India's biggest slum has so far nailed coronavirus. Here's how they did it
"Coronavirus update: India's number of coronavirus cases passes 800,000 after record daily rise "Trump and Modi are the mainstream faces of the global far right""
By South Asia correspondent James Oaten, Som Patidar, and Nagesh Ohal in Mumbai
Posted 12 hours ago, updated 54 minutes ago
Sameer Vatkar (centre), his wife Yogita, his daughter Samruti and son Omkar all suffered COVID-19 when the virus arrived in their community. (ABC News: Nagesh Ohal)
With its narrow streets, congested housing, underfunded health care and poor sanitation, many thought India's largest slum would be devastated by COVID-19.
In fact, Dharavi — located in India's financial capital Mumbai — was often heralded as a prime example of why the country was ill-prepared to deal with the coronavirus.
[...]
With a million residents crammed within 2.4 square kilometres, local government assistant commissioner Kiran Dighavkar said relying on home quarantine was not an option.
"In one apartment of 10 feet by 15 feet, you'll find at least 10 to 12 people," he said.
"It is very difficult to do contact tracing because one person who used the community toilet, or toilet seat, is used by another 500 people.
[...]
Anything from sports centres, schools, nursing homes and hotels were converted into coronavirus treatment and isolation centres.
Hundreds of community toilets were sanitised multiple times a day.
Instead of waiting for symptomatic patients to come forward, authorities would doorknock homes to test temperatures and oxygen levels.
Anyone considered at risk or showing depleting oxygen levels was taken into care.
"Slowly, slowly, the cases were appearing in all the slum pockets," said Dr Virendra Mohite, a chief medical officer for one of Dharavi's coronavirus hospital wards.
"So, our biggest challenge was to isolate the high-risk contacts from the slum to the institutional quarantine.
Isolating patients in treatment centres may have been key in stopping the spread of coronavirus through the community. (ABC News: Nagesh Ohal)
"If we diagnose suspects early, it is easy to cut the chain of transmission, to start the treatment early and reduce further mortality."
Most temporary treatment centres have been closed due to the decline in cases, but authorities say they remain vigilant for a second wave.
The Dharavi Model has been adopted in other parts of the country
The system was initially rough around the edges.
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The number of daily cases is slowly coming down in hotspot megacities — such as Delhi, Chennai, Pune and even Mumbai — but numbers are surging in poorer states like Bihar.
"We do not have very good health infrastructure," said Professor Shamika Ravi, from the Brookings Institute.
"While 75 per cent of our health infrastructure is concentrated in our urban areas, we are already beginning to see the spread of infection to smaller, rural townships.
"We cannot give up on containment. It's a very large country."
Experts have suggested that given India's huge population and diverse states, the impact of the coronavirus on India should be looked at on a state-by-state basis, rather than as a whole.
[...]
Another possible reason for India's recent success
There is a theory emerging that the decline in active cases in Dharavi is because a large proportion of the population has already been infected. Some have suggested herd immunity is now at play.
"I think Dharavi has reached herd immunity," said epidemiologist Dr Jayaprakash Muliyil.
"There are very sparse cases. It's stopped."
Officials in Dharavi aren't sure if herd immunity is responsible for stopping the spread.
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"The latest data from Italy is saying … the antibodies decay very quickly," she said.
"Perhaps the whole concept of herd immunity needs to be questioned."
In July, another serological survey in Delhi showed almost one in four people had been exposed to coronavirus.
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