July 9, 2021 (IANSlife) Sixteen-year-old Priyanka Rauth, along with her parents and grandmother, live in a one-room shelter in one of the most crowded slums of Kolkata. The family shares a community toilet with 12-13 other families in the neighbourhood. When her mother, the only earning member in the family, tested COVID-19 positive, she was unable to isolate herself completely in her 6 by 7 ft shanty. The family was forced to fight the virus in their claustrophobic living conditions. Priyanka’s story is not an isolated case as thousands living in urban hotspots continue to play catch-me-if-you-can with the COVID-19 virus.
Assessing the impact of the two Covid-19 waves
Since the beginning of the pandemic, urban areas have been hotspots, both globally and in India. In the past four to five months, the immediate peri-urban areas and rural hinterland surrounding these urban hotspots have also begun reporting infected cases. India currently ranks second among the top five countries with the highest active COVID-19 cases. With 20,26,092 active cases (as of May 31), the virus has affected the adult population aged 30 to 45 years more in the second wave when compared to the first wave. But epidemiologists and public health experts fear that a third wave might affect children more severely.
To beat the surge in cases, many states have gone into lockdown with varying degrees of restrictions. Towards the end of last year and beginning of this year, the infection rate slowed down and that led to complacency towards following the Covid-19 prevention protocols. As a result, while the urban hotspots continued to be the hotspots in the lethal second wave, they also led to a spread of infections in their surrounding rural hinterland due to the sudden opening up of the economic activities and removal of travel restrictions.
Safeguarding the Hotspots
Maharashtra, Karnataka, Kerala, Tamil Nadu, Andhra Pradesh, Delhi NCT and West Bengal are the top seven states with high prevalence of COVID-19 cases. (Table 1). These seven high-burden Covid-19 states account for 48.6 percent of the total urban children population in the country.
Table 1: Covid-19 confirmed cases, level of urbanisation and urban children (0-18) in 7 states
The state capital of these seven states, Mumbai, Bengaluru, Thiruvananthapuram, Chennai, Hyderabad, Delhi, and Kolkata, are the main urban centres in their states and respective region/hinterland too. These state capitals house international airports and have a high footfall of domestic and international travellers. They are also important business centres for their surrounding peri-urban areas and rural hinterlands.
Whether big or small cities or towns, the urban and rural economy thrive on each other. As a result, the marketplaces in these urban hotspots are focal points for huge socializing with people gathering and migrating for work, selling their produce or getting essential services. As the states start easing lockdown restrictions, it becomes important to safeguard the urban centres as a lot of these children belong to informal settlements and their vulnerabilities are further exacerbated due to Covid-19 induced food and livelihood crisis.
It is critical that these highly Covid-19 affected states, especially their capitals, and other cities (like Malappuram Urban Agglomeration, Pune, Mysore, Cochin, Thane, Nagpur etc) be prioritised for COVID-19 containment measures for pre-emptive and preventive action towards reducing the impact of third wave on children and other non-infected population.
Augmenting Healthcare Infrastructure & Reinforcing Preventive Protocols
In Mumbai, when the cases were surging a few months back, the Brihanmumbai Municipal Corporation (BMC) decided to decentralise its disaster control room and divide it into 24 COVID response war rooms. Each war room came with a dedicated helpline connected to 30 lines. These helplines were operated by a team of doctors, medical interns, schoolteachers, and social workers who were working in eight-hour shifts to keep the helplines active 24/7. This became the ‘Mumbai Model’ drawing praise from the Supreme Court and the Bombay High Court.
The Mumbai model, formation of Covid-19 paediatric task force (Maharashtra, Delhi NCT), auto ambulances in Kochi, monitoring COVID-19 integrated command and control centre by Varanasi, Pimpri-Chinchwad, Seva Ahaar initiative of Hyderabad Police - studying these state initiatives will help in planning, preparation and fight towards the third wave, along with the implementation of a few other measures and checks.
Source:*https://www.covid19india.org/ (as on 27th May 2021); **Handbook of Urban Statistics 2019, MoHUA; ^Status of Children in Urban India, Baseline Study, NIUA (2018)
(Manish Thakre, Head Urban Programme and Policy, ‘Save the Children’, India.)
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