Assessing Public Perception on Health Challenges and Identifying psychosocial Challenges due to National Lock-down at COVID-19 outbreak

 Assessing Public Perception on Health Challenges and Identifying psychosocial Challenges due to National Lock-down at COVID-19 outbreak 

Highest percentage (27.1%) of samples were from Rajasthan, followed by Kerela , Gujurat and Moharashtra . Maximum (54.3%) were female samples and maximum (22.9%) belonged to 26- 30 years of age. Majority (64.3%) of the samples were married and highest percentage (50%) of samples were post graduates followed by graduates and doctorates . Most of them (57.1%) were doing professional services and remaining were business men , students, retired and other forms of maximum (75.7%) samples were staying with family during lockdown, 21.4 percent were away from family and 2.9 percent were staying at hostel;

Caronavirus disease ( COVID-19) is an infectious disease caused by a newly discovered caronavirus. The COVID-19 virus has affected different people hu in different ways. All the countries announced nationalwide lockdown to find, isolation,test ,treat and trace the cases. Little literature is available on the pandemic outbreak and lockdown affect especially in a country like India. The general public faces lockdown as a challenge because isolation, physical, mental and social health. This study dweels on public perception on health challenges in lockdown during covid-19 outbreak, psychosocial Challenges being faced and the measures suggested to cope with the psychosocial Challenges. The research design adopted was mixed research approach (Embedded Design) , where qualitative data is in support with quantitative data. Non- probability purposive sampling technique was used initially and latter snow ball sampling also adopted. The online survey included 70 participants. The tools used were baseline data and semi-structured open- ended questionnaire since standardised tool was not available. Samples were electronically invited to recruit in the study. Highest percentage (27.1%) of samples were from Rajasthan, followed by Kerela , Gujurat and Moharashtra . Maximum (54.3%) were female samples and maximum (22.9%) belonged to 26- 30 years of age. Majority (64.3%) of the samples were married and highest percentage (50%) of samples were post graduates followed by graduates and doctorates . Most of them (57.1%) were doing professional services and remaining were business men , students, retired and other forms of maximum (75.7%) samples were staying with family during lockdown, 21.4 percent were away from family and 2.9 percent were staying at hostel; 34.3 percent felt that lockdown is really a challenge; 40 percent of samples shared that they were not prepared for nationwide lockdown. Half the sample revealed that lockdown would cause impact on physical health of general population. 42.9 percent had concern about self family member, significant other getting with covid-19 infection; 52.9 percent felt that lockdown is affecting their occupation as well as financial stability. Majority (57.1%) of the participants felt that lockdown caused impact on their mental health. The study found general population supporting lockdown for the time being despite all the challenges they are facing. But some aspects they felt like physical health, psychosocial health, occupation and financial stability are disturbed because of extended lockdown. Also, the negative mental health outcomes were associated with the lockdown. Suggested measures could be adopted to cope with the psychological challenges due to the lockdown.

Caronavirus disease (COVID-19) is a communicable disease caused by a newly discovered caronavirus. Person s infected with covid-19 virus will experience mild to moderate respiratory illness symptoms and mostly recover without requiring special treatment. Older population and people with underlying medical problems like heart disease, diabetes, chronic respiratory disorder, and cancer are more likely to develop serious illness. The covid-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. At this point ,there aren't any specific vaccines or treatments for Covid-19 virus, the disease it cause and wat it spreads. Protect your self from infection by washing your hands or using an alcohol -based rub frequently and not touching your face.

The outbreak was first discovered in late December -2019 when cluster of pneumonia cases of unknown aetiology were found to be related to epidemiologically joined exposure to a food market and untraced exposure within the town of city of Hubei Province . Since then , the quantity of caused has continued to increase exponentially among an on the far side city , spreading to all 34 regions of China by 30 January 2020. On the same day, the World Health Organization (WHO) declared the Covid-19 outbreak a public health emergency of international concern. 

WHO declared Novel Coronavirus disease ( Covid-19) outbreak as a pandemic on 11March 2020 and reemphasised the call for all nations to take prompt action and reduce its transmission to save lives of population. Due to this unprecedented crisis, Indian Prime minister announced a 21 days nationwide lockdown for the first time in the country on 24 March 2020 , to protect the nation and its citizens from rapid transmission of caronavirus and public were advised to avoid stepping out of their home. 

Ministry of Health and Family Welfare (MoHFW), India reported total 1024 Covid-19 cases on 29 March 2020 which was reported in 27 deaths and home quarantine was ongoing.

Need for study : 

Quarantine is the separation and movement of people who have been exposed to a contagious disease while isolation differs from it, which is the separation of people who have been diagnosed with a contagious disease from the people who are not at all sick. Quarantine was firstly used in Venice, Italy, 1127 during outbreak of Leprosy.

