MASTERS IN GLOBAL PUBLIC HEALTH
STUDENT NUMBER: 22456493
MODULE CODE: 2E7V0041
MODULE TITLE: Dissertation
RESEARCH PROPOSAL TITLE: The Socio-Economic Impact of Frequent Handwashing and
Social Distancing Measures in The United Kingdom
DISSERTATION SUPERVISOR: Dr. Faye Bruce
DATE OF SUBMISSION: 29th SEPTEMBER 2022
CONTENTS
CHAPTER ONE ......................................................................................................................................... 3
1.0. INTRODUCTION................................................................................................................................ 3
1
1.2. RESEARCH QUESTION/ PROBLEM STATEMENT ................................................................... 6
1.3. RESEARCH AIM AND OBJECTIVES ............................................................................................ 7
1.4. LITERATURE/ PRELIMINARY LITERATURE REVIEW ......................................................... 7
1.5. METHODOLOGICAL APPROACH ................................................................................................ 9
1.6. DATA ANALYSIS AND SYNTHESIS ............................................................................................ 14
TABLE 1: TIME FRAME FOR THE RESEARCH STUDY .......................................................... 31
REFERENCES .......................................................................................................................................... 31
List of Tables
Table 1: Socio-Economic Impact of Frequent Handwashing and Social Distancing Measures in The
United Kingdom measurement framework ................................................................................. 8
Figure : Flow diagram of selection of articles for the Socio-Economic Impact of Frequent
Handwashing and Social Distancing Measures in The United Kingdom ............................ 10
Table 2: Time frame for the research study ........................................................................ 11
2
CHAPTER ONE
INTRODUCTION
1.0. INTRODUCTION
At the height of the "first wave" of the COVID-19 pandemic in early 2020, nearly every country
in the world imposed lockdown policies to halt the virus's spread. Lockdown policies were
relaxed in many countries after infection rates had slowed over the summer. The COVID-19
pandemic had a global impact not only on public health but also on the economic status of all
nations. However, by the end of 2020, infection rates in many parts of the world had rapidly
increased, triggering the "second wave" of the pandemic and further lockdowns.(Hale et al.,
2020; WHO, 2020). Even though most citizens appeared to support vital public health policies,
there were elements of dissent based on moral grounds and fundamental rights claims. The
purpose of this paper is to help readers understand the socioeconomic impact of the
aforementioned public health policies, as well as compliance or noncompliance with frequent
hand washing and social distancing measures.
The COVID-19 pandemic was responsible for bringing the global economy to its knees, which
had never happened before in human history (Leach et al., 2020). Due to a lack of available
treatments or vaccines, most affected countries implemented non-pharmaceutical measures to
slow and mitigate the spread of COVID-19. Pandemic mitigation efforts resulted in poor income
generation, job loss, and disruption in the economy, with poor income generation, loss of jobs,
and disruption in production, manufacturing and transportation as a form of reducing the impact
of the disease globally (Leach et al., 2020; Pak et al., 2020). Since direct contact between
humans has been identified as the most common mode of transmission, the emphasis on nonpharmaceutical prevention efforts has primarily been to enforce social distancing practices.
3
Social distancing (or physical distancing) is the action taken to increase the physical space
between people to reduce the possibility of transmission (Gross and Padilla, 2020). These steps
include but are not limited to, working from home, closing academic institutions, restricting mass
gatherings, and "stay-at-home" guidelines. However, the success of these implementations is
largely dependent on citizens' compliance with said state measures. According to the ECDPC
(2020), social distancing has been a critical factor in lowering transmission thus far. As a result,
virtually all affected nations have implemented policies and/or legislation to increase the social
distance to impede the spread of the virus (Hale et al., 2020). The pandemic and physical
distancing are applied nationally across all regions, but the impact of the pandemic and physical
distancing may vary by region, either due to a varying disease burden (reducing healthcare
capacity or preventing attendance) or behavioural change (including physical distancing
measures). According to the United Nations Conference on Trade and Development (2020),
government restrictions to help mitigate the spread of the coronavirus are a result of economic
influence. Travel restrictions, the closure of business offices and marketplaces, and the
