Local Lockdowns Research Articles

Kepemimpinan Strategis dalam Masa Krisis Pandemi Covid-19 (Belajar dari Pemimpin Daerah Kota Tegal)

The Covid-19 pandemic crisis is a test for Regional Leaders in showing their strategic leadership characteristics. One of the things that is interesting to study is the policy carried out by the Mayor of Tegal, which had caused controversy due to the announcement of the implementation of a local lockdown by closing the access to the inner city protocol roads and connecting roads between villages under his leadership. This research was made for the purpose of identifying and analyzing the strategic leadership of the Regional Leaders of the City of Tegal in overcoming the Covid-19 pandemic crisis and the impact of this leadership on Indonesia's national resilience. The method used is a qualitative approach with descriptive analysis techniques and secondary data collection through literature review. The results of the analysis of the Tegal Mayor's strategic leadership show efforts to facilitate the ability of the social system in Tegal City to adapt to the conditions of the Covid-19 pandemic and learn to overcome problems that arise. The strategic analysis is to implement strategic leadership through the objectives, methods and tools used to reduce the spread of Covid-19 in the Tegal City area. The role of human values and concern and cooperation of all parties is considered effective in dealing with crises. With these efforts, it can build stronger satisfaction and achievements in involving stakeholders who are more representative of the people's side.

Return Migration During Coronavirus Disease (COVID-19) Outbreak in Special Region of Yogyakarta, Indonesia

<p><em>Population mobility during pandemic becomes the concern for government since COVID-19 has known spreading through droplets. Special Region of Yogyakarta is one of the provinces in Indonesia that is dealing with the problem of population mobility, especially in return migration during the pandemic. This study aims to give short analysis on the potency of return migration. This study is essential both for academic and practitioner in managing population mobility during pandemic. The analysis was supported by statistical data from Ministry of Health of the Republic of Indonesia, news, and related journals. This study confirms that return migration during the pandemic plays a role in causing new transmission centers. It means that migrants have a role in carrying the virus, in which the severity of its spread is determined by the interactions between infected migrants and local community and between infected local community and other local community. Lockdown in the local level such as villages is considerably more effective rather than massive travel bans in regional level. Local lockdown is considered to be more effective because it makes easy in controlling and also give little impact to the economic condition. Social capital and grassroot involvement is key to stop this pandemic.</em></p>

The English Patient: Evaluating Local Lockdowns Using Real-Time COVID-19 & Consumption Data

We find UK “local lockdowns” of cities and small regions, focused on limiting how many people a household can interact with and in what settings, are effective in turning the tide on rising positive COVID-19 cases. Yet, by focusing on household mixing within the home, these local lockdowns have not inflicted the large declines in consumption observed in March 2020 when the first virus wave and first national lockdown occurred. Our study harnesses a new source of real-time, transaction-level consumption data that we show to be highly correlated with official statistics. The effectiveness of local lockdowns are evaluated applying a difference-in-difference approach which exploits nearby localities not subject to local lockdowns as comparison groups. Our findings indicate that policymakers may be able to contain virus outbreaks without killing local economies. However, the ultimate effectiveness of local lockdowns is expected to be highly dependent on co-ordination between regions and an effective system of testing.

Did the Covid-19 Local Lockdowns Reduce Business Activity? Evidence from UK SMEs

This paper analyses the local lockdown measures introduced to contain the spread of Covid-19 in the UK. We use a spatial regression discontinuity design to assess whether the fall in business activity during the lockdowns was driven by the policy measures or by other factors, such as voluntary social distancing. We conclude that the local lockdowns did causally reduce business activity but that activity would have probably fallen substantially even in the absence of the lockdowns. During the local lockdowns, the average turnover growth for SMEs in the UK was around -20%. SMEs that were up to two kilometres inside the lockdown boundaries had 8 percentage points lower turnover growth than those up to two kilometres outside. This implies that the local lockdowns accounted for two fifths of the overall drop in business activity at most. The estimates are largest for restaurants and non-food retail (eg clothes shops), which were directly targeted by the restrictions. Costs fell by much less than turnover, reducing cash flow.

