The effect of extended closure of red-light areas on COVID-19 transmission in India

TL;DR

This study models the impact of extended red-light area closures on COVID-19 transmission in India, showing that prolonged closures significantly reduce cases, hospitalizations, and deaths, and delay epidemic peaks.

Contribution

It introduces a transmission model specific to red-light areas in Indian cities, quantifying the effects of extended closures on COVID-19 spread and public health outcomes.

Findings

Extended closures reduce transmission at all scales.

Over 90% of cases and deaths could be averted in some cities.

Nationwide, closures delay peaks and significantly decrease cases and deaths.

Abstract

The novel coronavirus disease (COVID-19) pandemic has resulted in over 200,000 cases in India. Thus far, India has implemented lockdown measures to curb disease transmission. However, commercial sex work in red-light areas (RLAs) has potential to lead to COVID-19 resurgence after lockdown. We developed a model of COVID-19 transmission in RLAs, evaluating the impact of extended RLA closure compared with RLA reopening on cases, hospitalizations, and mortality rates within the RLAs of five major Indian cities, within the cities, and across India. Closure lowered transmission at all scales. More than 90% of cumulative cases and deaths among RLA residents of Kolkata, Pune, and Nagpur could be averted by the time the epidemic would peak under a re-opening scenario. Across India, extended closure of RLAs would benefit the population at large, delaying the peak of COVID-19 cases by 8 to 23 days, and avert 32% to 60.2% of cumulative cases and 43% to 67.6% of cumulative deaths at the peak of the epidemic. Extended closure of RLAs until better prevention and treatment strategies are developed would benefit public health in India.