prohibition on international travel all had a significant impact on the economies of the countries
(UNCTAD, 2020). According to the International Monetary Fund (IMF) (2022) report, the
COVID-19 pandemic has harmed the global economy. The United Kingdom suffered the
greatest economic blow in the second quarter of 2020, with GDP falling by 19.5%. Furthermore,
it was predicted that the UK's economy would contract by 9.8% in 2020. (IMF, 2022). COVID19 hurt the economic status of America, Europe, Asia, Africa, and other continents, indicating
that the disease has disrupted the economies of several nations worldwide. The economic
consequences of the pandemic stemmed from its preventive measures (Leach et al., 2020).
4
According to a large-scale pan-European survey, the majority of citizens support the
implemented lockdown policies (Schreyögg et al., 2020). Nonetheless, thousands of people
began to protest the measures in cities around the world (Carothers, 2020). Many rallies have
defied social distancing guidelines, causing public health experts great concern (Gabbatt, 2020).
Citizens who attend these rallies have stated a variety of reasons for attending, ranging from
concern about civil rights being restricted to belief in various conspiracy theories centred on the
coronavirus.
Furthermore, Jackson et al. (2021) demonstrated that the virus reduced global economic growth
by around -3.2%, with a 5.9% recovery projected for 2021. The foregoing necessitates the need
to combat the disease's global economic impact and achieve a sustainable economic structure. To
effectively combat the economic impact of COVID-19 and achieve a sustainable structure,
countries have reported various strategies that could have been used to overcome the disease's
economic impact and improve the overall health of their population (Pak et al., 2020). According
to Bárcena et al. (2020), nations have developed policies to help combat the pandemic's impact
and reduce its economic and social consequences. According to Kruja (2013), sustainability is a
common term used by governments and researchers because it allows the population's
developmental needs (such as economic development) to be met without compromising or
affecting the capacity of future generations to meet theirs.
The impact of COVID-19 has shifted the focus of several researchers and governments toward
finding ways to achieve economic sustainability as different variants of the disease (such as the
omicron) and future disease outbreaks emerge (World Bank Group, 2020). Because diseases like
COVID-19 and its variants persist and future outbreaks are expected, effective proactive
international actions are required to achieve a sustainable economic structure (Pak et al., 2020).
5
Furthermore, Shang et al. (2021) reported that increasing the involvement of government
authorities in mitigating disease outbreaks (such as COVID-19) could result in economic
improvement.
In addition, Leach et al. (2020) demonstrated that post-corona virus development can be
achieved through transformative, egalitarian, and political involvement, rather than the top-down
approach. As a result, it is necessary to assess the impact of social distancing and hand-washing
measures on the social and economic well-being of people living in the United Kingdom.
1.1. RESEARCH QUESTION/ PROBLEM STATEMENT
The current study's research question is, "What is the Socio-Economic Impact of Frequent
Handwashing and Social Distancing Measures in The United Kingdom?" According to Brown
(2020), the PICO (P – population, I- intervention, C-comparison, O- outcome) tool is essential in
structuring research questions. For the above-stated research question, the population under
study is the United Kingdom, and the intervention or what is being evaluated is the social and
economic impact of social distancing measures; the comparison here represents comparing the
UK economy status before COVID-19, and the current economic status as the world economy is
recovering. Also, the outcome is to gain insights into the economic and social constraints due to
COVID-19.
The economic impact of COVID-19 affects the UK population's overall health and well-being,
making it a National health problem. This is due to poor income generation, job losses, and
disruptions in production, manufacturing, and transportation as a means of reducing the disease's
global impact (Leach et al., 2020; Pak et al., 2020). Furthermore, the impact of COVID-19 has
shifted the focus of several researchers and governments toward identifying ways to achieve
economic sustainability as different strains of the disease spread. COVID-19 and its new variants
6
are still present, according to Pak et al. (2020), and future outbreaks are expected. As a result, it
is critical to investigate whether COVID-19 has influenced the world to move toward a more
viable economic structure, which will aid in the resolution of the aforementioned research
problems.
1.2. RESEARCH AIM AND OBJECTIVES
The current research study aims to determine whether COVID-19 has influenced the world to
move towards a more sustainable economic structure. The specific objectives of the current study
include the following:

