The Global Impact of COVID-19: A Comprehensive Analysis of Its Effects on Various Aspects of Life

Abstract

In this study COVID-19 effects on different aspects of life that how this virus created a mess in every discipline of life starting from a small tuck shop of a street to a huge business with a chain between different countries; and some preventive measures are also suggested. Not only mental healthiness as well as physical health of people was also disturbed to a large extent. People being quarantined did not do any practice and had nothing to do, their boredom made them mentally and physically inactive. For minimization the effect of this pandemic on mental healthiness, interventions were practiced and psychological support systems were developed to help mentally effected people; on the other hand, to improve physical health the hospital workers worked day and night in return they got affected too either mentally or physically. Many of the youngsters started alcohol consumption during quarantine. Because of the closure of educational institutes, the students were sent back to their homes where there was no proper guidance for them and they lost their interests in studies; and in a sense educational impact of COVID-19 was also unbearable. Agricultural system was affected badly and the whole world passed through a huge economic loss. The flights and traffic were blocked throughout the world, and it is the only positive impact that COVID-19 led to the environment by improving water and air quality as there was a remarkable reduction in the emission of greenhouse gases.

Introduction

Coronaviridae is a family of viruses with a positive-sense RNA having an outer viral coat that can cause illness from mild common cold to acute respiratory tract infection (RTI). Under the electron microscope, a unique corona of peplomer proteins is observed around it.^1,2 This family of viruses mainly causes respiratory diseases in humans in the form of respiratory infections, common cold/pneumonia and even death. These viruses have potential to infect animals basically,³ e.g. two (alpha (α) and beta (β) coronavirus infect mammals while remaining (gamma and delta coronavirus) are reported to cause infection in birds. Furthermore, six categories of coronaviruses are recognized that infect humans. Some types of bird, mammal and human infecting viruses are shown in Table 1.

Table 1.

Classification of Corona Viruses on the base of specie.

Bird Infecting	Mammal Infecting	Human Infecting
Gamma coronavirus	Alpha coronavirus	HCoV229E
Delta coronavirus	Beta coronavirus	SARS-CoV HCoV-NL63 MERS-CoV HCoV-OC43 HCoVHKU1

In 21^st century, the appearance of SARS-CoV-2 have marked the introduction of highly pathogenic coronaviruses into the humans for the third time after severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2004 and 2018 respectively.⁴ Novel coronavirus caused pneumonia, transformed to coronavirus disease 2019 (COVID-19) by WHO on February 11, 2020, a viral pneumonia as a result of extreme acute breathing syndrome coronavirus 2 (SARSCoV-2). Inhalation experience to respiratory droplets by coughing, sneezing² or an unsafe touch between the infected and healthy person,⁵ can lead to the transmission of coronavirus from a gap of more than a few meters to room scale.⁶ The organ that is the most susceptible to be infected by coronavirus in human body is lung, because the virus has capability to joins up the alveolar cells by ACE2 enzyme using its spikes. Therefore, it is to be understood that the inactivity or reduced activity of ACE2 is considered to be protective.² By now it has been spread all over the World due to which it was declared to be a “pandemic” by WHO.⁵ At present, the instances of COVID-19 have been determined in lots of nations across the ecosphere. According to recent figures there have been more than 79,968 declared cases in China, of which 2,873 have died and 41,681 have been cured since January 2020. In addition to China, there were 7,041 performance examples in different countries/regions, of which 105 people died and 459 people were cured.^7–9 Jaws of COVID-19 can engulf almost all age groups but children and infants observed to have a milder clinical course than adults except delta variant coronavirus that is supposed to be making covid-19 more common in kids.¹⁰ It should be noted that although children may have typical symptoms, newborns may have non-specific symptoms. The ailment is rare in the neonate, so, it is suspicion in this group to make a quick diagnosis.¹¹ However, in Italy, literature reports have shown that subjects of age 0–9 years and older than 10 are found to be significantly involved in the spread of SARS-CoV-2.¹²

Although scientists feel essentially “stuck,” enough to carry out experimental activities because of COVID-19- based working restrictions, or sometimes because they need to look after children with the closure of schools and kindergartens. But a marvelous job has been done by them moving towards scientific study and development of vaccine for COVID-19 Fig. 1.

Fig. 1.

Research domains of SARS-CoV-2 from 2019–2021 source web of science and google scholar from November 2019 to July 2021.

Research domains regarding a route of origin, structural determination, symptoms, transmission mode, treatment and vaccine development of SARS-CoV-2 from November 2019 to July 2021 is shown in Fig. 1. A pictorial abstract of data publication with different aspects of COVID-19 on Google scholar, science direct and pub med etc. in Fig. 1. builds a gradual story of scientific study of SARS-CoV-2 from emergence of COVID-19 to July 2021. A gradual rise of scientific investigation of transmission to draw a border line for restriction infected individuals from SARS-CoV-2 was the initial preference of scientist till May, 2020. A parallel approach was running alongside to understand the origin of this novel virus. Although on December 11, 2020, FDA had issued an Emergency Use Authorization (EUA) of Pfizer-BioNTech COVID-19 vaccine to prevent COVID-19,¹³ but significant steeply rising graph of publications on vaccine was observed in February, 2021, per data of Fig. 1_. At the end of story July 2021, each and everything was accommodated in struggle for a synthesis of a vaccine. Figure 1 also depicts that although a negative impact on students have destroyed the whole mechanism but academia has been involved in studying and reporting symptoms, transmission modes and origins, structure and death rates in different waves of COVID leading to a successful development of vaccine.

Psychological Impacts of COVID-19

In response to COVID-19 pandemic, the first safety measure adopted was lockdown (LD) and quarantine policies (QP), which have caused a psychological distresses and social anxieties aggravating risk factors regarding mental health and psychological stability of almost each group of age. A comparative analysis of major psychological traumas e.g. mental disorders, anxiety, depression, fear, worries, stress, insomnia, reduced physical activity, weight gain and loss, variation in sleep & screening time, food intake and alcohol consumption in leading countries is shown in Fig. 2.

