If you’re into thought-experiments, get started with (NCBI PMC) The U.S. Military and the Influenza Pandemic of 1918–1919. Attend to this question: Are there civil environments in less developed countries that can reprise the process in those U.S. military camps that selected for increased virulence?
Modern, urban India is similar in social organization to other modern countries, so propagation is likely to be similar in nature, though greater in scope. Of note, though, India is historically light on influenza, the closest proxy for experience.
Rural, “Village India”, has different social characteristics:
- Relative immobility.
- Such mobility as there is, is based on kin relationships.
- Likely erection by local authorities of ineffective barriers that actually select for characteristics of virulence.
- General absence of infrastructure to support modern hygiene.
- An incredibly rich microbiota “soup”, which may promote diverse forms of transmission, including human-nonhuman-human.
- Lots of opportunities for genetic reassortment.
- By comparison to China, an absence of top-down pervasive social control.
Factors that support rapid mutation might coincide with selection for virulence.
Yet India isn’t much troubled by the flu!
The next article is the promised layman’s intro to epidemiology.