Five weeks of lockdown has not only failed to protect India’s poorest from the rampaging coronavirus pandemic but made them even more vulnerable by taking away their livelihood means and cutting their access to healthcare, top public health experts have pointed out.
“Countries must let people get on with their lives — to work, earn money, and put food on the table. Livelihoods are imperative for saving lives.
The policies of widespread lockdowns and a focus on high-technology health care might unintentionally lead to even more sickness and death, disproportionately affecting the poor,” two professors from the Harvard University - T H Chan School of Public Health, Boston, Massachusetts - wrote in an opinion piece in the Lancet.
Data from India’s National Health Mission indicate there was a 69% reduction in measles, mumps, and rubella vaccination in children, a 21% reduction in institutional deliveries, a 50% reduction in clinic attendance for acute cardiac events and, surprisingly, a 32% fall in inpatient care for pulmonary conditions in March 2020, compared with March 2019.
“There are now emerging very worrying data, for example from Malegaon, of significant surges of mortality in April, compared with March and the previous year, which cannot be accounted for by unrecognised COVID-19 deaths,” Vikram Patel, one of the two authors of the Lancet article and Pershing Square Professor of Global Health and Wellcome Trust Principal Research Fellow, told DH.
“What’s more worrying and mystifying, is that despite five weeks of lockdown, India’s COVID-19 death tolls are still rising to record levels. How do we interpret this - that the lockdown period was not used effectively to either contain the epidemic and our poorest wasn’t protected from its effects; a double whammy!” he said.
Patel and his fellow professor Richard Cash argued to return to a society where the emphasis is on personal hygiene and protection rather than locking down the economy.
The catastrophe of hunger fuelled by the lockdown, they observed, would lead to a famine-like situation with many more deaths in the coming weeks not only in India but in other resource the poor nations too, unless there is a change in the policy measures.
Hunger is an immediate threat both due to the loss of daily wages and the disruption of the food supply chains.
The UN has estimated that over 300 million children who rely on school meals for most of their nutritional needs (such as India’s Mid Day Meal programme) may now risk acute hunger that could reverse the progress made in the past 2–3 years in reducing infant mortality within a year.
In addition to being aligned with the founding principles of global health such as social justice and equity, the government policies would adhere to the Hippocratic Oath’s principle "primum non nocere"—"first do no harm", they added.