Strict Lockdown Research Articles

Overlooked voices under strict lockdown: mapping humanitarian needs in 2022 Shanghai COVID-19 outbreak

ABSTRACT The COVID-19 pandemic that emerged in 2020 has caused significant health crises worldwide. Countries and regions around the globe have practiced different policies to contain the pandemic. One commonly adopted strategy is the Zero-COVID policy, comprising two phases: an initial suppression phase, typically enforced through lockdowns, followed by a sustained containment phase. However, sudden and strict lockdown policies in the suppression phase would inevitably bring unexpected challenges to vulnerable populations. There is a need to identify the emergent needs of underprepared, vulnerable populations under lockdowns to inform future pandemic management. In this study, the messages posted on an online mutual help-requesting platform during the 2022 Shanghai lockdown were leveraged as the near real-time agent to represent the side effects of the lockdown policy. This work explores the spatiotemporal correlation of the posts to their potential influencing factors and mines knowledge from the textual content of the posts. The results indicate that the help requests were clustered in downtown Shanghai. The access to profuse medical resources and public services may be hindered in districts with more stringent lockdown policies. The help requests’ content unveils a need for medication and groceries under lockdown. It also underscores that the elderly population was affected most by the lockdown. Based on these insights, policymakers can better anticipate and address the urgent residential needs that may arise in future lockdowns. This knowledge can contribute to more effective planning and preparedness efforts to mitigate the impact on vulnerable populations and ensure their well-being during similar crisis situations.

The Impact of the COVID-19 Pandemic on Online Grocery Supply Chain Management: A Case Study in Istanbul

The COVID-19 pandemic has already crippled normal life all over the world. Its negative impact not only changed the human health system tragically but also disrupted the global economic system. One negative result was ended up in the global food supply chain. As the lockdown times have suspended the manufacturing and logistic activities, therefore, the customers have experienced unimaginable chaos in the shopping markets. Moreover, the purchasing habit of the consumers has remarkably changed compared to pre-pandemic. To meet this new demand pattern, many grocery retailers have tried to adapt to the new normal. While before COVID-19 offline grocery purchasing was popular, after the pandemic, online service got tremendous attention in market. In this study, online grocery supply chain management during the COVID-19 in Istanbul is considered. The aim is to find out how online grocery companies will serve more efficiently during the pandemics and which factors have more effect on the customer’s satisfaction. To do so, first, three popular grocery retailers in Istanbul were selected. Then, a related survey was designed to understand the consumer experience as doing online grocery shopping in COVID-19. Unsurprisingly, a result shows that 60% of the respondents did online shopping every 3-4 days in one week, and the delivery time is the most important factor for the customers. Then, the SWOT analyses were performed accordingly, and the related strategies were summarized. Finally, several managerial implications were given to may improve the company’s online services in COVID-19 and post COVID-19 in Turkey.

The third age interrupted: experiences of living in a retirement village during the first year of COVID-19 in Victoria, Australia

Abstract The COVID-19 pandemic in Australia has profoundly affected older adults, particularly in the state of Victoria, which experienced strict lockdown restrictions six times since the pandemic began in 2020; totalling 245 days over three years. This study explored the experiences of older adults living in retirement villages during the first three lockdowns in Victoria from March 2020 to February 2021. We draw on the concept of the ‘third age’ to explore how residents’ post-retirement social and lifestyle aspirations were disrupted by the pandemic and associated lockdowns. In-depth qualitative interviews were conducted with 14 residents during January and February 2021. All data were analysed using thematic mapping. Five key themes were identified: (1) benefits and frustrations of retirement village living during a pandemic; (2) the loss of amenities and activities; (3) heightened loneliness and social isolation; (4) reaching out to others; and (5) variable experiences of operators’ response. Although the COVID-19 pandemic has highlighted short-term and long-term issues around social isolation and the management of retirement villages, it has also demonstrated the resilience of residents and the strength of community ties and relationships. Retirement villages are promoted as age-friendly environments that enable an active and healthy post-retirement lifestyle. Yet our findings reveal heterogeneity within village populations. When services closed during lockdowns, this revealed a tension between the policy assumption that retirement villages are a housing consumption choice, and the unmet needs of those residents who depend on village services for day-to-day functioning.

