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Impact of lockdown during COVID‑19
pandemic and its advantages
Abhishek PR Nadig, K. L. Krishna

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Abstract:
www.ijhas.in COVID‑19, caused by novel coronavirus SARCoV2, is a contagious disease, emerged in the end of
December 2019, at Wuhan seafood market, China. This disease is spiraling like a wildfire and rapidly
DOI:
10.4103/ijhas.IJHAS_77_20 spreading worldwide, overburdening the health system with newly infected cases. As of April 25,
2020, a total of 2,846,536 COVID‑19‑positive cases and 197,859 total deaths were reported across
the globe. This epidemic has exponential growth characteristics in the absence of specific vaccine
and treatment for COVID‑19. Many countries across the world including India, the USA, China, Italy,
and German are implementing the lockdown measures to control the COVID‑19 pandemic and to
maintain the infection at manageable levels. Keeping the prospectus of future such pandemics, we
reviewed; what is lockdown and containment? Does it works? What are the advantages of lockdown
and containment in cotrolling the spread of the virus?.  The present review answers these questions
and tries to spread light on the impact of lockdown. Our review concludes that the implementation of
lockdown has forced many countries in flattening the epidemic curve and strengthening the health‑care
system and improves the environmental quality during the COVID‑19 pandemic.
Keywords:
COVID‑19, epidemic, lockdown, pandemic, social distance, WHO

Introduction 2002–2003 and Middle East respiratory

syndrome coronavirus  (MERS‑CoV)

A case of unknown pneumonia in

late 2019 December was reported in
Wuhan, China. The clinical characteristic
of this disease was very much similar
to viral pneumonia. Analysis on case
samples by the Chinese Center For Disease
Control and Communication  (CDC)
officially declared that pneumonia was
Department of
Pharmacology, JSS
caused by novel coronavirus and named
College of Pharmacy, it as novel coronavirus pneumonia.[1] Later
JSS Academy of Higher on January 7, 2020, the World Health
Education and Research, Organization (WHO) officially named it as
Mysore, Karnataka, India
COVID‑19. Novel coronavirus belongs to a
Address for large family of viruses, family Coronaviridae
correspondence: and subfamily Coronavirinae.[2] According
Dr. K L Krishna, to the WHO, COVID‑19 belongs to Group 2
Department of
of betacoronavirus, which is similar
Pharmacology, JSS
College of Pharmacy, to severe acute respiratory syndrome
JSS Academy of Higher coronavirus  (SARS‑CoV) widespread of
Education and Research,
Mysore ‑ 570 015
Karnataka, India. This is an open access journal, and articles are
E‑mail: klkrishna@jssuni. distributed under the terms of the Creative Commons
edu.in Attribution‑NonCommercial‑ShareAlike 4.0 License, which
allows others to remix, tweak, and build upon the work
Received: 01-05-2020 non‑commercially, as long as appropriate credit is given and
Revised: 02-05-2020 the new creations are licensed under the identical terms.
Accepted: 05-05-2020
Published: 15-10-2020 For reprints contact: reprints@medknow.com
epidemic in 2013–2015. Despite both
COVID‑19 and SARS‑CoV belong to
betacoronavirus subgroup.[3] Initially, cases
of COVID‑19 reported that it may be less
severe than SARS and MERS, but later,
the virus was transmitting rapidly from
human to human, and evidence suggested
that novel coronavirus is more a infectious
disease than SARS‑CoV and MERS‑CoV.[4,5]
COVID‑19 is a respiratory disease,[6] which
affects many people in different ways, and
infected people will get mild‑to‑moderate
symptoms, usually seen after 2–14 days.
Common symptoms include fever,
cough, sneezing, runny nose, sore throat,
exacerbated asthma, and diarrhea.[7] The
National Institutes of Health reported that
young children, people above 60 years
or older, pregnant women, and people
underlying disease conditions have a higher
risk of getting infected with the disease and
prone to mortality. Respiratory infections
How to cite this article: Nadig AP, Krishna KL.
