Ongoing onslaught of COVID-19 pandemic has been a public health concern all over the world. The contagion has disrupted the world economic system, individual savings as well as human values. Indian Govt. declared lock-down since 25 Mar 20 and that’s being followed by the State Govts. consistently resulting in stand-down in public transports, private/public offices including services of all-purpose petite job-doers.1 Lock-down in many parts of the world, that are contributing largely to the global economy, has led to the halting of services and products upsetting the world economy brutally.2 Many have lost jobs and been denied salary. In the face of such economic stand-off, Govt. provided basic commodities like food provisions for the poor, however that couldn’t be relied upon to make much good for all. Considering this distressing trend, it was decided to determine the extent of certain adversities experienced aside the mind frame of the commons to fight the odd in the background of their knowledge and preventive behaviour to avert COVID-19 in a Kolkata slum.
Materials and Methods
The study was conducted among 282 adults in a slum area in south Kolkata during first and second week of May 20. There were 118 families with 402 members altogether, including 291 adults; however only 282 subjects consented to participate. Clearance was taken from local authority for conduct of study among the residents. The colony was visited initially to meet the members in small groups explaining the purpose of the study aside taking informed individual consent. Nominal roll of consenting participants along with their address and mobile no. was prepared. A relevant questionnaire was made after scanning through existing related literature including necessary modifications due local factors and issues.
The questionnaire consisted of two parts; first part had details of personal attributes besides socio-demographic elements with employment status of the subjects and second part contained details of knowledge about personal protective measures against COVID-19 along with preventive practices for the same amid their projected mind-frame towards the COVID-19 issues. Socio-economic status (SES) was determined as per recent scale.3
The questionnaire was introduced to 186 willing members through mobile/electronic media; 96 members, who declined for mobile/e-interactions, were communicated individually in small groups at a time. Any doubt in data collected through e-mode was clarified during personal visit to the colony. Name, address and mobile no. of study subjects were coded maintaining confidentiality, but the record of the same was preserved to avoid duplication protecting validity of data. Standard precautions like use of mask, hand sanitizer and social distancing were followed to avoid COVID-19 during the interactions. The data acquired was assimilated, tabularized and statistically validated to confer inference. Common statistical functions were applied to determine significance of certain variables as appeared pertinent.
The colony is located by the southern side of a main road connecting Kolkata further to south 24-parganas district of West Bengal. Houses are generally brickwork with asbestos roof, while few of them are temporary improvised type. Public toilets, municipal water supply point, water hand-pumps and street lights are on hand but not sufficient to make common life at ease. Open drainage system is untidy with disorganized and irregular garbage disposal.
Majority of the subjects (36.9%) belonged to 30-39 years age group as compared to 34.8% from 20-29 years (Table 1). Sex ratio was 958.3 with 51% male and 49% female. Mean age of male and female members were 38.04±12.78 and 34.95±10.39 respectively. Majority of the individuals (85.8%) were Hindu. Majority of the respondents (34%) were middle school educated followed by 30% educated up to primary standard (Table 2). Most of the subjects (46%) belonged to lower socio-economic group apropos 40% were from lower middle class. Very few (1.77%) were illiterate. 98 of 144 (68%) male members worked in various organisations as compared to 85 (61.6%) working females prior to lock-down (Table 3). Majority (20.2%) worked in retail shop followed by 15.8% each worked in Govt. offices and hospitals. Large no. of males (34) worked in retail shop vis-à-vis many females (13) were employed as ayah in health care agencies. Only 20.2% continued job in spite of lock-down restrictions because of essential service requirements as compared to 17%, who earned salary without execution and many of the latter were employed in Govt. offices (Table 4). 47% had no work and no pay while 15.9% were terminated.
Around 94% subjects knew about transmissibility, infectiousness and virulence of COVID-19 (Table 5). Above 95% were aware about the importance of hand washing and wearing gloves. Around 93-94% appreciated significance of non-indulgence in personal contact greetings (hug/shake), reporting to hospital in case of worrying symptoms and staying back home. About 94% knew about importance of wearing mask, social distancing, use of sanitizer and cough hygiene. 95% respondents used mask and followed cough & sneeze hygiene while around 94% washed hands with soap & water twice daily and maintained social distancing (Table 6). All stated taking regular bath & changing to fresh clothes daily besides not going out of home without necessity. 93.6% avoided hand shaking & hugging, however only 68% used alcohol based hand sanitizer and meagrely 36.8% used gloves at markets & shops.
