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Opinion

When Covid-19 enters India’s slums: analysis

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The spread of coronavirus disease (Covid-19) in the slums of India will be even faster than in the non-neighborhood areas that we seem to be tracking so far.

Overcrowding, lack of clean water, poor sanitation, social dependency, increased number of human contacts, low immunity of people living with diseases, in addition to poor medical facilities, cause the transmission of the virus in Poor neighborhoods are tremendous and fast. Poor air quality in urban slums is a common cause of respiratory illness that further reduces the ability of the respiratory tract to shut down the coronavirus. Our research at the Center for Sustainability has explored the implications of the unique social infrastructure of slums in India on the important role it plays in the spread of Covid-19.

India is home to about a third of the world’s slum population, with an average of one in six city residents living in slums where population densities range from 277,136 people per square kilometer (square km) in Dharavi to 125,000 people per square km in the Rasolpoora Slum in Hyderabad. Slums are an integral part of the city’s economy, as this is where most of the workers and domestic help stay.

Several authors have estimated that the reproductive ratio (nothing) for Covid-19 is somewhere between two and three, and that it would be approximately 20% more in the case of the slum population in India. This means that the reproductive ratio of Covid-19 would range from 2.4 to 3.6 in the slums of India. Nothing applies to a situation where everyone in the population is susceptible and no control measures are taken. It gives us the number of new cases that an existing case can generate over time, on average. If R nothing is less than one, the population of infected individuals will decrease over time. But in a fictitious population, where an infected person infects three other people on average: A gives it to three people (B, C and D) and these three people give it to three more people each: R nothing is the same to three.

In fact, the spread of Covid-19 depends on the susceptible population that an infected person will encounter per unit time, say per day, multiplied by the average duration of infectivity in days, multiplied by the average probability that transmission occurs per unit. Contact unit. To determine if Covid-19 is going to extend fast and wide, besides nowhere, we also need to know the serial interval of the spread. The serial interval is a measure of how quickly the disease spreads from one person to another, and this changes according to locations and time.

We take a fictional case of 1,000 individuals in a poor Delhi neighborhood who have never been exposed to the coronavirus. While R nothing is three, we find that the current serial interval in a moderately dense slum area of ​​Delhi is close to approximately 7.5 days. So, in the first 7.5 days, the infected person infects three people and they develop the disease.

After an additional 7.5 days, each of these individuals infects three more people and then develops the disease. So now we have nine people infected, and after another 7.5 days each of those nine people infects three people each. Similarly, after another 7.5-day phase, every 27 infected individuals infect three people each, meaning 81 individuals. Add the first individual with the next three, then the next nine, then the next 27, and then the final 81. And, in one month, it has 121 new cases per 1,000 people.

This simulation indicates the high propagation speed of Covid-19 in all the slums of Delhi / India. Assuming that such community transmission occurs, we find ourselves in a disastrous situation, whereby the precautionary measure to maintain the physical distance between people in the slums seems impossible for at least three reasons.

First, the great lack of living space in the slums makes physical separation from people impossible. The average size of slum households in India is generally three times that of non-slum households, but members only have a few square meters to live within. The average population density is about 1,000 people per square mile, but in the slums, it is 10-100 times higher.

Second, the lack of adequate state social security or private insurance makes the fight against Covid-19 even more complex. It leads to the impossibility of waiting for the inhabitants of the slums to socially distance themselves from the only insurance policy they usually have: their family and social networks.

Third, with an average of 88.7% of households in India having access to improved sanitation services under the government of the Swachh Bharat Abhiyan government, the situation is better than before 2014. However, access to sanitation continues being low. Our research indicated that 70.30% of households in the slums of Delhi do not have improved sanitation. The situation is much worse in Dharavi with one bathroom for every 1,440 residents. How do people maintain social distance in such situations? Also, the current Covid-19 pandemic survives even more than three days on fecal matter, making crowding around toilets and living amid poor drainage a major threat right now.

And instead, we propose the immediate deployment of the following urgent measures.

First, the focus should shift to proactive testing for symptomatic and symptomatic Covid carriers within the most vulnerable high-density population groups in our population. There are genuine capacity issues, but this would mean that we need mandatory Covid-19 testing of all slum dwellers in India. Quarantine asymptomatic and symptomatic carriers of the virus in slum areas in different isolated locations.

Second, we must ensure that slum residents do not have to travel around sanitation facilities. Install temporary or mobile toilets.

Third, we must deploy tank trucks to immediately provide clean water to slums so that they can maintain good hygiene.

Our research shows that 19.15% of Delhi’s slum dwellers have no clean water sources. Some 160 million Indians do not have access to clean water, and they definitely do not have hand sanitizers.

And finally, the only way people with mild or severe slum symptoms will show up is if they believe that the state or health authorities can do something to help them. We should not make Covid-19 a social stigma.

Miniya Chatterji is CEO of Sustain Labs Paris; adjunct professor, SciencesPo Paris; and director of the Center for Sustainability (CFS), Anant National University. Mohammad Zeeshan is a Senior Researcher at CFS. This piece was written by Dhaval Monani and Sharadbala Joshi of CFS

The opinions expressed are personal.

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