Consider a housemaid living in a two-room dwelling, with her three sons, her mother in-law, and her husband who is a construction worker. Recent evidence by the World Health Organization (WHO), suggests that COVID-19 is spread through the air, from droplets released through breathing, talking, coughing, and sneezing, Thus, measures have to be taken to establish social distance, so as to prevent the airborne spread of the virus. However, the following questions remain – Can the housemaid and her family follow social distancing with limited space, money and resources? How realistic is social distancing for society’s most vulnerable?
Over the last few months, the world has been struggling with the crushing impact of the COVID-19 pandemic. As part of a coping mechanism, governments have imposed several “new normals” on our lives, radically changing almost everything we do – working from home, online grocery shopping, online classes, etc. Many want things to go back to normal quickly, but most have not realized that some things will never be the same again. For the most vulnerable, this pandemic will be yet another disaster which the world has failed to protect them from.
In coming to terms with the new normal, two phrases have crept into our vocabulary and everyday conversations – Social Distancing and Flattening the Curve.
The phrase, “flatten the curve” has been thrown around a lot, particularly in the media. It was coined by Dr. Howard Markel, a distinguished medical historian at the University of Michigan. It refers to a public health strategy of slowing down the rate of growth of an infectious disease, to prevent healthcare systems from being overwhelmed. In the context of the ongoing COVID-19 pandemic, this would imply increasing the number of available ICU beds and ventilators, and reducing the number of patients who need urgent medical care from one day to the next.
The race to develop, approve, and manufacture a COVID-19 vaccine is urgent, yet unpredictable. According to the Milken Institute’s COVID-19 Vaccine Tracker, about 263 treatments are currently in development, of which 192, are vaccines. Out of these, only 16 vaccine candidates have reached the clinical testing stage. Although numerous reports have claimed that the clinical trials for a Russian vaccine at Sechenov University have been ‘successfully’ completed, they particularly forget to mention that only Phase I of the clinical trials have been completed. Phases II and III, are yet to be completed. In this light, the only vaccine candidate farthest along the vaccine development timeline, is AZD1222, being jointly developed by the University of Oxford and AstraZeneca, which is currently in Phase III of clinical trials.
As the race towards developing a vaccine or specific cure is far from the finish line, the only way to flatten the curve is through collective action, that is, communities take steps to slow the spread of the virus, so that the number of cases is distributed across a longer span of time. As individuals in a community, non-medical interventions such as regular hand washing, self-isolation, and disinfection of households and surroundings, can go a long way in reducing daily infection. But the most important intervention of all, is social distancing.
Social distancing is the maintenance of distance between oneself and others, when out in the public, or even at home. To practice social distancing in public, one must stay 2 metres away from other people, avoid gathering in groups, and avoid crowded places and mass congregations. At home, social distancing involves limiting running errands outside the house, separating family members into different rooms, and preventing those easily susceptible from caring for children and the ailing.
It has been said that the coronavirus sees no colour, race, class, caste, or ethnicity, and that it will infect anybody. In reality however, the virus has a tendency to target the most vulnerable in society. This is because, the vulnerable are the most exposed and most susceptible to illness. Moreover, lockdowns have exacerbated pre-existing problems such as poverty, unemployment, and inequality. For example, in a paper on the United States of America by Millett et. al. (2020), the authors find that counties with a higher proportion of black residents, experience higher rates of COVID-19 cases and deaths. Moreover, higher rates of cases are associated with a higher proportion of uninsured residents, and with a higher proportion of residents in crowded living conditions. In addition, higher rates of deaths are associated with a higher proportion of persons aged 65 years or older.
While social distancing has been hailed as a critical step in the fight to flatten the curve, the unfortunate reality is that not everyone has the ability or resources to hole themselves up in crammed quarters for an extended period of time. In India, the lockdowns have not only rendered thousands of migrants jobless and homeless, but have also pushed them further into a state of distress. Many have hit the road back home on foot to reunite with their loved ones, openly breaching lockdown protocol. Social distancing thus, becomes a luxury that many can’t afford; and it is class that creates the divide.
When the state enforces lockdowns to ensure social distancing, the question to be asked is, what is the reality of such a measure? To illustrate, we study three aspects of material wellbeing – income, family size, and housing conditions.
