Pre-lockdown Phase Research Articles

Unravelling Bangalore's air quality during the second wave: Multifaceted analysis of COVID-19 lockdown impact

This study assesses the impact of the second wave COVID-19 lockdown (March–June 2021) on air pollution levels in Bangalore, India, using real-time data from eight CPCB monitoring stations across the city. This research endeavours to dissect the multifaceted impact of the 2021 ​s wave COVID-19 lockdown on Bangalore's air quality. Leveraging real-time data sourced from eight CPCB monitoring stations across the city, the study meticulously delves into diverse analyses to grasp the nuanced implications of the lockdown measures. It scrutinizes changes in six major pollutants: PM2.5, PM10, CO, NO2, SO2, and O3 during the 2021 lockdown compared to the same period in 2020. The comprehensive studies of different temporal scales were examined such as daily, weekly, and seasonal. The daily and weekly averages were computed to assess the percentage change in air pollutant concentrations during the March to June 2021 lockdown and pre-lockdown phases. The seasonal averages were derived to capture trends in seasonal variations. The examination of air pollution disparities across the city's eight monitoring stations (ST1 to ST8), unravelling localized variations and comprehending the spatial intricacies influencing air quality levels within Bangalore. The comparison of air pollution concentrations between the 2021 and 2020 lockdown periods, offering insights into relative changes in pollutant levels. The concentrations during the 2021 lockdown period (April 27 to June 14) significantly dropped compared to the pre-lockdown phase (March 9 to April 26) by considerable percentages across various pollutants: PM2.5 (45 %), PM10 (49 %), O3 (37 %), NO2 (41 %), SO2 (5 %), and CO (30 %). The comparative evaluation between air pollutant intensity changes during the common lockdown periods of the first wave (2020) and the second wave (2021) of COVID-19. This contiguity illuminates the shifts in pollution levels and underscores the differing dynamics of air quality between these distinct phases. This research provides comprehensive insights into air quality over Bangalore city during the second wave lockdown. The multifaceted analyses offer a detailed understanding of temporal, spatial, and comparative facets of air pollution dynamics, shedding light on the significant impact of COVID-19 restrictions on urban air quality.

How Did the COVID-19 Lockdown Pandemic Affect the Depression Symptomatology in Mediterranean Older Adults with Metabolic Syndrome?

Background and Aims. To control the COVID-19 spread, in March 2020, a forced home lockdown was established in Spain. In the present study, we aimed to assess the effect of mobility and social COVID-19-established restrictions on depressive symptomatology in older adults with metabolic syndrome. We hypothesize that severe restrictions might have resulted in detrimental changes in depressive symptomatology. Methods. 2,312 PREDIMED-Plus study participants ( men = 53.9 %; mean age = 64.9 ± 4.8 years) who completed a COVID-19 lockdown questionnaire to assess the severity of restrictions/lockdown and the validated Spanish version of the Beck Depression Inventory-II (BDI-II) during the three established phases concerning the COVID-19 lockdown in Spain (prelockdown, lockdown, and postlockdown) were included in this longitudinal analysis. Participants were categorized according to high or low lockdown severity. Analyses of covariance were performed to assess changes in depressive symptomatology across lockdown phases. Results. No significant differences in participant depression symptomatology changes were observed between lockdown severity categories (low/high) at the studied phases. During the lockdown phase, participants showed a decrease in BDI-II score compared to the prelockdown phase (mean (95% CI), -0.48 (-0.24, -0.72), P < 0.001 ); a nonsignificantly larger decrease was observed in participants allocated in the low-lockdown category (low: -0.59 (-0.95, -0.23), high: -0.43 (-0.67, -0.19)). Similar decreases in depression symptomatology were found for the physical environment dimension. The post- and prelockdown phase BDI-II scores were roughly similar. Conclusions. The COVID-19 pandemic lockdown was associated with a decrease in depressive symptomatology that returned to prelockdown levels after the lockdown. The degree of lockdown was not associated with depressive symptomatology. The potential preventive role of the physical environment and social interactions on mental disorders during forced home lockdown should be further studied. This trial is registered with ISRCTN89898870. Retrospectively registered on 24 July 2014.

