Coronavirus | Commercial sex work could spike COVID-19 cases in India, says study

If red light areas stay closed after lockdown, peak in cases can be delayed, say Yale, Harvard researchers

A sex worker carries packs of biscuits distributed by volunteers at GB Road in New Delhi on April 18, 2020. There are close to 6,37,500 sex workers in India as per the National AIDS Control Organisation (NACO), and over 5 lakh customers visit red light areas.

Allowing

commercial sex work to commence immediately after lockdown in India’s red light areas could lead to a rapid rise in cases that could quickly overwhelm hospitals, says a modelling study from researchers at the Yale School of Medicine and Harvard Medical School. Though these findings have been “shared” with State governments, the findings are still being peer-reviewed.

As per the study, if red light areas are kept closed following the lifting of lockdown, there can be a delay in the peak of COVID-19 cases by up to 12 days in Mumbai, 17 days in New Delhi, 29 days in Pune, 30 days in Nagpur, and 36 days in Kolkata. For the purposes of the study, the lockdown period was considered from March 24-May 3. While relaxations have been made in several zones, lockdown continues to be in effect in India.

Maharashtra, West Bengal and Delhi are among the regions with the highest COVID-19 burden.

Percentage fall

The closure can reduce COVID-19 cases by 21% in Mumbai, 27% in Pune, 31% in New Delhi, 56% in Nagpur, and 66% in Kolkata in a 45-day period, the study finds. Deaths can be reduced by 63% in India, 28% in Mumbai, 38% in New Delhi, 43% in Pune, 61% in Nagpur and 66% in Kolkata in the first 60 days, the study also says. These numbers are based on the prevalent reproduction number (R0) of 2.0, meaning that every infected person spreads the disease to two others. Experts say that an epidemic starts to cease when the R0 dips below 1.

There are close to 6,37,500 sex workers in India as per the National AIDS Control Organisation (NACO), and over 5 lakh customers visit red light areas.

The study relied on data from Census figures on sex worker populations as well as interviews in red light areas to determine the extent to which sex workers, brothel owners and pimps interacted with clients.

Other countries

Experience from other countries have brought out the links between commercial sex work and COVID-19. Japan registered a sharp increase in cases among sex workers and their customers. In Germany and Australia, brothels remain indefinitely closed, the authors underscore.

“The purpose of our modelling exercises in not to predict what will happen in the future, but to understand the effect of the intervention on the future. Our study findings show that there is a strong effect of the red light area closures, especially immediately following the lockdown,” study co-author Dr. Jefferey Townsend, Professor of Biostatistics, Yale School of Medicine, said in a statement. The other authors of the study are Alison Galvani, Director, Center for Infectious Disease Modelling & Analysis, Yale University; and Dr. Sudhakar Nuti, Department of Medicine, Massachusetts General Hospital and Harvard Medical School.