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 4:48 PM

The Coronavirus Disease

Severe acute respiratory syndrome-Coronavirus 2 (SARS-CoV-2) is a novel virus from the family of coronaviruses which causes COVID-19 i.e. Coronavirus Disease-2019. It is the successor of the SARS-CoV-1 which caused the SARS outbreak in the year 2003-2004. This is a positive-sense single-stranded RNA virus which has rapid mutation properties.

The etymology of the name suggests that 'Corona' comes from the Latin word corōna meaning crown, garland, or a wreath. When seen under an Electron Microscope, the virion which has a diameter of 50-200 nanometres looks like the solar corona hence named Coronavirus.

When the virus enters the body; it attaches itself to the binding site or the ACE 2 receptors of healthy lung cells through its spike protein. Then it enters the cell via this attachment and causes apoptosis or cell death. The virus also affects organs other than lungs such as the brain, heart and kidneys. The multiple impact points make it problematic for the researchers to create a vaccine in addition to its rapid mutation properties.

The disease might have a zoonotic origin i.e. the transmission occurs from animals to humans. On comparing the genomic sequences the Human Coronavirus strain is found to be 96% identical to Bat Coronavirus samples and 92% similar to the Pangolins samples. Human transmission of the disease takes place via air droplets when the infected person is coughing, sneezing or talking.

The first cases of this respiratory illness were reported to the World Health Organization (WHO) from Wuhan City, Hubei Province, China, on 31 December 2019. It is the first severe outbreak since the 2009 H1N1 Influenza Pandemic. Initially, it was supposed that the site of origination is Huanan Seafood Wholesale Market but, in May 2020 the negative samples tested, by  Chinese Center for Disease Control and Prevention, from the livestock market suggested that it was the site of the super spreading of the virus.

SARS-CoV-2 is known to have an average reproduction number of 2.2-2.6 which means that, on an average, one infected person can spread the infection to 2-3 people. Although if measures like social distancing are put into use, to reduce the exposure of the infected population, it leads to a significant reduction in transmission rates. The infection fatality rate (IFR) of COVID-19 in various studies till 16th June 2020 was projected to range 0.60% to 1% of infected people . However few studies suggested the IFR as high as 3.6%.

The testing of an individual takes place through a method known as real-time Reverse transcription Polymerization Chain reaction (rRT-PCR). The process of obtaining strains and testing the patients usually involves nasal swabs or sputum swabs; the results come in within a span of a few hours to a couple of days.

Currently, there are no known vaccines available for the virus or any specific antiviral treatments, but there are numerous vaccines in works all over the world to tackle COVID-19. Experts believe that the minimum time required to test a vaccine is 12 to 18 months.

Trials are also going on for the repurposed drugs or the drugs which are useful for treating other diseases and might be capable against COVID-19: Some of these drugs are Hydroxychloroquine, chloroquine, Remdesivir, Dexamethasone, Lopinavir-ritonavir, and Convalescent plasma.

The only current solutions for tackling the pandemic are social distancing, hand wash, hygiene and face masks.

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