The Effect of Nationwide Lockdown in India on the Epidemiology of Injuries During the First Wave of COVID-19

Background. The pattern of hospital admissions and medical care changed during the COVID pandemic.
 The aim of the study to describe the nature of patients attending the orthopedic emergency department of a level 1 trauma center in terms of number and proportion based on demographic characteristics and the nature of the injury before the lockdown, during the lockdown, and during the unlocking period of the nationwide lockdown for controlling the COVID-19 pandemic in India.
 Methods. We conducted a longitudinal study from 01.01.2020 to 31.12.2020. Patients attending the orthopedic emergency were grouped based on cause, type, and site of injury. The median number observed each day with IQR. The distribution of the same was compared between the prelockdown with lockdown period and the lockdown period with a phased unlocking period.
 Results. A total of 10513 patients were included. There was a statistically significant reduction in the proportion of patients needing inpatient care between the prelockdown phase and lockdown phase (p = 0.008). However, this was not seen between lockdown and postlockdown periods (p = 0.47). The proportion of road traffic accidents dropped from 26% to 15% during this time (p0.001). The proportion of contusions was reduced and that of soft tissue injuries increased (p0.001). The proportion of lower limb injuries decreased from the prelockdown phase to the lockdown phase, and that of spinal injury patients increased (p = 0.007). The proportion of patients with contusions increased and soft tissue injuries decreased during this period (p0.001). Lower limb injuries and road traffic accidents increased, and spinal injuries were reduced (p0.001).
 Conclusion. The lockdown for controlling the spread of the pandemic affected the demographic and epidemiological aspects of injuries attending the orthopedic emergency department of a level 1 trauma center in a developing country. There was a decrease in the proportion of females and children attending the ED during the lockdown. The number of road traffic accedents s decreased during the lockdown. The number of patients with contusions attending the trauma center during the lockdown decreased, but there was an increase in the number of patients with spine injuries. We suggest that improvement in triage facilities, wider use of telemedicine, and increasing the stock of PPEs are essential for tackling such situations in the future.

Impact of COVID-19 Lockdown on Mental Health, Physical Activity, and Eating Behaviours Among IT Professionals in India

Governments took preventive measures like lockdown to curb the spread of the global COVID-19 pandemic, which affected mental health of many, their eating behaviours, and physical activity. This study focused on evaluating the impact of the COVID-19 lockdown on these aspects among IT professionals considering their change in working patterns. This was a web-based cross-sectional study conducted in Pune city. A total of 103 participants participated in the study by completing an online structured questionnaire shared through various social media platforms. Information regarding their vitals, physical activity, and eating behaviour was collected. The DASS-21 scale was used to assess mental health. The prevalence of stress, anxiety, and depression among IT professionals was found as 20.4 %, 44.7 %, and 35.9 %, respectively. Based on their BMI, the majority of the population was obese (63 %), and almost 57 % thought their body weight had increased during the lockdown. Participants doing any kind of physical activity significantly dropped down during the lockdown as compared to the pre-lockdown phase (p < 0.001). Stress levels were significantly higher among the obese participants (p < 0.01). Anxiety was observed to be significantly higher among the 20 to 34 year-old male participants (p < 0.05). Ready-to-eat snacks, instant noodles and easy to cook foods, Indian sweets, and confectionery showed a significant positive correlation with high levels of stress, anxiety, and depression (p < 0.05). Thus, a negative impact of COVID-19 and a subsequent lockdown was observed on the mental health and eating patterns among IT professionals.