Fig. 2.

Mental health issues in major countries during lockdown of COVID-19 Fig. 2 shows abrupt fluctuations in above mentioned attitudes in response to COVID-19 based LD. On the other hand, China, Australia and South Africa have also faced psychological crises during period of LD, most probably the bigger victims of COVID-19. Remaining countries e.g. Iran, Turkey, KSA, India, UAE, Qatar, Singapore, Spain and France have also exposed to adverse effects of pandemic.

Incubation Period & Symptoms of SARS-CoV-2 Infection

Incubation time for SARS-CoV-2 infection was an important factor for implementation of surveillance and control measures Table 2.

Table 2.

Some details of incubation periods of SARS-CoV-2.

Sr. No.	Nature of Incubation Period	Duration	Reference
1	Develop symptoms	11.5 days	(Lauer, Grantz et al. 2020)102
2	Normal incubation period	14 days	(Lauer, Grantz et al. 2020)102
3	Median incubation period	5.1 days	(Lauer, Grantz et al. 2020)102

The most common symptoms were fever and cough, multiple mottling and ground-glass opacity on chest CT images. Symptoms of the virus are similar to those of influenza and respiratory illnesses (Zhao, Yao et al.⁴⁶).

COVID-19 Symptoms

Patients infected by this virus indicated many symptoms which extends slight to extreme and these includes 83% fever, 82% cough as well 31% shortness of breathing and in many cases, pneumonia was also developed which is very lethal^14–22 (Fig. 3). Patients that create acute respiratory distress syndrome may compound quickly and die because of numerous organ failure. About 2%–10% patients having COVID-19 also includes many issues regarding gastrointestinal like as diarrhea, vomiting, pain in abdominal region and nausea. Almost 100% affected patients develop vomiting, diarrhea and nausea and then followed by respiratory tract infections (RTI) as well as fever.¹⁴

Fig. 3.

Clinical Symptoms of COVID-19.

Physical Inactivity

Worldwide outbreaks of infectious diseases are always associated with psychological distress and the symptoms of mental instability. Lack of information, deprived physical health; and absence of activity and non-availability of healthcare access leads to a tremendous increase in anxiety and depression levels. Being home in isolation, studying independently and decreased physical contact with other people is also a significant psychological stress that may cause negative changes such as poor diet and physical inactivity. Physical exercise (PE) is connected with better mental health and emotions consequences, & reduction of physical activity or exercise leads to mental sicknesses like as anxiety and depression. To know the relation between these two aspects, an online survey was conducted on Google forms. When they were questioned related to the PE after and before as well as in the duration of COVID-19 pandemic, 30.32% of the respondents had no PE before the isolation, but this percentage increased during the period of COVID-19 outbreak i.e. 54.16% of the total participants did not practiced any type of PE during the isolation period. Most of the people showed fear of contamination of this severe disease. The survey represented an association between psychological symptoms and physical exercise; its results showed the higher stages stress, anxiety and depression in people who don’t accomplish any PE during quarantine than those who had maintained regular PE.²³ Due to physical inactivity and so reduced organ systems activity, there was a higher risk of damaging respiratory and immune systems. Inactivity also reduces cardiac well-being and results in coronary artery diseases; muscle protein synthesis is also deactivated.^24–27 Upon these consequences it was recommended that it is very important for peoples to carry on their physical activities following all the preventive measures,²³ such as proper exercise, proper nutrition full of nutrients, like vitamins E, D, B and A, and trace elements like zinc etc.²⁴

As a result of tireless efforts of scientists, there was the introduction of corona vaccination. But an issue still remained that the cancer patients were constantly at the greater risk of catching disease as they have weakened their immune system due to this severe disease. Proper awareness and cure treatments are needed for these infected peoples and patients.

Increased Alcohol Consumption

In the 21th century coronavirus epidemic was very crucial situation all over the World since 2019 and all countries are facing economic as well as health challenges since its outbreak. The available data about the outcomes of this epidemic on the mental health of people propose that it can be regarded as a “disaster” and utmost public demonstrations of COVID-19 regarding with mental-health are mood disturbances, poor sleep, anxiety beliefs and worries.²⁴ To reduce the effects of these mental health problems many communities started more consumptions of alcohol and alcoholic based beverages during and even after this outbreak and this consumptions of alcohol to large extent causes many complications and hazardous issues.²⁸ According to one survey about 17% increase in alcohol consumption was observed in American women and adults, only in the United Kingdom during the pandemic. Australian adults drank more than 25% than their previous routine. In China remarkable increase in addictive behaviors was reported. The people of Greece showed increased drinking habits because of isolation (29.7%) and to cope up with depression (13.6%).^22,29

The health crisis of the covid-19 outbreak has global impacts on humanity and the economy and such pandemic effects also influence human behavior. As all the countries implemented lockdown to reduce the infection of the virus and to avoid further transmission of this novel disease. The governments have introduced measures including close contacts of those persons with community which were screened and confirmed this viral disease, avoiding non-essential gathering, closures of schools, wearing masks in public areas etc. for the prevention measures of COVID-19. No doubt these prevention measure prevented this outbreak to a larger extent but these preventive measures also increased the causes of anxiety, depression, and stress. 2.6044 and 4.6180 was the behavior change rate and transmission rate respectively which was measured due to quarantine and from these measures we can conclude that quarantine have both positive as well as negative impact on community but positive impact was double as compared to negative effect.