Analysis of the educational and cultural activity of the Spanish government in social media: a comparison between pandemic and post-pandemic times

The COVID-19 pandemic challenged education systems as a whole, which had to act on emergency and without previous experience. The aim of this study is to examine the Spanish Government's response to the lockdown scenario through social media and the current (post-pandemic) activity. We collected the Twitter output of the 11 accounts linked to educational and cultural bodies and institutions of the Spanish Government and the interaction of citizens with them. We undertook analyses of social media output in pandemic and post-pandemic times. At the same time, we conducted a content analysis of the 126 tweets posted during the pandemic that had the greatest impact. The results point to increased production during the pandemic and a peak in interactions during the period of strict lockdown. The qualitative analysis reveals that Twitter is mainly used as an information and unidirectional communication board, where the Spanish Government's commitment to resources and tools based on open licences stands out, offering alternatives for Education in times of COVID-19, mainly to teachers. Finally, the analysis has allowed us to identify elements of success in social media communication.

Investigating epidemiological distribution (temporality and intensity) of respiratory pathogens following COVID-19 de-escalation process in Catalonia, September 2016-June 2021: Analysis of regional surveillance data.

Following the low incidence rates of non-SARS-CoV-2 respiratory viruses registered during the strict lockdown enforced in the pandemic, a resurgence of several endemic viruses in Catalonia (Spain) was noted during the early summer of 2021. In this study, we investigated whether the circulation of non-SARS-CoV-2 respiratory viruses in Catalonia, assessed by Microbiological Reporting System of Catalonia (MRSC) and the Epidemiological Surveillance Network of Catalonia, was affected by the strict lockdown measures, as well as, the implication of the Coronavirus Disease 19 (COVID-19) de-escalation process in the late season outbreaks registered during the 2020-2021 season. A retrospective comparison of epidemic patterns in the respiratory viruses' incidence, using regional public health surveillance data from MRSC, was performed between weeks 26/2016 to week 27/2021. Data were expressed as the weekly total number of test positivity for individual viruses. A segmented negative binomial regression model was conducted, with two parameters included (level and trend) for each segment of the time series (2020 pre-lockdown, 2020 post-lockdown and 2021). Results were reported as a unit changed in the strict lockdown. A total of 51588 confirmed cases of the different respiratory viruses were included in the analysis, the majority were influenza cases (63.7%). An immediate reduction in the weekly number of cases was observed in 2020 after the COVID-19 outbreak for human adenovirus virus (HAdV) (β2 = -2.606; P <0.01), human parainfluenza virus (HPIV) (β2 = -3.023; P <0.01), influenza virus (IFV) (β2 = -1.259; P <0.01), but not for respiratory syncytial virus (RSV), where the number of cases remained unchanged. During 2020, a significant negative trend was found for RSV (β3 = -0.170, P <0.01), and a positive trend for HAdV (β3 = 0.075, P <0.01). During 2021, a significant reduction in the weekly number of cases was also observed for all respiratory viruses, and a borderline non-significant reduction for HPIV (β3 = -0.027; P = 0.086). Moreover, significant positive trends were found for each viral pathogen, except for influenza during 2020-2021 season, where cases remained close to zero. The respiratory viruses increased activity and their late season epidemic start particularly affected children under 6 years old. Our data not only provides evidence that occurrence of different respiratory virus infections was affected by the strict lockdown taken against SARS-CoV-2 but it also shows a late resurgence of seasonal respiratory viruses' cases during the 2020-2021 season following the relaxation of COVID-19-targeted non-pharmaceutical interventions.