To determine the impact of social distancing on the national economic status

To determine the effects of social distancing and handwashing on environmental
sustainability and human well-being.

To determine the government policies that have resulted from COVID-19 that constrain
the social and economic well-being of the population.

To determine approaches that ensure the wider public is recovering from the economic
influence of the COVID-19 pandemic are available in the UK.

What are the best approaches to sustainably increasing the productivity and incomes of
the population while maintaining social distancing?
1.3. LITERATURE/ PRELIMINARY LITERATURE REVIEW
Three relevant research papers that will help answer the research question and achieve the
current study's objectives were identified during the preliminary literature review for the current
7
study. M. Nicola et al., (2020), Bernal et al., (2020), and Jarvis et al., (2020) are the three
identified research papers (2020). The study title for M. Nicola et al. (2020) is "The socioeconomic implications of the coronavirus pandemic (COVID-19): A review." The study found
that COVID-19 has a significant economic impact and suggested that actions be taken to help
mitigate the virus's spread. This article, however, was unable to demonstrate the impact of social
distancing. The title of the Bernal et al (2020) study is "The impact of social and physical
distancing measures on COVID-19 activity in England: findings from a multi-tiered surveillance
system." The study focused on community surveillance and found that the impact of social
distancing and hand washing on COVID-19 activity could be detected within one week using
community surveillance indicators, highlighting the importance of these behaviours. The study,
however, was unable to provide information on the socioeconomic consequences of disease
outbreaks. Furthermore, Jarvis et al., (2020) published a study titled "Quantifying the impact of
physical distance measures on the transmission of COVID-19 in the UK." According to the
study, the physical distancing measures adopted by the UK public have significantly reduced
contact levels and will most likely have a significant impact and a decrease in cases in the
coming weeks. However, this anticipated decrease in incidence will not occur immediately
because there are significant delays between infection, the onset of symptomatic disease, and
hospitalization, as well as additional delays in reporting these events. However, the study was
unable to establish a link between behavioural change and socioeconomic consequences. As a
result, the current study will fill the gaps identified in these published articles, to determine
whether frequent handwashing and social distancing have a socioeconomic impact on the UK
population.
8
1.4. METHODOLOGICAL APPROACH
This research will be an exploratory systematic review, determining the cause-and-effect
relationship between the socioeconomic status, age, gender, and compliance with social
distancing and frequent handwashing.The study will conduct an electronic search in scientific
databases, such as Mendeley, PubMed, and ScienceDirect. These databases are selected because
it allows for narrowing the literature search with respect to answering the research study's
question due to the presence of search filters. The search terms will be formulated from the
above-structured research question.
9
Main concept
Potential
Boolean search using combined
keywords
terms
Male
and
Female
Population

COVID-19

Social Distancing

Handwashing

United Kingdom

MeSH =" COVID-19
(

"[Mesh]) AND ( " United
Social Distancing OR
Kingdom
Handwashing ))
UK
Adults
aged
30-60 years
COVID-19OR
/epidemiology"[Mesh] OR
"
United
/statistics
and
Kingdom
numerical
data"[Mesh] ))
Lifestyle
I
modification
Intervention or
and
Indicator
economic

Impact
Impact

MeSH = "social distancing
AND
SocioMonitoring"
"handwashing,"[Mesh]
Impact
C
UK
status
Comparison or
Control
economic
before

