Asia’s largest slum and our otherwise troubled neighbour have largely achieved herd immunity, simply because they had no choice. They are unlikely COVID success stories.
As we speak, Dharavi with an estimated population of about 8-9 lakh (crammed in just about 2.5 sq. Km) has had fewer than 3,000 positive cases (all figures as of August 28, 2020) and a death toll in the low 100s.
Pakistan with an estimated population of about 22 crore, just about 2.5 times the size of Maharashtra, records under 3,00,000 positive cases and just over 6,000 deaths.
Yes. We can talk till the cows come home about smart lockdowns, effective screening and timely treatment as being key to achieving these noble exceptions.
Accidental Successes
These unlikely COVID success stories actually make virtue out of unpalatable reality. And, of ACCIDENTAL SUCCESSES.
Let’s look at Dharavi first. With that kind of population density (80 people sharing a toilet), there is no way that an effective lockdown can be enforced.
Pakistan has a relatively lower population density and a young population. But a meaningful lockdown has hardly been enforced because of religious hardliners who insist on communal prayer.
So, in either case, infections would have to be rampant. Then why have so few people tested positive and thankfully only a tiny fraction of whom have succumbed?
The answer to the question of low positives is low per capita testing.
The low fatality rate would call for a more complex explanation.
Viral loads
The discourse on COVID-19 has neglected ‘VIRAL LOAD’. In a hyper dense population setting, how much of the virus does each person carry and transmit? The load would naturally be very high.
Therefore, quite obviously, initial positives and deaths were quite high in Dharavi and Pakistan. But just as almost everybody in the community got infected, and the virus mutated, immune systems also kicked up a gear. They also multiplied, mutated and attacked the invaders. An invisible but robust balance of power was achieved.
A person from such high-density communities would bear the virus but the chances of him/her getting seriously ill or dying of it becomes progressively lower. They would test positive but register as asymptomatic.
Herd Immunity
We recognise this phenomenon as HERD IMMUNITY. Scientists throw up wide-ranging estimates (40-70 percent) of the population that needs to be infected to achieve herd immunity.
But nature seldom has neat solutions. Only when the actual battle between the virus and the immune systems plays out can we know the ideal threshold of people needing to be ‘safely’ infected. We are as ignorant of the invader as the defender.
Trying to bring down cases to a zero by repeated lockdown and containment is like trying to get a firm grip on a large water-filled balloon.
It will wobble unpredictably and burst just when you think you have it in your grasp.
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