Impact of lockdown during COVID-19 pandemic and
its advantages. Int J Health Allied Sci 2020;9:316-21.

316 © 2020 International Journal of Health & Allied Sciences | Published by Wolters Kluwer ‑ Medknow
[Downloaded free from http://www.ijhas.in on Friday, July 9, 2021, IP: 203.112.75.194]
Nadig and Krishna: COVID-19: Lockdown and its advantages
usually transmit from person to person through droplets
varying of different sizes, when the diameter of droplet
size  >5 μm is called respiratory droplets and <5 μm
is called droplet nuclei.[8] According to the WHO, the
spread of coronavirus is basically through respiratory
droplets and contacts.[9,10]
The novel coronavirus epidemic has an exponential
growth characteristic; till now, no specific vaccines
and antiviral treatment are approved for COVID‑19
treatment. [11] According to the WHO, it will take
at least 18 months since from March 2020; hence,
nonpharmaceutical interventions are the only way to
control this pandemic and thereby impact on individual
health can be reduced.[12,13]
According to the WHO and Johns Hopkins University,
COVID‑19 has affected more than 28,46,536 people and
total deaths were 1,97,859 across worldwide. Countries
including the USA, Spain, Italy, France, Germany,
the UK, and China have been exposed to this virus
intensely.[14] By imposing the largest and continuous
lockdown in India, according to Ministry of Health
and Family Welfare (MoHFW) by 25 April 2020, a total
24,530 positive cases were witnessed among 1.3 billion
population which is almost 4 times more population than
US, thus number of positive cases reported were less as
compared to other countries.[15] If in case, the epidemic
of coronavirus hits with the speed of the USA, Spain, or
Italy, then it is very much difficult to handle the situation
without having the specific vaccine.[14] The main reason
behind the increased number of COVID‑19‑positive cases
and maximum death in European countries such as Italy
and Spain is because of late response to the outbreak and
delayed lockdown measures.[16] It is reported that after
lockdown in China, the number of COVID‑19‑positive
cases was decreased.[17] Our analysis reports the impact
and advantages of lockdown during COVID‑19.
Lockdown
An emergence protocol prevents the spread of infection
between individuals from staying in a given area. The
lockdown protocol usually allows essential supplies
such as pharmacies, hospitals, banks, and grocery shops
and shut down of all nonessential activities throughout
the period. Around the world, most of the countries
including India, America, China, Italy, and Spain are
implementing the lockdown protocol to control the
spread of COVID‑19.[18] Even the WHO recommends the
strict lockdown protocol to fight against the COVID‑19.
The epidemic of COVID‑19 began by the end of
December 2019 in Wuhan seafood market, China, and a
day‑by‑day number of cases are increasing; due to this,
remarkable and unparalleled steps took by the China
International Journal of Health & Allied Sciences - Volume 9, Issue 4, October-December 2020 317
Government to control the infectious virus by massive
lockdown which involves of travel restriction, work from
home, etc., Lockdown in Wuhan and other cities in Hubei
province of China was commenced from 23 January 2020.
Implementation of such lockdown resulted in reduced
spread of the virus both in Hubei and in other parts of
China by 2 weeks period. The epidemic was peaked on
5 February 2020 in Hubei and 3 February 2020 in the rest
of China and thereafter it was declined.[19] According to
Union Health Ministry, Govt. of India, India would have
seen 8.2 lakh COVID-19 positive cases by April 15, 2020
if there was no lockdown and containment measures
were implemented. If containment measures were taken
but no lockdown, then the cases would have raised to
1.2 lakh. However, after implementation of complete
nationwide lockdown and containment measure India
witnessed only 7,447 COVID19 positive cases by April
15, 2020. Hence, lockdown was effective in controlling
the spread of virus.
