strain and that the annual flu shot will protect those who have taken it. Though H1N1 is not fatal except in extreme cases for those with co-morbidities, the disease debilitates a patient for quite some time with a disruptive, lingering dry cough and fatigue. But the unexpected upsurge of the disease this monsoon season points to a hitherto unanticipated cause: The impact of climate change. 

Like other kinds of seasonal flu, H1N1 flourishes in humid weather. This year, the long-delayed and stop-start nature of the monsoon rains as a result of the El Nino effect has subjected the country to rising heat stress, with weak winds and wet grounds from early rainfall resulting in a spike in relative humidity. Weather analysts have pointed out that indices such as “wet bulb temperature”, which tracks both heat and humidity, have been dangerously close to critical levels. These are conditions in which flu viruses thrive. With climate researchers predicting increasing heat in India, flu outbreaks, including the debilitating zoonotic varieties, are likely to emerge as a regular public-health challenge. Indeed, India’s crowded and insanitary cities can be considered suitable petri dishes for the rapid transmission of such viral infections, as this year’s swine-flu outbreak has demonstrated. The opportunities for strains to mutate into more virulent versions and multiply are concomitantly high. 

These circumstances call for a planned programmatic response from the health authorities to prevent the infection’s spread.  Though flu shots for the entire population may be difficult to administer, one standard practice could be to mandate that institutions administer the annual flu shot to all workers in hospitals, clinics and related institutions. While flu shots that cost between ₹600 and ₹2,500 may be expensive for the general population, the experience with Covid-19 has shown that the simple and cost-effective solution of masking up in public places works as well in preventing the transmission of the virus, as does regular hand-washing. Indeed, these are the two basic precautions that health experts recommend for the current outbreak. 

Although Delhi and Karnataka are the known epicentres of the current outbreak, a growing number of cases has been recorded in parts of Maharashtra (including Mumbai), Tamil Nadu and Kerala. India’s constant migratory labour movement and the growing number of Indians travelling regularly by train or aircraft can have a multiplier effect on the transmission risks. Air-conditioned malls and movie theatres, the other magnets for people during the hot weather are another source of viral diffusion. A compulsory mask mandate imposed by state and urban administrations on all public places — malls, movie halls, markets, airports, railway stations, even parks — should become a norm that is imposed without exception. People are likely to resist, but the government must convey the message through mass-awareness campaigns to help contain the spread.