This was a period when people faced an enormous amount of stress resulting the change in routines and structures of lives. An uncertainty surrounded the humanity that no one knows about this that how much long this will go and what will be the final impact on families, communities, and workplaces. As we familiar that all humans are social in nature and due to this outbreak, all humans were quarantine because of which they feel lonely as well as fear of this viral pandemic and severity of this disease causes anxiety, depression, mental disorders and many health issues especially immune system deficiency. Children learned fears more frequently by seeing scary news and see their parents in anxiety and depression. On peak level of outbreak physical gatherings and meeting were replaced with WhatsApp, zoom call and also other social media applications, and communities learned to engage themselves in homes and their sense of domesticity has intensified by de-cluttering, painting and gardening. People learnt new etiquettes and other sensitivities. On the other hand, feeling of tediousness, fear, disgrace frustration and anger, phobia significantly increased not only due to fear of death but also due to termination of routine life activities e.g. school closure, social isolation, being quarantined and social consequences, associated with several destructive outcomes including suicide. During this outbreak there were many surveys which describe that due to fear of this disease many humans attempts and developed suicidal behaviors. Vulnerability towards such lockdown effects might be higher in people who are already suffering from psychiatric disorders.³⁰ Only one was the positive impact which was observed during this outbreak the all family members were together and there are many examples which revealed that they were supporting with each other.^31,32

Economic Losses

The economic growth was slowed down as a result of this pandemic all over the globe particularly in under developing countries such as India. The disciplines that have a huge contribution towards the economy of a country like agricultural, aviation, construction, textile etc. came up to a standstill and therefore economic grown was affected. Each of the sectors faced a projected loss of thousands of crores due to lack of resources and funds.³³ Many of the countries rely upon tourism for their trading affairs and in such crisis all the travelling agencies canceled the flights and meetings that also negatively affected the economy of the countries.³⁴ More than 15% of gross domestic product (GDP) of Spain, Greece and Portugal is affected because of such catastrophe.³⁵ Good economy is converted into bad economy and bad has become worse. It will take a large tenure to back up the previous economic progress as there are no such chances for the stoppage of spread of this pandemic. Following are the countries that have to face the catastrophe regarding their economic condition as they are mostly dependent upon tourism for trading.³⁴

Similarly, an abrupt decrease of about 87% visits of tourists was observed in the Islands of Balearic.³⁶ As a result of a survey 10%–15% reduction in the economic activity was reported.³⁷ In Pakistan, poverty level raised up to 33.7% due to a huge economic loss of about 1.1 trillion Pakistani rupees.³⁶ As compared to 2019, GDP of China decreased by 6.8% in 2020 and it is a prediction if the situation remains constant, the growth of China’s economy will be less than 1%.³⁸ In 2020, the GDP of Germany, Mexico and the United State fell by 2.2, 1.6 and 1.3% respectively³⁹ (Fig. 4). E-commerce was highly preferred during the lockdown and the people started getting their goods through online shopping at their doorsteps. It resulted in the closure of physical businesses especially of leather and textile shops in bazars increasing the poverty level nationally and internationally that indirectly effects the economy.

Fig. 4.

Tourism Importance for Different Countries.

The world is facing a lot of failures. Unlike other pandemics, it has not only increased the death rate but created a severe condition for the destruction of the businesses and stock market too. A shortage of edibles occurred in markets. Many clothing brands, vehicles business, companies of edible things, currencies of countries, e-business, media, aviation department etc. and many more sectors are hit by this pandemic which has led the world towards a huge economy loss.³⁴

Impact on Education

UNESCO created a report in which it mentioned that starting from 1 April 2020, more than 185 schools, colleges and universities have been closed around the globe. This sudden closure of schools influences around 1,54,24,12,000 learners. A study was held in which the most point was distinctly watch the impact of COVID-19 on the instructors as well as the students. As per this overview, a few teachers and students had to move from face-to-face learning to separate learning or online learning in arrange to recommence education. In any case, this came with abundant challenges such as the need of appropriate get to specialized framework, capabilities and pedagogies for distance learning and usage of this strategy of learning in a few specific areas of consider.⁴⁰

In the start of COVID-19, everyone was advised to remains close in their homes to minimize the risk of catching this contagious outbreak. Only specified professionals doing important tasks for community were allowed to come out of their house and work. All the educational institutes were closed and the students were also sent back to their homes,⁴¹ as a few cases were reported among children that affected 80% of student population in the entire world. The closure of institutes and this critical condition had a great negative impact on the stress levels of inclusive of students, and this stress lead to unwanted effects on learning psychological health of students. Some of the students adapted a habit of being lazy and not studying properly because of not having a care and guidance regarding their studies. The students were stuck to their places and those who managed to go home were worried that they were not able to come back to their institutions for further studies. The pandemic destroyed the careers of university graduates of this year as they were facing interruptions in the assessment of final part of their studies. The international students were asked not to travel overseas and continue studies from their residence; the students who traveled overseas put themselves at the risk of being infected. Then how could they study if they were not physically or mentally well? The students had to face internet issues for attending their classes, many had financial issues that was the reason behind their increased stress level. It was also difficult for the staff to deal with such situation as the sudden shift from face-to-face to online delivery of assessment was challenging. They also needed to vary the assessment types so that it may become fit for online mode. Several other factors are also included that greatly affected the study stress levels of students and staff. Therefore, it was necessary for the universities to help out international students who could not go home for not having a proper setup (books, internet availability, personal computers etc.) by providing them accommodation, food and safety services and it was a challenge for the management of the institute. Administration must ensure to fulfill the requirements of students and faculty must pay careful attention for effective learning.⁴² The nearness of cables, modems, computers and exhaustive web get to could be a prerequisite in arrange to move to online learning mode. The instructors must be prepared to provide their lectures and instructions online. Tragically, many governments, especially the middle and low-income countries did not have an appropriate possibility to arrange input and thus, they failed to relieve the negative impacts on their instruction framework due to this widespread. The decreased learning time has truly impeded student learning and it also prevents the proper development of a child, all the educational institutes must give the students with additional time, summer improvement programs and personalized instructions once this pandemic subsides.⁴³ Many students who are restricted inside their homes endure acute anxiety disorders, stress and grief. Such variables meet with one another and result in negative impacts on learning. Online-based learning cannot give effective socialization; subsequently the students endure since the school environment proliferates learning through peer impacts and this cannot accomplish within the online learning mode. The students need inspiration on a significant level and this exacerbated the education system. The governments of various nations such as Spain, Italy have proclaimed that students will not have to repeat their academic years despite their performance due to the prevailing conditions of COVID-19.⁴⁴ This drift was moreover watched in Pakistan when the O-level and A-level students were awarded with SAGs (Schools Assessed Grades) in their CIEs (Cambridge International Examinations).