Crime in the Era of COVID-19: Evidence from England

The rapid spread of the COVID-19 pandemic and the prescribed countermeasures of restrictions to mobility and social distancing are disrupting economic activity around the world. This applies to legal economic activity but also to criminal behavior and illegal activity. In this study, we investigate the effects of COVID-19-induced lockdowns on recorded crime in England. The enforcement of lockdowns in the country at both the national and local levels, temporally and spatially, allows unveiling the impact on criminal activities by type of shutdown policy. We use official crime data across the universe of local authorities dating back to May 2013 for recorded crime categories. We find that (1) National lockdowns decrease all types of criminal behavior, except for anti-social behavior and drug offences which are recording increases. (2) The increase in drug offences is solely due to an increase in policing during the lockdown. (3) Relaxing national lockdown restrictions attenuates the initial crime effects of strict lockdowns across all crimes. (4) Local lockdowns affect fewer crime categories, limited to increasing anti-social behavior and weapons possession offences and decreasing other theft violations, with findings being driven by late-entry areas of such policies. (5) A change in the local lockdown scheme implemented by the government in October 2020 does not have a markedly dissimilar effect on criminal activity compared to the earlier scheme. (6) Back-of-the-envelope calculations suggest that government-mandated lockdowns reduced the economic costs of crime by £6 billion for the country as a whole (in 2020 British pounds).

Different Mental Health Responses to the COVID-19 Pandemic: Latent Class Trajectory Analysis Using Longitudinal UK Data

Background: The UK population’s mental health declined at the pandemic onset. Convenience sample surveys indicate recovery began soon after. Using a probability sample, we tracked average mental health during the pandemic, characterised distinct mental health trajectories and identified predictors of deterioration.Methods: Secondary analysis of five waves of UK Household Longitudinal Survey from late April-early October 2020 and pre-pandemic data, 2018-2019. Mental health was assessed in 19,763 adults (≥16 years) using 12-item General Health Questionnaire. Latent class growth models identified discrete mental health trajectories and fixed-effects regression identified predictors of change in mental health.Findings: Average population mental health deteriorated with onset of the pandemic and did not begin improving until July 2020. Latent class analysis identified six distinct mental health trajectories up to October 2020. Three-quarters had consistently good (46·2%) or very good (30·9%) mental health. Two ‘recovery’ groups (15·8%) initially experienced marked declines in mental health, improving to their pre-pandemic levels by October. For 4·8%, mental health steadily deteriorated and for 2·3% it was very poor throughout. These two groups were more likely to have pre-existing mental or physical ill-health, live in deprived neighbourhoods and be non-white. Infection with COVID-19, local lockdown and financial difficulties all predicted subsequent mental health deterioration.Interpretation: Between April-October 2020, the mental health of most UK adults remained resilient or returned to pre-pandemic levels. One-in-fourteen experienced deteriorating or consistently poor mental health. People living in areas affected by lockdown, struggling financially, with pre-existing conditions or COVID infection might benefit most from early intervention.Funding Statement: None.Declaration of Interests: None.Ethics Approval Statement: Ethics approval was granted by the University of Essex Ethics Committee for the COVID-19 web and telephone surveys (ETH1920-1271).

Debt Expansion as “Relief and Rescue” at the Time of the Covid-19 Pandemic: Insights from the Legal Theory of Finance

