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 Table of Contents  
REVIEW ARTICLE
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 1-3

Scope of imposing lockdown in the containment of coronavirus disease-2019 pandemic and the decision to relax


1 Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission30-Nov-2020
Date of Decision03-Jan-2021
Date of Acceptance20-Feb-2021
Date of Web Publication30-Mar-2021

Correspondence Address:
Saurabh RamBihariLal Shrivastava
MD, FAIMER, PGDHHM, DHRM, FCS, ACME, Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ed.ed_35_20

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  Abstract 


The ongoing coronavirus disease-2019 (COVID-19) pandemic has forced the public health authorities to implement stringent measures, with an aim to reduce the mobility of the general population and thus interrupt the chain of transmission. An extensive search of all materials related to the topic was carried out in the PubMed search engine and World Health Organization website, and a total of six articles were selected based upon the suitability with the current review objectives. Keywords used in the search include COVID-19, Lockdown, and Exit. To contain the rapid spread of the disease, some of the affected nations have imposed complete lockdown within their settings. However, it is important to consider that the strategy of lockdown cannot be there for prolonged periods of time as it interrupts the social life and negatively affects the economy of the nation immensely. Thus, it is quite essential to lift these restrictions, but of course, the decision should be not taken in haste as it will again result in the resurgence of the cases and will overwhelm the health system. In conclusion, the decision to impose a lockdown has been an effective strategy to reduce the risk of transmission. However, it is also important to plan for revoking the same, and this will obviously require strengthening of the health system and the complete support from the community.

Keywords: Coronavirus disease-2019 pandemic, lockdown, World Health Organization


How to cite this article:
Shrivastava SR, Shrivastava PS. Scope of imposing lockdown in the containment of coronavirus disease-2019 pandemic and the decision to relax. Environ Dis 2021;6:1-3

How to cite this URL:
Shrivastava SR, Shrivastava PS. Scope of imposing lockdown in the containment of coronavirus disease-2019 pandemic and the decision to relax. Environ Dis [serial online] 2021 [cited 2022 Oct 6];6:1-3. Available from: http://www.environmentmed.org/text.asp?2021/6/1/1/312681






  Introduction Top




The ongoing coronavirus disease-2019 (COVID-19) pandemic has forced the public health authorities to implement stringent measures, with an aim to reduce the mobility of the general population and thus interrupt the chain of transmission of the disease.[1] As of January 5, 2021, a total of more than 83 million cases and 1.83 million deaths have been attributed to the infection across the 222 affected nations and territories.[2] The case-fatality rate of the infection has been estimated as 2.2% worldwide.[2] Thus, national leaders across many nations have imposed various restrictions, such as closing educational facilities, encouraging work from home, delayed social gatherings or sports events, or for that matter any event which promotes gathering of people.[1],[3]




  Isolation of the New Strain of Coronavirus Disease-2019 Top




Further, as we are still recovering from the impact attributed to the original strain of the virus, reports have suggested and the genomic analysis has reflected a newer strain of the virus and it has been traced for its origin in South Africa and has been subsequently reported in the United Kingdom and various other nations.[2] This new strain of the virus has again made the global public health authorities to be concerned and has set an alarm. As a precautionary measure, to interrupt the spread of the transmission, some of the nations like India have stopped international flights for a brief period of time and are working toward strengthening of the public health measures in this period.[2]



An extensive search of all materials related to the topic was carried out in the PubMed search engine and the World Health Organization website. Relevant research articles focusing on COVID-19, lockdown, and exit strategy published from June 2020 to January 2021 were included in the review. A total of 10 studies similar to current study objectives were identified initially, of which four were excluded due to the unavailability of the complete version of the articles. Overall, six articles were selected based upon the suitability with the current review objectives and analyzed. Keywords used in the search include COVID-19, Lockdown, and Exit. The collected information is presented under the following subheadings, namely COVID-19 and imposing lockdown, improving the health outcomes during lockdown, exiting from lockdown, factors under consideration, implications for practice, and implications for research.




  Coronavirus Disease-2019 And Imposing Lockdown Top




However, considering the rapid spread of the disease, some of the affected nations (viz., China, New Zealand, United Kingdom, and India) have imposed complete lockdown within their settings.[1],[3],[4] This has been done as the impact of imposing lockdown in China is very much evident, as the nation has succeeded in interrupting the chain of transmission of the disease and the caseload has reduced significantly. At the same time, from the policymaker's perspective, the period of lockdown gives an opportunity for the health sector to improve their outbreak readiness, response plan, and be ready to respond to a large-scale community transmission.[1],[4]




  Improving The Health Outcomes During Lockdown Top




Moreover, it is very important to acknowledge the fact that mere lockdown will not bring about a downfall in the caseload, unless it is simultaneously accompanied by interventions such as active surveillance for the identification of suspect cases and subjecting them to laboratory tests, isolation of the confirmed cases, provision of appropriate treatments, identification of all the contacts of the cases and subjecting them to quarantine, and finally strengthening of the infection prevention and control measures.[4],[5],[6] In addition, the support and involvement of community in each and every step of the disease containment are crucial for sustained gains.[7]