Agricultural Impact of COVID-19

The spread of COVID-19 had an unexpected impact of it on agricultural discipline in Pakistan. Harvest crisis were energized in the regions of Punjab and Sindh. Thousands of farmers had to face the disaster because of not having proper labors as well as transport & a fear of catching this outbreak. Lockdown impact on harvesting of wheat crops was observed as a result of which it was to be concluded that about 70% of the wheat harvesting was practiced by the labors belonging to the remote areas and they used to come sometime before the harvesting period. Because of the prolonged lockdown they could not practice their job well and make good profit this time. One more aspect is that the machinery used for harvesting is checked and repaired before the harvest season but now the workshops were shut down that no repairing, no usage, no harvesting and no profit. The disruption in supply chain management of pulses, vegetables, grains and fruits etc. this time reflected the image of the millions of deaths in Bengal in 1943 because of no proper means of food supply; it is to be noted that food availability was huge but people died of not having food supply. In Pakistan during this time period only 15% of the children could consume acceptable amount of diet, many women and children were affected by malnutrition.⁴⁵ During the pandemic the demand of crops and vegetables was increased but due to the non-supply of the goods to public the prices were dropped. As all the hotels and restaurants were sealed sale of crops was reduced.³³ Almost 27% workers which were performing their duties in agricultural systems lose their careers during the period of lockdown in China as the economic loss of this category was recorded 7%.⁴⁶

To overcome these effects of lockdown in this aspect there is a huge need to review how imbalanced supply and demand of products are responded by market forces; food policies should also be analyzed.⁴⁵

Reduction in Green-House Gases

It is obvious that human beings manipulate the nature according to their own will and needs and as a result of this man has destroyed the nature. In spite of all the efforts the nature could not be recovered because of the increasing demands of increasing population and urbanization, the environment got polluted day by day. During the pandemic of COVID-19 complete or partial lockdown was carried out all over world and all the gathering ceremonies were postponed or even cancelled. All the travelling vehicles such as airplanes, rails, buses etc. we’re not allowed to run as they used to run in daily routine. No industries and factories were working. This decreased activity had an excellent impact on environment that the quality of water was improved to a large extent as no waste from industries was disposed of to water bodies. Although air plane emissions contribute 2.4% of global carbon dioxide emissions, the closure of travelling vehicles improved air quality. In US, 40% CO₂ emissions were reduced due to restriction in public transport hence air pollution was reduced (Fig. 5). A trimming of 250 m tons of carbon emissions was reported in China^47,48 making better quality of air in China. As the transportation was restricted globally, there was a reduction in nitrogen dioxide and carbon concentration in the atmosphere. This is the only positive impact of COVID-19 that it prevented the environment from being polluted by greenhouse gases.⁴⁹ Similarly, in India better air and water quality was observed during this lockdown. A decrease of 71% in nitrogen dioxide amount was reported in India. The water quality in river Ganga has improved by 27 points and this water is fit for use of bathing and fisheries propagation.^33,50 A remarkable difference between the concentrations of CO, HCOH and NO₂ was also reported in Jakarta, East and West Java regions of Indonesia before and during the COVID-19 pandemic.⁵¹ Ecosystems are also recovered for less or no use of fossil fuels in industries.⁴⁷

Fig. 5.

Rise and fall of Green House Gases (O₃, CO₂, NO₂) in Leading Countries (India, Iraq, Spain, Italy, France, China, Belgium, Saudi Arabia, Germany, Poland, Portugal, Sweden, United Kingdom, USA, South Korea, Iran, London). Source: Articles from Google scholar, science direct and PubMed.

Anxiety and Preventive Measures

The novel coronavirus has not only seen with positive cases but also increased death rate to a large extent across the world. There is no such proper antiviral vaccine been investigated as yet, the only way to cope up with the severity of condition is the use of preventive measures. A survey resulted that health-care related infections were 30% reduced by adapting the preventive measures. The basic measures include the usage of alcoholic gel, hand hygiene, social distancing etc.⁵² It was observed that anxiety and preventive measures have direct relationship, if any country follows more preventive measures the anxiety rate was also higher in those countries and vice versa. Participants showed frequency of six emotional states related to outbreak e.g. being calm, nervous, depressed, relaxed, contented, and worried. Preventive measures were assessed. From the past weeks to the starting of COVID-19 outbreak, the anxiety increases in greatest proportion from moderate to severe cases in the age group of 41–50 about 5.2% and this is very significant statistically as compared to the age of 20–30 group the normal to severe anxiety level decreases - 2.8%. If we compare female’s anxiety level with male group, the female group increased its proportion (3.3%) and showed significantly higher than males which is 2.7%. A moderate to severe anxiety level of 6.0% was shown in higher educational institutes.⁵³

In recent weeks, the people who washed their hands with soap for their personal protective measures have highest proportion which is 49.0%° and who wore masks for their protection have maximum proportion that is 31.8%. The tissues were commonly used for self-protection and as for cough etiquette that is almost 80.1%. The people who were coughing and sneezing covered their mouth and nose are 65.2%, hand hygiene reported maximum proportion of participants that is 60.3%; people who avoided proximity and kept social distancing from others are 34.4% and those who avoided group gathering are 41.2% and the persons who isolated or voluntary quarantined themselves are 61.6% and who informed health authorities for their sickness are 45.4%. If we compare the ratio of people’s who use tissues after coughing and sneezing for particular preventive measures in recent weeks and at the starting of COVID-19 pandemic have highest proportion that is 13.6% which is because of keeping social distancing and those who avoided the gathering in groups have ratio of 10.3%. The 10.8% participants washed their hands frequently 1.9% people using eyes protection and 3.0% people cover their nose and mouth after coughing and sneezing.

