Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: a mixed methods study

Abstract

Background People with chronic conditions are disproportionately prone to be affected by the COVID-19 pandemic but there are limited data documenting this. We aimed to assess the health, psychosocial and economic impacts of the COVID-19 pandemic on people with chronic conditions in India. Methods Between July 29, to September 12, 2020, we telephonically surveyed adults (n = 2335) with chronic conditions across four sites in India. Data on participants’ demographic, socio-economic status, comorbidities, access to health care, treatment satisfaction, self-care behaviors, employment, and income were collected using pre-tested questionnaires. We performed multivariable logistic regression analysis to examine the factors associated with difficulty in accessing medicines and worsening of diabetes or hypertension symptoms. Further, a diverse sample of 40 participants completed qualitative interviews that focused on eliciting patient’s experiences during the COVID-19 lockdowns and data analyzed using thematic analysis. Results One thousand seven hundred thirty-four individuals completed the survey (response rate = 74%). The mean (SD) age of respondents was 57.8 years (11.3) and 50% were men. During the COVID-19 lockdowns in India, 83% of participants reported difficulty in accessing healthcare, 17% faced difficulties in accessing medicines, 59% reported loss of income, 38% lost jobs, and 28% reduced fruit and vegetable consumption. In the final-adjusted regression model, rural residence (OR, 95%CI: 4.01,2.90–5.53), having diabetes (2.42, 1.81–3.25) and hypertension (1.70,1.27–2.27), and loss of income (2.30,1.62–3.26) were significantly associated with difficulty in accessing medicines. Further, difficulties in accessing medicines (3.67,2.52–5.35), and job loss (1.90,1.25–2.89) were associated with worsening of diabetes or hypertension symptoms. Qualitative data suggest most participants experienced psychosocial distress due to loss of job or income and had difficulties in accessing in-patient services. Conclusion People with chronic conditions, particularly among poor, rural, and marginalized populations, have experienced difficulties in accessing healthcare and been severely affected both socially and financially by the COVID-19 pandemic.

Patient experiences and perceptions of chronic disease care during the COVID-19 pandemic in India: a qualitative study

“…Lastly, as indicated by previous studies, low SES is a major underlying factor for psychosocial distress and response to the pandemic. 24 Therefore, further research is warranted to shed light on the long-term psychological, health and socioeconomic impacts of COVID-19 pandemic among vulnerable or marginalised population. 25 26 …”

Parallel Outbreaks of Deadly Pathogens (SARS-CoV-2, H5N8, EVD, Black Fungi) around East Africa and Asia in 2021: Priorities for Outbreak Management with Socio-Economic and Public Health Impact

“…Social distancing might be necessary to contain these deadly pathogens, but it comes with panic and socio-economic collapse [41]. However, considering vaccination, pandemic control measures, and the re-emergence of new variants, global economic activity might reduce to 4% in 2021 and 3.8% in 2022, or on the darker side, might face downfall with below-potential growth by 2022 if the situation becomes worse [17,19,33]. Additionally, due to lockdown and other restrictions, mental health would wither away mainly because of unemployment, which may also lead to crime, burglary, and fraud business [42][43][44][45].…”

“…A study by Shammi et al, 2021 [18], revealed the impact of COVID-19 in Bangladesh on gender discrimination, gender-based violence, business, economy, and education sectors, which was supported by another study by Singh et al, 2021 [19], in India who reported that 59%, 38%, and 28% of people lost job, income, and food security, respectively, due to the surge of ongoing COVID-19 in 2021. This socio-economical scenario can be seen everywhere around the world [17][18][19][20]. Moreover, due to the death of 3,538,764 people around the world, it has already affected the amount of working manpower, mainly in food and other basic industrial levels [10,11,[17][18][19][20].…”

“…This socio-economical scenario can be seen everywhere around the world [17][18][19][20]. Moreover, due to the death of 3,538,764 people around the world, it has already affected the amount of working manpower, mainly in food and other basic industrial levels [10,11,[17][18][19][20]. While the impact of the COVID-19 pandemic is known to all, the other three outbreaks should not be ignored, considering their potential impact on health and living standard.…”

Broad Impact of Exchange Protein Directly Activated by cAMP 2 (EPAC2) on Respiratory Viral Infections

“…For example, since the emergence of severe acute Viruses 2021, 13, 1179 2 of 15 respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 [4,5], there were about 91 million confirmed infections and 2 million deaths worldwide as of 14 January 2021 [6]. The COVID-19 pandemic has been generating health, economic, and social crises worldwide [7]. Given that multiple viruses are the causative agents of human respiratory infection and co-infection has been continuously reported, the development of a novel treatment modality that has a broad-spectrum antiviral effect is urgently needed.…”