How social distancing (does not) work in poor surroundings

Social distancing – a horror scenario for the poor?

(Citation of article mentioned below):

As many of us are painfully aware, social distancing is an impossibility for much of India (and a lot of other regions). Measures such as hand-washing, keeping oneself at home if symptomatic, working from home can be followed without any major life repercussions only by a tiny minority of the country – i.e. the socioeconomically privileged. This reality came through quite poignantly in a recent blog post by three Tamil Nadu-based physicians. These doctors (Vijay Gopichandran, Sudharshini Subramaniam, Vinod H. Krishnamoorthy) describe their interactions with a 50-year-old woman who came to them with fever, cough and breathlessness. These symptoms will make any healthcare professional today consider the possibility of the novel coronavirus infection. Hence, while the woman was put on appropriate treatment according to existing protocols, the doctors suggested some social distancing measures to her, just to be on the safe side.

This is the response they got:

“Doctor, what you are saying is not practical. Our house is a little hut and all four of us live in the same room. We have enough room just to lie down and sleep. Keeping a 1-metre distance is impossible. Three of us are women and it is not safe for women to sleep outside the house. There is also the threat of scorpions and snakes outside.”

After describing the insuperable difficulties of social distancing and shutdowns in the Indian scenario, the doctors argue that “by creating a social shut down, and halting the spread of the virus, we will save lives, no doubt, but how many lives will we be harming in order to save those who may be killed by the coronavirus?” This is a very loaded ethical question. The doctors proposed one way out:

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