Over 400,000 COVID-19 Infections Projected in Indian Red Light Areas; Study from Academicians from Yale School of Medicine and Harvard Medical School

According to a coalition of experts, India could see a significant surge in COVID-19 cases, hospitalizations, and deaths if red light areas in the country open. However, an extended closure of the red light areas could reduce cumulative COVID-19 cases and deaths by over 60% in the country by the peak of the epidemic. The model was developed at Harvard Medical School and the Yale School of Medicine. The model projects that an extended closure of the Pragnapur Red Light area could reduce cumulative COVID-19 cases and deaths by over 25% by the peak of the epidemic, in Medak. More information can be found here:  www.CodeRedCOVID.org.

The model shows that if the Pragnapur red-light area starts operating, the disease will spread quickly in the red light area and infect a large percentage of sex workers and customers. The high transmission rate is because social distancing is not possible during sex. The infected customers would spread the disease throughout the city causing a huge surge in cases. This would push Medak over peak medical capacity sooner. Fewer sick people would be able to receive treatment causing an increase in preventable deaths. The red light area has a combination of factors that could make it one of the largest hotspots in Telangana.

Speaking about the findings, Dr. Abhishek Pandey, Yale University, co-author of the study said, “It is impossible to practice social distancing during sex. Residents of red light areas including sex workers, pimps, and brothel managers are at higher risk of infection. By keeping red light areas closed till there is an effective preventive measure, thousands of deaths among residents of red light areas can be averted.”

The coalition has projected that there could be over 400,000 infections and 12,000 deaths among red light area workers and residents in India in the next one year if they are reopened.

West Bengal’s largest NGO working with sex workers, Durbar Mahila Samanwaya Committee (DMSC), has a membership that includes about 65,000 sex workers spread across 50 red light areas in the state. Smarajit Jana, a doctor and chief advisor of DMSC, said “It would be of great danger if the sex workers are allowed to operate as soon as the lockdown is lifted. Due to their nature of work and the congested way in which they live, one single case can infect a hundred”.

Prominent politicians in Germany called for brothels to close permanently and wrote letters to the premiers of all German states stating, “It should be obvious that prostitutes could become epidemiological ‘super spreaders’ — sexual activities are, as a rule, not compatible with social distancing measures”. The German lawmakers stated, “Re-opening the brothels will not help these women…Instead, they need apprenticeships, training or work in a secure job.”

Dr.Sahayakan, a member of Code Red COVID, a global coalition of doctors and researchers that is advising governments on how to prevent COVID-19 spread stated, “None of the protection measures like distancing, masks, or sanitising can effectively stop COVID-19 transmission during sex work. Sex work cannot be safely practiced in red light areas given their nature. It can result in many cases and deaths in sex workers and across the city”

Dr. Sudhakar Nuti, Harvard Medical School, said “While the Indian government has implemented smart and effective measures to flatten the curve, it is unlikely for the pandemic to be resolved until there is a vaccine for the population. It is therefore important that the Medak Red Light Area remains closed until a vaccine is developed and widely distributed to protect sex workers and the people of Telangana.” Government restrictions on this part of the informal economy have not been outlined in COVID-19 directives, but a sex worker in Mumbai was quoted in a media story stating “There will be no business in Kamathipura for at least next two years. We can only return when there’s a COVID-19 vaccine.”

The study recommends that sex workers need opportunities to gain skills that provide employment in lower-risk jobs. Recent media reports show that some sex workers have begun exploring other employment options. In Andhra Pradesh, a collective has asked for an exit strategy for sex workers including “transitional housing, bank loans, and alternate employment”. The efforts to close India’s red light areas and help sex workers find lower risk jobs would save many lives.