Considering income, informal sector workers as compared to their formal sector counterparts, are the most affected by lockdowns, as they are not in a position to simply give up work (which may even be seasonal in nature). The necessity to continue working, stems from the fact that these workers make hourly or daily wages. They do not have access to any form of social security. Even under normal circumstances, the monthly per capita income of a casual worker in the unorganized sector, is approximately ₹4,290 (ILO, 2018), as compared to ₹11,202 in the organized sector (MoSPI, 2019). Low income becomes a problem for households that live hand to mouth, as they are unable to spare money for sanitizers and masks. Only those who have enough savings, can afford to forgo their income and maintain their standard of living for an indefinite period of time.
In terms of family and household size, the wealthy fare better during isolation, as they live in spacious houses, and can comply to social distancing norms far better than those living with say, five children in a tiny room. They also find it easier to distance themselves from ailing family members. The average family size in a typical Indian slum is 5 members, with about 60 to 70 percent of deprived households having 3 or more persons occupying a single bedroom (Bag et. al., 2016). As an illustration, if we assume that an individual requires an area of at least 2 square metres for physical distancing, a typical slum dwelling family would therefore need a total distancing space of at least 10 square metres (This is based on the assumption that the space is not occupied by furniture and other belongings. If we are to include these, the requirement would be greater than 10 square metres). This is much more than what a typical slum dwelling family occupies in a jhuggi, which is roughly 8 square metres in floor area (Jain, 2016). With extremely narrow bylanes and tightly packed houses, social distancing is next to impossible.
The tools that enable social distancing are themselves, a result of one’s privilege – One must have enough savings, or a work from home job (which requires a stable internet connection); they must have sufficient living space, access to healthy food, gas, piped water, accessible washrooms and bathrooms, and the comfort of social media or entertainment to keep them occupied. For instance, only about 26% of slum households in Mumbai have access to personal sanitation facilities, while the rest rely on government or private facilities; 60% have access to household piped water, 65% cook inside the sleeping room, and only 21% have access to a computer. Besides this, less than 50% of slum households are of the pucca type (Bag et. al., 2016).
Therefore, future reform must be geared towards making the vulnerable sections of the population, less susceptible and more equipped towards adopting social distancing as a new normal. A welcome step in this regard, would be the free distribution of personal hygiene and sanitation kits, through the Public Distribution System. Before we call out someone for not following social distancing, we must realize that not everyone has the privilege to do so; and that space, is just another manifestation of inequality.
Bag, S., Seth, S., & Gupta, A. (2016). A comparative study of living conditions in slums of three metro cities in India. Leeds University Business School Working Paper, (16-07).
International Labour Organisation (ILO). (2018). India Wage Report: Wage Policies for Decent Work and Inclusive Growth. India: International Labor Organization.
Jain, A. K. (2016). Housing for All: Optimising Planning and Development Controls. Shelter, 17(1), 2-9.
Milken Institute. (2020). COVID-19 Vaccine Visualization. Retrieved 13 July 2020, from https://www.covid-19vaccinetracker.org/
Millett, G. A., Jones, A. T., Benkeser, D., Baral, S., Mercer, L., Beyrer, C., … & Sherwood, J. (2020). Assessing differential impacts of COVID-19 on Black communities. Annals of Epidemiology.
Ministry of Statistics and Programme Implementation (MoSPI). (2019). Press Note on Second Advance Estimates of National Income 2019-20 and Quarterly Estimates of Gross Domestic Product for the Third Quarter (Q3) of 2019-20. New Delhi, India: Press Information Bureau (PIB).
World Health Organization (2020). Transmission of SARS-CoV-2: implications for infection prevention precautions. Retrieved 13 July 2020, from https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions/
Author: Daniel Challam
Daniel Challam is a freelance writer and researcher, currently based in Delhi. He is a Postgrad from the Delhi School of Economics, and an Undergrad from Ramjas College, Delhi. A New Institutionalist by training, he loves taking models to the real world (and secretly enjoys proving them wrong, as long as they’re not his). His current interests lie in Political and Institutional Economics, Public Economics, and the Economics of Discrimination.