Economic status
n/a
COVID-19, and
the
UK
10
economic status
post COVID-19
economic
O
Outcome
and

AND
social
" COVID-19”
to COVID-19
6 months
MeSH
=
"social
constraints" AND MeSH =
constraints due
T
((("economic"[Mesh])

6 months

24 weeks
Timeframe
( economic pressure
OR
economic
constraints )
(twenty-four
weeks
OR six months)
Table. 1. Socio-Economic Impact of Frequent Handwashing and Social Distancing Measures in
The United Kingdom measurement framework.
11
This research will advance cross-sectional design methodology, combining several in-depth
qualitative and quantitative approaches to determine the compliance to social distancing and
frequent hand wash guidelines and difficulties in the economic situation of the research
demographic, secondary data will be used for this research.
12
36,914 articles identified, through database
searches of PubMed®, Embase®, Emcare®, Global
Health, Cochrane Library,PsycInfo® and CINAHL
37 additional
articles identified
from other source
3,211 records screened after duplicates
removed
2899 records excluded
312 full-text articles
assessed for eligibility
251 articles excluded: 160 articles
not focused on social distancing
and handwashing, 32 articles
qualitative study only, 26 articles
reported no data for outcomes of
interest, 24 articles had no full
text of study available, 9 articles
did not study COVID -19
61 studies
included in
final review
fig. 1. Flow diagram of selection of articles for the
Socio-Economic Impact of Frequent Handwashing and
Social Distancing Measures in The United Kingdom.
13
1.6. DATA ANALYSIS AND SYNTHESIS
The PRISMA model, as previously stated, will be used to synthesize the research data. In terms
of data analysis, this study will use Braun and Clarke's six-phase framework, which includes;
i.
familiarizing the data,
ii.
initial code generation,
iii.
searching for themes
iv.
reviewing the themes,
v.
defining the themes, and
vi.
writing up the report (Maguire & Delahunt, 2017).
Because the current study uses a systematic review approach, this type of data analysis is
required. Furthermore, the critical appraisal would be used to assess the quality of the chosen
research study.
14
CHAPTER TWO
LITERATURE REVIEW
2.0. COVID-19
Covid-19, which has been classified as a member of the coronavirus family, infects not only
people but animals as well (Kooraki et al. 2020). In 1966, Bynoe and Tyrell became the first to
examine coronaviruses by isolating them from people who had a common cold. They named it
coronavirus due to the surface's resemblance to a solar corona, which contains four other
subfamilies, including gamma, beta, delta, and alpha coronaviruses. While delta and gamma
coronaviruses primarily infect birds and pigs, beta- and alpha coronaviruses are derived from
bats (Ather et al. 2020). The dimensions of a coronavirus's genome are between 26 and 32 kb.
While alpha-coronaviruses are implicated in asymptomatic infections, betacoronaviruses are
linked to serious illnesses. Because Covid-19 is a member of the beta group and shares 96% of
the genome structure of bat coronaviruses, its origin can be traced back to the SARS outbreak
(Cao et al. 2020; Kucharski et al. 2020).
Health professionals believe that the animal trade sector in Wuhan, China, is where COVID-19
first emerged. Despite the paucity of studies to determine the aetiology of the Covid-19
pandemic. The disease outbreak has resulted in over 160 million cases and over 4 million
fatalities reported internationally, with the United States (US), India, Brazil, the United Kingdom
(UK), and Italy among the countries with the highest death tolls globally. The recent resurgence
in Southeast Asia, which resulted in over 100,000 fatalities in 2021 as more people gained access
to vaccines, is a sobering reminder that the fight against Covid-19 is far from ending on a global
scale. Governments have used a variety of policy tools to contain the pandemic and lessen its
effects on socioeconomic systems as the number of Covid-19 cases and fatalities globally
15
continue to rise. One extensively used technique in the armoury of governments to stop the
spread of Covid-19 is the implementation of social exclusionary practices and hand washing.
Undoubtedly, the COVID-19 coronavirus pandemic has provided the greatest threat to global
public health in the past century and non-pharmaceutical measures to control viral propagation of
this nature including social exclusionary practices, such as social isolation, have been crucial.
In the UK, during the epidemic, social segregation policies were not restricted to maintaining
