LAST GASP

What Tuberculosis can teach India about COVID-19

- VIDYA KRISHNAN

{1} IN DECEMBER 2019, Dr Lalit Anande was anxiously following the news from Wuhan. A mysterious SARS-like virus was spreading through the Chinese city. “I heard it was an airborne disease,” Anande told me, recalling the conversation among his doctor friends at the time. “We were hearing that patients had similar symptoms, like coughing, fever, et cetera.”

Anande’s anxiety gave way to panic around February, when he saw videos coming out of China showing more and more people dying from COVID-19. “I thought Wuhan is a big city, but Mumbai is bigger in terms of population density. What would happen if something like this hits us?”

Wuhan has a population of 11.1 million, where Mumbai has a population of 18.4 million—on a smaller landmass. And Mumbai already has the melancholy distinction of being ground zero for a different infectious, airborne respiratory disease: tuberculosis.

Any attempt to understand how India’s pandemic response has gotten to the point it has must begin in Mumbai—one of the most crowded cities in the country, and the world. Anande is the medical superintendent of Sewri TB hospital on Mumbai’s southeastern edge. The sprawling complex is one of the grand theatres of the global battle against tuberculosis. It has a residential campus for staff, and is a medical city within the megacity. When I visited it last, in 2018, to interview Anande for my book on tuberculosis, he said he was coping with a “tsunami” of patients. A wry, almost bitter joke Anande likes to crack is that “if TB was a religion, Sewri would be Mecca.” The fact that Mumbai is now one of India’s COVID-19 epicentres, he believes, is not a coincidence.