Debt Expansion as "Relief and Rescue" at the Time of the Covid-19 Pandemic:Insights from the Legal Theory of Finance Iris H-Y Chiu (bio), Andreas Kokkinis (bio), and Andrea Miglionico (bio) I. Introduction The outbreak of the Covid-19 pandemic has led to a public health crisis of widespread contagion. As such, lockdowns have been imposed in many countries to limit face-to-face social interaction, thereby severely impacting economic activity and workplaces.1 The United Kingdom (UK) was "locked down" between March 23 and July 4, 2020, which resulted in the freezing of business activity for many sectors, such as brick-and-mortar retail (except groceries and pharmacies), travel and leisure, restaurants, public services, and service-based industries affected by social distancing such as transport, work-sharing facilities, leisure, hospitality, etc. Although many sectors have reopened since early July, the risks to public health have not subsided and emergency local lockdowns are being reimposed.2 It is estimated that economic output has been reduced in the UK by at least 20% compared to the [End Page 29] same period last year.3 Gross domestic product was reduced by 9.5% in the United States (US) in the second quarter of 2020.4 The financial implications of economic lockdown in so many sectors were immediate, as the corporate sector is heavily financialized.5 The freezing of business activity in hard-hit sectors has implications for their cash flow, servicing of debt, solvency, and market-valuation and credit-rating assessments. The economic woes for corporations inevitably affect households as redundancies have been gradually announced6 and wider macroeconomic uncertainties affect household income and welfare.7 Besides public finance packages for emergency help, such as furloughing8 and paycheck protection,9 policy makers have turned to private-sector finance to alleviate the financial stress and hardships caused to households and corporations during the pandemic. Private-sector finance is being relied on—to a significant extent, but not [End Page 30] exclusively—to meet the policy goals of "relief" and "rescue." "Relief" refers to the policy goal of giving corporations and households temporary release from the pressures of debt which would be exacerbated in the weak economic conditions during the pandemic. "Rescue" refers to the policy of facilitating the access of corporations to finance to keep them afloat in relation to expenses, losses, and shoring up capital for the future. The upshot of relief and rescue policies is that debt expansion, or the carrying of increased debt burdens for corporations and households, has been adopted as a key policy response to the financial woes of corporations and households during the pandemic. These policies are not dissimilar to those undertaken in many countries.10 The legal implementation of relief and rescue policies in the US, UK, and European Union (EU) involves legal and regulatory suspensions to facilitate a level of debt expansion that would normally have been limited by the operation of microprudential regulation for lenders and contractual constraints in debt arrangements. Further, the legalization of extraordinary fiscal and monetary policies has been carried out. This episode reflects how law and regulation have been made elastic in order to address crisis management and social needs.11 Reis and Vasconcelos argue that such elasticity is institutionally supported based on the expected macroeconomic behavior of agents in markets.12 Empirical evidence also offers support for the ex post efficiency and welfare effects of certain suspensions, particularly in private law agreements such as debt moratoria.13 Carruthers characterizes contractual suspensions as "financial decommodification," which is necessary when markets are temporarily dysfunctional.14 We situate the policies for relief and rescue within the theorization of legal elasticity in Pistor's legal theory of finance.15 This theorization, [End Page 31] drawn largely from observations during the global financial crisis of 2007-09,16 offers a path for structural reforms in law and regulation as part of post-crisis management.17 In particular, such theorization allows us to critically query the alleged temporary nature of the legal and regulatory suspensions during the pandemic. The theoretical insight drawn is that legal elasticity is often more structural in nature and will have to continue to apply to mitigate...

No cases of asymptomatic SARS-CoV-2 infection among healthcare staff in a city under lockdown restrictions: lessons to inform 'Operation Moonshot'.

ABSTRACTBackgroundLeicester was the first city in the UK to have ‘local lockdown’ measures imposed in response to high community rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. As part of this response, a directive was issued by NHS England to offer testing of asymptomatic healthcare workers (HCWs) at University Hospitals of Leicester NHS Trust (UHL) for SARS-CoV-2 infection.MethodsBetween 20 July and 14 August 2020, we invited all HCWs at UHL to attend for SARS-CoV-2 testing by nucleic acid amplification (NAAT). We combined the result of this assay with demographic information from the electronic staff record.ResultsA total of 1150 staff (~8% of the workforce) volunteered. The median age was 46 years (IQR 34–55), 972 (84.5%) were female; 234 (20.4%) were of South Asian and 58 (5.0%) of Black ethnicity; 564 (49.0%) were nurses/healthcare assistants. We found no cases of asymptomatic infection. In comparison, average community test positivity rate in Leicester city was 2.6%.ConclusionsWithin the context of local lockdowns due to high community transmission rates, voluntary testing of asymptomatic staff has low uptake and low yield and thus its premise and cost-effectiveness should be re-considered.

