Lockdowns do not eliminate virus, livelihoods imperative to save lives: The Lancet

Researchers from the Harvard School of Public Health and Harvard Medical School have urged countries with fewer resources to allow the average citizen to travel freely, with restrictions only applied to clusters where lockdowns are necessary.

4 min readPuneUpdated: May 5, 2020 09:48 PM IST

Delhi red zone, Delhi population, Delhi lockdown, Coronavirus crisis, Delhi news, indian express news

At least two billion people make their living in the informal economy and more than 90 per cent of them live in low-income and low-middle-income countries. (Representational)

A one-size-fits-all approach to the coronavirus pandemic is likely to increase inequalities in the long term, so countries with less resources must let people get on with their lives — to work, earn money and put food on the table – researchers from the Harvard School of Public Health and Harvard Medical School said in The Lancet on Tuesday.

Dr. Vikram Patel, the Pershing Square Professor of Global Health at Harvard Medical School and Richard Cash from the Harvard T Chan School of Public Health, in their perspective on ‘The art of medicine-Has COVID-19 subverted global health?’, urged countries with less resources to allow the average citizen to travel freely with restrictions only applied to clusters where lockdowns are necessary.

Dr. Patel told The Indian Express that it has been repeatedly stressed that the primary objective of a lockdown is to delay and reduce the spike of severely affected persons, allowing time for the health system to prepare for future waves and caring for the sick.

“Lockdowns do not eliminate the virus. Livelihoods are an imperative for saving lives. So, the question for India is how well has the country used the five weeks of opportunity to put into place the essential components of a long term strategy to manage the epidemic, including future waves, essentially a clearly defined and nationally implemented testing strategy, a community based strategy for case finding, contact tracing and quarantining and a district level strategy for intensive care support with adequate protective equipment for health care workers,” Dr. Patel said.

Twinned with lockdowns to achieve physical distancing is the promotion of wide-scale COVID-19 testing that relies on expensive kits and an emphasis on intensive-care units and ventilator capacity. These strategies, which have dominated much of the health-system response in rich countries, are a remote possibility in many low-resource contexts where access to intensive care or anything beyond basic diagnostics is far from universal, the researchers said.

At least two billion people make their living in the informal economy and more than 90 per cent of them live in low-income and low-middle-income countries. Data from India’s National Health Mission indicate that there was a 69 per cent reduction in measles, mumps and rubella vaccination in children, a 21 per cent reduction in institutional deliveries, a 50 per cent reduction in clinic attendance for acute cardiac events and, surprisingly, a 32 per cent fall in inpatient care for pulmonary conditions in March, 2020, compared with March, 2019.

Then there is the practical challenge of physical distancing and quarantining in urban slums and rural households where multiple people share a room and toilets cater for many families. Lockdowns have been enforced with an increase in “authoritarian behaviour of police with the poor experiencing brutality and humiliation in countries such as India, Nigeria, Kenya, and South Africa”, researchers said.

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A focus is needed on what is possible, acceptable, just, and sustainable, researchers have said, adding that a community-based approach is needed that emphasises active case finding (through syndromic diagnosis where laboratory confirmed diagnosis is not available) by community health workers and primary care providers, with contact tracing and home quarantining, especially early in an epidemic, engaging and enabling community resources with due attention to avoiding stigmatisation, and banning mass gatherings, researchers said.

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. ... Read More

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