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 Table of Contents  
LETTER TO THE EDITOR
Year : 2020  |  Volume : 33  |  Issue : 3  |  Page : 1111-1112

COVID-19 readiness, emergency response, and recovery in slums and informal settings


1 Medical Education Unit and Institute Research Council, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Ammapettai, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Ammapettai, Tamil Nadu, India

Date of Submission10-May-2020
Date of Decision07-Jul-2020
Date of Acceptance12-Jul-2020
Date of Web Publication30-Sep-2020

Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Professor, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur, Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu 603108
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_158_20

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How to cite this article:
Shrivastava SR, Shrivastava PS. COVID-19 readiness, emergency response, and recovery in slums and informal settings. Menoufia Med J 2020;33:1111-2

How to cite this URL:
Shrivastava SR, Shrivastava PS. COVID-19 readiness, emergency response, and recovery in slums and informal settings. Menoufia Med J [serial online] 2020 [cited 2020 Oct 29];33:1111-2. Available from: http://www.mmj.eg.net/text.asp?2020/33/3/1111/296650



Abstract

The corona virus disease-2019 (COVID-19) pandemic has affected all sections of the society, and none of us are immune to the infection. The global estimates depict that a total of 11 327 790 cases and 53 2340 deaths have been attributed to the infection across the 216 affected nations and territories [1]. In contrast to the rural pockets, the probability to acquire infection is more in urban settings, and even in these urban locations, the risk of acquisition and speed of transmission are relatively higher in the slums and informal settlements, and thus, we have to improve our preparedness to respond to a large-scale community transmission [2].

The global distribution of the population suggests that 56% of the world's population live in cities, of which 22.7% are residing in slums and informal settings. We have to accept that the health and socioeconomic consequences of the emergence of an outbreak in such locations will be severe owing to the simultaneous presence of multiple factors and challenges, which together enhance the probability of a COVID-19 outbreak. The potential predisposing factors include their unplanned nature owing to which the houses are overcrowded and often lack access to health services, water supply, sanitation, and hygiene facilities [2],[3],[4]. In many settings, it is extremely difficult to implement physical distancing and frequent handwashing, and as the disease spreads by close contact, the overall risk of COVID-19 in these settings is much higher [2],[3]. A live example of rising incidence of COVID-19 cases in slum settings owing to the presence of various predisposing factors is in Dharavi slum located in the Mumbai city of India, wherein till date a total of 2334 cases have been reported [5].

From the financial perspective, it is an extremely difficult prospect for the residents of slum to limit their movement during the periods of imposed lockdown as their livelihood and survival predominantly depends upon the daily income, and thus, staying indoors for prolonged duration is just not feasible [2]. Moreover, owing to their informal nature, the precise estimates and their needs are more often than not recognized by the governments, and therefore, they are prone for ignorance, stigma, and negligence on many fronts. The residents from these settings often keep the urban city moving by keeping it clean and are also involved in a wide range of activities (security guards, vegetable vendors, mechanic, etc.) and if their health and safety is not given due attention, there is a definite risk that they will transmit the infection to the different group of individuals [2],[3].

Amidst the presence of all these factors, there is an indispensable need to include their interests in the national and local readiness and emergency response to the novel viral infection. In terms of preparedness and response, there is an immense need to develop liaison with the community leaders and take their inputs not only for reducing the risk of transmission but also to aid the public health authorities in ensuring uniform implementation of the standard recommendations, including support for contact tracing [2]. Furthermore, the epidemiologists should identify the total population living in slum and informal settings, perform a comprehensive assessment of all the important resources (water, sanitation, health facilities, etc.), and design the local map to mount a better public health response against the disease [6].

In these difficult times, wherein lots of myths and uncertainties are prevailing about the disease, it is extremely important to develop trust with the residents through involving their community or religious leaders and ensuring that trustworthy information is delivered to them through reliable sources in a timely manner to enhance the level of trust [2],[6]. Moreover, there is a significant need to invest in the welfare services so that people have easy access to safe water and sanitation facilities, including establishment of adequate number of handwashing stations in strategic locations. Likewise, the government has to take steps to ensure their livelihood is maintained by promoting cash-based assistance to the residents, ensuring provision of sexual and reproductive health services for girls and women, and that the risk of social problems (like gender-based violence or abuse) is minimized with the help of community workers [2].


  Conclusion Top


In conclusion, the overall risk of COVID-19 acquisition or transmission in slums and informal settings is much higher than other geographical locations. Thus, it is the responsibility of the public health authorities to acknowledge the risk and invest resources for a better outbreak readiness, public health response, and recovery from the infection.

Acknowledgements

S.R.S. contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work; P.S.S. contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
WHO. Coronavirus disease 2019 (COVID-19) situation report – 168; 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200706-covid-19-sitrep-168.pdf?sfvrsn=7fed5c0b_2. [Last accessed on 2020 Jul 07].  Back to cited text no. 1
    
2.
Inter-Agency Standing Committee. Public health and social measures for COVID 19 preparedness and response operations in low capacity and humanitarian settings; 2020. Available at: https://interagencystandingcommittee.org/system/files/2020-05/IASC%20Interim%20Guidance%20on%20Public%20Health%20and%20Social%20Measures%20for%20COVID-19%20Preparedness%20and%20Response%20Operations%20in%20Low%20Capacity%20and%20Humanitarian%20Settings.pdf. [Last accessed on 2020 May 10].  Back to cited text no. 2
    
3.
Corburn J, Vlahov D, Mberu B, Riley L, Caiaffa WT, Rashid SF, et al. Slum health: arresting COVID-19 and improving well-being in urban informal settlements. J Urban Health 2020; 97:348–357.  Back to cited text no. 3
    
4.
De Oliveira Andrade R. The Brazilian slums hiring their own doctors to fight covid-19. BMJ 2020; 369:m1597.  Back to cited text no. 4
    
5.
Mumbai Mirror. Mumbai: eleven new COVID-19 positive cases in Dharavi; tally climbs to 2334; 2020. Available at: https://mumbaimirror.indiatimes.com/coronavirus/news/mumbai-eleven-new-covid-19-positive-cases-in-dharavi-tally-climbs-to-2334/articleshow/76817125.cms. [Last accessed on 2020 Jul 07].  Back to cited text no. 5
    
6.
WHO. 2019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan. Geneva: WHO Press; 2020. 1–20.  Back to cited text no. 6
    




 

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