Effects of Nationwide Lockdown due to COVID-19 on Ambient Air Quality in the State of West Bengal, India

The present study assessed the nationwide lockdown impacts on the air pollution situation across West Bengal, India. Air pollution data was collected from the online monitoring stations of the Central Pollution Control Board across West Bengal. The gradual declining pattern of overall pollution status was observed during the lockdown phase from the pre-lockdown phase. The early unlocking stage found slow and gradual increasing air pollution levels. Siliguri’s pre-lockdown ‘poor’ Air Quality Index (AQI) improved in the lockdown phase to ‘satisfactory’ level. ‘Moderate’ level AQI in Asansol of the pre-lockdown stage improved to ‘satisfactory’ level during the lockdown phase. Pre-lockdown AQI of both Kolkata and Howrah changed from ‘moderate’ to ‘good’ level during the lockdown phase. Unlike other pollutants, the ozone level increased in Kolkata, Howrah, and Siliguri in the lockdown phase. The early monsoonal washout possibly caused the changes in the pattern of pollution status of specified periods in the 2019 and 2020. Thus, in the study period of lockdown in 2020, the decrease in pollution level may not only caused by the stoppage of vehicles or industry but also have a possible natural influence.

Variations in local, transported, and exposure risks of PM2.5 pollution: Insights from long-term monitoring data in mega coastal city

Urban air quality is influenced by both local and external sources of pollution. The outbreak of Coronavirus COVID-19 had led to implementation of stringent lockdowns at different levels of governance. National Level Lockdown (NLL) was imposed in 2020 and State Level Lockdown (SLL), in 2021 to curb the spread of disease. A direct consequence of lockdown is the dramatic improvement of air quality in various urban agglomerations. The present study investigated the effects of national and regional lockdown on PM2.5 levels at various urban morphological units in the Chennai Metropolitan Region, the fourth-largest urban conglomeration in India. Hourly measurements of PM2.5 over a 6-year period (2016–2021) at three monitoring sites in Chennai were segregated into Pre-lockdown Phase (PLP) (2016–2019), NLL, and SLL to analyze reductions in PM2.5 levels. Local PM2.5 sources were investigated using Conditional Bivariate Probability Function (CBPF) whereas transported PM2.5 was evaluated using Concentration Weighted Trajectory (CWT) and Cluster Analysis. The results showed that PM2.5 in Chennai Metropolitan Region reduced by 33.45% during NLL and 48.95% during SLL when compared to PLP. Mann Kendall Test showed a statistically significant (p < .001) decreasing PM2.5 trend at Manali Monitoring Site, Alandur Monitoring Site, and Velachery Monitoring Site. CBPF showed variations in local contributions for all sites during the selected time frames. CWT and Cluster analysis showed reductions in transported PM2.5 during NLL and SLL when compared to PLP. Health Risk Assessment using Integrated Exposure Response (IER) model function showed a decreasing trend of excess mortality for various health endpoints over 6-year period. Steep reductions in excess mortality cases were observed during NLL and SLL. The results show that lockdown implemented at the state level proved to be more effective than the national level in reducing PM2.5 levels over Chennai metropolitan Region.

Effect of COVID-19-induced lockdown on NO2 pollution using TROPOMI and ground-based CPCB observations in Delhi NCR, India.

The present study investigates the reduction in nitrogen dioxide (NO2) levels using satellite-based (Sentinel-5P TROPOMI) and ground-based (Central Pollution Control Board) observations of 2020. The lockdown duration, monthly, seasonal and annual changes in NO2 were assessed comparing the similar time period in 2019. The study also examines the role of atmospheric parameters like wind speed, air temperature, relative humidity, solar radiation and atmospheric pressure in altering the monthly and annual values of the pollutant. It was ascertained that there was a mean reduction of ~ 61% (~ 66.5%), ~ 58% (~ 51%) in daily mean NO2 pollution during lockdown phase 1 when compared with similar period of 2019 and pre-lockdown phase in 2020 from ground-based (satellite-based) measurements. April month with ~ 57% (~ 57%), summer season with ~ 48% (~ 32%) decline and an annual reduction of ~ 20% (~ 18%) in tropospheric NO2 values were observed (p < 0.001) compared to similar time periods of 2019. It was assessed that the meteorological parameters remained almost similar during various parts of the year in 2019 and 2020, indicating a negligent role in reducing the values of atmospheric pollution, particularly NO2 in the study area. It was concluded that the halt in anthropogenic activities and associated factors was mainly responsible for the reduced values in the Delhi conglomerate. Similar work can be proposed for other pollutants to holistically describe the pollution scenario as an aftermath of COVID-19-induced lockdown.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10661-022-10362-8.

