One of the many tragic aspects of the hysteria around Covid back in March 2020 was the enthusiasm with which self-proclaimed Covid experts around the world and the international media forecasted that poor & populous India would be hammered by Covid. After all, said these Covid gurus, if the Western economies with well-developed health infrastructure could not cope with Covid, what chance did India have. In an indictment of India’s reserves of self-confidence, the Indian media copy-pasted these Western pronouncements and amplified the hysteria. Then as spring  became summer and as India’s Covid deaths remained mercifully low, the new view that was circulated is that India underreports Covid deaths. Otherwise, incredulous Covid-gurus wondered, how could it be that a country with 1.4 billion has only 13,000 Covid deaths. Given this backdrop, the Indian Express should be congratulated for sensible, rational reporting about the Covid outbreak in Dharavi, Asia’s largest slum and one that sits smack in the middle of the island-city of Mumbai:
“Dharavi, the 2.4-square kilometre slum sprawl, which had emerged as a Covid-19 hot spot in Mumbai by mid-April, and had the Brihanmumbai Municipal Corporation (BMC) deeply worried, has witnessed a steady decline in the number of new cases in June. On June 19, addition to cases was in single digit for the first time since the area reported its first case on April 1…The drop in new cases in Dharavi is characterised by a steep fall in the doubling time of 18 days in the last week of April to 78 days as of June 19.”
So how did Dharavi get a grip on Covid? After all, back in April, “Controlling the spread of infection in an area, where 9-10 people stay in a 10×10 sq ft room, was seen as almost impossible.” Here is the sequence of steps that the Municipal Commission in Mumbai (BMC) took to tame Covid in Dharavi:
  1. “…within 48 hours, it barricaded the entrance and exit to the slum cluster, carried out disinfection of 425 public toilets, began door-to-door screening, and provided food to people in the first month of the world’s strictest lockdown to slow down the spread of the pandemic.”
  2. “In the initial weeks, with a gargantuan task of screening the 8.5 lakh population, the BMC staff, with full personal protection equipment (PPE), carried out door-to-door screening of citizens. But the strategy didn’t yield results. Many staffers said citizens were non-responsive. “Citizens lied about the number of people living, about medical conditions after hearing the health workers are from the civic body,” said a community health volunteer working in Dharavi.”
  3. “After screening 47,000 citizens, BMC changed its approach. The civic body roped in 350 private and local practitioners from within the area, provided them PPE kits, and asked them to open clinics…The 350 local practitioners worked as a bridge between us and the people in Dharavi. People had faith in the local doctors and followed their instructions diligently…nine BMC dispensaries were also included along with fever camps, bringing detection to the doorstep of people. Vans were dispatched in slums announcing the symptoms of Covid-19 and the location of fever camps…Fever camps were set up to isolate vulnerable people, and shift high risk contacts from slums to institutional quarantine. The civic body also took over some private hospitals, so that it had adequate treatment capacity….Since patients were screened, and isolated early, they could be continuously monitored, thus avoiding a rise in the mortality rate…”
  4. “The civic body also changed its strategy on classifying contacts of Covid-19 patients following deliberations with the visiting team from the Centre. Earlier, contact tracing followed a model of quarantining around 15 high risk contacts of every patient. Until the second week of May, patient contacts were classified as high and low risk. Later all contacts staying in slum settlements and used community toilets were considered high risk and shifted to quarantine facilities. Nine quarantine facilities in schools, sports complexes, hostels and community halls were set up to accommodate the people. For providing critical care, the BMC took over five private hospitals in the area. Until June more than 8,500 were quarantined in such facilities. Now, most new cases are of high risk contacts of patients and no new slum cluster has been added as a containment zone.”
Now, as described in this Times of India article – the Dharavi-approach is being replicated in other slums in Mumbai. As a result, even as Covid-cases in India approach the 0.5mn mark, the death ratio remains one of the lowest in the world. It would be nice if the same self-proclaimed Covid gurus could now give us some rational analysis of why this is happening. Until then we will celebrate the spirited response of the BMC in a city where: a) it is the norm to look down upon the public sector, and b) regard as the gospel truth anything which is published in the Western media.

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