MANAGEMENT IN A TIME OF RADICAL UNCERTAINTY

Societies are still, now, indubitably, in the middle of a major sanitary and health crisis, all over. If April 2020 was a time of local lockdown in Asia, Europe and the Americas, it is expanding globally, and countries that are unable or unwilling to manage the spread of the disease are putting their health system as well as their social and economic activities under pressure, without ignoring the heavy toll on human populations. The impact of the Sars-CoV-2 and the resulting disease for humans is already tremendous, above 3 percent of GDP for the first quarter of 2020 and above 15 or 20 percent for the whole current year. According to the World Trade Organization (WTO 2020) the decline of global trade is reckoned between 13 and 32 % (OECD 2020).

Prediction-based analysis on power consumption gap under long-term emergency: A case in China under COVID-19

With the coronavirus pandemic wreathing havoc around the world, power industry has been hit hard due to the proposal of lockdown policies. However, the impact of lockdowns and shutdowns on the power system in different regions as well as periods of the pandemic can hardly be reflected on the foundation of current studies. In this paper, a prediction-based analysis method is developed to point out the electricity consumption gap resulted from the pandemic situation. The core of this method is a novel optimized grey prediction model, namely Rolling IMSGM(1,1) (Rolling Mechanism combined with grey model with initial condition as Maclaurin series), which achieves better prediction results in the face of long-term emergencies. A novel initial condition is adopted to track data with various characteristics in the form of higher-order polynomials, which are then determined by intelligent algorithms to realize accurate fitting. Historical power consumption data in China are utilized to carry out the monthly forecasts during COVID-19. Compared with other competitive models’ prediction results, the superiority of IMSGM(1,1) are demonstrated. Through analyzing the gap between predicted consumption values and the actual data, it can be found that the impact of the pandemic on electricity varies in different periods, which is related to its severity and the local lockdown policies. This study helps to understand the impact on power industry in the face of such an emergency intuitively so as to respond to possible future events.

Social Distancing in America: Understanding Long-term Adherence to COVID-19 Mitigation Recommendations

In the period from May to July, the United States repealed statewide and local lockdown measures, reopened society, and became the global leader in reported infections and deaths from the coronavirus COVID-19. During this timeframe, the country saw some of the largest civil rights protests in United States history, and increasing politicization of the pandemic leading up to the Presidential elections. Throughout these events, social distancing recommendations have remained in force. However, social distancing was no longer the focus of the public health response, and was largely overshadowed by face masks – despite evidence of its effectiveness for reducing virus transmission. This study examines to what extent Americans have continued to adhere to social distancing measures across these developments, and which factors sustained adherence. Our findings, based on three waves of nationally representative and cross-sectional studies conducted in May, June, and July, show that adherence to social distancing measures declined from May to July, as did knowledge of these measures, citizens’ practical capacity to adhere to them, and the social norms for adherence. At the same time, opportunities to violate these measures have increased. However, adherence levels stabilized in July, and support for social distancing measures among Americans has remained high throughout. These findings provide important insight into what motivated Americans to adhere to social distancing measures when distancing ceased to be the focus of the public health response. It thereby identifies important directions through which public health policy could sustain or promote adherence to mitigation measures in the United States.

Response of a non-governmental organisation to COVID-19

The COVID-19 pandemic has had a global impact with local or national lockdowns imposed in 172 countries. Morbidity and mortality due to the virus has seriously damaged both the health of populations and the economy. Government and non-governmental agencies (NGOs) have been hard pressed to respond meaningfully in the global crisis, the likes of which have not been experienced in recent times. A disability and development organization in India, a branch of a global non-governmental organization, reflects on the challenges and lessons learnt in responding to the crisis. The need to be alert, responsive, and consultative is highlighted.