Significant effect of COVID-19 induced lockdown on air quality of the Indian Metropolitan City Kolkata using Air Quality Index and Health Air Quality Index

The lockdown, commencing in India from March 23, 2020 to control the escalation of Covid-19 cases, exhibited a positive impact on the air quality. The study attempts to assess the outcome of lockdown on the air quality of Kolkata, India followed by the comparison of six priority pollutants during pre-lockdown, lockdown, and unlock phases. Averaged concentrations of PM10 (72%), PM2.5 (73%), NOx (84%), SO2 (48%), and CO (61%) showed reduction throughout lockdown in comparison with pre-lockdown phase, although no significant reduction was observed in ground-level Ozone. Unlock Phases I and II showed similar concentrations of the pollutants as that in the lockdown period whereas, in unlock Phase-III, the air quality became comparable to that before lockdown. Statistical analysis confirmed that the reduction in air pollution is attributed to atmospheric factors. PCA analysis established significant positive correlation between particulate matters, CO, SO2, and NO x ; however, no significant correlation was observed between NO x and O3. January and December showed the highest load of most of the pollutants. Health risk was evaluated by calculating the Relative risk and Health Air Quality Index, which showed maximum health risk during the pre-lockdown and minimum during lockdown and unlock Phase-II with the highest contributor being PM10. The study outcome manifests a reduction in environmental pollution as a result of controlled anthropogenic activities.

COVID-19 pandemic and care of transfusion-dependent patients of thalassaemia: Experience from a paediatric centre in North India.

AimCovid‐19 has presented an unprecedented challenge to health services and has significantly affected the management of non‐Covid illnesses, like thalassemia. The present study documents the impact of Covid‐associated restrictions and disruptions on working of the pediatric thalassemia day care centre (TDCC), and measures taken by TDCC and blood transfusion services to adapt to and mitigate the negative impact of Covid pandemic and associated lockdown on patient care.MethodsPre‐transfusion haemoglobin and packed cell transfusion requirement were compared across three time periods, namely pre‐lockdown, lockdown and post‐lockdown in paediatric transfusion‐dependent thalassaemia (TDT) patients. Caregivers were interviewed to document any problems faced by them.ResultsThe study involved 181 TDT patients. There was a significant reduction in mean pre‐transfusion haemoglobin and red cells transfused during lockdown phase as compared to pre‐lockdown phase. Regular care was interrupted in 45% of patients and 76% of patients getting blood from outside could not get leukoreduced red cells. Investigations, monitoring and continuity of iron chelation were also affected. Blood centre faced 30.5% reduction in blood supply during lockdown. TDCC and blood centre took several steps, including prolongation of service hours and staggering of transfusions to ensure maximum transfusions while ensuring social distancing.ConclusionThe Covid‐19 pandemic imposed many unprecedented challenges to the routine care of thalassaemic patients; however, some of them could be dealt with by a proactive approach and micro‐planning at the institution level. Other similar resource‐limited settings could learn from experiences for continued quality care for chronic medical conditions during pandemic like situations.

Potential hotspot modeling and monitoring of PM2.5 concentration for sustainable environmental health in Maharashtra, India.