Can we predict a “tsunami”? Symptomatic and syndromal density, mood instability and treatment intensity in people with bipolar disorders under a strict and long lockdown

BackgroundConverging evidence supports the involvement of circadian rhythm disturbances in the course and morbidity of bipolar disorders (BD). During 2020, lockdown measures were introduced worldwide to contain the health crisis caused by the COVID-19 pandemic. As a result, chronobiological rhythms were critically disrupted and illness outcomes were expected to worsen. The current study aimed to explore changes in morbidity among BD patients living under lockdown. MethodsNinety BD outpatients under naturalistic treatment conditions were followed from March to September 2020 using a mood chart technique. Different treatment and illness variables, including mood instability, were assessed and compared with the outcomes obtained during the same 28-week period in 2019. ResultsFor most clinical variables, no significant differences were observed between time periods. A slight decrease was found in symptom intensity (from 15.19 ± 20.62 to 10.34 ± 15.79, FDR-adjusted p = 0.04) and in the number of depressive episodes (from 0.39 ± 0.74 to 0.22 ± 0.63, FDR-adjusted p = 0.03), whereas the intensity of pharmacological treatment remained unchanged. Previous illness course predicted mood outcomes during the confinement. LimitationsFollow-up periods were relatively short. Further, actigraphy or other methods capable of ensuring significant changes in physical activity were not used. ConclusionsIn line with other studies, our findings show no worsening in the clinical morbidity of BD patients during lockdown. This conspicuous contrast between our initial predictions and the observed findings highlights the fact that we are still far from being able to provide accurate predictive models for BD.

Medication abortion during the COVID-19 pandemic in France: A research based on the French national health insurance database.

During the COVID-19 pandemic in France, abortion was recognized as an essential service that cannot be delayed, and such care was therefore presumed to be maintained. The aim is to analyze the changes in the practice of abortion in 2020 to identify the consequences of the two lockdowns and the effects of the extension of the legal time limit. We analyzed the data collected by the French national health insurance system, which covers 99% of the population. All women who had an elective abortion, either surgical or with medication, in France in 2019 and 2020 were included in the study. Trend changes in abortions were analyzed by comparing the ratio of the weekly number of abortions in 2020 with the weekly number in 2019. Both 2020 lockdowns were followed by a drop in abortions, particularly after the first and stricter lockdown. This may be explained not by an abrupt shutdown of access to abortion services, but rather by a decrease in conceptions during the lockdown weeks. The decrease was more marked for surgical abortions than for medication abortions in a hospital setting, and less so for medication abortions in non-hospital settings. Moreover, the proportion of the latter type of abortions continued to increase, showing the reinforcement of a previous trend. Our findings indicate that expanding the legal time limit for abortion, diversifying the settings where abortions can be performed and the range of abortion providers help to facilitate access to this fundamental reproductive care.

Panic during Covid-19 Pandemic: An Analysis of Media Coverage in India

The COVID-19 pandemic came as a nightmare across the Globe. In time of crisis, people rely on Mass Media for information and updates on the present situation. News related to death rates and the shortage of proper medical infrastructure caused panic and anxiety. The infodemic created mental health concerns. The role of television became crucial as a source of information leaving behind the newspapers and magazines, which people refrained because of contactless preference of information. The BARC India report confirmed that a substantial jump in television viewership was seen during the Pandemic and the average time spent per day per viewer increased. After the onset of the coronavirus, India underwent a strict lockdown, which led people to be confined to their houses and television screens. This is a review-based paper to explore the Media coverage and the panic caused by the news coverage during the COVID-19 pandemic. Different news articles, journals, and studies related to Media coverage affecting people during COVID-19 were reviewed. The research is descriptive in nature and the data is secondary. In this study, prior research is combined to obtain a full overview of the research conducted in this area.

