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 Table of Contents  
PERSPECTIVE
Year : 2020  |  Volume : 9  |  Issue : 5  |  Page : 97-100

Impact of COVID-19 pandemic on the dimensions of health and well-being: Time to widen our gaze


1 Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
2 Department of General Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
3 Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India

Date of Submission14-May-2020
Date of Decision15-May-2020
Date of Acceptance15-May-2020
Date of Web Publication04-Jun-2020

Correspondence Address:
Dr. Praveen Kulkarni
Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_114_20

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  Abstract 


Novel coronavirus disease termed as nCOVID-19 by the World Health Organization has posed serious threat to the health and well-being of humankind. The pandemic has caused unprecedented disruption of life and impacted almost all the sections of the society. Health-related emergencies and urgencies due to COVID-19 have drawn major attention of all the stakeholders involved in ensuring the well-being of the society. On the other hand, the pandemic has impacted the mental, emotional, social, educational, nutritional, and vocational dimensions of health. Nationwide lockdown, a measure taken toward achieving social distancing, thereby flattening the curve has resulted in a rise of mental health issues, emotional disturbances, migrant exodus, poverty, deficient food supply, hunger, academic stagnation, learning crisis, unemployment, and job insecurities among people. All these problems have the potential to impact the health and well-being of the society in the long run and hamper the attainment of sustainable development goals.

Keywords: Dimensions of health, impact, nCOVID-19, sustainable development goals


How to cite this article:
Kulkarni P, Hathur B, Vishwanath P. Impact of COVID-19 pandemic on the dimensions of health and well-being: Time to widen our gaze. Int J Health Allied Sci 2020;9, Suppl S1:97-100

How to cite this URL:
Kulkarni P, Hathur B, Vishwanath P. Impact of COVID-19 pandemic on the dimensions of health and well-being: Time to widen our gaze. Int J Health Allied Sci [serial online] 2020 [cited 2020 Jul 13];9, Suppl S1:97-100. Available from: http://www.ijhas.in/text.asp?2020/9/5/97/285957



N COVID-19 is a dreaded emergency, bothering the humanity, which initiated its journey from a small province of China in the last week of December 2019. The disease has spread like a wildfire involving more than 210 countries and territories in the world.[1] Apart from the previous pandemics of the century such as H1N1 and Middle East respiratory syndrome, the one due to COVID-19 has caused an unprecedented impact on medical, political, administrative, financial, education, industries, and business sectors.

India reported the first confirmed case of COVID-19 on January 30, 2020, in the state of Kerala after a gap of almost a month of the emergence of the infection in its neighboring country.[2] Even though the spread of infection was sluggish at the initial days, it took a major surge after some socio-religious gatherings in the country, which, in turn, resulted in local spread among close contacts and secondary contacts, taking a shape of public health emergency.

India being the second most populous country in the world with tremendous demographic, sociocultural diversities took major decisions in a preemptive manner to curb the spread of the infection. Public health education on the prevention of the spread of disease, screening and strict quarantine on deployment for international passengers, establishing fever clinics, strengthening hospital infrastructure to manage COVID patients, establishing nationwide public as well as private labs to conduct tests, active surveillance for symptomatic cases, contact tracing, elaborating cluster containment plans, involving private medical establishments in clinical care, risk communication through social media and websites, and bringing amendments in the Epidemic Disease Act-1987 are the few notable ones.[3] In the absence of vaccine and specific medicines and higher contagiousness of disease, social distancing is the only effective strategy to prevent the spread of infection.[4] In order to achieve this, a three-phase nationwide lockdown was implemented in the country with varying degree of success and distress expressed in some regions.

Undoubtedly, the current pandemic has posed serious risk on the health and well-being of the population across the globe. An exponential increase in the number of cases, varying level of severity of disease, unpredictable case fatality rates, unpredictable spread in spite of the containment measures, etc.,[5] exhaustion of hospital beds and medicines, shortage of health-care staff, insufficient number of intensive care units and ventilators, and nonavailability of personal protective equipment for frontline health-care workers are the matters of serious concern.[6] Apart from the direct impact on the physical dimension of health, other domains such as mental (psychological), emotional, social, educational, nutritional, and vocational dimensions are equally affected by the pandemic [Figure 1]. In this article, we would be discussing the impact of the current pandemic on nonphysical dimensions of health which can have long-lasting effects on the well-being and hinder the attainment of sustainable development goals set by the United Nations.[7]
Figure 1: Impact of COVID-19 on nonphysical dimensions of health

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Nationwide lockdown is the biggest psychological experiment. Fear of infection, lack of knowledge related to disease and its transmission, information overload, spread of misinformation through news rooms/social media platforms, fear of loss of job, closure of schools/colleges, fear of salary deductions, loss of wages, emotional isolations, stigma, and familial conflicts pose risk for the development of an array of psychosocial problems among people. Mental health problems such as depression, anxiety, stress, substance abuse, domestic violence, child abuse, insomnia, irritability, anger, and frustration are increasing in their magnitude and are expected to expand furthermore in the days to come.[8] There are reports suggestive of higher risk of relapse and deterioration among people who were already diagnosed to have these conditions in the prepandemic period.[9]

The impact of the COVID-19 pandemic on the emotional dimension of health cannot be fully separated from that of psychological dimensions as they go hand in hand. Vicarious traumatization caused by the pandemic on the general public and health-care professionals has resulted in emotional distress, suicidal ideation, and suicidal tendencies.[10] Stigmatization associated with quarantine and isolation is related with emotional disturbances, fear of falling sick, staying away from the close ones, helplessness, and a sense of being responsible for spreading infection to family members, which will further add to the emotional deterioration.[11],[12]