Understanding public preferences and trade-offs for government responses during a pandemic: a protocol for a discrete choice experiment in the UK

IntroductionSocial distancing and lockdown measures are among the main government responses to the COVID-19 pandemic. These measures aim to limit the COVID-19 infection rate and reduce the mortality rate of...

The Discourse of Covids-19 Pandemic Policies in Indonesia

Since covid-19 has become pandemic, an abundance of coronavirus news fills the mass media throughout the world. The pandemic is constructed verbally from various perspectives for many purposes. In Indonesia, the discourse of the pandemic is not only about the disease, but also about other social issues related to the pandemic. Through certain discourses, the text producers may present various meanings. This study purposes to uncover social meanings presented in the discourses constructed by the mass media regarding the Indonesian government policies to cut the Covid-19 pandemic. Using a critical discourse analysis approach, the researchers analyze clauses containing three terms: Isolasi Mandiri, PSBB, and local lockdown from 28 downloaded texts. The focus of analysis is on the selection of lexico-grammar used to represent the policies to cut the chain of the pandemic. The result shows that there are three patterns in positioning participants regarding who has to take the responsibility for the implementation of the policies. The discourse about Isolasi Mandiri position residents as a party who has to be responsible and the government was positioned as the controller. The discourse of PSBB has positioned the government as a party that conducts and controls the implementation of the policies. The discourse of local lockdown represented that the policy was only as planning urged by the NGO and has not been conducted by the government. The context influencing the discourse is the socio-economic context. The discourses also show that the way media represented the policies is in line with the government agenda.

Effect of sub-urban scale lockdown on air pollution in Beijing

After recovering from epidemic COVID-19 by April, China suffered a setback in June with an outbreak in Xinfadi market in the Fengtai District in southwest Beijing. Decreased emissions of air pollutants has characterised cities under lockdown, which has led to observations of reduced pollutant levels particularly in cities such as Wuhan, where restrictions were strongly imposed earlier in 2020. Daxing the closest monitoring site, unsurprisingly shows the largest change before and during the local lockdown in terms of NO2 concentrations: 31.9 ± 8.8 μg m−3 just before and 21.2 ± 7.38 μg m−3 locked-down. Traffic flows and NO2 fell on Beijing's Third Ring Road, while rush hour CO peaks disappeared from some inner roads. The broad daytime peak in SO2 concentrations seems to remain, but the concentrations appear lower. The partial lockdown had a clear influence on human behaviour (expressed as mobile phone activity), visits to important sites, passengers and freight on roads and fuel production. These changes were broadly consistently with the reduced pollutant concentrations and their diurnal cycles. While the lockdown was restricted to a small part of Beijing in June 2020, the more general social response meant changes in pollutant concentrations were more broadly found across the core of Beijing.

Practice Implications for Acute Ischemic Stroke during the COVID-19 Pandemic for the Indian Scenario: Realistic and Achievable Recommendations by the Society of Neurocritical Care (SNCC), India.

COVID-19 disease caused by the SARS coronavirus has caused significant morbidity and mortality around the world ever since it was first declared as a pandemic by the World Health Organization (WHO) in March 2020. Acute neurological manifestations of this disease have also started emerging and being recognized around the world and acute ischemic stroke (AIS) or thrombotic stroke is becoming one of the major neurological illnesses related to COVID-19. The management of AIS is time-critical and major advances in its management over the recent years, such as bridging thrombolysis and mechanical thrombectomy (MT), are multidisciplinary activities requiring robust coordination and management in the acute setting. All these advances are severely challenged in the COVID-19 pandemic where severe pressures exist on the clinical resources and logistics required to deliver an effective stroke service. This is further compromised by legal and preventive measures during this pandemic like local lockdowns. Reporting of minor or initial symptoms has also been compromised due to the fear of approaching healthcare settings which are perceived as high-risk zones to catch the infection. The purpose of this document is to highlight these challenges and provide a guiding framework for the management of AIS under three principles: (a) Delivering an effective service, (b) Preventing infections within the healthcare setting, and (c) Optimizing resource utilization.How to cite this article: Kakkar G, Zirpe KG, Sapra H, Dixit S, Chugh C, Nagaiyan S, et al. Practice Implications for Acute Ischemic Stroke during the COVID-19 Pandemic for the Indian Scenario: Realistic and Achievable Recommendations by the Society of Neurocritical Care (SNCC), India. Indian J Crit Care Med 2020;24(9):757–762.