Modern human civilization has suffered from the disastrous impact of COVID-19, but it teaches us the lesson that the environment can restore its stability without human activity. The Government of India (GOI) has launched many strategies to prevent the situation of COVID-19, including a lockdown that has a great impact on the environment. The present study focuses on the analysis of Particulate Matter 2.5 (PM2.5) concentration levels in pre-locking, lockdown, and unlocking phases across ten major cities of Maharashtra (MH) that were the COVID hotspot of India during the COVID-19 outbreak; phase-wise and year-wise (2018–2020) hotspot analysis, box diagram and line graph methods were used to assess spatial variation in PM2.5 across MH cities. Our study showed that the PM2.5 concentration level was severe at pre-lockdown stage (January–March) and it decreased dramatically at the lockdown stage, later it also increased in its previous position at the unlocking stages, i.e., PM2.5 decreased dramatically (59%) during the lockdown period compared to the pre-lockdown period due to the shutdown of outdoor activities. It returns to its previous position due to the unlocking situation and increases (70%) compared to the lockdown period which illustrated the ups and downs of PM2.5 and ensures the position of different cities in the Air Quality Index (AQI) categories at different times. In the pre-lockdown phase, maximum PM2.5 concentration was in Navi Mumbai (NAV) (358) and Mumbai (MUM) (338), and Pune (PUN) (335) and Nashik NAS (325) subsequently, whereas at the last of the lockdown phase, it becomes Chandrapur (CHN) (82), Nagpur (NAG) (76), and Solapur (SOL) (45) subsequently. Hence, the restoration of the environment during the lockdown phase was temporary rather than permanent. Therefore, our findings propose that several effective policies of government such as relocation of polluting industries, short-term lockdown, odd–even vehicle number, installation of air purifier, and government strict initiatives are needed in making a sustainable environment.

Pre-to-post COVID-19 lockdown and their environmental impacts on Ghoghla beach and Somnath beach, India.

Environmental impact of COVID-19 imposed lockdown (2020) and the new normal condition (2021) on two different beaches of India (Ghoghla beach, Diu and Somnath beach, Veraval) were compared with the pre-lockdown era, 2013. The lockdown phase favored the natural restoration of the beaches and showed infinitesimal values of the parameters tested when compared with the pre-lockdown regime. However, the new normal situation in 2021 opened up the accessibility of these beaches to the tourists and pilgrims resulting in significant changes of water quality. The release of diluted sewage mixed with freshwater from the Somnath town to the sea has led to the drastic change in beach water quality. The mean cadmium concentration increased drastically in beach waters (Ghoghla: 1.35, 0.28 and 7.09 μg/L; Somnath: 0.45, 0.28 and 0.58 μg/L) during pre-to-post lockdown, respectively. However, post-lockdown resulted in the rise of toxic heavy metals in the sediments of Somnath beach but Ghoghla beach remained to be pristine which may be due to the Blue Flagship status. The total number of marine bacteria was higher during 2013 and 2021 when compared during lockdown describing greater human interventions. For instance, Vibrio spp. count in Ghoghla beach water during pre-lockdown phase was 7733 CFU/mL and this value reduced to 70 and 5 CFU/mL in the lockdown and post-lockdown phases. Interestingly, the diversity of planktonic and benthic components showed a different trend from pre-to-post lockdown due to significant change in the inorganic nutrients and metal bioaccumulation. To our knowledge, this will be the first comprehensive assessment to report the environmental and ecological health of Ghoghla beach and Somnath beach during the pre-to-post lockdown.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11356-022-21586-z.

