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As governments prepare to open economic activity across India, they need to determine the areas where blockages can be relaxed and where they should be extended. This depends on a single metric: the extent of the spread of the COVID outbreak. There is only one way to measure it: through community testing.
Government facilities will have to prepare to increase the capacity to conduct many more tests and conduct them frequently to monitor the situation after lifting the blockade. Given limited resources, governments will also have to prioritize which locations to test.
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Representative image. PTI
From what we have seen so far of this outbreak, we know that the spread is uneven and that many of the critical points have emerged in the great meters. While contact tracing can be used in areas where there are few infected cases, areas with larger outbreaks will require more community testing to monitor prevalence.
Effective implementation of community testing requires random sampling of households, staff, cooperation of residents, and adequate logistical support to perform the tests. While random sampling can easily be done with the help of voter lists and electoral lists, governments may face obstacles in these other areas.
There are simply not enough staff to conduct tests at scale, and communities are often unwilling to take the tests due to stigma. This is where Resident Welfare Associations (RWA) can play a crucial role.
RWAs are legal entities comprising members who are residents of local housing companies. These are registered under the Companies Registry Act of 1860 and are entrusted with responsibilities such as the management of general affairs, the maintenance of their localities and the guarantee of a “healthy life”.
Many of the Tier 1 and Tier 2 cities have active RWAs, some of which have been used to aid in the COVID-19 epidemic. There is at least one case of a district magistrate who created a WhatsApp group with RWA members to help oversee the implementation of the quarantine.
In the first days of the spread of the infection, the RWAs also participated in documenting their members’ travel stories and alerted authorities. In the areas declared as containment zones, the RWAs have monitored families in quarantine and have imposed the strict blockade and movement of people inside and outside the localities. There may be more such cases that have not been reported, but there is enough anecdotal evidence to show that the RWAs are playing an important role in fighting the crisis.
In addition to monitoring, RWAs have mobilized for other types of assistance, such as organizing essential retail supplies for members. Online grocery and retail companies are channeling bulk deliveries of combined orders through RWA.
The RWAs have even attempted to serve residents outside their localities. In Delhi, for example, a dairy store located within a housing society was made accessible to those waiting at the door of the society. This participation in a variety of activities has happened without any external directive reporting on any of these actions.
Sometimes their involvement has been limited to vigilantism, as rules are set on the fly, unsubstantiated in science or in compliance with privacy regulations, and government orders are ruthlessly implemented. This trend should be reduced by regular and clear communication from local authorities with RWAs about their duties, responsibilities and competencies.
Overall, given their ability to mobilize voluntarily, RWAs can be an invaluable resource for implementing community testing in cities, where the outbreak has been most severe. Specifically, they can help organize logistical support for randomized testing and ensure member cooperation, as they have community sanction, a legal mandate and have so far demonstrated their willingness to contribute.
However, a possible drawback could be accusations of bias in selecting households for testing. This can be easily addressed, either by assigning the random sampling process to others and by submitting membership lists to RWAs directly, or by maintaining a random flat number lottery to select for testing.
To further standardize the testing process, RWAs should receive a standard operating procedure with an emphasis on ensuring that there is no discrimination against those who may sample or test positive. In the early stages of the crisis, some RWAs released the contact details of 722 residents in South Delhi who had a travel history, violating privacy standards. Such cases should be considered when designing protocols.
Another potential problem could be a lack of knowledge about the tests themselves. The government can map the RWAs with the respective local hospitals which can then supervise the basic distribution of the PPE kits, the creation of test centers, etc. RWAs can coordinate with testers to help provide the necessary support.
While individual families may have no incentive to volunteer to assess whether it was selected, given fear of isolation or stigma, RWAs have an incentive to find positive cases in order to better protect other members. Given their ties to communities, they can speak to members and families to ensure cooperation.
If there are positive case cases, RWAs can help monitor isolation and quarantine, as they have been doing so far. They have the de facto authority to make decisions that may not be attractive to people, but are accepted by the community as a whole.
Therefore, enabling RWAs to assist with testing can be a crucial step in monitoring conditions to determine when to lift mobility restrictions.
Vaidehi Tandel is a junior member and Prakhar Misra is a senior associate at the IDFC Institute
Update date: 8 May 2020 08:29:47 IST
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