Social distancing
Social distancing also called as physical distancing
is a non-pharmaceutical intervention or measures
undertaken to prevent the spread of contagious diseases
by reducing the close contact between the individual. It
typically involves avoid of gathering and maintaining
a physical distance from each others. This could be, one
of the best way of controlling the spread of disease in
the absence of available pharmaceutical remedies.[20]
The reason behind the social distancing is to reduce
the outbreak of an infectious disease. Epidemiologists
quantify the intensity of outbreak of COVID‑19 using
Ro number, unlike SARS pandemic in 2003, H1N1
influenza in 2009, and Ebola in 2014.[21] Ro indicates
the reproduction number which describes an average
number of patients getting infected during the infectious
period. Ro is calculated by the following formula.[22]
RO = p × c × D
Where, P = probability of transmission per exposure,
c = number of contacts per unit time, and D = duration
of infectiousness
From the knowledge of epidemiologists, if RO is above 1
infection will become epidemic, RO is equal to 1 infection
will become endemic, and if RO is <1, then the infection
will disappear.[23] An earlier study by Tim Churches
reported on March 3, 2020, that the reproductive number
of COVID‑19 in the United States ranges from 1.4 to 6.5
on an average of 2.5, which indicates that infection will
become epidemic in the coming days. Researchers from
the Indian Council of Medical Research and Imperial
College, London, suggested that the epidemic of
COVID‑19 cases can be reduced up to 62% if quarantine
and social distancing are strictly followed.[24] Similarly,
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Nadig and Krishna: COVID-19: Lockdown and its advantages
many studies had reported that the spread of COVID‑19
can be controlled by maintaining social distance.[25,26]
Hence, the main aim of social distancing is to reduce the
reproduction or R value below 1.[13] Similar to COVID-19,
In the year 1957-1958 Influenza infection (Asian Flu)
infected 50% of the population but on implementing
lockdown, social distance and containment measures,
this epidemic was reduced by more than 90% was
observed.[27]
Researchers from the University of Johns Hopkins report
the spread of COVID‑19 before and after lockdown
in India. With the absence of lockdown, the disease
would continue to spread without any interventions
and reproduction number (RO) = 2.66. At lockdown,
the reproduction number will reduce to 2. After
hard lockdown and continuation of interventions,
the reproduction number will reduce to 1.5; hence,
the continuation of lockdown with interventions
significantly reduces the epidemic of COVID‑19 in India.
Saturation of epic curve
Epic curve is also known as Epidemic curve. A statistical
graph in epidemiology displays the onset of illness
outbreak.[28]
Epidemic curve helps us to predict:
1. Illness magnitude
2. Its time trend of disease outbreak
3. Inference of illness spread pattern
4. Time period of exposure
5. Mode of transmission identification.
As per the report by CDC, nonpharmaceutical
intervention including lockdown, social distancing,
hand sanitizing, quarantine, and cleaning surfaces can
lower the transmission of coronavirus epidemic in the
community which helps to improves the health‑care
Figure 1: Flattening the curve improves the health‑care system[44]
318 International Journal of Health & Allied Sciences - Volume 9, Issue 4, October-December 2020
system [Figure 1]. [7] Strictly practicing the strong
massive lockdown rules in China, the saturation or
flattening epidemic curve of COVID‑19 is observed.
Hence, lockdown measures are necessary for epidemic
management. The probability of infected person contact
with uninfected person can be reduced, which helps to
suppress the community spread of illness.[5]
Lockdown and health system
Health‑care system has a major role in controlling the
epidemic of COVID‑19. Massive lockdown protocol
benefits the national and global communities. In addition
to that, burden and pressure on health‑care system get
reduced, which helps to serve the COVID‑19 as well
as non‑COVID patients [Figure 2]. If the transmission
of COVID‑19 is not curtailed or the lockdown breaks,
the spread of the virus cannot be controlled easily, and
finally, health‑care system becomes overwhelmed. We
have seen such increasing scenario in many countries
including Italy, Spain, and the UK.[16] Hence, lockdown
and nonpharmaceutical intervention play a major role
in building the health‑care system.
