Coronavirus

The Negative Healthcare Paradox Of India's Lockdown

A year after the world's second most populous nation went into quarantine, a new study aims to calculate the cost in terms of mental health illness, suicide and inability to receive medical care.

In India, mental health has been impacted at a large scale
Kanika Sharma

-Analysis-

NEW DELHI — On March 23, 2020, the Indian government announced a complete lockdown in response to COVID-19. This measure, taken in the name of public health, exacerbated many healthcare issues and inequalities. As we assess the lockdown's success or failure a year after its announcement, it is critical to look at not just what the lockdown did to prevent COVID-19 spread, but also to assess what the lockdown did to cause both deaths and negligence in terms of other important health requirements.

Although there is no official data on deaths caused by the lockdown, we created a publicly available dataset from media reports between April and July 2020. Our data shows that at least 989 deaths were directly attributable to the lockdown. These numbers are a gross underestimate, however, as media reports are not a comprehensive representation of the overall death toll. Even at this lower rate, though, these deaths indicate the humanitarian and health tolls that the lockdown instigated.

One of the direct health-related consequences of the lockdown is the deaths caused by a lack of timely medical care. At least 79 such deaths have been reported in the media, which include deaths due to transport restrictions or lack of ambulance to reach hospitals, refusal by hospitals to admit patients without negative COVID-19 reports, denial of care by hospitals to people from high infection areas, and lack of timely services for patients suffering from other health conditions. Take, for example, the death of a 34-year-old man in Pune who had severe anemia. The hospital staff admitted that the patient could not be saved because of a shortage of blood in the blood bank due to the lockdown and lack of availability of staff for non-COVID patients.

The lockdown also led to maternity mortality, an issue that India's health system has already struggled with. Media reports show that at least 10 maternity deaths happened as a result of a lack of timely care. One of these was a 28-year-old woman from Bangalore who had body pains and low hemoglobin count and was denied treatment by seven hospitals. Her husband, an auto-rickshaw driver, said "at every hospital, we were asked to wait, fill up forms, and then later informed that admitting her was not possible".

In many cases, the lack care during the lockdown went hand-in-hand with discrimination, hinting at the rampant inequalities and bias faced by socially marginalized populations in India's healthcare services. Several media reports have highlighted how being a Muslim or coming from Muslim-majority areas contributed to the denial of healthcare. In one such incident, a 22-year-old Muslim woman in Meerut who had an intestine infection was refused emergency care after the receptionist found out that she was from Mawana, a Muslim-majority area. After refusals and delays in treatment, she died.

A deserted view of the Atta market in New Delhi — Photo: Mayank Makhija/NurPhoto via ZUMA Press

Lack of timely healthcare, however, was not the only direct health-related consequence of the lockdown. Mental health has also been impacted at a large scale. The data from media reports shows that at least 140 people died by suicide due to fear of infection and stigma, loneliness, and lack of freedom of movement. For instance, in two different cases from Uttar Pradesh, two young women died by suicide –­ one because of her inability to go to her parents' house and the other because of her inability to be with her stranded husband due to the lockdown restrictions.

The hurriedness and strictness with which the lockdown was announced likely worsened the anxieties and fears. Lack of effective health communication, absence of emotional and mental health support, and inadequate relief measures during the lockdown collectively contributed to increasing despair and deaths.

Overall, as the government's own data show, lockdown massively disrupted routine health services, including immunization and preventive care from life-threatening diseases in India. This disruption was uneven among states, with some states having a stronger commitment to welfare and healthcare performing better than those without it. By most measures, these disruptions will have long-term consequences, especially for children and vulnerable populations.

India's lockdown and its devastating effects are a tragic example of how policy measures, taken in the name of public health but without adequate preparations or support systems in place, can end up creating another kind of healthcare crisis. It is also an example that unless the issues of health are understood as deeply linked with socioeconomic wellbeing and support, policy measures like the lockdown are likely to do more harm than good.


Kanika Sharma is a researcher focusing on social inequalities in health. This dataset on lockdown deaths was created in collaboration with Aman, Thejesh GN, and Krushna Ranaware, and with support from Roadscholarz. The full dataset is available at: https://thejeshgn.com/projects/covid19-india/non-virus-deaths/.

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La Sagrada Familia Delayed Again — Blame COVID-19 This Time

Hopes were dashed by local officials to see the completion of the iconic Barcelona church in 2026, in time for the 100th anniversary of the death of its renowned architect Antoni Guadí.

Work on La Sagrada Familia has been delayed because of the pandemic

By most accounts, it's currently the longest-running construction project in the world. And now, the completion of work on the iconic Barcelona church La Sagrada Familia, which began all the way back in 1882, is going to take even longer.

Barcelona-based daily El Periodico daily reports that work on the church, which began as the vision of master architect Antoni Gaudí, was slated to be completed in 2026. But a press conference Tuesday, Sep. 21 confirmed that the deadline won't be met, in part because of delays related to COVID-19. Officials also provided new details about the impending completion of the Mare de Déu tower (tower of the Virgin).

El Periódico - 09/22/2021

El Periodico daily reports on the latest delay from what may be the longest-running construction project in the world.

One tower after the other… Slowly but surely, La Sagrada Familia has been growing bigger and higher before Barcelonians and visitors' eager eyes for nearly 140 years. However, all will have to be a bit more patient before they see the famous architectural project finally completed. During Tuesday's press conference, general director of the Construction Board of the Sagrada Familia, Xavier Martínez, and the architect director, Jordi Faulí, had some good and bad news to share.

As feared, La Sagrada Familia's completion date has been delayed. Because of the pandemic, the halt put on the works in early March when Spain went into a national lockdown. So the hopes are dashed of the 2026 inauguration in what would have been the 100th anniversary of Gaudi's death.

Although he excluded new predictions of completion until post-COVID normalcy is restored - no earlier than 2024 -, Martínez says: "Finishing in 2030, rather than being a realistic forecast, would be an illusion, starting the construction process will not be easy," reports La Vanguardia.

But what's a few more years when you already have waited 139, after all? However delayed, the construction will reach another milestone very soon with the completion of the Mare de Déu tower (tower of the Virgin), the first tower of the temple to be completed in 44 years and the second tallest spire of the complex. It will be crowned by a 12-pointed star which will be illuminated on December 8, Immaculate Conception Day.

Next would be the completion of the Evangelist Lucas tower and eventually, the tower of Jesus Christ, the most prominent of the Sagrada Familia, reaching 172.5 meters thanks to an illuminated 13.5 meters wide "great cross." It will be made of glass and porcelain stoneware to reflect daylight and will be illuminated at night and project rays of light.

La Sagrada Familia through the years

La Sagrada Familia, 1889 - wikipedia

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