physical separation (1-2 meters in the UK), and only convening meetings distancing oneself as
necessary in ways permitted by the law were put into effect at the time.
2.1. Transmission Characteristics
We've seen that epidemiological and ecological data, as well as models, support the efficacy of
physical distance and handwashing. Some COVID-19 patients are asymptomatic, and the
presymptomatic incubation period ranges from 2 to 15 days, with a median length of 5.1 days
(Lauer et al., 2019). Patients may be most infectious when their symptoms are mild or absent (To
et al., 2020, To et al., 2020).
This distinguishes SARS-CoV-2 (COVID-19) from SARS-CoV, as replication begins early in
the upper respiratory tract (URT) (Wölfel et al., 2019). According to a study of temporal
dynamics, infectiousness began 2.3 days before symptom onset and peaked 0.7 days before
symptom onset. As a result of these disease characteristics, effective policy interventions address
transmission due to infectious patients who exhibit few or no symptoms and may be unaware
that they are infected. Because people with symptoms such as coughing and sneezing were
generally expected to stay at home, other transmission vectors such as speaking, breathing, and
physical contact suggest that particles much larger than the 5-m boundary (a number sometimes
cited by public health authorities as a droplet/aerosol cutoff) can remain suspended in the air for
16
many minutes or more and, most importantly for public health implications for this pandemic,
can waft around (Milton, 2020). Normal speaking generates thousands of oral fluid particles
(aerosols and droplets) with diameters ranging from 1 to 500 m (Asadi et al., 2019), which can
harbour respiratory pathogens such as SARS-CoV-2 (Stadnytskyi et al., 2020). Many of these
emissions will then evaporate and become aerosolized particles, which are three to five times
smaller and can float in the air for 10 minutes or more (Stadnytskyi et al., 2020, Papineni and
Rosenthal, 2007, Wells, 1934). It is known that speech emits up to an order of magnitude more
particles than breathing (Bourouiba, 2020, Morawska et al., 2009, Duguid, 1946). According to a
recent study (Anfinrud et al., 2020), transmission through talking may be a key vector, with
louder speech producing more and larger particles, and a small percentage of people acting as
"speech super emitters," releasing an order of magnitude more aerosols than their peers (Asadi et
al., 2019).
Vuorinen et al., ( 2020) concluded with high certainty that a large proportion of particles of
respiratory origin remain airborne for long enough to be inhaled. They observed that the number
of particles produced by speaking is significant, particularly given that it is typically done
continuously over a longer period (Vuorinen et al., 2020)
2.2. Social/Physical Distancing
Physical distancing is a measure that is recommended to keep a space of at least 6 feet between
you and other people to prevent diseases like COVID-19 from spreading, the phrase "social
distance" was used earlier in the epidemic as people stayed at home to curb the spread of the
virus. Physical distance is used to emphasize the significance of keeping physical space when in
public areas when communities are reopening and people are out in public more frequently.
According to the World Health Organization (WHO), social distance is intended to "provide safe
17
physical distance through reduced crowding" (WHO, 2020). Social distancing techniques include
lockdowns, school closings, and bans on social gatherings in private and public spaces, to name a
few.
Most countries have implemented strict policy measures like lockdowns or stay-at-home days to
stop the spread of Covid-19, including the United Kingdom (Topriceanu et al., 2020), Germany
(Michalowski et al., 2021), China (Yang et al., 2021), the United States (Djulbegovic et al.,
2020), Italy (Coppola and Rania, 2021), and India (Agoramoorthy and Hsu, 2021).
2.3.1. General Introduction of Social Distancing and Handwashing
To lessen the possibility of disease transmission, social distancing is a public health technique
that seeks to keep sick people from being close to healthy people. Large-scale actions like
postponing gatherings or closing public areas are examples of this, as well as more personal
choices like avoiding crowds. The objective of social isolation in the case of COVID-19 at the
moment is to delay the outbreak to decrease the risk of infection among high-risk populations
and to ease the strain on healthcare facilities and personnel. This is referred described as
