Abstract
This paper highlights the major challenges and considerations for addressing COVID-19 in informal settlements. It discusses what is known about vulnerabilities and how to support local protective action. There is heightened concern about informal urban settlements because of the combination of population density and inadequate access to water and sanitation, which makes standard advice about social distancing and washing hands implausible. There are further challenges to do with the lack of reliable data and the social, political and economic contexts in each setting that will influence vulnerability and possibilities for action. The potential health impacts of COVID-19 are immense in informal settlements, but if control measures are poorly executed these could also have deep negative impacts. Public health interventions must be balanced with social and economic interventions, especially in relation to the informal economy upon which many poor urban residents depend. Local residents, leaders and community-based groups must be engaged and resourced to develop locally appropriate control strategies, in partnership with local governments and authorities. Historically, informal settlements and their residents have been stigmatized, blamed, and subjected to rules and regulations that are unaffordable or unfeasible to adhere to. Responses to COVID-19 should not repeat these mistakes. Priorities for enabling effective control measures include: collaborating with local residents who have unsurpassed knowledge of relevant spatial and social infrastructures, strengthening coordination with local governments, and investing in improved data for monitoring the response in informal settlements.
Highlights
COVID-19 emerged in Wuhan, China, and its spread was initially concentrated in high-income countries such as the US, Spain, Germany, France and the Republic of Korea, as well as in middle-income Iran
There are major concerns about the potential burden of COVID-19 in low- and middle-income countries (LMICs).(6) These can be categorized as: 1) epidemiological vulnerability; 2) transmission vulnerability; 3) health system vulnerability; and 4) vulnerability to control measures, including social protection failures
This paper provides an initial mapping of key considerations that, it is hoped, will be of use for advocacy and action among residents, government and agencies to protect informal settlements from COVID-19
Summary
Vol 32 No 2 October 2020 public health response relies on a good baseline understanding of their populations and an ability to monitor changes. This paper sets out what is known about vulnerabilities to COVID-19 and priorities to support local action It was initially written as a rapid response briefing for the Social Science and Humanitarian Action Platform(3) and involved contributions from a wide range of people listed in the acknowledgements. It illustrates the potential of collective and rapid social science analysis in humanitarian and health crises. It is written in the context of the ongoing COVID-19 pandemic, it provides advice that may be relevant to future outbreaks of highly infectious disease
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