Abstract
Four billion people worldwide have experienced coronavirus disease 2019 (COVID-19) confinement. Such unprecedented extent of mobility restriction to curb the COVID-19 pandemic may have profound impacts on how individuals live, travel and retain well-being. This systematic review aims to identify (i) the social consequences of mass quarantine—community-wide movement restrictions—during previous and current infectious disease outbreaks and (ii) recommended strategies to mitigate the negative social implications of COVID-19 lockdowns. Considering social determinants of health, we conducted a systematic review by searching five databases (Ovid-MEDLINE, EMBASE, PsycINFO, China National Knowledge Infrastructure and the World Health Organization COVID-19 database) for publications from inception to 9 April 2020. No limitation was set on language, location or study type. Studies that (i) contained peer-reviewed original empirical evidence and (ii) focussed on non-epidemiological implications of mass quarantine were included. We thematically synthesized and reported data due to heterogeneous disease and country context. Of 3067 publications found, 15 original peer-reviewed articles were selected for full-text extraction. Psychological distress, heightened communication inequalities, food insecurity, economic challenges, diminished access to health care, alternative delivery of education and gender-based violence were identified as negative social consequences of community-based quarantine in six infectious disease epidemics, including the current COVID-19 pandemic. In contrast, altruistic attitudes were identified as a positive consequence during previous quarantines. Diverse psychological and social consequences of mass quarantine in previous and current epidemics were evident, but individual country policies had been highly varied in how well they addressed the needs of affected individuals, especially those who are socially marginalized. Policymakers should balance the pros and cons of movement restrictions, facilitate multisectoral action to tackle social inequalities, provide clear and coherent guidance to the public and undertake time-bound policy evaluations to mitigate the negative impact of COVID-19 lockdowns and to establish preparedness strategies for future epidemics.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic has become the largest global health emergency of the 21st century
NU Social consequences of mass quarantine MA We identified seven types of social consequences of mass quarantine (Table 4): psychological distress (n=11), heightened communication inequalities (n=9), food insecurity (n=8), economic challenges (n=7), diminished health care access (n=6), adjustment for school
T response to epidemics, the needs of populations affected by movement restrictions, especially IP those who are socially and economically vulnerable, were not sufficiently addressed
Summary
The coronavirus disease 2019 (COVID-19) pandemic has become the largest global health emergency of the 21st century. Mass CO quarantine could be a double-edged sword: while community-wide containment has been N shown to effectively decelerate the epidemic, it has profound impacts on how individuals live, Utravel, and retain their well-being.[8] Four review articles have identified negative implications of quarantine affecting public mental health and access to education.[9,10,11,12] In the current response to the COVID-19 pandemic, scholars have raised concerns over travel, ethical, legal, and equity challenges during confinement.[13,14,15,16] no studies have systematically assessed the social consequences of mass quarantine, defined as the impact of large-scale population-based containment with movement restrictions on individuals in specific social contexts.[17] Little is known about the negative implications of community confinement that countries should consider in developing mitigation strategies in managing the current.
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