  Exiting From Lockdown Top




It is important to consider that the strategy of lockdown cannot be there for prolonged periods of time as it interrupts the social life and negatively affects the economy of the nation immensely.[4] Thus, it is quite essential to lift these restrictions, but of course, the decision should be not taken in haste, as it will again result in the resurgence of the cases and will overwhelm the health system.[8]




  Factors Under Consideration Top




Thus, the decision to lift a lockdown should be based on the status of the containment of the transmission and the availability of adequate medical services, including logistics, which enables health professionals to respond to the rise in number of cases, if the situation arises.[2],[3],[4],[5] In addition, the risk of disease outbreaks in special settings (viz., camp, refugee, long-term care facilities, and vulnerable population groups) has to be minimized. Further, once the restrictions are lifted, schools, workplaces, or public transport will re-open and it becomes extremely crucial that all measures are in place to minimize the risk of acquisition and, at the same time, be well prepared to respond to an occasional outbreak of the disease.[3],[4],[5],[8],[9],[10]



In addition, the decision to lift the lockdown restrictions should also be determined by reducing the risk of importation of cases, which will essentially require strengthening of the activities at various points of entries.[6],[10] Finally, the members of the community should be aware of the essential aspects of the disease and should be ready to support the government in ensuring successful containment of the infection by adhering to the infection prevention measures and other strategies such as social distancing.[1],[4],[6]




  Implications For Practice Top




The decision to exit from lockdown is an important one, and the public health authorities should strengthen all aspects of the prevention and control services. It is very important that the members of the community are engaged and are empowered with the right and specific information about how they can play their part in reducing the transmission or acquisition of the infection. As all the educational institutions and workplaces were closed during the lockdown, it becomes the responsibility of the administrators of individual institutions to strengthen the infection control practices within their settings.[7],[8],[9],[10] There has to be a specific policy drafted on the lines of government recommendations, and all measures should be kept in place to avert the possibility of emergence of infection or establishment of a standard operating procedure to approach the situation, if a suspect case is reported.[7]




  Implications For Research Top




As a matter of fact, owing to the novel nature of the viral infection, all the aspects of the infection–epidemiology, clinical spectrum, management, development of vaccine or drug, and prophylaxis measures require extensive research. It is the responsibility of the policymakers to invest and intensify research activities in the field of COVID-19. With regard to the successful revoking of lockdown, the public health authorities should have a strict monitoring toward the rise in the number of cases or deaths, as lockdown is gradually revoked. These results of research should be employed in other settings as they undergo relaxation so that previous mistakes can be avoided.




  Conclusion Top




The decision to impose a lockdown has been an effective strategy to reduce the risk of transmission. However, it is also important to plan for revoking the same, and this will obviously require strengthening of the health system and the complete support from the community.



Financial support and sponsorship



Nil.



Conflicts of interest



There are no conflicts of interest.



 
  References Top

1.
Lau H, Khosrawipour V, Kocbach P, Mikolajczyk A, Schubert J, Bania J, et al. The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China. J Travel Med 2020;27:taaa037.  Back to cited text no. 1
    
2.
World Health Organization. Weekly Epidemiological Update - 5 January 2021; 2021. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update---5-january-2021. [Last accessed on 2021 Jan 05].  Back to cited text no. 2
    
3.
Ravi RC. Lockdown of colleges and universities due to COVID-19: Any impact on the educational system in India? J Educ Health Promot 2020;9:209.  Back to cited text no. 3
    
4.
World Health Organization. 2019 Novel Coronavirus (2019nCoV): Strategic preparedness and response plan. Geneva: WHO press; 2020. p. 1-20.  Back to cited text no. 4
    
5.
World Health Organization. WHO Director-General's Opening Remarks at the Media Briefing on COVID - 19-10 April 2020; 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---10-april-2020. [Last accessed on 2020 Nov 30].  Back to cited text no. 5
    
6.
Shrivastava SR, Shrivastava PS. Minimizing the risk of international spread of coronavirus disease 2019 (COVID-19) outbreak by targeting travelers. J Acute Dis 2020;9:47-8.  Back to cited text no. 6
  [Full text]  
7.
Cresswell K, Dhami S, Sheikh A. National COVID-19 lockdown exit strategies need to pay more attention to community engagement and workplace safety. J Glob Health 2020;10:020323.  Back to cited text no. 7
    
8.
Sheikh A, Sheikh A, Sheikh Z, Dhami S. Reopening schools after the COVID-19 lockdown. J Glob Health 2020;10:010376.  Back to cited text no. 8
    
9.
Dawoud D. Emerging from the other end: Key measures for a successful COVID-19 lockdown exit strategy and the potential contribution of pharmacists. Res Social Adm Pharm 2021;17:1950-3.  Back to cited text no. 9
    
10.
Sheikh A, Sheikh A, Sheikh Z, Dhami S, Sridhar D. What's the way out? Potential exit strategies from the COVID-19 lockdown. J Glob Health 2020;10:010370.  Back to cited text no. 10
    




 

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Introduction
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Exiting From Loc...
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