Strict COVID-19 lockdown and popular regime support in China

ABSTRACT In response to the COVID-19 crisis, China implemented lockdown measures that were the most stringent and enduring in the world. This study conducts the first systematic analysis of how China’s historic COVID-19 lockdown impacted popular support for the authoritarian regime. I argue that strict lockdowns have differential effects on popular regime support depending on their duration. A relatively short lockdown signals to citizens the state’s resolution and capacity to protect them from threats, thereby increasing their support. Long-lasting restrictions, however, cause excessive harm to their victims and ultimately turn the citizenry against the state. I utilize people’s varying exposure to the lockdown measures and two rounds of original surveys to provide evidence for the theory. The study contributes to our understanding of the effectiveness of authoritarian rule in managing major crises and highlights the role that fear and coercion play in maintaining authoritarian stability.

The incidence of dental fractures in the Italian population during the COVID-19 pandemic: An observational study.

The COVID-19 infection has become a pandemic after breaking out in China in the past months of 2019 and spreading rapidly worldwide. To counter this pandemic, several governments worldwide have taken several drastic measures to try to stop the spread of the virus, including a very strict lockdown that has caused a sudden and, in many cases, negative change in people's daily lives. In the literature, several studies have shown how the pandemic has significantly impaired many people's mental health, causing short- and long-term stress, anxiety, and sleep disturbances. This study aims to analyze the correlation between the stress caused by the COVID-19 pandemic and the parafunctions of the temporomandibular joint and masticatory muscles, which in turn, have led to an increase in the incidence of fractures and dental injuries. The ultimate goal is to understand the best choice the dentist must make in the preventive and therapeutic fields. A questionnaire called "Incidence of tooth fractures during the COVID-19 pandemic" was prepared using the Google® Forms platform. This questionnaire consists of 13 questions. This electronic questionnaire was addressed to all dentists in the Campania Region (ITA) and disseminated through social networks such as WhatsApp® or Facebook® or E-mail. A total of 730 dentists completed the survey. Of these, 450 (61.7%) stated that the number of patients reporting muscle and joint pain in the morning had increased during the COVID-19 pandemic. 414 (56.7%) dentists noted an increase in parafunction and 392 (53.6%) an increase in dental fractures during the pandemic period. As can be seen from the study results, an important correlation was found between the stress resulting from the COVID-19 pandemic and dental fractures. The dental elements treated endodontically, depending on the extent of the damage, require restoration, which is also the best preventive strategy in the case of dental fractures.

The Covid‐19 lesson from Sweden: Don't lock down

AbstractCovid‐19 triggered a wave of lockdowns across the world, contributing to a severe downturn in economic activity. Governments responded by introducing expansionary fiscal and monetary measures. We compare the health and economic outcomes in Sweden, commonly viewed as an outlier relying more on recommendations and voluntary adjustments than on strict lockdowns, with those of comparable European OECD countries. Our results suggest that the Swedish policy of advice and trust in the population to reduce social interactions voluntarily was relatively successful. Sweden combined low excess death rates with relatively small economic costs. In future pandemics, policymakers should rely on empirical evidence rather than panicking and adopting extreme measures. Even if policymakers appeared to act rapidly and decisively, the rushed implementation of strict lockdowns in 2020/21 probably did more harm than good.

A Comparative Analysis of COVID-19 Response Measures and Their Impact on Mortality Rate

(1) Background: The coronavirus disease 2019 (COVID-19) pandemic significantly affected the population worldwide, with varying responses implemented to control its spread. This study aimed to compare the epidemic data compiled by the World Health Organization (WHO) to understand the impact of the measures adopted by each country on the mortality rate. (2) Methods: The increase or decrease in the number of confirmed cases was understood in logarithmic terms, for which logarithmic growth rates “K” were used. The mortality rate was calculated as the percentage of deaths from the confirmed cases, which was also used for logarithmic comparison. (3) Results: Countries that effectively detected and isolated patients had a mortality rate 10 times lower than those who did not. Although strict lockdowns were once effective, they could not be implemented on an ongoing basis. After their cancellation, large outbreaks occurred because of medical breakdowns. The virus variants mutated with increased infectivity, which impeded the measures that were once effective, including vaccinations. Although the designs of mRNA vaccines were renewed, they could not keep up with the virus mutation rate. The only effective defence lies in steadily identifying and isolating patients. (4) Conclusions: these findings have crucial implications for the complete containment of the pandemic and future pandemic preparedness.

