analysis

Updated: Mar 19, 2020 08:27 IST

India houses some of the most densely populated cities in the world, where people are forced to live in cramped spaces and travel in packed metros and buses every day. With novel coronavirus (Covid-19) cases on the rise — it has so far affected more than 150 countries — it is important to understand the urban dimensions of pandemic planning, and ensure preventive and curative measures for mitigation. With robust city management, India could become a forerunner in tackling the disease.

In today’s world, the growth of medical science and digital infrastructure can be leveraged to successfully fight the spread of Covid-19. More than half the world’s population lives in urban areas. And national economies are heavily intertwined, thanks to globalisation.

City governments play a crucial role in developing efficient and innovative methods of confronting emerging infectious diseases, from ensuring the efficacy of physical and social infrastructure (water and sanitation, and hospitals and health care systems) to safeguarding the ecosystem through more connected networks of digital and economic infrastructure.

Here is what needs to be done.

One, water and sanitation authorities must ensure hygienic systems in the city. Environmental hygiene is an absolute necessity to effectively combat the spread of the virus. All public and community toilets must be sanitised at regular intervals and equipped with handwashing facilities and tissues. Public spaces such as parks, markets and institutions should have waste management and safe disposal systems working round the clock. The initiatives under the Swachh Bharat Mission and the Atal Mission for Rejuvenation and Urban Transformation (AMRUT) have already prepared many cities to effectively handle this effectively.

Two, digital infrastructure needs to be strengthened and monitored regularly by the district administration. Kerala is leading the way in successfully tracking and combating coronavirus cases. It is making effective use of its digital health infrastructure to isolate and diagnose positive cases. As part of an intensive drive, the Pathanamthitta district administration has come up with a system, with a GPS-supported system to track those quarantined in the district in order to restrict stray movement. A NITI Aayog report, Health System for a New India (2019), also advocates that digital initiatives are crucial in effectively managing health facilities clinically, administratively and financially.

Three, data can play an important part in enhancing preparedness, curbing incidences, and containing the spread of identified cases. Local authorities must regularly monitor the spatial and temporal distribution of affected cases and geographical proximity to the affected regions. Subsequently, such data can be analysed to develop a comprehensive and robust response system. Given that smart infrastructure is in place in 100 Smart Cities of India, data collection and management can be explored and extended regionally.

Four, non-pharmaceutical interventions (NPIs) help contain communicable diseases. The NPIs such as work-from-home, school closures and restricting public gatherings, which eliminate high-risk chances for mass infection and enforces social distancing, prevent the spread of the disease. This, in turn, reduces the chance of burdening the health care system and saves precious resources.

Five, strong lines of communication with the community can go a long way in being the first line of defence. Certain NPI actions may draw public attention and can have negative psychosocial and economic consequences, especially to high-risk and vulnerable populations. Public messages should address fear, stigmatisation and discrimination. The Union ministry of health and family welfare recently released a comic book Kids, Vaayu and Corona: Who Wins the Fight? for creating awareness among children about the coronavirus. Using such early warning systems create a line of informed and cautious citizenry.

Six, rationing of the health care system and temporary expansion of facilities may be required on critical care beds. Respiratory diseases such as Covid-19 necessitate specialist hospital treatment for a sizable proportion of those who become symptomatic, in the form of ventilation and the need for antibiotics to fight secondary infections. Quarantine centres and provisional hospitals with isolation facilities will be required to deal with established cases of Covid-19 infections.

Seven, maintaining and regulating the supply of essential drugs and precautionary items such as masks, medical textiles, hand wash and alcohol-based sanitisers is necessary. On March 13, the Union government declared hand sanitisers and masks as “essential commodities” under the Essential Commodities Act till June 30. It was important to do this to avoid a situation of demand–supply mismatch, rent-seeking, hoarding and exorbitant pricing.

And, eight, the urban economy is likely to be hit, and this cannot be disregarded as cities contribute significantly to GDP. District authorities can play an important role in minimising local economic impact. Individuals in precarious employment deserve targeted attention. Precautionary measures will definitely help to keep the economic engine going, and early response can abate long-term impact.

A well-managed and planned urban system can reduce the risks of pandemics and endemics. India’s urban system will have to champion the change for a more organised and formal development.

Even though there is little or no population immunity to the virus, with proactive planning and implementation, the impact of this pandemic can be mitigated effectively to avoid the worst-case scenario effectively.

Amitabh Kant is CEO, NITI Aayog, and Richa Rashmi is Young Professional, NITI Aayog

The views expressed are personal