The COVID-19 pandemic has emerged as a major contributor to the already-existing social pathologies. Economic crisis associated with the pandemic is pushing the families to poverty, hunger, unemployment, migration, and xenophobia. People who do not have shelters to lead their life (homeless), refugees, displaced populations, and destitute stand to suffer disproportionately both from the pandemic and its socioeconomic consequences.[13] Children who are largely spared by the direct health-related effects of COVID-19 till date are expected to be the biggest victims. The economic emergencies arising from the pandemic along with the school closure may force children to dropout from schools and indulge in child labor. Street children and orphans who have no homes and parental care are at risk of exploitation and other negative coping measures.[14] Older persons are at the risk of double trouble. The discourse around COVID-19, in which it is perceived as a disease of older people, exacerbates negative stereotypes about them who may be viewed as weak, unimportant, and a burden on the society. This may lead to discrimination of older persons which has a direct impact on the seeking of health care and well-being. Other vulnerable sections of the society such as unemployed youth, people with disabilities, and indigenous people are also at the potential risk of being victims of the social consequences of this pandemic.[13]

Learning crisis among children and youth is another important outcome of the current pandemic. The unprecedented closure of educational institutions in more than 180 countries and territories across the world has resulted in stagnation of academics. The potential losses that may accrue in learning children and youth of today, and for the development of their human capital, are hard to fathom. In order to minimize these losses, few academic institutions have started distance education through online learning platforms. Availability of android phones/supportive devices, accessibility to the Internet, and residence in remote settlements/inaccessible areas with limited web infrastructure are the major barriers for the online education in low- and middle-income countries.[14]

Food security has emerged as one of the major issues in the current pandemic, which deserves due attention. Impact (reduced) agricultural production, exhaustion of stock, delays in transportation, and less efficient distribution of food grains to the beneficiaries are the root causes behind food insecurity. People who reside in the urban slums, informal settlements, and difficult-to-reach areas are at higher risk of suffering with hunger. These are the ones who rush to get the food packets and rations offered by the governments, philanthropists, and civil societies without caring much for social distancing and end up becoming either the victims or persons responsible to transmit the disease in the community.[15] Governments have taken several steps to ensure food security through public distribution systems, but there are still large numbers of people who crave for food and sleep with hunger. If we do not give due attention to this dimension, we may face undernutrition and related complications in the days to come. There appears to be another extreme of this problem, where people have ample of food to eat, but due to lockdown and social distancing, they may not practice physical activities/exercises and end up with overweight and obesity.

Vocational well-being is another important dimension of health. The lockdown has resulted in serious job insecurities among people working in unorganized sectors. Loss of daily wages, deduction in salaries, changed working patterns such as work from home and disrupted division of labor, etc., have posed a tremendous impact on people.[6]

Health-care professionals including paramedics are facing major vocational consequences due to the current pandemic. At one end, they are at extremely high risk of acquiring COVID infection due to their close proximity with active/suspected cases and at the other end, they are at a tremendous stress of working in resource-limited health-care settings with insufficient personal protective gears.[16] Grassroot level health-care workers involved in contact tracing are receiving backlash from people in communities and having hard time in convincing people for testing and quarantine.


  Conclusion Top


The COVID-19 pandemic has stretched its tentacles toward all the dimensions of health and well-being. Thus, we need to adapt a comprehensive, multidimensional, and multipronged strategy to combat the menace and exigencies created by the present pandemic. Along with quality medical care, we also should give emphasis on reducing its impact on mental, social, emotional, nutritional, educational, and vocational dimensions of health to achieve holistic well-being and attain sustainable development goals.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report. No. 113. World Health Organization; 12 May, 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/. [Last downloaded on 2020 May 13, 15:30.00 HRS].  Back to cited text no. 1
    
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World Health Organization. Novel Coronavirus Disease 2019 (COVID-19) Situation Update Report. No 1. India: World Health Organization; 31 January, 2020. Available from: https://www.who.int/docs/default-source/wrindia/india-situation-report 1.pdf?sfvrsn=5ca2a672_0. [Last downloaded on 2020 Mar 15, 13:00 IST].  Back to cited text no. 2
    
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Kulkarni P, Mohapatra A, Narayana Murthy MR. Coronavirus-19 pandemic: Time to defuse misbelief and build trust. Int J Health Allied Sci 2020;9:97-8.  Back to cited text no. 5
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U.S. Department of Health and Human Services Office of Inspector General Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23–27; 2020. Available from: https://oig.hhs.gov/oei/reports/oei-06-20-00300.pdf. [Last downloaded on 2020 May 11, 20:00 Hrs].  Back to cited text no. 6
    
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Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr 2020;52:102066.  Back to cited text no. 8
    
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Ministry of Health and Family Welfare, Government of India. Addressing Social Stigma Associated with COVID-19. Available from: https://www.mohfw.gov.in/pdf/Addressing SocialStigmaAssociatedwithCOVID19.pdf. [Last downloaded on 2020 May 10, 18:30 Hrs].  Back to cited text no. 12
    
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Global Network against Food Crisis. Key Takeaways of the Global Network against Food Crises on Preventing a Food Catastrophe during the COVID-19 Pandemic. Available from: https://www.fsinplatform.org/sites/default/files/paragr aphs/documents/Key%20takeaways%20Preventing%20a%20food%20catastrophe%20during%20the%20COVID-19%20pand emic.pdf. [Last downloaded on 2020 May 19, 10:15 Hrs].  Back to cited text no. 15
    
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