The difference calculated and it is statically significant because during the recent weeks the proportion is 25.4% and when COVID-19 outbreak was started ratio is 23.4%^54,55 (Figs 6 and 7).

Fig. 6.

Differences of anxiety level during outbreak of COVID-19 Outbreak in past weeks and beginning of pandemic.

Fig. 7.

Preventive Measures adopt by peoples during outbreak of COVID-19 Outbreak in past weeks and beginning of pandemic.

Psychological Impact of COVID-19 based LD on Asian Population

As we know China was the hometown of novel coronavirus so, in china both non-health care community as well as health care related community was much posed to greater incidents of depression and anxiety because of their occupational exposure or long-time strict measures, which meant that depression was associated with their participation in rescue operations to mitigate the epidemic. Health-care workers reflected their occupational exposure risk, worries and work intensities. Amazingly more than half of the workers were proud of their work. A literature review also exposed the higher incidence of posttraumatic stress sickness in rescue labors than the overall populace. This study reported that anxiety levels were closely co-related with the severity of epidemic.⁵⁶ Job burnout is defined as a work-related stress i.e. the situation when job affects your health. Similar cases were observed in health care workers in China during the epidemic. Nurses and doctors for fighting with this infection in highly infected areas. at a greater risk of catching this virus caused a serious job burnout in HCPs (health-care professionals) here. Minimization of working hours was strictly required.⁵⁷ In China remarkable increase in addictive behaviors, weight loss and gain due to reduced PA, variation in sleep pattern and screening time was observed to raise.⁵⁸ Changes in dietary behaviors in post-lockdown has been reported in different surveys.

Iran was suspected as the second largest victim in the world till 2020 but declared as 4^th most infected country until 2021 after China, Italy and Spain.⁵⁹ The people of Iran not only effected mentally but the death rate was highly increased. Higher anxiety and depression levels were observed in different regions of Iran. The surveys resulted that ignorance and unavailability of protective tools has caused fear and panic among Iranians, hospital workers became mentally ill because hospitals were at their breaking point due to increasing number of patients.⁵⁹ This unwanted condition lead Iran into a double trouble due to false claims that the contamination of alcohol and disinfectants can cure COVID-19 disease, the methanol outbreak co-occurred in Iran and ethanol demand was also raised.⁶⁰ To know the emotional and anxiety status and protective measures of the population in Turkey, conducted surveys resulted that most of the respondents used to wash hands frequently and wore protective gloves. Almost 38% of them responded “worried” about their relatives of catching disease when asked about their emotions regarding COVID-19. Understanding and timely information helps to control disease spread, manage fear and to design outbreak control strategies.¹

The control measures were adapted in Kingdom of Saudi Arabia (KSA) to minimize the blowout of this pandemic and results mental illness of people in KSA. Younger population reported higher rates of psychological distress in northern and western domains KSA.⁶¹ Women were at greater risk to expire as compared to men in Pakistan.⁶² Significant increase in social media usage and decline of mental health of students in Karachi with increase in the length of sleep was notable.^63,64

Medical and non-medical staff was psychologically affected in India as a result of online survey answered by 85% population.⁶⁵ Lockdown resulted in significant economic costs with fall in income. Arise of mask usage, increased indoors activities and hand washing effected economical lines. Alarming level of hunger, scarcity and access to medical care destroyed mental health. Public health compliance of novelty and media coverage of COVID-19 subside destroyed the overall picture of life in India.⁶⁶ The COVID-19 lockdown has resulted in a high prevalence of unhealthy lifestyle behaviors and practices among UAE residents. A survey regarding the change of life style in UAE during COVID-19 lockdown concluded an increased intake of food up to 31.8%, with fall in physical activity up to 30%, weight gain of up to 29.4%, sleep deprivation of up to 20.8%, and increased smoking up to level of 21%. In addition, female obesity was frequent living in apartments during pandemic.⁶⁷ Decreased Physical activity, increased sitting time, and decreased life satisfaction along with reduced PA during early COVID-19 confinement of 2020 was observed in Qatar.⁶⁸ In Asia PA drop of 42% among younger and predominantly singles during COVID-19 mobility restriction, PA appears to be more severely affected than sleep in Singapore⁶⁹ An elevated emotional feature of dream activity in workers who have stopped working, and with infected or died dear ones from COVID-19 are identified to have changes their sleep habits (Fig. 8).

Fig. 8.

During lockdown, nightmare content was variable: 85% featured worries, 75% conflict, 60% helplessness, 40% assault or failure, 20% illness, 10% lockdown, and 5% COVID-19 (Cohen, Hall et al. 2020)¹⁰³.

Psychological Impact on European Population

In the European countries Italy was the country where they face this pandemic earlier as compared to other European countries⁷⁰ and is now on 2^nd number from the whole world.⁷¹ On March 9^th 2020, lockdown safety measures were imposed by the government throughout the whole national territory. People were advised to stay at home and socially isolate themselves to prevent them from the infection. The psychological impact of pandemics was observed greater even during the quarantine measures. Increasing rate of bad mental healthiness like high stress level, depression, irritability and insomnia outcomes were shown by the general Italic community 3 to 4 weeks during lockdown and this pandemic. Moreover, being quarantined resulted in trauma-related and acute stress disorders, specifically in health workers in Italy (Fig. 9).