"flattening the curve" by experts, which mainly refers to the likelihood of social isolation
strategies to minimize spikes in disease that could overwhelm healthcare infrastructure.
Avoiding large crowds, keeping a safe distance (about 6 feet or 2 meters) from others, and
avoiding congregate settings. This entails "no embraces, no handshakes, maintaining the same
6-foot distance from individuals who are showing symptoms of disease, such as coughing,
sneezing, or fever, is especially crucial—and perhaps obvious. Because the virus can spread
even when there are no symptoms, thorough hand washing is crucial for safeguarding not just
oneself but also those people around us.
18
Hand hygiene, commonly referred to as handwashing, is the practice of washing one's hands
with soap or handwash and water to get rid of bacteria, viruses, and other harmful and unpleasant
elements that have stuck to the hands. As wet and moist hands are more easily recontaminated,
drying the cleansed hands is a necessary step in the process [CDC, 2020] [Huang, Ma and Stack,
2012]. Hand sanitiser that is at least 60% (v/v) alcohol in water can be used in place of soap and
water if those two options are not available, provided that the hands are not overly unclean or
greasy. [Centers for Disease Control and Prevention, 2020, ]. Maintaining good hand hygiene is
essential for halting the spread of infectious illnesses in residential and daily environments
[Bloomfield et al., 2007 ]. Before and after specific activities, the World Health Organization
(WHO) advises washing hands for at least 20 seconds, after using the restroom (for urination,
excrement, menstrual personal care), after cleaning a child's bottom (changing diapers), before
feeding a child, before eating, and before/after preparing food or handling raw meat, fish, or
poultry are crucial times where washing hands with soap is important to reduce faecal-oral
transmission of disease [Paludan-Müller et al., 2020, WHO 2020].
2.4. The Impact of Quarantine Policy
In recent years, the social and economic landscape has shifted dramatically. Millions of Covid19 cases have been confirmed worldwide; as a result, governments all over the world have
implemented lockdown measures to ensure the safety of their citizens. As social isolation has
become the new norm, the UK has advocated for up to two weeks of self-isolation, and the UK
has urged its citizens to avoid international travel to combat the Covid-19 pandemic (Shehzad et
al. 2020). All of these precautions helped to keep Covid-19 exposure to a minimum (ZambranoMonserrate and Ruano 2020). As a result, transportation, business, and industrial shutdowns
have significantly reduced revenue generation.
19
2.5. Social Distancing, Handwashing and Socioeconomic changes
Socioeconomic and demographic data show that Covid19 is not having an equal impact on
everyone (Collivignarelli et al. 2020). It is quite challenging to properly understand why
infectious pandemics affect various socioeconomic groups differently, with data credibility being
the main challenge. Unfortunately, social distance has a greater impact on underprivileged areas
than other socioeconomic variables do, thus it's crucial to consider factors like education, rural
versus urban areas, population density, and the number of tenants in a home (Messner 2020).
Research has indicated that impoverished residential areas have a substantially higher infection
incidence than other regions of the city, which suggests that residential areas with lower mean
income are likely to be at a larger risk of becoming infected than places with higher income.
1. Due to the higher population density, maintaining social distance in urban settings is
difficult.
2. People become infected in a home with several occupants without having much social
contact with others since one person can spread the virus and infect others.
However, several factors can influence the outcome:
a) Different regions may adopt different official policies for Covid-19; for example, in the
United Kingdom, different nations (England, Wales, Scotland, and Northern Ireland)
have adopted different strategies to combat Covid-19.
b) Home offices can reduce social contact with others, but only higher socioeconomic jobs
benefit from this, and only a small number of people benefit from this scenario.
c) Official regulations prohibiting people from going out can be counterproductive in
densely populated areas.
20
d) Patients who already have chronic illnesses are at a higher risk than healthy people
(Giannis et al. 2020; Zheng et al. 2020).
e) According to WHO, people who smoke heavily are at a much higher risk because both