Analyzing emergency call volume, call durations, and unanswered calls during the first two waves of the COVID-19 pandemic compared to 2019: An observational study of routine data from seven bavarian dispatch centres

BackgroundThe spread of the COVID-19 pandemic and the corresponding implementation of measures such as stay-at-home orders and curfews had a major impact on health systems, including emergency medical services. This study examined the effect of the pandemic on call volumes, duration of calls and unanswered calls to the emergency number 112. MethodFor this retrospective, descriptive study, 986,650 calls to seven emergency dispatch centres in Bavaria between January 01, 2019 and May 31, 2021 were analysed. The absolute number of calls and calls per 100,000 inhabitants as well as the number of unanswered calls are reported. The Mann‒Whitney U test was used to compare mean call durations between 2019 and 2020/2021 during several periods. ResultsCall volume declined during the pandemic, especially during periods with strict lockdown restrictions. The largest decline (−12.9 %) occurred during the first lockdown. The largest reduction in the number of emergency calls overall (−25.3 %) occurred on weekends during the second lockdown. Emergency call duration increased, with the largest increase (+13 s) occurring during the “light” lockdown. The number of unanswered calls remained at a similar level as before the pandemic. ConclusionThis study showed that the studied Bavarian dispatch centres experienced lower call volumes and longer call durations during the first two waves of the COVID-19 pandemic (up to May 2021). Longer call durations could be the result of additional questions to identify potentially infectious patients. The fact that the number of unanswered calls hardly changed may indicate that the dispatch centres were not overwhelmed during the study period.

Changes in park visits and the shift towards rural recreation: Evidence from the COVID-19 pandemic in the UK

The spread of COVID-19 and corresponding government interventions have changed residents’ travel and mobility, and recent academic literatures suggests that this have had a positive impact on rural recreation. This study analyzed the impact of the COVID-19 pandemic on rural recreation from the perspective of population mobility, aiming to explore the changes in park visits during the pandemic, identify the motivation and demand of urban residents for leisure activities under the impact of the pandemic and to test the hypothesis of the accelerating the shift to rural recreation. Using the UK as the case study, it compared the park visits in four stages according to the COVID-19 policies: pre-, strict, eased, and fully lifted lockdown. Based on multivariate datasets, stepwise regression models of park visits in urban areas of 25 counties in the UK during each stage were constructed and compared. The results showed that residents preferred to visit smaller parks before and in the early stage of the pandemic. In the strict lockdown stage, the movement of residents to parks decreased significantly. During the eased lockdown period, park visits increased significantly, but there was clear spatial variation across the country attributed to the severity of the pandemic in each region, and different control policies of local governments. During the period when the lockdown was fully lifted, the frequency of park visits remained an increasing trend compared to the baseline period but decreased slightly compared to the eased lockdown period due to the increasing number of park visitors and more crowded park sites. Obviously, residents were more willing to visit distant country parks after an extended period of lockdown control, and mainly congregated in dispersed recreation sites such as the wilderness and forests that were distributed outside of urban areas and farther away. This study broadens the related literature using the evidence from changes of park visits, which to some extent confirms that the pandemic accelerates the leisure activities taking place from urban to suburban parks. The results can provide new inspiration for the future research on rural recreation and tourism, and also provide guidelines for planning peri-urban rural parks to prepare for future public health crises along with the population shift tendency.