Lockdown and environmental changes
To reduce the spread of novel coronavirus, most of
the countries across the globe adopted lockdown. This
action has put automobiles, trains, planes, and major
industrial activity on hold. Due to this, unparalleled
decrease in air pollution is being noticed in most of
the countries.[29] During lockdown, according to the
Central Pollution Control Board  (CPCB) of India, air
quality index was improved up to 90% in major cities
of India including Delhi, Mumbai, and North India’s
many industrial areas [Table 1]. A recent study reported
that China has found a big relief in anthropogenic
pollution emission which results in a 25% reduction
in carbon mission and a 30% reduction in NO2 level
during lockdown.[30] The WHO reports that more than
90% of the global population are living in the area
Figure 2: Illustration of management health‑care system
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Nadig and Krishna: COVID-19: Lockdown and its advantages
Table 1: Before and after lockdown air pollution in North India’s industrial areas
City Before lockdown days (16‑24 March)
Noida 152
Mandi Gobindgarh 117
Manesar 123
Khanna 73
Ballabhgarh 102
Ghaziabad 188
Bhiwadi 207
where the quality of air is below the guideline level.
An ambient air pollution kills nearly 7 million people
annually across the globe, and majority of the deaths
are in China and India. An increase in NO2 has linked
to various diseases including respiratory,[31] cardiac,[32]
diabetes,[33] asthma and chronic obstructive pulmonary
disease,[34] and hypertension[33] diseases and increased
rate of hospitalization.[35] The fatality rate of COVID‑19
is significantly higher with the patient who already
had preexisting health conditions, specifically those
with cardiovascular disease, diabetes, and respiratory
disease, and these diseases are strongly connected
with the air pollution.[36] In addition to that, the quality
of water has seen a significant improvement since
enforcement of the lockdown shuts the dumping of
industrial waste. According to CPCB, out of 36 water
monitoring points, 27 had shown improvement in the
quality of water of river Ganga. The following parameter
data were measured to assess the quality of water of
the river: biochemical oxygen demand  (<2  mg/l),
dissolved oxygen (>6 mg/l), coliform level (500/10 ml),
and pH (6.5–8.5). Hence, the quality of air, water, and
health indices improved after the complete lockdown,
which directly helps to fight against the coronavirus.
Life easier during lockdown
Strength of health system
Working against COVID‑19 victim is necessary, in
addition to that health supporters are also continuing
their work for non‑COVID patients who require
regular treatment, especially for chemotherapy,
dialysis patients, etc., [Figure 2]. To minimize the
overcrowd in hospitals, health‑care global has
emphasized to monitor through telemedicine, video
calls, 24 × 7 health emergency helpline, mobile medical
transport units, etc., Suspected COVID‑19 patients are
quarantined for 14 days; if the patients get COVID‑19
positive, then the treatment is followed as per the
Ministry of Health and Family Welfare  (MoHFW)
protocols at COVID‑19 care centers, fever clinics,
dedicated COVID‑19 health center, and dedicated
COVID‑19 hospital.
Strengthening immune system
To keep any disease at bay, one must boost and
strengthen the immune system, by supplementing
International Journal of Health & Allied Sciences - Volume 9, Issue 4, October-December 2020 319
During lockdown days (25‑27) Change (%)
71 −54
42 −64
46 −63
34 −54
51 −50
81 −57
42 −80
nutrients which are rich in Vitamin A, Vitamin C,
Vitamin E, Vitamin D, selenium, copper, and zinc‑rich
foods. In addition to that, regular exercise, yoga, and
sufficient sleeping (8–10 h) help reconstruct the immune
system to fight against pathogens. Most of the working
people are at home in the lockdown period, whereas the
free time helped them to get good food and sufficient
sleep and lead a stress‑free lifestyle which contributed
very much in increasing their immunity.
Online classes
As lockdown continuous, online classes have surged
in popularity and most of the universities and colleges
across the globe are continuing their classes through
online to help the students. It is reported that till April
17, 2020, more than 2,23,930 online classes on various
subjects have been conducted, and these are attended
by students in an average of 144,431/day. In addition
to that, various online courses are conducted and
researchers are published more than 2823 research and
review papers and books.
