Lockdown - A tale of other diseases

Lock down or die. Lockdown or economy. Lockdown or jobs. Lockdown or lives. These were the debates prevalent. World over and in Pakistan, from experts to individuals, the over whelming discussion was on the necessity of lockdown to defeat a virus that was crippling health. China was the first country to adopt the lockdown strategy, and as the disease spread, so did the lockdown strategy. The world was shut down. Economies crashed. As the discussion turned to the impact of lockdown on jobs and businesses the debate took a new turn. Those for lockdown became the humane socialists and those against it the inhuman capitalists. Any talk of lockdown creating more poverty, hunger and death was brushed aside as mercenary thoughts ignoring the present and close danger to health.
As the 'save lives stay home' argument dies down the need to reflect starts. The headlong and headstrong view on lockdown as the saviour of mankind strategy must be reviewed to bring forward the reality of the true and unhidden cost of the strategy. Many studies are now emerging pointing out how lockdown has saved lives from coronavirus but has killed and will keep on killing millions suffering from other diseases for many years. This reality as it unfolds will make the consequences of this lockdown appear more and more harrowing in the coming years. Questions will be asked on why, for how long, and what was the total death toll, for a long time. The reason why everybody in the world went into a unanimous mold of "stay home save lives" was because the only solution was minimizing human to human contact. But when you minimize human to human contact you also maximize risks of no treatment to other diseases that need human to human contact to prevent, treat and cure. Millions who will die, be crippled or become bigger contagious viruses in the future may tell a very sorry tale of this approach.
Professor Michael Levitt, who teaches structural biology at Stanford University and is the Nobel prize winner for chemistry in 2013 says: "There is no doubt in my mind that when we come to look back on this, the damage that is caused by lockdown will exceed any saving of lives by a huge factor." This statement by a Nobel laureate has really forced minds to reflect. Analysts who were just set on lockdown strategy need to look at the dire consequences of the shutdown of health and medical facilities to millions of people who will now become critical or die. This number, most agree, far exceeds the corona deaths and infections in the world. This does not include billions who will be affected by job layoffs and poverty due to economic depression. This also does not take into account the mental traumas that will result in severe psychological, medical and social issues due to the extreme isolation and desolation caused by the prolonged lockdown. As most countries try to reduce lockdowns they need to calculate and develop emergency plans to tackle the deadly backlog in saving lives and livelihoods:
1. Health Backlog Evaluation - Nearly all countries have reported a drastic drop in regular disease reporting and treating. The fear of coronavirus as a contagion not only affected health professionals but health patients. The alerts given for Corona was: "All people who have previous preconditions and complications are especially vulnerable to this virus". This created such panic in patients suffering from other conditions that they stopped going to hospitals for regular treatment-consequently endangering themselves more. A report in the Journal of the American College of Cardiology on nine high-volume cardiac catheterization labs across the country found a 38 percent drop in patients being treated for a life-threatening event known as a STEMI.
2. Support Backlog - Many diseases need volunteer backed support facilities. They are supported by foundations, trusts and NGOs who depend on donations of money, blood or even organs. The lockdown has affected all of them. Take the case of Thalassaemia patients in Pakistani, i.e., children. Thalassaemia has a prevalence rate of 6% in the country. Pakistan has over 100,000 Thalassaemia patients, each requiring 3 to 4 pints of fresh blood per month. Students are the primary donors but due to closure of educational institutions, NGOs are no longer able to hold blood donation camps, resulting in severe shortages. Without fresh blood these children may not survive.
3. Funds Deficit - Many diseases and social welfare activities are dependent on donations and fund raising from corporates, individuals, etc. These organizations may be working on health issues like Shaukat Khanum on cancer or SIUT on kidney transplant, etc. Whenever there is a natural disaster in a country it is normal that internal fund raising dries as most people want to donate to the immediate disaster. That is what happened during the earthquake in 2005 in Pakistan. Many organizations then resort to international donors. Covid-19 is a pandemic affecting every individual and organization in the world. This has created global donor fatigue posing huge threats to hundreds of other causes that may be neglected due to lack of funds resulting in health disasters that are cumulatively much bigger than coronavirus mortality and morbidity.
The challenge of this pandemic is complex. In curtailing its contagion the danger is of doing so at the cost of spread of many other deadly diseases. The cumulative impact of hundreds of other untreated diseases due to exclusive Corona focus on the health of the citizens of this world may be more devastating and enduring than coronavirus. The world/countries/leaders need to calculate four costs and their ramifications. Firstly, the cost of the business shutdown and economic depression. Secondly, the cost of fighting COVID-19 till the vaccine arrives in terms of health emergency cost. Thirdly, the cost of all other health issues and diseases that have not been neglected and their costs. Lastly, the loss of productivity due to the psychological post-trauma stress of lockdown and layoffs.
These are what the planning analysts have to factor in to come up with the right strategic solutions. Easing off lockdowns is the first step but what need to be co-focused are the other three hidden or secondary costs which will rear their dangerous heads after the Corona uproar dies down. Countries who are using the multi-dimensional approach to assess, evaluate and prepare plans for these four contingencies will lead the new world order that will emerge from this global disorder. (The writer can be reached at [email protected])