Health-Related Quality of Life in Adolescents during Quarantines Due to COVID-19 Pandemic: The Effect of Physical Activity and Gender

Given that deterioration of adolescents’ health status during pandemic is well documented, health related quality of life (HRQoL) assessment is very important, as it contributes in adolescents’ development and maturation into healthy adults. The main purpose of the study was to assess adolescents’ HRQoL during the two strict lockdowns due to COVID-19. Secondary aims were to examine differences in HRQoL with regard to gender, and physical activity/sport participation before and during lockdowns. It was a cross-sectional study and conducted during first and second strict lockdowns. Three hundred and sixty-three adolescents (Ν=363) from secondary schools, in the Greek territory (108 boys and 255 girls) filled in the TNO-AZL Questionnaire for Children’s Health-Related Quality of Life Children’s Form, online, once. Also, demographic and anthropometric data were collected. For all TACQOL-CF subscales results showed that scores were lower, than the maximum subscales scores. Also, adolescents’ responses to open questions supported further the low subscales scores. In addition, adolescents who participated in sport before lockdowns reported better scores in motor functioning/performance during lockdowns than their non-physically active peers (p&lt;0.05). Moreover, girls reported significantly lower scores compared to boys in general physical functioning/complaints subscale (p&lt;0.05). The findings of this study highlighted that during the two strict quarantines adolescents’ HRQoL was deteriorated. Sport participation before the pandemic influenced positive HRQoL during quarantines and also quarantines affected differently adolescents by gender. Thus, the results should give information in adopting preventive strategies by policy makers to alleviate long-term negative consequences, in order adolescents to gain pre-pandemic HRQoL levels, in the transitional post-COVID-19 era.

Psychosocial stress, adult suicidal ideation, and the mediating effect of poor sleep quality during the COVID-19 pandemic in South Africa.

South Africa instituted one of the world's strictest lockdowns during the COVID-19 pandemic, which generated heightened conditions of psychosocial stress and posed widespread mental health risks. Despite the elevated burdens of suicidal behaviors and risk of psychiatric disease in the country, few studies have examined the impacts of psychosocial stress from the pandemic on suicidal ideation in South Africa. This study examined the association between psychosocial stress experienced under the COVID-19 pandemic and adult suicidal ideation, as well as degree to which sleep quality and duration mediated this relationship. An online survey assessed experiences of COVID-19 psychosocial stress, sleep quality and duration, and suicidal ideation in a sample of 189 South African adults during the second and third waves of the COVID-19 pandemic. A causal inference framework for mediation analysis was used to assess the degree to which sleep quality and duration explained the association between COVID-19 psychosocial stress and suicidal ideation. Suicidal ideation was reported in 21% of adults. Adults described having moderate sleep quality and an average of 6.9 hours of sleep per night. COVID-19 psychosocial stress significantly predicted adult suicidal ideation in fully adjusted models. Sleep quality, but not sleep duration, significantly mediated the association between COVID-19 psychosocial stress and suicidal ideation, accounting for 25.9% of the total effect. Poor sleep quality may play an important role in exacerbating the alarming stress-induced mental health effects of the COVID-19 pandemic. Further research is necessary to understand the underlying sleep dynamics and associated psychological and neurobiological processes that perpetuate adult suicidal ideation.

The Politics of State-level COVID-19 Responses in India: Evidence from the First Wave in 2020

We examine if policy interventions to curb the spread of COVID-19 were driven by political factors. We focus on the period between 1 June and 31 August 2020 when lockdowns and testing were the only responses available with governments and policymakers across the world. These instruments are costly. Stringent lockdowns post challenges to livelihoods while only testing without any lockdown accentuates health risks. This choice between life and livelihood becomes all the more pertinent in a developing country like India. We find that state governments in India that had upcoming elections, faced close margin victory in the last election, were non-incumbents and were aligned with the party at the centre adhered to aggressive testing as a strategy and did not impose strict lockdowns to avert losses in economic activity. Such policy responses indicate an attempt to avert possible losses in future elections. These findings confirm the strong role of political factors in policy decisions. JEL Codes: P52, P16, P36

Dynamic assessment of the COVID-19 lockdown in the Xinjiang region using night-time light remote sensing

