Coronavirus | Government identifies informal urban settlements as ‘vulnerable’ zones

Issues guidelines preparedness and response

May 16, 2020 10:50 pm | Updated May 17, 2020 12:54 am IST - NEW DELHI:

Close quarters: The Ministry notes that such localities are often overcrowded, making social-distancing difficult.

Close quarters: The Ministry notes that such localities are often overcrowded, making social-distancing difficult.

Informal settlements within cities have been identified by the Union Health Ministry as among the vulnerable urban settlements for the spread of the coronavirus ( COVID-19 ).

Stating that a substantial percentage of the population here are migrant workers employed in industrial and other informal sectors, the Ministry said these areas are characterised by poor structural quality of housing, inadequate access to safe water, poor sanitation and insecure residential status. There are gaps in health and healthcare services.

COVID-19 and the vulnerable

“In the context of COVID [or any other respiratory infectious disease for that matter] implementing strategic interventions such as surveillance, physical distancing, isolation, quarantine and communicating the risk to the dwellers could be challenging,’’ notes the Ministry.

In a note — Preparedness and response to COVID-19 in Urban Settlements — issued on Saturday evening, the Ministry notes that these localities are often overcrowded, with many people crammed into very small living spaces.

It said in these areas local bodies should cover the management of COVID-19 and focus on challenges unique to such populations.

Growing numbers: On India's COVID-19 preparedness

“An incident response system should be put in place depending upon the geographic extent of the settlements and its population size. There is a need for coordination mechanism, COVID-19 containment plan, stringent surveillance and hospital preparedness and clinical management,’’ says the Ministry.

It said enough quantity of hydroxychloroquine will be stocked in civil dispensaries, health posts, health & family welfare centres for chemo-prophylaxis of healthcare workers and high risk contacts of confirmed cases of the COVID-19.

The note accepts that social distancing is a major challenge due to many people crammed into very small living spaces.

How to handle a pandemic

“While sleeping the distancing can be achieved to an extent by sleeping in opposite direction — head of one person faces the legs of the other. Social distancing should be practised particularly in community water points, public toilets, PDS distribution points and health centres etc. Social distancing is to be promoted at all formal and informal gatherings and quarantine facility [school, stadium, etc.] in a nearby area needs to be identified, where a large number of high risk contacts can be accommodated. Shifting of high risk contacts [elderly and those with co-morbid conditions] is a crucial intervention to minimise the spread of disease in such persons, thereby limiting morbidity and mortality among them,’’ the Ministry has said.

It has directed for a contingency plan to be put in place to move the high risk population to alternate or temporary sites.

“Face cover should be made mandatory. It can be manufactured locally within the area as self-help group activity or through NGOs. Common mask distribution sites and disposal sites should be identified and all dwellers may be made aware about the same, also community cleaning and disinfection drive needs to be undertaken on daily basis. In particular, the community toilets need to be cleaned at least three to four times a day.’’

The latest advisory also advocates for passive surveillance stating that in addition to the government health facilities serving these population, surveillance network linkages need to be established with private medical practitioners working in such localities.

“These practitioners also need to be informed about common signs and symptoms of COVID-19, protocol to be followed while dealing with suspect cases, need for alerting the local public health authorities and referral centres for suspect cases,’’ it said.

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