ABSTRACT
Background In May 2020, considering gradual restoration of all economical activities the Government of Pakistan updated containment strategy from locking down the whole country to locking down high-risk areas to mitigate COVID-19 spread. All districts having ≥300 cases/100,000 population. COVID-19 case incidence and test positivity rates by real-time RT-PCR before and after zonal lockdown were compared to assess whether the locality-based lockdowns can be used as an alternative to country lockdown to contain COVID-19 spread. Methods Smart lockdowns were implemented in ten localities in the Islamabad Capital Territory (ICT), having a population of 60,000 from 12 May 2020 to June 3, 2020. Movements were restricted. Entry and exit points were guarded by police. Any person with symptoms of fever, cough, or sore throat tested by real-time RT-PCR methods and reported within 24 hours of collection. To compare the rate of active cases and positivity rate by weeks, we performed a z-test for two proportions and set p < 0.05 as the level of significance. Results The red zone had 60,000 persons in 2.00 square kilometers. The rate of active COVID-19 cases significantly decreased (p < 0.0001) during intervention from 300/100,000 population pre-containment time to 22/100,000 population after the first three weeks of lockdown. The COVID-19 positivity rate also decreased significantly (p < 0.0001) from 24% (24/78) pre-containment to 5.3% during containment. A total of 3800 people were tested in the following three weeks of intervention and 26 cases were detected. Conclusions The smart lockdowns approach reduced COVID-19 transmission in the ICT district. This type of intervention was recommended to reduce the COVID-19 infection spread Key messages • Reduced COVID-19 transmission in the ICT district. • Keeping balance between life and economy.
ABSTRACT
Background The unprecedented public health crisis of the COVID-19 pandemic has caused heightened levels of stress and fear among health care workers.With the advent of COVID-19 in Pakistan,frontline workers of POEs have been under physical and psychological pressure including a high risk of infection, abnormal levels of workload, prolonged working hours, lack of personal protective equipment for safety from contagion, isolation, exhaustion, and lack of contact with family.The study aims to assess the impact of Covid-19 on the mental health of frontline healthcare workers. Methods A descriptive study was conducted among HCWs across points of entry from 1st October 2020 to 31st December 2020.Data was collected using a structured questionnaire.Depression, anxiety, and stress scale (DASS-21)was used for the assessment of depression, stress, anxiety. Descriptive analysis of socio-demographic and professional factors was done. Multivariable logistic regression analysis (MLRA) was performed using SPSS version 23.0. Results A total of 628 participants (586 males and 42 females) completed questionnaire.The mean age of the participants was 42.6 ± 45.9 years. The majority of the respondents were married (94.3%). The frequency of depression, anxiety, and stress in the HCWs was 12.1%, 42.3%, and 22.1 %, respectively. Multivariable logistic regression analysis found that the depression in HCWs was significantly associated with the profession and age (P < 0.001). The anxiety in HCWs was associated with their age and gender (P < 0.005). The stress in HCWs was significantly associated with their age (P < 0.05). Conclusions The HCWs at the Points of entry across Pakistan showed mild to moderate symptoms of DAS. The COVID-19 pandemic has caused a heavy psychological impact among the frontline healthcare professionals. Timely psychological counseling and early psychological intervention need to be implemented for HCWs to alleviate their anxiety and stress and improve their general mental health. Key messages • The COVID-19 pandemic has caused a heavy psychological impact. • Timely psychological counseling and early psychological intervention.