Fig. 9.

The extent of PI of the COVID-19. 24.7% symptoms of depression, and 23.2% symptoms of anxiety, 42.2% sleep disturbances and 17.4%.

According to web-based survey 8,177 students of only one university (Milan University) showed depression and anxiety symptoms. In European, Northern Italy was most effective regions which cause increase in depression and worsened working performance varies in poor housing during LD by pandemic.⁷² After experiments on Covid-19 for justice and collaboration of multi-platform architecture revealed that the lack of attention in Italy due to prolonged LD.⁷³ If we look into reported eating habits, in Verona, Italy there was no reported vegetable intake but an increased intake of fruits such that potato chip, red meat and sugar drink. During LD the social activities was decreased by 2.30 h per week and indoor activities increases i.e. sleeping time increased by 0.65 h per day.⁷⁴ Even a so-called “intelligent lockdown” imposed on Italian adult population from government in response to the COVID-19 pandemic, ended at serious behavioral issues.⁷⁵ Due to prolonged LD increase in boredom and anxiety that cause significant weight gain and BMI in women.⁷⁶ The LD has had both a positive and negative effect on pregnant women’s mental health, along with significant psychological implications.⁴⁹ Psychological distress of Northern Italian mothers along with mood disorders and increase maladaptive coping strategies in isolated women as compared to living in area at lower risk which has been assessed through a survey.⁷⁷ Because of high depression and anxiety, the dreams of adults were transfer into nightmares.

Spain has also been a country came under the mental illness and surveys was conducted in this regard of SARS-CoV2.⁷⁸ Almost one third of the population had to go through mild to moderate psychological distress (about 11.5%) in Japan and its severity was highly reported in hospital workers enhanced by isolation, anxiety, work pressure and poor sleep. The depression rate was also increased by 17.9%.⁷⁹ In the result of strict lockdown, a comparable trend in Peru, Spain was seen. Administrative data of phone calls reporting domestic violence showed a 48% in violence against women.⁸⁰ The crisis of reduced solidarity across Europe.^81,82

In Paris, a hotline was created in three days of mental health recovery for medical and paramedical staff following these steps: got an official permit to start the project, created the hotline number, formulated psychological Intervention policies, certified psychologists & psychiatrics were hired, protected database was created and communication & reminders for existence of hotline for hospital workers. If people were facing psychological issues, they may contact to get relief. The frequency of the reasons is listed below: In first 26 days, total 149 calls were received of the patients of trauma reactivation, depression, anxiety, anger etc. It assisted the medical staff that was affected mentally.⁸³ France was likely to lead negative psychological outcomes on cardiovascular health in most of the population.⁸⁴ Increase in alcohol consumption and mental disturbance were seemed in Belgium, in the result of un-employment due to lockdown.²⁸ In the result of pandemic mental health in the UK worsened substantially for young adults and inequalities in mental health have been increased.⁸⁵ People with self-perceived chronic pains were reported to increase in levels of pain severity during the most stringent period of lockdown, reduced levels of PA in the UK. Self-isolation and high-risk status are more likely to cause other illness in the preceding fortnight compared to non-pain counterparts.⁸⁵

Psychological Impact of COVID-19 on European Population

Stress factor was seen in non-infected pregnant females during this outbreak in different countries like Germany, Austria, Switzerland, but no effect was observed in preterm baby birth rate or normal baby birth rate.^86,87 The relation between social and biological rhythms was also affected as well as sudden and severe lockdown in Dutch household survey suggested that this pandemic have also exponential impact on greater level of political support.⁸⁶ In Scotland there was positive change scores in female, from younger age groups, married or living with their partner, employed, and in better health.⁸⁸ COVID-19 restrictions during lockdown of 2020 Germany are reported to impact on the relationship between social and biological rhythms as well as sleep patterns during a six-week period.⁸⁶

Obesity, weight losses among slims, increased BMI, less frequent consumption of vegetables, fruit, and legumes during quarantine as compared to meat, dairy, and fast-foods, higher alcohol consumption, rise in smoking frequency is reported in Poland as well as in other countries.⁸⁹

Psychological Impact of COVID-19 on American Population

In Canada, a prominent 20% of participants who selected to keep on at house practiced an increase in their alcohol drinking. On the other hand, there was a reduction in binge drinking, but the frequency of alcohol drinking presented a rising tendency. A study directed in Brazil recognized that 18% of the sample reported greater alcohol drinking during the pandemic as compared to their previous habits. Among participants having age 30 to 39, the increase was particularly pronounced, reaching 25.6%. Notably, the consumption of alcohol was associated to feelings of sadness and depression.

In the same way, both American females and adults in the United Kingdom described a 17% surge in alcohol drinking amidst the pandemic. Moreover, Europe and the USA witnessed a noteworthy increase in boredom, which was accompanied by a noteworthy increase in online searches related to loneliness, worry, and sadness. In contrast, searches related to stress, suicide, and divorce exhibited a decline. These results propose a potential severe impact on individuals’ mental well-being caused by the pandemic and associated lockdown measures in the United States.⁹⁰ Utilizing data from cell phone activity at the block level and administrative 911 and crime records from Chicago, a study verified an increase in domestic violence.⁹¹

Psychological Impact on African Population

According to the South African health system there were some with poor glycemic control and lesser physical activities resulting in a continuous intake of unhealthy diet is affected by the prolonged effects of lockdown on psychosocial support services resulted in the surges of acute panic, uncertainties, phobias, depression, obsessive behaviors, stigmatization, anxiety, increased gender-based violence cases and social unrests. South Africa the study revealed that adults who retained paid employment during the COVID-19 lockdown had significantly lower depression scores than adults who lost employment. Paid leave is reported to have a substantial and robust impact related to mental healthiness in young community.⁹² Uganda in east central Africa is reported with 40% decrease in food expenditure per adult but increasing trend of usage of savings and borrowing is came to known and they are found to increase by household labor. Uganda and other developing countries need of consumption support is highlighted from here.⁹³ PubMed reviewed observations concerning the addictions and SARS-CoV2 in 2020. Individuals with addictions were at higher risk of multimorbidity and mortality during COVID outbreak.⁹⁴