Coronavirus disease 2019 pandemic has profound effect on psychological and social life. Live stories of suicide due to Covid 19 were noted in various media. A father of there, from Andhra Pradesh's Chittoor district took his life on 15 February after contracting flu- like symptoms, which was reported at in Telegraph UK. Another incident was reported at Safdarjung Hospital on 19 March, a 23- year-old man, who had flown from Sydney to Delhi, admitted on suspicion of Caronavirus, who jumped off the hospital building. Dr Brunda Amruthraj, Psychiatrist from Bengaluru has shared about getting anxious calls on covid-19 which is the need of the hour , she shared to the media that people feel anxious, depressed and tense during this time which is natural and people with existing psychological symptoms are feeling an increase in their symptoms. Another Psychiatrist Dr. Amitabh Saha saw people develop acut depression, with some developing OCD about washing hands.

Very little litterateure is available on the pandemic outbreak and lockdown effect especially in India. The general public looks at lockdown as a challenge because isolation, physical distancing, closer of schools,colleges, Universities , workplaces etc. Has affected their physical, mental and social health. More and more people are obliged to remain indoors and it is their first time experience in the life and it can cause boredom , anxiety , hypersomnia, OCD, stress included disorder, physical health issues such as increasing weight, blood pressure,etc. Hence, the investigator decided to conduct a study via web- based survey to assess public perception on physical health challenge and identify psychological challenges facing by them in nationwide lockdown at covid-19 outbreak.

Review of Literature :

Wang et al (2020) conducted a study to survey the general public (1210 respondents) from 194 cities in China to understand their levels of psychological

Impact, anxiety, depression,and stress during the initial stages of the covid-19 outbreak. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with covid-19, knowledge and concerns about covid-19 precautionary measures against Covid -19 and additional information required with respect to covid-19. Psychological impact was assessed by the Impact of Event Scale -Revised (IESR) and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21) . In total, 53.8 percent of respondents rated the psychological impact of the outbreak as moderate or  severe; 16. 5 percent reported reported moderate to severe depressive symptoms; 28.8 percent reported moderate to sever anxiety symptoms;and 8.1 percent reported moderate to severe stress levels. Most repodents (84.7%) spent 20-24 hours at per day at home , 75.2 percent were worried about their family members contacting covid-19 and 75.1 percent were satisfied with the amount of health information available. The study findings identified factors associated with a lower level of pasychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the covid-19 epidemic.

Methodology:

The research design adopted was Mixed Research approach (Embedded Design) , where Qualitative data is in support with Quantitative data. For Quantitative data , cross-sectional online survey approach was used and for Qualitative, Phenomenological design was used in the study. Non-pro ability purposive sampling technique was used initially and later snow ball sampling was also adopted in the study. Total 70 of partipants participated in this online survey. Individuals who are not going for work/ studies (any form of employment, business,duty, daily routine job etc.), due to lockdown and staying at home; those above 18 years of age, and those willing to respond through online were included in the study. Individuals who were mentally ill, who were in terminal stage of  illness, who were advised for home quarantine and isolation, and who are already diagnosed as covid-19 were excluded from the study. The tools consisted of baseline data and semi-structured open - ended questionnaire since standardised tool was not available for the study asit is a novel disease. The tools were validated from various experts. As the Indian Government recomended the public to minimise face to face interaction and isolate themselves at home, samples were electronically invited to be recruited in the study. The purpose was explained through online and consent from the samples was obtained prior to the online survey. The participants were co-operative in writting their experience for open- ended questions. Prior to data collection, ethical approval was obtained from Instructional Ethical and Research Committee, Global Hospital and Research Centre, Mount lAbu.

The data was collected from 6 to 10 April. Descriptive statistics were used to describe the baseline data. Qualitative data analysis was done to assess public perception on physical and psychosocial challenges during lockdown. The collected data was analysed by using Coloizzi's method (1978). The data was organised and transcribed. Each statement were read and significant statements were extracted and spelt out the meaning of each significant statements ( i.e. formulate meanings) Finally the formulated meanings were organised into cluster of themes and subthemes.

Results

Findings related to baseline data of samples 

The data collected were from total 16 states including Union territories, in which heigest percent Highest percentage (27.1%) of samples were from Rajasthan, followed by Kerela , Gujurat and Moharashtra . Maximum (54.3%) were female samples and maximum (22.9%) belonged to 26- 30 years of age. Majority (64.3%) of the samples were married and highest percentage (50%) of samples were post graduates followed by graduates and doctorates . Most of them (57.1%) were doing professional services and remaining were business men , students, retired and other forms of employment. Maximum (47.1%) of the collected samples belonged to urban area, remaining from semi- urban and rural. 

Maximum (75.7%) samples were staying with family during lockdown, 21.4 percent were away from family and 2.9 percent were staying at hostel; 20 percent of samples had present history of medical illness such as diabetic, hypertension, hypothyroidism. All the samples (100%), acquired adequate information on covid-19 through mass media, health professional, social medias, health website like WHO, MoHFW etc .