Wednesday, July 22, 2020

How Dharavi, Asia’s biggest slum, fought against COVID-19

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Inshiya Nalawala

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How Dharavi, Asia’s biggest slum, fought against COVID-19

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Global Views 360

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July 22, 2020

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A still from Dharavi, Mumbai

A still from Dharavi, Mumbai | Source: M M via  Flickr

Imagine a place where 8-10 people live in 100 square feet structures. A place which squeezes close to 6,50,000 people, 5,000 small factories, and about 15,000 single-room workshops in just 2.5 square kilometer area. Welcome to  Dharavi, the biggest slum of Asia situated in the heart of fashion, entertainment, and commercial capital of India, Mumbai.

When the first COVID-19 case was discovered in Dharavi, it caused massive panic among the citizens as well as officials. Social distancing is virtually impossible to achieve in Dharavi, which is a maze of narrow congested lanes with tenements on either side of it and where 80% of the population use community toilets.

With their fingers crossed, people were speculating about Dharavi turning into a graveyard. These fears turned out to be misplaced and three months later Dharavi won praise from the WHO for effectively restricting the spread of coronavirus. According to the official data, the COVID-19 case doubling rate improved greatly, from 18 days in April, to 43 days in May, to 108 days in June, and 480 days in July.

Mr. Kiran Dighavkar, Assistant Commissioner of the top civic body of Mumbai, Brihanmumbai Municipal Corporation (BMC) said that their undertaking of an aggressive strategy of 4T’s - Tracing, Tracking, Testing & Treating, is the key to Dharavi’s successful fightback against the pandemic. The fightback plan was aptly coined "Mission Dharavi".

Extensive screening and testing of residents was done to detect the symptoms for coronavirus in "fever camp" which were set up by medical workers in different parts of the slum everyday. Many buildings such as schools, wedding halls, and sports complexes were overtaken by the civic authorities and were repurposed as quarantine facilities. A 200-bed hospital was also set up in record 14 days.

The BMC commissioner, I S Chahal said “Proactive screening helped in early detection, timely treatment and recovery.” Close to six hundred thousand people were screened, 14,000 people tested and 13,000 quarantined in nearby institutions, schools, marriage halls, and sports complexes. Furthermore, continuous monitoring of people’s movement using drones helped reinforce containment measures and scaled progress swiftly.

To further strengthen the measure, locals of the community emerged as “COVID Yodhas” (warriors) to address the concerns, a senior official said.  Many well endowed citizens and NGO’s provided Free meals, ration, PPE gear, oxygen cylinders, gloves, masks, medicines, and ventilators to residents and doctors.th July

On 8th July 2020 Dharavi recorded a total of 2,335 COVID-19 out of which 1,735 patients have recovered and there are only 352 active cases at present. Only 82 deaths were recorded in Dharavi till 8th July as against more than 4500 in the whole of Mumbai.

This phenomenal success has given the world a yet simple and effective technique in curbing the spread of the deadly virus. World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus, in a virtual press conference in Geneva, acknowledging the efforts of various nations and Dharavi to contain the virus, said that “There are many examples from around the world that have shown that even if the outbreak is very intense, it can still be brought back under control”. Further, he added, “And some of these examples are Italy, Spain, and South Korea, and even in Dharavi -- a densely packed area in the megacity of Mumbai -- a strong focus on community engagement and the basics of testing, tracing, isolating and treating all those that are sick is key to breaking the chains of transmission and suppressing the virus.”

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February 4, 2021 4:43 PM

Sweden’s No Lockdown Policy: How That Changed The Outcome

Sweden has gone against conventional wisdom in its response to the COVID-19 situation. While the neighbouring countries like Denmark, Finland and Norway imposed strict lockdown on the places and services frequented by the public, Sweden has chosen to not do so at all during the initial phases when COVID-19 started taking the shape of a worldwide pandemic. The public places like Cafes, restaurants, gyms, malls, playgrounds, ski slopes and some of the schools were kept open all across Sweden.

The country’s fight against the threat of pandemic was handled exclusively by the Public Health Authority, with no political interference. They believed that a lockdown only serves to delay the virus, which is not necessary since the health services are equipped to deal with the cases. They also made it clear that achieving herd immunity is also not their aim. The public authorities in Sweden instead relied on the public's sense of responsibility, and appealed to them to do frequent hand washing, observe social distancing and keep people over 70 years old from going out.

The state epidemiologist, Anders Tegnell, made multiple statements about the state’s unusual approach, such as 1) “Once you get into a lockdown, it’s difficult to get out of it,”, “How do you reopen?  When?” 2) “There is no evidence whatsoever that doing more at this stage would make

any difference. It’s far better to introduce stringent measures at very specific intervals, and keep them running for as little time as possible” , 3) " As long as the healthcare system reasonably can cope with and give good care to the ones that need care, it's not clear that having the cases later in time is better”.

The assumption of public responsibility did not work for Sweden and there were people out on the streets, in cafes, restaurants and playgrounds. Not wearing a mask was the social norm instead of the reverse. The models for charting the virus spread given by the concerned authorities also turned out to be faulty forcing them to rescind it. Over 2000 Swedish researchers and doctors signed a petition which claimed that there was not enough testing,tracking or isolation in the country. They believed that the authority has clearly not planned their response and that the authority’s claim for herd immunity has very little scientific basis, even though the government has repeatedly claimed that herd immunity is not what they were aiming for.

Sweden’s lax approach to the combating of coronavirus forced its neighbouring Scandinavian countries to close the border for the Swedish citizens. Some of the Swedish officials were worried for the possible harm to the long term relations between Sweden and its neighbours.  Also, the plan of letting life go on as usual to avoid the economic recession occurring due to a lockdown also failed as it didn’t shield  the country from economic slowdown.

Here comes the question; was the lockdown successful or not? There are some comparisons that have been drawn which indicate more deaths per 100,000 people than in nearby countries with homogenous population, even though it is significantly lesser than some of the European countries. While the infections rates are double that of Denmark, the death rates in comparison are much higher. This difference has been attributed to the fact that approximately half of these deaths have occurred in old care homes despite the stated priority of the officials to protect the elderly. This has been in part to the volunteer program, which replaced symptomatic old age home cares with new volunteers, hence increasing exposure. Another factor is the lack of protective equipment in such homes, along with laws preventing administration of medical procedures without the presence of doctors. There were reports of people threatened with lawsuits for banning visitors.

All of this led to Mr.Tegnell claiming that the ideal policy would have been something between what Sweden adopted and what the other countries did, in the light of what they know now. However this claim of Mr.Tegnell will be put to test when the second wave comes, later in time.

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