Work from home
To ensure the continuity of business, most of the IT and
BPO company employees are continuing their work
from home.
24 × 7 helpline
To tackle the complaints and problems faced by citizens,
the government has provided helpline number.
Emergency passes
People will get access to emergency purposes including
medical and pharmacy and need to specify the place
and time.
Carps as friend
Even during the lockdown, carps are serving their
duty to help and support the individual on streets with
problems.
Relief funds
The government announced immediate financial
packages, essential grains, and relief measure to rescue
the poor people of the country.
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Nadig and Krishna: COVID-19: Lockdown and its advantages
Psychological benefits during COVID‑19
lockdown
One of these factors is an emerging sense of shared
identity, and concern for others, which arises from a
common experience of being in a disaster. This feeling
can be harnessed by addressing the public in collective
terms and by urging “us” to act for the common good
and to help others. When individual thinks, they do so in
conformity to norms. Their perception of what others are
doing or what they think, others approve or disapprove
of, is from an inherent desire to learn from them. During
this lockdown, since there is social distance, people crave
to gain affiliation, even though the scenario is different.[37]
A study on numerous models of mass emergency
behavior suggests a social psychological basis for
resilience. Normative approaches and affiliation seem
to be most preferred. They are based on the principles
of self‑categorization theory, comprehending the
psychological nature of resilience, and probable
conditions will supplement planning of evacuation
procedure, emergency services, and suitable after‑care
procedures.[38] It is interesting to note that moral and
political orientation were of less concern in comparison
with fear and anxiety symptom predictors on complaint
behavior. Fear and anxiety symptoms led individuals
into compliance with necessary public health behaviors
such as personal hygiene and social distance. Further,
the prescribed behavioral change is not noted to have
had any decline in quality of life. For some during the
lockdown period, they work as usual and they stay with
family that make them feel more comfortable rather than
thinking of any other issues.[39]
To control the spread of virus, lockdown is a strict action
that has to be followed by all the citizens who belong
to country. Here, when people have faith and trust in
the government bodies and the authorities the way
the individual thinks is completely different compared
to another scenario. Participants with higher trust in
institutions exhibited slightly less anxiety about the
coronavirus pandemics.[40] In any global situation of life,
avoiding stress is not so easy. It is not the type of stress
or the amount of stress that plays an important role in
these kinds of situations. Rather, it is the mindset of the
individual which helps the person or group of people
to face the situation dynamically and alter the impact of
situation. Adaptive mindsets about stress could increase
positive emotion and reduce negative health symptoms.
During this lockdown process, some people instead of
thinking only about the stress (virus) have adopted their
lifestyle to the current situation. A healthy mindset can
entirely change the vision of an individual.[38,41]
Public health experts believe that “individual behavior
will be crucial to control the spread of COVID‑19.[42]
320 International Journal of Health & Allied Sciences - Volume 9, Issue 4, October-December 2020
These prosocial behaviors include washing hands more
frequently and for longer, avoiding public gatherings,
canceling travel plans, and keeping distance from others.
If measures like these are adopted on a temporary basis,
experts suggest that the deaths caused by coronavirus
would drop dramatically. Hence, all these things will
help in limiting social activity. To prevent the spread of
contagious disease, travel restrictions were implemented
except the emergency services. Work from home option
were provided to all professional activities wherever
possible to maintain good interpersonal relationship
and stable economy by maintaining social distancing to
avoid spread of virus.[40]
Conclusion
The coronavirus epidemic has exponential growth
characteristics and caused a global mayhem. Due to
high degree of contagiousness and absence of specific
vaccine, nonpharmaceutical intervention like lockdown
is the only prescription to battle the virus. Lockdown
prevents the local and global spread of virus which has
forced many countries in flattening the epidemic curve
and strengthening the health‑care system and improves
the environmental quality.
Acknowledgment
We thank everyone who is working to control the
epidemic of COVID‑19.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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