Page - 324 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE324 the socio-economic ladder. In many countries, these people are also among racial and ethnic minority groups, women, migrants, and other socially disadvantaged groups.18 A second dimension to the mega-lockdowns, particularly in some high-income countries, was that the expectation that hospitals would be overwhelmed with COVID-19 patients led to the transfer of non- COVID-19 patients, such as older people to nursing homes—a deci- sion that has resulted in an alarming spread of infections and deaths.19 Paramedics responding to health emergency calls raised the threshold for people being admitted to hospitals.20 Moreover, as news spread of hospitals focusing their efforts on the COVID-19 response, of health care workers dying of COVID-19, and the uncertainty expressed by individuals wondering whether they would get adequate care, the end result was people deciding not to go to a hospital despite needing care. Nursing homes in the U.S., the U.K., France, Spain, and Canada saw infections spread among patients, but were unable to provide sufficient care, nor did they seem to be able to easily transfer nurs- ing home residents needing care to hospitals. While much attention focused on hospitals’ daily death toll due to COVID-19, the number of people dying at home and in nursing homes increased dramatically. By May, “excess mortality” due to non-COVID-19 causes was also increasing dramatically.21 More people were dying from other causes well beyond normal as there were people dying from COVID-19. A third dimension of the lockdowns is the increase in various harms to health and well-being, particularly for those with variety of social disadvantages and vulnerabilities. For example, in India, the Prime Minister gave a few hours’ notice before implementing a national lockdown.22 As a result, millions of people, especially migrants who live on a daily cash wage, were left without any ability to pay for food, housing, and other living costs. Without any social 18. The Lancet Editors, “The Plight of Essential Workers During the COVID-19 Pandemic” (23 May 2020) 395:10237 The Lancet 1587. 19. Kelly Grant & Tu Thanh Ha, “How Shoring up Hospitals for COVID-19 Contributed to Canada’s Long-Term Care Crisis”, The  Globe  and  Mail (20 May 2020), online: <www.theglobeandmail.com/canada/article-how-shoring-up-hospitals- for-covid-19-contributed-to-canadas-long/>. 20. Sarah Bloch-Budzier, “Fears Some COVID Patients ‘Not Taken to Hospital,’” BBC News (23 April 2020), online: <www.bbc.com/news/health-52317781>. 21. “Tracking COVID-19 Excess Deaths Across Countries”, The Economist (16 April 2020), online: <www.economist.com/graphic-detail/2020/04/16/tracking-covid- 19-excess-deaths-across-countries>. 22. Abi-Habib & Yasir, supra note 10.