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Social distancing measures in the containment of COVID-19 pandemic and its thoughtful relaxation

1 Medical Education Unit Coordinator and Member of the Institute Research Council, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission16-Apr-2020
Date of Decision07-Jul-2020
Date of Acceptance24-Jul-2020

Correspondence Address:
Saurabh RamBihariLal Shrivastava,
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV)-Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet-603108, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_190_20

How to cite this URL:
Shrivastava SR, Shrivastava PS. Social distancing measures in the containment of COVID-19 pandemic and its thoughtful relaxation. Med J DY Patil Vidyapeeth [Epub ahead of print] [cited 2021 Dec 6]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=316404

Dear Sir,

The effective containment of the coronavirus disease-2019 (COVID-19) pandemic will require planning for the preparedness for the outbreak and strengthening of the emergency public health response.[1] As of now, 11,327,790 cases and 532,340 deaths have been linked to the novel infection in 216 nations and territories.[2] It is important to note that the majority of the global caseload has been reported in the American and the European region.[2] However, from the public health perspective, more than the caseload, it is the pace with which the number of cases has increased in the affected nations that have outstretched the health system and even accounted for the death of thousands of individuals.[1],[2]

Moreover, we have to acknowledge and accept the fact that the strategy of social distancing is one of the most effective approaches for the public health authorities to reduce the spread of the disease as well as provide a window of opportunity for the strengthening of the health system and logistics required for the management of the illness.[3],[4] In fact, realizing the impact of social distancing, the number of nations has imposed social distancing measures (like closing schools, delaying religious gatherings, promoting work from home, canceling sports events, etc.) and even complete lockdown to reduce the overall possibility of the disease transmission.[3],[4]

The findings of a mathematical model suggested that owing to the implementation of a wide range of social distancing measures in Seattle and Washington, and the policymakers succeeded in flattening the epidemic curve of the infection.[5] In another study done to assess the effectiveness of social distancing measures in 10 of the high caseload nations, social distancing again was found to be an effective strategy. However, the impact of the social distancing was quite variable owing to the intensity with which these measures were implemented in the general population.[6]

It has been time and again emphasized that we have to support social distancing with other interventions to enhance the overall outcome.[1] In that regard, it has been advocated that all the suspects of the disease should be subjected to diagnostic tests and subjected to isolation and appropriate treatment if the virus is detected in the collected sample. This will ensure containment of the source of the infection and prevent the further transmission of the infection. At the same time, steps should be taken to perform holistic contact tracing and subjecting all the contacts to quarantine. In addition, it is extremely important to continually and constantly adhere to the standard infection prevention and control measures (like frequent hand washing, respiratory hygiene, use of personal protective equipment, etc.) to ensure that the potential risk of the transmission of the infection can be minimized.[1],[3],[7]

All the nations who have been successful in reducing the caseload are on the lookout to relax these social distancing measures as the enforcement of complete lockdown has not only affected the national economy but even the livelihood of people from low socioeconomic status, especially in developing nations.[4],[7] We can understand the pressing needs to relax these social restrictions, as it has affected all the aspects of lives, but any such decision for relaxation should be done with extreme caution and based on the scientific evidence pertaining to the transmission pattern of the infection, the number of samples which can be processed each day, bed-strengths in hospitals, the supply of personal protective equipment, health workforce, ability to perform contact tracing, etc.[7]

These all parameters need to be assessed as we have to be ready for the onset of large-scale community transmission, which is expected once these social restrictions are relaxed, and it will pose immense load on the health system.[4],[7] If we relax these social distancing provisions without adequate preparation, the outcome will be disastrous in terms of initiation of the multiple new chains of transmission and it will not only prolong the health and financial crisis but will even significantly enhance the societal suffering and socioeconomic uncertainty in the area.[7]

In conclusion, the implementation of social distancing provisions has delivered encouraging results in heterogeneous settings in the battle against COVID-19. However, the decision to relax these measures should be done with complete thoughtfulness and based on scientific evidence; otherwise, the consequence can be really worrisome.

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Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. 2019 Novel Coronavirus (2019-nCoV): Strategic preparedness and response plan. Geneva: WHO press; 2020. p. 1-20.  Back to cited text no. 1
World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 168; 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200706-covid-19-sitrep-168.pdf?sfvrsn=7fed5c0b_2. [Last accessed on 2020 Jul 7]  Back to cited text no. 2
Mahase E. Covid-19: UK starts social distancing after new model points to 260 000 potential deaths. BMJ 2020;368:m1089.  Back to cited text no. 3
Lewnard JA, Lo NC. Scientific and ethical basis for social-distancing interventions against COVID-19. Lancet Infect Dis 2020;20:631-3.  Back to cited text no. 4
Matrajt L, Leung T. Evaluating the effectiveness of social distancing interventions to delay or flatten the epidemic curve of coronavirus disease. Emerg Infect Dis 2020;26:1740-8.  Back to cited text no. 5
Thu TPB, Ngoc PNH, Hai NM, Tuan LA. Effect of the social distancing measures on the spread of COVID-19 in 10 highly infected countries. Sci Total Environ 2020;742:140430.  Back to cited text no. 6
World Health Organization. COVID-19: PAHO Director Calls for “Extreme Caution” when Transitioning to More Flexible Social Distancing Measures; 2020. https://www.paho.org/en/news/14-4-2020-covid-19-paho-director-calls-extreme- caution-when-transitioning-more-flexible-social.[Last accessed on 2020 Apr 16].  Back to cited text no. 7


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