Comprehensive analysis of ambient air quality during second lockdown in national capital territory of Delhi

The lockdown imposed in Delhi, due to the second wave of the COVID-19 pandemic has led to significant gains in air quality. Under the lockdown, restrictions were imposed on movement of people, operation of industrial establishments and hospitality sector amongst others. In the study, Air Quality Index and concentration trends of six pollutants, i.e. PM2.5, PM10, NO2, SO2, CO, and O3 were analysed for National Capital Territory of Delhi, India for three periods in 2021 (pre-lockdown: 15 March to 16 April 2021, lockdown: 17 April to 31 May 2021 and post-lockdown: 01 June to 30 June). Data for corresponding periods in 2018–2020 was also analysed. Lockdown period saw 6 days in satisfactory AQI category as against 0 days in the same category during the pre-lockdown period. Average PM2.5, PM10, NO2 and SO2 concentrations reduced by 22%, 31%, 25% and 28% respectively during lockdown phase as compared to pre-lockdown phase, while O3 was seen to increase. Variation in meteorological parameters and correlation of pollutants has also been examined. The significant improvement arising due to curtailment of certain activities in the lockdown period indicates the importance of local emission control, and helps improve the understanding of the dynamics of air pollution, thus highlighting policy areas to regulatory bodies for effective control of air pollution.

Impact of Covid-19 on Active Lifestyle, Physical Activity Behaviour and Physical Fitness of Adult Male Sportsmen of Delhi

Introduction:- The spread of COVID 19 infection led to nationwide lockdown and posed many difficulties for people to perform physical activities. Statement of Problem: The present study focuses on the impact of this COVID virus &amp; precautionary lockdown on the physical activity behavior, active lifestyle and physical fitness of adult male sportsmen of Delhi. Methodology: 500 sportsmen from all over Delhi were chosen through convenience sampling technique, who were actively participating in sports &amp; physical activities pre lockdown phase and their responses were recorded through a self-constructed questionnaire that consisted of 14 questions related to active lifestyle, physical activity routine pre &amp; post lockdown, condition of their physical fitness &amp; their views regarding future. Data Analysis:- The data collected was analyzed through descriptive statistics. Results: The results thus obtained revealed that the subjects emphasized on the active lifestyle, the fitness levels were affected adversely due to lockdown because of various reasons discussed in the paper. The results also revealed that although it was a great learning to perform physical activities through digital platform, but it should not be emphasized over traditional training methodology and the way to proceed in the future is the old way.

Effect of COVID-19 Pandemic on Hepatocellular Carcinoma Diagnosis: Results from a Tertiary Care Center in North-West Italy.

The COVID-19 pandemic has forced us to direct most of the available resources towards its management. This has led to the neglect of all other pathologies, including cancer. The aim of this study was to verify whether the difficulty in accessing the health system has led to a reduction in new diagnoses of hepatocellular carcinoma (HCC) and whether this has already been reflected in a more advanced stage of the cancer. A single-center, retrospective study including adult patients with a new diagnosis of HCC was performed. Patients were divided into three groups: the prelockdown phase (May 2019–February 2020), the lockdown phase (March 2020–December 2020), and the postlockdown phase (January 2021–October 2021); 247 patients were included. The number of patients diagnosed with HCC distinctly diminished in the periods March 2020–December 2020 (n = 69; −35%) and January 2021–October 2021 (n = 72; −32%) as compared to the period May 2019–February 2020 (n = 106). Noteworthy was the reduced surveillance in the period January 2021–October 2021 as compared to May 2019–February 2020 (22.9% vs. 36.6%, p = 0.056). No significant changes have yet been observed in tumor characteristics (BCLC staging distribution remained unvaried, p = 0.665). In conclusion, the number of new HCC diagnoses decreased sharply in the first 2 years of the pandemic, with no worsening of the stage. A more advanced stage of the disease could be expected in the next few years in patients who have escaped diagnosis.

Effects of COVID-19 lockdown and unlock on the health of tropical large river with associated human health risk.

