Coronavirus: The lockdown Period


Coronavirus: The lockdown Period


At this writing, some 8.6 lakh people around the world have been found infected with the coronavirus and over 42,300 people have died of it. In India, some 1,580 cases are reported, and 47 deaths. There is little question that India had no choice aside from the lockdown to avoid the colossal toll the virus could combat lives, or a minimum of delay as the country, with our poorly equipped and historically underfunded health system, prepares to face it. However, the lockdown was poorly conceived and declared without preparation. Considering the delay since the primary case was reported from China (84 days), and therefore the first case was reported in India (54 days) to the country-wide lockdown, the preparation could have been much better. The sudden lockdown, including the closing down of a substantial number of personal hospitals, essential medical services, and pharmacies, is causing and can still cause enormous damage to demographic and health outcomes.

Data presented in February, when COVID-19 deaths were maximum in China, showed that it was still the 49th biggest cause of deaths in that country. More people die of TB, Malaria, HIV, and other diseases annually than of COVID-19 (even if we account for the projected number of COVID-19 deaths). While these infections have been around longer and generally affect mostly lower-income groups, COVID-19 is affecting everyone. (Coronavirus: The lockdown Period)

Although we do not have reliable concurrent statistics of deaths for March 2020 in India, considering the Medical Certification of Causes of Death (MCCD) data from one of the highly affected states, Maharashtra, it's hard to believe that COVID-19 will rank among the highest 20 causes of deaths within the country even after its lifetime run.

Lockdown costs

The lockdown Period to contain the spread of COVID-19 has and can have an enormous impact on other healthcare provisions and outcomes. Considering the high multiple and untreated morbidity prevalence in India, it will adversely a huge number of people. In fact, out of the total deaths caused due to COVID-19, most have been reported in co-morbid patients. Ignoring other healthcare services further aggravates the probabilities of an outsized section of the population whose immunity is compromised with existing ailments being infected with Covid-19.

The closing down of private healthcare facilities, especially in the smaller towns and cities that take care of a considerable proportion of the total healthcare burden will have severe implications for those with chronic diseases and people who need emergency care. At the national level, on a mean, some 6.9 million people visit outpatient care on a day to day, out of which, government hospitals, private hospitals, private doctors/clinics, and other (Charities and NGOs) healthcare service providers treat 30%, 23%, 43%, and 4% of cases, respectively. Thus, private healthcare service providers cater to 66% of daily healthcare needs. Further, the lockdown has hit hard the poor and lower-middle-income classes who don’t have their own vehicles to succeed in hospitals in emergencies. (Coronavirus: The lockdown Period)

Mobility restrictions and excessive fear have also hit the attendance of frontline doctors to basic healthcare provisions during pregnancy, delivery care, and new-born healthcare. The lockdown panic and crisis are certainly getting to affect outcomes for pregnant women. For instance, the limited mobility and stigmatization of frontline health workers are harming the nutritional needs of pregnant women and new mothers and their babies. As many as 49,481 births happen per day, of which private hospitals perform 55% of the cesarean and sophisticated deliveries.

Further, the lockdown may induce irregularities in obtaining Antenatal Care Services (ANCs), which have a possible risk of causing health complications and consequential maternal and child mortality. Even in normal times, the shortage of access to healthcare services causes nearly 3,600 pregnancy-related deaths of girls a month and a couple of,800 deaths of youngsters under five years per day. The postponement of child immunization can negatively affect child health outcomes. Though these essential services are available, the non-availability of transport facilities and therefore the fear of infections hamper access to them. The lack of access to pharmacies will also affect menstrual hygiene practices. (Coronavirus: The lockdown Period)

Globally, China is the second-largest exporter of pharmaceutical products. The shutdown of drug-manufacturing plants in China has delayed supplies to Indian factories for producing generic medicines. Further, the lack of access to medicine and regular healthcare among patients with non-communicable and chronic diseases results in severe healthcare issues which might be more fatal than COVID-19 in the days to come.

The asymptomatic nature of the disease and isolation increase the fear and anxiety not only among the youth and older population, but children also are its invisible victims. Social disconnectedness is fuelling psychological state issues among the older population while youth are affected by a fear of an uncertain future, school year, and job losses. Many cases of psychological state emergencies thanks to COVID-19 phobia have already been reported in India.

The global evidence suggests that there was a high demand for contraceptives and abortion services during the outbreak of the Zika virus in 2015-16. Limited availability and accessibility of contraceptives impact unintended pregnancies, abortion, and sexual and reproductive tract infections in large numbers in India, especially as long as current supplies, also as production, have been stalled as a result of lockdowns in many countries. Previous pandemic experiences have also shown a rise in intimate partner violence, divorce, and separation rates in families.

Amidst the COVID-19 lockdown, therefore, it is critical that the Centre and states monitor the population’s other healthcare needs through public and private partnerships. The government must use the private sector services, which hold 62% of hospital beds in the country, instead of shutting them down. The government must subsidize other healthcare services within the private sector hospitals and clinics and make sure that these are available to people at affordable costs while it deals with the grim situation arising out of the coronavirus pandemic. (Coronavirus: The lockdown Period)


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