Self-isolation for Covid-19 is impossible for 40% of Indian families
3 min read . Updated: 06 May 2020, 10:47 PM IST
PremiumTwo of every five Indian households live in houses where they average three to a room. And the stress of this physical proximity is more in rural areas
In order to utilise India’s healthcare infrastructure optimally to manage the expanding fallout of Coronavirus, the Central government on 27 April signaled a change in approach. From mandating that every person who tests positive for the virus be moved to isolation beds in dedicated hospitals or units, the government allowed home quarantine for those with mild symptoms. The key additional condition was that their house should allow for self-quarantining. That, in India, is easier said than done.
According to Census 2011, about 42% of Indian households were living in houses where, on average, three or more people were sharing a room. In the context of coronavirus, this challenge of physical distancing is greater in rural areas (45% of households) than in urban ones (35% of households). Only one state, Kerala, is looking relatively dignified on this metric. And all districts reporting at least 250 cases have anywhere between 34% and 54% households averaging three or more to a room.
Increasingly, more instances are emerging of familial units testing positive for coronavirus. For instance, there was a family of 31 in Jahangirpuri in Delhi, a family of 10 in a Byculla chawl in Mumbai, a family of 11 in Ramganj in Jaipur.
The real estate requirement mandated by the government for self-isolation is “a well-ventilated single-room, preferably with an attached/separate toilet" and a distance of “at least one metre" between another family member compelled to stay in the same room. As India gradually reopens for business, the fear is of the virus being carried back to small, closed, and cramped houses.
The extent of cramped living conditions can be seen in a Census 2011 dataset that gives the number of members in a household and the number of rooms in their house. The dataset allows one to calculate what percentage of households average three or more people to a room, what percentage of households average four or more people per room, and so on.
Of the 246 million households in Census 2011, about 103 million households average more than three people to a room. About 75 million are rural households and 28 million are urban households. As many as 74 million of these 103 million households occupy a single room, and the number of family members varies from three to above nine. The physical-distancing stress is most acute in these single-room dwellings.
Among urban households, the three most stressed states are Uttar Pradesh, Bihar and Maharashtra. In Uttar Pradesh, for example, 55 of its 71 districts had more than 40% of households averaging three people to a room. Similarly, in Maharashtra, it was 19 out of 31 districts.
Uttar Pradesh, Bihar, and Maharashtra face even greater levels of physical-distancing stress among rural households. West Bengal, Andhra Pradesh and Madhya Pradesh are other stressed states, with a large majority of districts having this metric above 40% for rural households. In rural areas, the stress of physical distancing comes on top of ill-equipped health infrastructure, an influx of returning migrants, and the pressure to work necessitated by lower incomes.
One state is an exception among both rural and urban households. That is Kerala, whose physical-distance stress levels in a near-majority of its districts is less than 20%, even going below 10% in some districts. Kerala was one of the first states in India to have registered coronavirus cases, and it’s also had the maximum success in checking its spread.
Cities that are bearing the brunt of this pandemic provide unforgiving—and now, also unsafe—living conditions to large swathes of their residents. As of 3 May, Mumbai (two districts), Delhi (11 districts) and the next 18 districts in terms of case count accounted for 68% of cases. These 20 geographies are all principally urban areas.
Between them, these 20 geographies have 45% of households staying in dwellings where they average three or more to a room. Mumbai is worst-off in this set of 20 geographies, both in terms of count of cases in terms of physical distancing stress. As many as 54% of households in the maximum city—numbering 1.4 million—live in minimum conditions, averaging more than three to a room.
Census 2011 also tells us that 0.92 million households in Mumbai lived in slums. The growing number of cases in Dharavi—one of Asia’s largest and densest slums—points to the challenge of containing the outbreak in a scenario where the health infrastructure is unable to keep up and physical distancing at home is next to impossible.
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