River Damodar (India) is one of the most significant tropical large rivers and this river is carrying predominantly industrial effluents, urban sewage, and non-degradable chemical agricultural fertilizers. Several industries, cities, and townships directly depend on this important river throughout the year. It is highly essential to evaluate its surface water quality, characteristics, and improvement status during the COVID-19 lockdown and unlock phases. The major objectives of the present study are to analyse changing nature of heavy metals (Zn, Cd, Pb, Ni, Cr, and Fe) and microbial load (TVC, TC, and FC) of river water and to identify heavy metals impact on water quality and human health in pre, during, and after unlocking of COVID-19 lockdown. Here, a total of 33 water samples have been collected in the pre-lockdown, lockdown, and unlock phases. The results showed that decreasing trend of the microbial load was found in the lockdown phase. Heavy metal pollution index (HPI) illustrated that all samples are highly polluted (HPI > 150) during the pre-lockdown phase, while during the lockdown phase; HPI showed that around 54.54% of samples have been positively changed (low pollution level). During the unlock phase, 45.45% of samples were again amplified to the high pollution level. Pearson’s correlation coefficient and hierarchical cluster analysis indicated strong relation among heavy metals with faecal coliform at a 0.05% level of significance. Noncarcinogenic hazard index (HI) shows the higher possibility of health risk (HI > 1) particularly for children in all the phases and during the lockdown phase, 36.36% of samples showed no possible health risk for adults (HI < 1). However, HI of dermal contact showed no possible health risk for children and adults in the assessment periods. This applied research can definitely assist planners and administrators in making effective solutions regarding public health.

Effect of COVID-19 driven lockdown on social contact pattern in Puducherry, India: A longitudinal study.

This study was undertaken to assess the change in social contact and transmission dynamics among adults in the Puducherry district during the different phases of country-wide lockdown. Adults aged 18-69 years in Puducherry were assessed for frequency and duration of contacts in the following time points: prior to lockdown (March 2020), during lockdown, immediate post-lockdown (April, June 2020), and seven months post-lockdown (February 2021). Adjusted incidence rate ratios (aIRR) were obtained using a generalized estimating equation. We also assessed the exponential trajectory of the time-varying reproduction number (Rt) during and after lockdown. Compared to pre-lockdown phase, frequency of social contacts during 1st week, 4th week of lockdown, and immediate post-lockdown were reduced by 89% (aIRR = 0.11; 95% CI: 0.09-0.13), 40% (aIRR = 0.60; 95% CI: 0.52-0.69) and 91% (aIRR = 0.09; 95% CI: 0.07-0.10) respectively. However, the decline was not statistically significant at seven months post-lockdown. Correspondingly, we observed an initial spike in Rt during the lockdown phase followed by a gradual decline during the immediate post-lockdown phase. However, seven months post-lockdown, Rt has increased again. The study showed high compliance to the lockdown measures in Puducherry during the lockdown and immediate post-lockdown periods. However, as the lockdown measures were relaxed, the contact rate returned to the pre-lockdown state.

EP.WE.641Spectrum of Right Iliac Fossa Pain Presentation and Management During the First COVID-19 Lockdown: A Single Institution Experience

AimsAcute surgical presentations and management approaches have witnessed a changing pattern occasioned by COVID-19 pandemic and attendant lockdown. We report the spectrum of right iliac fossa (RIF) pain referrals and management trend within an acute surgical unit before and during the National lockdown.MethodsA retrospective review of all patients referred to the acute surgical unit with RIF pain before and during first National lockdown was undertaken. Patients managed during these periods were segregated into Pre-Lockdown (January-2020) and Lockdown (April/May-2020) cohorts. Relevant data were obtained from patients’ electronic medical records and main outcome measures compared between both arms were definitive diagnosis, rate of acute appendicitis, diagnostic imaging modality utilised, management approach and post-operative 30-day complications.ResultsRIF pain referrals were fewer (17% vs. 23%, P = 0.045) but more likely to be related to acute appendicitis during the lockdown (52% vs. 28%, P = 0.002). However, the risk of presenting with complicated appendicitis did not alter significantly (26% vs. 19%, RR = 1.34, P = 0.56). Diagnostic imaging was increasingly deployed (for RIF pain: 91% vs. 74%, P = 0.07; for appendicitis: 77% vs. 42%, P = 0.007) especially computerised tomography scan (45% vs. 31%). Increased adoption of conservative approach in the management of acute appendicitis was significant (61% vs 23%, RR 2.65, P = 0.01) although other outcomes such as length of stay, post-operative complication and 30-day re-presentation rates were comparable to pre-lockdown phase.ConclusionFewer RIF pain but more likelihood of acute appendicitis, increased use of radiological imaging and conservative approach to management reflect an evolving pattern during the lockdown phase.