smoking and Covid-19 target the lungs.
f) Residents in lower socioeconomic areas are more vulnerable due to a lack of healthcare
services.
As a result, we can safely conclude that socioeconomic demographics are at the heart of the
Covid-19 pandemic, which explains why densely populated areas have higher infection and
mortality rates. Social distancing has a significant impact on industrial and economic activities,
and the implementation of complete and partial lockdown strategies ensures that post-Covid-19
economic and social goals will be opposed to the pre-Covid-19 timeline.
2.6. Vulnerable Populations and Risk Factors.
During the lockdown, vulnerable populations such as the elderly, children/students, low-income
people, migrant workers, prisoners, disabled people, sex workers, and domestic violence victims
faced the risk of worsening socioeconomic and living conditions. To begin with, the elderly
(aged 60 and up) are more likely to experience more severe Covid-19 clinical symptoms (WHO,
2021). While stay-at-home orders may have kept them from contracting Covid-19 infection,
these policy measures inadvertently resulted in decreased use of hospital services by vulnerable
people for non-Covid-related medical conditions (Michalowsky et al., 2021). Migrant workers
lost jobs and income and had difficulty returning home due to lockdowns. School closures
effectively excluded many children, particularly those from low-income families, from learning
and socializing with their peers (Donohue and Miller, 2020; Fantini et al., 2020; Zhao et al.,
2020). Other vulnerable groups, such as prisoners, people with disabilities, sex workers, and
21
domestic violence victims, faced increased risks of economic losses, increased poverty, mental
health issues, disruption of health services, and violence when social distancing measures were
implemented.
Social distancing put additional strain on already overburdened services (Mladenov, 2015).
More targeted welfare benefits, sanctioning, and entitlement reductions have impacted those who
are unable to work (Glasby et al., 2020). According to the Institute for Government, local
authorities in England cut spending on adult social care by nearly 9.3% in real terms between
2009/2010 and 2014/2015, and by 2019 social care funding had been cut by 2% in real terms
compared to 2008/2009. (Institute for Government, 2019). Cuts of this magnitude to an already
overburdened service have resulted in reductions to service range and quality. Individuals' wellbeing was significantly impacted by the lockdown and social isolation tactics, which
compounded pre-existing concerns about a balanced diet, body image, mental health,
employment chances, and decreased access to outdoor space. The lockdown has severely
impacted the general well-being of the citizenry by slowing economic progress. Following the
initial shock of the COVID-19 crisis and its repercussions, measures were taken to
counterbalance diminished financial revenue. However, the protracted lockdown period created a
threat to the well-being of people who were already suffering from some kind of difficulties in
their life. People were stressed due to the pandemic when they were unable to purchase the food
they required to keep a healthy body due to panic buying in stores. The lesser physical activities
resulted in disturbed mental health. People mobilized coping mechanisms to deal with the
declining psychological well-being they felt as a result of their lack of agency during the
lockdown and how, before the pandemic, their lives were structured and goal-driven, but the
22
lockdown scenario had created an aimless existence that threatened their wellbeing. These
coping mechanisms included changing their routines and motivational focus.
2.7.
Adaptations to the Working Environment during the COVID-19
Lockdown
Quantitative information about how the population perceives changes in working conditions
brought on by pandemics are scarce in the literature, and during the earliest stages of the
COVID-19 epidemic, remote working was noted as both a potential and a challenge (Longhurst
et al., 2020). This most likely reflects certain aspects of one's home life, such as a home office
setup, technological proficiency, and parental and caring obligations (Longhurst et al., 2020).
The education sector has also expressed worries about network sustainability, technical
difficulties, and support for online instruction (Pather et al., 2020), all of which are exacerbated
by remote employment. Intellectual collaborations offer assistance and are viewed as having