ABSTRACT China used to have the world’s most stringent prevention policies during the COVID-19 pandemic. The strict lockdown in Xinjiang region in 2022 was considered to be the longest in the process of COVID-19 pandemic prevention. Therefore, we examined the dynamic effects of the COVID-19 lockdown in Xinjiang region using night-time light data. The findings showed that before the outbreak of COVID-19, the night-time light in Xinjiang region still maintained a significant growth. However, after the lockdown of COVID-19 in August 2022, the night-time light showed a significant decrease, especially in August. Urumqi's night-time light decreased by at least 25% compared to the non-lockdown, while that in other major cities was between 5% and 15%. After the lockdown was lifted in November 2022, the night-time light in Urumqi increased by at least 50% compared to the lockdown, while that in other major cities was generally less than 30%. The regions where night-time light decreased in Urumqi were mainly within a radius of 40 km, whereas that in other cities were mainly concentrated within a radius of 6 km. The changes in statistical data and night-time light indicated that the economic activities in Xinjiang region were significantly affected by the COVID-19 lockdown.

Impact of Lockdown on Air Quality in the Most Polluted Cities of India.

COVID-19 has become a global pandemic, prompting lockdowns in practically every country. To prevent the spread of the disease, India has enforced a rigorous nationwide lockdown that commenced in March 2020. The lockdown imposed amid the pandemic ensured that most commercial activities and vehicle transportation ceased, resulting in a significant reduction in air pollution levels. The value of air pollutants PM10, PM2.5, NO2, and SO2 from January to May 2020 was obtained from the Indian Central Pollution Control Board. Before lockdown and during lockdown, relative fluctuations in ambient concentrations of four air contaminants were investigated. The Box-Jenkins approach was used to estimate future air pollution data points using time series data analysis. The PM10 level reduced by 61%, 30%, 68%, 37%, and 43% in the selected cities, respectively. Comparison of other pollutant concentrations before and after the lockdown also found a reduction in ambient pollutant concentrations, resulting in improved air quality. Inference of predicted model values to observed values revealed a significant increase in the concentrations of all pollutants. The percentage increases in AQImean from predicted to observed values were 206% in Ghaziabad, 148% in Delhi, 59% in Hyderabad, and 160% in Cochin. The strict lockdown has resulted in a significant drop in air pollutant levels. Upgrading present technologies could help keep pollution to a minimum of 37% under control. The findings would prompt the government to consider how to strictly reduce vehicle and industrial pollution to improve air quality and maintain improved public health.

An Exploratory Evaluation of Implementing a Rapid-response Online Mental Health Service During the COVID-19 Pandemic: A Mixed Methods Study from India.

Strict social distancing and lockdown measures imposed to curb transmission during the early phase of the outbreak of the COVID-19 pandemic posed challenges to people's psychological wellbeing, limited access to social support, and disrupted routine mental health service delivery. In response, a consortium of mental health stakeholders from Goa, India launched the COVIDAV program, which provided pro-bono virtual psychiatric and counselling consultations across India through an online platform. This study describes the acceptability and feasibility of the program from the perspective of various stakeholders. Data were collected via a survey with clinicians who had volunteered on COVIDAV (n = 40), in depth interviews of the clinicians (n = 14), and focus group discussion with key collaborators (n = 1). Process data were mapped at various stages during the online platform's development and use. The qualitative and quantitative data was analysed using thematic analysis and a descriptive analysis respectively. Over 17 months, 63 clinicians conducted 2245 online sessions through the COVID platform, primarily accessed by youth across the country. The clinicians acknowledged the online platform's ability to enhance access and reduce stigma. Challenges included session time constraints, connectivity issues, and user interface inconsistencies that interfered with clients' accessibility to the services. High satisfaction rates amongst the service providers were reported, with 79.3% content with the service provision and 82.8% with pro bono contributions through the platform. This study illustrates the feasibility, flexibility, and applicability of a rapidly designed pro-bono online platform for delivering mental health care services through the collaboration of stakeholder groups in the mental health care, private, social, and governmental sector. Our findings highlight the potential of rapidly deployed digital platforms, developed via cross-sector partnerships, to meet mental health care needs during unprecedented global emergencies such as the COVID-19 pandemic.