Psychological Impact on Australian Population

Australian adults drunk more than 25% than their previous routine. The global influence of the OVID-19 on mental health is a pressing concern. However, there leftovers a scarcity of community-level data in this respect. This study presented conclusions from the COLLATE project (COVID-19 and you: mental health in Australia survey), an ongoing initiative aimed at understanding the impact of the outbreak on mental well-being in Australia. The study reported prevalent primary anxieties connected with the pandemic, as well as the current extent of negative emotions and factors that forecast such negative emotional situations. From April 1st to 4th, 2020, an online survey was conducted by 5,158 adults from the common population. Participants ranked their top ten principal concerns pertaining to COVID-19 and finalized identical assessments of negative emotions. The foremost three concerns mainly revolved around the health and well-being of family and loved ones. The levels of negative emotions described were notably raised up. Through predictive modeling of influences contributing to negative emotions, quite a lot of risk elements were recognized, encircling demographic variables, personal exposures, financial strains, and observations associated to social distancing. Precisely, being young, female, or having a diagnosis of a mental illness emerged as substantial risk factors.

The collected data produces a crucial understanding of the present state of mental health in Australia. It is obvious that certain segments of the populace may necessitate targeted attention to safeguard their mental well-being. These conclusions hold the potential to guide international researchers grappling with similar issues, provided that valuable insights for reasonable analyses.⁹⁵ The population of Reunion Island was also suffered from mental distress during lockdown.⁹⁶

Interventions to Mitigate Psychological Impact of COVID-19

All over the World there were many problems which were emerged with the pandemic of COVID-19 and these issues were social, economic and related to health. Due to this outbreak health centers in all countries were becoming overburden and on 11, March 2020 it was declared as pandemic. For the reduction of overburdening and peak of this pandemic as well as non-availability of vaccine or cure against this virus many mitigation strategies were adopted and were compulsory to turn out its spreading all over the World. Generalized gloomy psychological effects of the pandemic were investigated through online web-based surveys all over the world. Along with the general population, healthcare systems were over-burdened and pressurized, so the medical staff around the world had to face continual psychological challenges such as high risk of infection, discernment, overtiredness, separation from our dear-ones and care for this infection. Along with the proceedings followed to ward off the communication of COVID, the development and implementation of well-planned and structured intercessions for governments.⁹⁷ A significant frequency of mental disorders, anxiety, depression, fear, panic, worries, stress, and insomnia, less PA, weight gain and loss, irregular sleeping periods is shown in (Figs 10 and 11).

Fig. 10.

A figure with two subfigures.

Fig. 11.

Estimated growth in GDP during outbreak of COVID-19.

Cure of COVID-19

It was very necessary to spread awareness among people to adapt the preventive measure so that the transmission of COVID-19 could be inhibited to some extent. Physical exercise usually has health benefits and helps prevent several chronic diseases. In addition, physical exercise can improve mental healthiness by reducing depression, anxiety and emotions which causes negative impacts and educating self-confidence. An adaptive exercise program can be a significant feature for the prevention of COVID-19 virus and also imparts many beneficial impacts to improve the psychological and physical performances among the peoples even which were affected by this disease. A proper and healthy workout can also reinforce the lungs to support respiratory system, protect the immune system and reduce the long-lasting costs of treatment.⁹⁸

Vaccination

Since immunization is one of the most successful and cost-effective health interventions to prevent infectious diseases, a vaccine against COVID-19 is considered essential for the prevention and control of coronavirus disease (COVID-19) (some of these vaccines are given in Table 3. with their efficiencies). Countries all over the world are working hard to accelerate the research and development of COVID-19 vaccines. According to reports, there are more than 160 candidate vaccines so far, of which about 20 are under clinical evaluation. Although considerable progress has been made, immunization against COVID-19 still faces major challenges in the future. One of them is that the public’s attractiveness of the COVID-19 vaccine remains uncertain. The acceptance of vaccines reflects people’s overall view of disease risks, vaccine attitudes and needs, which is critical to successfully achieving high vaccination rates, especially for emerging inoculations. As the COVID-19 pandemic has proven better severity in phrases of transmissibility and mortality in comparison with beyond pandemics of influenza, nations around the world which includes China are dealing with splendid stress. Manipulate modern epidemics and prevent unfavorable waves or epidemics from happening again in the expected population. In this case, understanding the influencing elements of the reputation of COVID-19 vaccination and figuring out not unusual place barriers and facilitators for vaccination selections are critical components with inside the layout of powerful techniques to enhance the vaccine insurance fee amongst the overall population.⁹⁹ One might undertake that monitoring the virus’s evolution would be noticeable through symptoms, hospitalizations, and successive damage of life within several populaces. However, COVID-19 has revealed previously concealed puzzle pieces to both the healthcare and global communities. As the virus spread and other circumstances came to light, European nations and the United States developed as hotspots for virus transmission and unsuccessful fatalities. Afterward, a few months down the line, the virus prolonged its reach to countries like India, Pakistan Russia, and key regions within South America and Africa. In addition to traditional media, social media has emerged as a prominent platform through which athletes, coaches, and sports organizations have connected with fans, enhancing brand recognition and dissemination during the pandemic. The paintings on this problem similarly demonstrates the significance of sports activities media and conversation sports in instances of crisis.¹⁰⁰

Table 3.

Some common vaccines used for COVID-19 with their efficiencies.