Study of Comparison of Suicidal Cases in the Lockdown Period During First Wave of COVID-19 with that of Suicidal Cases in the Period before it among Dead Bodies Brought for Autopsy at Nalanda Medical College, Patna - A Record Review

Introduction: The COVID-19 pandemic has affected the entire world, physically, psychologically and socio-economically. It has caused extreme mental stress to not only those infected but also those who had to remain indoors for prolonged period due to lockdown. Aims and Objectives: 1. To study and compare all confirmed suicidal deaths in the first lockdown period upto its peak period (September 2020) with suicidal cases during the previous six months from October 2019 to 24th march 2020. 2. Demographic analysis of suicidal cases with determinants like incidence, sex, &amp; age wise distribution, mode of suicide, any specific causes etc, will be studied &amp; evaluated for any perceptible change from earlier prelockdwn suicidal deaths Materials and Methods: It is retrospective, record review analytical and comparative study based on postmortem examination reports of all cases conducted by all doctors of department of FMT, Nalanda Medical College, Patna who did autopsy during both periods (pre lockdown &amp; post lockdown/unlock) together with study of all police inquests, requisitions (challans), sent by the police investigating officers of concerned cases. Study period- a) 25th march 2020 to September 2020 (lockdown phase). b) October 2019 to 24th march 2020 (Prelockdown phase). Results: Total number of suicides increase from 6.61%in pre-covid period to 8.56% in lockdown period. In the prelockdown phase the cases of hanging were 66.66% but due to poisoning 33.34%. But in the lockdown phase hanging accounted for the 95.45% and poisoning just 4.55%. Conclusions: Lockdown must be needed based, preplanned and financial support to the needy together with behavioural counseling should be undertaken in letter and spirit. There is an urgency to realize the severity of this suicidal tendency.

Impact of lockdown in COVID-19 on glycemic control in patients with type 1 diabetes mellitus

In this small cross-sectional study on 52 pediactric patients with T1D, a structured questionnaire was administered on follow up within 15 days after lockdown during the COVID-19 pandemic. Of these 52 patients, 36.5% had hyperglycemic and 15.3% had hypoglycemic episodes. Insulin dose was missed in 26.9%, glucose monitoring was not performed routinely anymore in 36.5%, and 17.4% were not diet compliant during the lockdown period. Average blood glucose was higher during lockdown 276.9±64.7 mg/dl as compared to the pre-lockdown phase 212.3±57.9 mg/dl in the same patients. Mean HbA1c values were also much higher during lockdown (10±1.5%) than pre-lockdown (8.8±1.3%) and this difference was indeed statistically significant (P < 0.05).

COVID-19 and Federalism in India: Capturing the Effects of State and Central Responses on Mobility.

In response to the rapidly spreading COVID-19 pandemic, governments resorted to containment and closure measures to reduce population mobility and ensure social distancing. Initially, India’s state governments enacted varying social-distancing policies until the Central government overrode states to impose a nationwide lockdown on 24th March. This paper examines the relative impact of state- and central-level social-distancing policies on changes in mobility, comparing the periods before and after the national lockdown. A district-level panel dataset is formed, compiling data on social-distancing policies and changes in population mobility patterns. Panel regressions reveal that the incremental effect of each social-distancing policy varied across states in the pre-24th March period. The national lockdown led to much larger, though varying, reductions in mobility across all states. Overall, states which were able to achieve higher compliance in terms of reducing mobility in the pre-lockdown phase performed better in the national lockdown.Supplementary InformationThe online version contains supplementary material available at 10.1057/s41287-021-00463-4.