Tackling the COVID-19 pandemic: The Bangladesh perspective.

An outbreak of a COVID-19 pandemic disease, caused by a novel coronavirus SARS-CoV-2, has posed a serious threat to global human health. Bangladesh has also come under the attack of this viral disease. Here, we aimed to describe the responses of Bangladesh to tackle the COVID-19, particularly on how Bangladesh is dealing with this novel viral disease with its limited resources. The first case of a COVID-19 patient was detected in Bangladesh on March 8, 2020. Since then, a total of 263,503 peoples are officially reported as COVID-19 infected with 3,471 deaths until August 11, 2020. To combat the COVID-19, the government has taken various steps viz. diagnosis of the suspected cases, quarantine of doubted people and isolation of infected patients, local or regional lockdown, closure of all government and private offices, increase public awareness and enforce social distancing, etc. Moreover, to address the socio-economic situations, the government announced several financial stimulus packages of about USD 11.90 billion. However, the government got 3 months since the disease was first reported in China, but the country failed in making proper strategies including contact tracing, introducing antibody/antigen-based rapid detection kit, and also failed to make multi-disciplinary team to combat this disease. Further, limited testing facilities and inadequate treatment service along with public unawareness are the major challenges for Bangladesh to tackle this situation effectively. Along with the government, personal awareness and assistance of non-government organizations, private organizations, researchers, doctors, industrialists, and international organizations are firmly required to mitigate this highly contagious disease.Significance for public healthA novel coronavirus, named SARS-CoV-2, causes COVID-19 disease. This has emerged as a serious threat to human health and economy of the whole world. Bangladesh is one of the densely populated countries in the world, which also has come under attack of COVID-19. The first case of COVID-19 patient was detected in Bangladesh on March 8, 2020. Since then, a total of 30,205 peoples are officially reported as COVID-19 infected with 432 deaths. This lethal COVID- 19 drastically hit the economy of Bangladesh, with 170 million of inhabitants. The local and regional lockdown has already suspended almost all economic activities. However, limited health care service facilities of the country along with public unawareness are the major problems for Bangladesh to tackle this situation effectively. Of note, a large number of low-income workers, day-laborers need to go outside to earn daily income for their livelihood that causes mass transmission. Moreover, many hospitals, some doctors, nurses and other health officials are reluctant to provide treatment to COVID-19 patients and also non- COVID-19 patients. This report described the responses of Bangladesh to tackle the dreadful COVID-19 and discussed prevailing challenges, and how to mitigate this highly contagious disease with limited resources.

A Prospective Cohort Analysis of COVID-19 Positive and Negative Patients Admitted to a Single Centre in the North-East of England During the Peak of a Pandemic