Sr. No.	Vaccine Name	Nature	No. of doses	Ages of Peoples	Efficiency (%)
1	Comirnaty (BioNTech)	mRNA	3	6 months to all age	95
2	Spikevax (Moderna)	mRNA	3	6 months to all age	94
3	Varzevria (AstraZeneca)	Adenoviral Vector	2	18 years to all ages	70
4	Jcovden (Janssen)	Adenoviral Vector	1	18 years to all ages	91
5	Nuvaxovid (Novavax)	Protein	2	16 years to all ages	89
6	VidPrevtyn Beta (Sanofi Pasteur)	Protein	10	18 year to all ages	72
7	Bimervax (HIPRA Human Health S.L.U.)	Protein	2	16 years to all ages	78
8	Coronavac (Sinovac)	Protein	2	16 years to all ages	50

Source: Web of Science and Wikipedia.

It is widely believed that high blood pressure will increase the growth severity and mortality of patients with the new COVID-2019 disease. However, despite the fact that hypertension or high blood pressure is widely pointed out in the media that it will increase the risk of extreme COVID-19.¹⁰¹ In December 2019, COVID-19 is started and surrounds the whole world rapidly. It has hit the world regarding various aspects at different level. In the result of outbreak, a huge amount of people has met to death. It has led not only toward life loss but many other losses like economy, education, mental health, agriculture, industrial etc. and many more others. In the result to reduce the extension of pandemic and prevention, the strict lockdown was imposed worldwide. Due to lockdown, world is facing many challenges related to mental and physical health, economy progress and settlement. Due to the high pressure on paramedical staff, these workers have suffered through mental illness as well as physical also. Common people have also suffered through mental illness. And many strategies have been adopted to face crisis by world. People became lazy more than enough from usual and have led toward physical sickness also. The percentage of alcohol consumption has also increased. Education system has also led toward destruction. Prevention from this outbreak vaccination is the essential part in which many countries contribute their efforts and it is last way to get rid from this pandemic.

Conclusion

In December 2019, the outbreak of this pandemic is started in Wuhan (China) and the virus is spreading rapidly all over the World and the list of effected countries was increased day by day continuously and the whole world was immersed in it as soon as they saw it. In 1^st March 2020, in China there have been 79, 968 cases recorded of which 2,873 have met to death and 41, 681 have been made well. In addition, there were 7, 041 examples in various regions, of which 105 people died and 459 were made well. All age groups are hit by virus but the children and newly born babies show specific symptoms of corona virus. This infectious disease is not also disturbed the human physical health but animals but also hit other many aspects of life including mental health, economy, education and daily routine etc.

There was a lot of rush in the result infection in hospitals due to this a great pressure have been faced by paramedical staff as well as non-medical staff. The routine was highly disturbed of these due to this severe pressure. It led toward high level of anxiety and depression in the health care workers. The second largest effected country in the world after China was Iran but until February, 2021 it is the 4^th most infected country after China, Italy and Spain. It led not only toward the death but also serious psychological and mental risks. People kept aware themselves through social media which also led toward serious psychological and mental disturbance. And the miss concept of use of use of alcohol for the cure of disease raised the alcohol consumption level in people. Lockdown was imposed to people worldwide which also approached the fear and anxiety, and large-scale isolation. There was a need to help them so a hotline was created in 3 days for their mental health recovery that include some steps. In this regard understanding variation of emotional responses may help to design the outbreak control strategies.

In the result of lockdown many people had lost their jobs and stayed at home continuously. People were free to study independently and result they also were affected physically and their daily routine schedule destroyed and they were free all the time and became lazy more and more. They did not exercise properly which led them toward physical inactivity. Due to this reason people had started consume alcohol quantity more than their routine bases which also a negative impact. The economy was affected worldwide by it. This has been led toward the severe lockdown and the supply chains were affected globally. The economy was affected worldwide by it. This has been led toward the severe lockdown and the supply chains were affected globally. It has led not only human life loss but destruction in business and also other aspects are included, worldwide. Many clothing brands, vehicles business, companies of edible things, currencies of countries, e business, media, aviation department etc. and many more other sectors are hit by this pandemic which has led the world toward huge economy loss and stock market is also severely affected. It is totally different situation world is facing with lots of failures. Here, the graph of gross domestic product of many during lockdown will show that which country is highly affected and which is less and in which range.

Education system was also affected by pandemic. Agriculture system was also influenced by this disease. Thousands of formers had also faced the disaster because of lack of transportation and labor force. Due to lockdown people did not come outside in this regard there was less use of transport which had led toward a positive change in the environment by reduction of green-house gases. In the regard of prevention from the virus, immunization/vaccination is basic and most important factor for mediation against the pandemic. According to recent data more than 160 candidates vaccinate, of which round about 20 are under clinical observation but still we face many severe challenges about vaccination because we can’t discover an effective and long-lasting vaccination that can prevent 100% all people throughout whole life. Anxiety and preventive measures increase with the rise in the prevalence of COVID-19. Greater the anxiety levels, the more use of COVID-19 preventive measures. There is an urgent need for public health interventions to benefit people who are poorly compliant with the identified preventive measures. Considering that COVID-19 is extremely contagious, even if only a small number of people lack compliance, it may cause serious significances and contribute to the continuous spreading of the COVID-19.

Author contributions

Nabiha Naveed: writing, reviewing and formatting of manuscript, Khalil Ahmad, Hammad Majeed, Fozia Noreen & Tehreema Iftikhar: Editing, reviewing and Supervision, Khizar Qureshi, Irfan Ahmad, Mudassir Fareed Awan, Muhammad Awais Amin & Hifza Batool: Editing and drawing of Tables and figures.

Funding

No funding was received for this study.

 

Conflict of interest statement. None declared.

Data availability

There is no new data associated with this article. No new data were generated or analyzed in support of this article.