Pramod Joshi, a 47-year-old resident of Delhi, was diagnosed with a brain tumour in September 2019. He started treatment the following month at the All India Institute of Medical Sciences, in Delhi, and soon needed surgery. He had the tumour resected at a private hospital in the city and started chemotherapy by February 2020. The next step was to start radiation to attack the remaining glioma—a tumour of the cells that surround and support nerves in the brain and spinal cord. Pramod was scheduled to start radiation treatment at AIIMS in mid-April. However, the COVID-19 outbreak hit India in full force by late March and the country went into lockdown. Pramod could not get his radiation therapy as hospitals closed their outpatient departments and major hospitals became COVID-19 centers admitting only patients infected with the novel coronavirus. Deepak Joshi, his brother, said that the family watched Pramod deteriorate for more than three months and lose function on the right side of his body.
Pramod had some hope in early June, when doctors at Venkateshwar Hospital, a private facility, agreed to start Pramod’s radiation. But there was another hurdle. “We were asked for some blood-reports and a COVID-19 report,” Deepak said. “The COVID-19 report of 10 June 2020, came positive. It was surprising as my brother had not gone out for a single moment.” Pramod remained asymptomatic for COVID-19 but his radiation was put off once again. He had to wait another month and take three more COVID-19 tests before he was clear of the infection and could start radiation in late July.
“But by then he had already lost all the strength of right leg and right hand,” Deepak said. “He is now almost paralysed in his right limbs.” He blamed his brother’s plight on the “casual approach on part of policy makers, who totally ignored the plight of patients suffering from other disease requiring timely treatment.”
The disruption of regular healthcare because of the COVID-19 pandemic and subsequent lockdowns has had severe, and sometimes catastrophic, effects on patients with other acute or chronic illnesses. Patients found that hospitals that had been treating them were suddenly closed. Others were turned away from public hospitals, private healthcare facilities and even primary health centers. Patients with manageable disease conditions have had their illness become irreversibly worse because COVID-19 has been given priority almost to the exclusion of all other healthcare.
Many patients struggled just to get to hospitals with the imposition of national and state-level lockdowns. One such case was Fulwa Devi, a resident of Amra village, in Bihar’s Gaya district. She had a form of cancer called chronic myeloid leukemia. In late May, her husband had to take her on his bicycle, riding a hundred kilometers, to the Indira Gandhi Institute of Medical Science in Patna because trains and buses were not functional. She managed to get her treatment after spending a night outside the hospital.