Objectives: To investigate the clinical haematological, radiological and biochemical factors associated with outcome in COVID-19 positive patients in North East England (NEE) where mortality rates were higher during the peak of the pandemic.Design: Prospective single-centre cohort study.Setting: Acute Medical Admissions service at Darlington Memorial Hospital in North East England.Participants: 275 patients were admitted with either fever and/or respiratory symptoms of cough, chest pain or shortness of breath over a three-week period from 26th March 2020 to 12th April 2020, during the peak of the COVID-19 pandemic.Main Outcome Measures: Patient outcome (mortality) and admission to the intensive care unit or high dependency unit.Results: Mortality rates for COVID-19 positive patients treated at the DMH in NEE was higher than the UK-wide data, 30.8% vs 26% respectively. Similar to other studies, COVID-19 positive patients had a median age of 70 years, a higher proportion of males and a high level of comorbidities (such as type 2 diabetes and hypertension), but they were mot associated with outcome. Comparison with the UK wide data highlighted a much higher number of obese patients with a BMI >30 (DMH 60.8% vs UK 10.5%, p2 ≤93%) and an immunocompromised status. Conclusions: We report a regional study from a hospital in NEE which has been designated by the UK government to have a higher than average number of cases and a substantially worse outcome. This study shows higher mortality than the UK national statistics and the independent risk factors identified in our study differed from national and international data. This analysis of COVID-19 positive patients demonstrates the importance of understanding the variability of risk profiling in different regions of the UK and will contribute to better management of local lockdowns and similar pandemics in the future.Funding Statement: No specific funding received.Declaration of Interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.Ethics Approval Statement: Data was collected as part of the DARlington CoVid Epidemiology (DarCoVE) Audit (registration number 889, Clinical Audit Department, County Durham & Darlington NHS Foundation Trust, exempt from ethical approval for analysis of anonymised healthcare data and clinical service evaluation).

Business Sentiments in the Time of COVID-19

The implementation of COVID-19 lockdown in March 2020 in India provided a unique opportunity to capture real-time changes in business sentiments during episodes of unexpected and sudden disruptions. Using a logit-probability model to analyse data of this natural experiment showed that firms’ 6-months ahead sentiments for its financial condition worsened drastically during lockdown compared to firms surveyed immediately prior to the announcement. Further, smaller firms showed a relatively higher impact. We also find that firms perceive this as a relatively higher demand shock in terms of falling domestic sales post-lockdown whereas supply shocks are perceived to be on the downside. Lastly the mitigation strategy of firms involved reducing employment for unskilled workers and wages for skilled workers. This unique study gives insights not only about firms and their strategies but regarding appropriate policy choices during lockdown. The lessons are applicable for governments which imposed local lockdowns during the second wave and potential disruption for the expected third wave.

Impacts of lockdown during the SARS-CoV-2 pandemic on patients presenting with cervicofacial infection of odontogenic origin: a comparative study

The SARS-CoV-2 pandemic caused unprecedented disruption to primary and secondary healthcare services. Our aim was to explore whether the pandemic had had any impact on patients presenting with cervicofacial infections (CFI) of odontogenic origin to secondary care and management. Comparative analysis was carried out evaluating prospective and retrospective consecutively admitted patients with a diagnosis of CFI of odontogenic origin in the COVID-19 lockdown period from 15 March to 15 June 2020 and pre-COVID-19 during the same period of the previous year. Data included patients’ demographics, comorbidities, systemic inflammatory response syndrome (SIRS) status on admission, clinical features, prior treatment in primary care, source of referral, SARS-COV-2 antigen status, treatment received in secondary care, intraoperative findings, and whether escalation of the level of care was required. Across both cohorts there were one hundred and twenty-five (125) patients admitted with CFI of odontogenic origin, with a 33% reduction (n=75 (2019) vs n=50 (2020)) in number of patients admitted during COVID-19 lockdown. There was no difference between the cohorts in terms of age (p=0.192), gender (p=0.609) or major comorbidities (p=0.654). Proportionally more patients in the COVID-19 group presented with SIRS (p=0.004). This group of patients persisted with symptoms for longer before presenting to secondary care (p=0.003), more delay from hospital admission to surgical intervention (p<0.005) and had longer hospital stays (p=0.001). More patients required extraoral surgical drainage during COVID-19 (p=0.056). This study suggests that the COVID-19 lockdown has had adverse effects on the presentation of CFI of odontogenic origin and its management within a Regional Acute Maxillofacial Service. Commissioners and clinicians should endeavour to plan for adequate primary and secondary care provision during any future local lockdowns to ensure that patient care is optimised.