95% and above opined that COVID-19 crisis is likely to resolve in near future and supported the necessity of lock-down aside several Govt actions that would help control the outbreak (Table 7). 95% and above expressed that social distancing, bar on religious gathering and emphasis on social norms like cough & sneeze hygiene were essential to avert COVID-19 spread. Around 94-95% stated that job prospects will open up & benched workers would be back to work soon. 93.6% supported use of hand sanitizers and non-indulgence in personal contact greetings and anticipated that public transport services would resume soon. Around 94% acknowledged Govt. directives on bar on social/family gathering to contain COVID-19. 93-95% individuals have shown positive outlook towards all the issues and viewpoints related to COVID-19 (Table 8). Positivity ranged between 92-94.8% among middle class, 93.8-95.5% in lower middle and 93 8-96% amongst lowest SES group without any significant difference.
The adult community portrayed a demographic structure, sex ratio and family size analogous to national statistics.4 Most of the members (98%) were literate; the last census (2011) recorded the literacy in West Bengal as 77.08%.5 Although 68% of adult males and 62% women added to family income coterie in pre-lockdown phase, yet most of them (46%) belonged to lower socio-economic strata; depicts a trying reality where literacy, dual income and compact family couldn’t boost up the social status.
Only 20% sustained job in the appalling hours of compulsive lock-down because of service call as compared to 17%, who earned pay and wages without effecting work being Govt. servants. 47% suffered no work and no pay while 15.9% were terminated. Estimated 122 million Indians lost jobs in unorganised sectors in April 20 and 75% of them are small traders and wage labourers.6 Out of 404 million employed countrywide in Mar 20, estimated 122 million lost jobs in Apr 20 counting to towering 30% loss. Worry of job loss and livelihood in post-COVID-19 lock-down has been highest in India (86%) as compared to 31% in Britain, 33% in Australia, 41% in US and a lofty 71% in Hong Kong.7
Knowledge and awareness about COVID-19 and its prevention were illuminating and gratifying when COVID-19 spate in India has been intensifying and escalating. 93-95% subjects not only knew about transmissibility, infectivity and modalities of prevention but also were actualising desirable preventive behaviour in most of the counts to tame the trot. It has been documented earlier that washing hands and use of alcohol-based sanitizer (23.3%), hygienic way of coughing/sneezing along with use of mask (19.6%), social distancing (16.1%) and following all preventative measures collectively (40.2%) can prevent COVID-19.8 Another recent study annotated that the participants had a moderate level of awareness regarding the mode of spread, symptoms and adequate awareness about the preventive measures. It was possibly due to the government and media emphasizing more on the preventive behaviour.9
More than 95% opinionated that COVID-19 catastrophe would ease out in near future and also supported the inevitability of lock-down imposition and several Govt actions to control the outbreak. 93-95% followed all kinds of social restrictions and behavioural reformations as new normal. 94-95% displayed positive standpoint in job prospects, springing of alternative jobs and winning a call back from previous employers. Most of them favoured Govt. directives, actions and accomplishments to contain COVID-19 resplendently. According to fourth leg of a five country opinion poll (US, Britain, Australia, India & Hong Kong), 84% Indians polled as satisfied with the way the Govt. has been dealing with the COVID-19 crisis as against other countries where the popularity of governments have been plunging.7 While 84% Indians are happy with Govt. actions; this is as low as 43% in US, 56% in Britain, 53% in Hong Kong and 71% in Australia.
Surprisingly, job loss, economic doldrums, social restrictions and home bound conditions couldn’t dampen the spirit of the subjects. It is possible that some of the subjects resorted to fill-in ways of earning livelihood, may have fructified the advantage of working spouse or curtailed sustenance expenses to cope up. It also emerged true that provisioning of free food commodities helped the poor undoubtedly. But we humans are an adaptable and stoic bunch. We generally look for ways to eek the positive out of the situation. We know that at some point days will return to normal, and when it does - we want our lives to have survived and thrived well. This isn’t the time to slow down; it’s the time to remain positive and find the prospect of opportunity for future.
Epidemics and pandemics are episodic phenomenon generally evanescent in nature. Community face several challenges during such periods. Lack of awareness often leads to an unconcerned attitude, which may adversely affect the preparedness to meet these challenges. This endeavour attempted to evaluate the awareness, practice of new behavioural norms in the background of adversities experienced correlating with psyche of the people towards the compulsive Govt. policies and directives. The study explicated convincingly the core contention of enduring motivation exhibited by the common that would go a long way to win over the cataclysm undoubtedly.