What does Lamentations 1:20 mean?

Lord, look at how much I’m suffering. I’m in agony inside. My heart is broken, because I’ve been so rebellious. Out in the streets, people are dying by the sword; inside, it’s just as deadly. People are barely hanging on to life. Lamentations 1:20 - Modern Text Bible

(The suffering is total—inside and out, there’s only pain and death, and Jerusalem knows it’s because of her own rebellion.)