great potential as a result of the COVID-19 pandemic (Longhurst et al., 2020).
Creating a cooperative online community is crucial because the virus is still changing the
environment and it is unclear what effects it will have on life in the long run. Virtual conferences
were held to share information on the best practices for online training on social media and
forums related to those platforms, online communities are also exchanging resources and best
practices (Evans et al. 2020). The potential to exchange knowledge in subspecialties around the
world is enormous. Online communities can also strengthen bonds between people because
social media use has been demonstrated to encourage a sense of community among users
(Hennessy et al., 2016).
23
It is important to create support systems that must constantly change to guide the work
environment through shifting landscapes and look into people's attitudes toward working
remotely and if their workplaces have altered as the pandemic has advanced.
The problems the workforce is facing are qualitatively described in two studies. According to
Patra et al. (2021), there are worries about the mental toll on employees, wage cuts, and how
senior personnel were disproportionately impacted by the changeover to online learning. Similar
problems with the workload, job security, and budget shortfalls were identified in a thematic
analysis of the effect of the disruption to work that focused on the initial replies in March 2020.
They also emphasized a lack of computer proficiency and a decrease in engagement [Cheng et al.
2021]. But it is clear that the epidemic and subsequent lockdowns have differed greatly
throughout nations and have had an impact on the workplace at various moments.
24
CHAPTER THREE
METHODS
3.0. METHODOLOGY
The systematic review method is used in this study. To begin, ten databases were searched for
articles on social distancing measures, including PubMed, Scopus, Web of Science, ProQuest,
ProQuest Coronavirus Research Database, Embase, ERIC (Educational Resource Information
Center) database, LITCOVID, Cochrane database of systematic reviews, and WHO's global
literature on COVID-19 disease. The initial data search yielded 36,914 records, with 3,211
remaining after duplicates were removed. Second, we combed through the titles of the 3,211
records to find studies on the policy, process, and effects of social distancing measures.
1. Studies related to the policy process and the effects of social distancing measures
published between November 2019 and April 2021;
2. Peer-reviewed studies (empirical, conceptual, and review studies), policy briefs, and/or
government official reports that examine various social distancing measures from a
public policy and/or legal standpoint;
3. Studies that employed jurisdiction (prefecture/district/city/county, state/province in the
UK) as a unit of analysis;
4. Studies that use quantitative, qualitative or mixed methods as research designs;
5. Studies that have been published as full-text articles in English.
The exclusion criteria are;
25
1. Studies published before November 2019; 2) clinical studies on the Covid-19 pandemic
without public policy; and
2. Studies that used an individual or organization as the unit of analysis. In the end, the title
screening yielded 312 relevant articles.
Third, we screened both article titles and abstracts from 312 articles related to the policy process
and the effects of social distancing measures to identify studies on vulnerable groups such as the
elderly, children/students, low-income people, migrant workers, prisoners, disabilities, sex
workers, and domestic violence victims. For this systematic review, we eventually found and
included 61 studies. The majority of studies focus on the elderly, children/students, and lowincome
people.
We
downloaded
the
61
studies
and
reviewed
the
full
papers.
Data extraction was carried out per a predesigned data extraction template, which covered
1. basic study characteristics such as setting (i.e., country/region/city), specific vulnerable
population, main research aim, main research finding, and research methodology (e.g.,
case study, model simulation, interrupted time-series analysis);
2. Social distancing measures that disproportionally or negatively impact vulnerable
populations, and what impacts are there;
3. Policy measures to ringfence vulnerable populations, and effects of these ringfence
measures.
For quality control, two rounds of data extraction practices were conducted for 15 out of the 61
papers to build a consistent understanding of the research aims and scope. After that, data was
extracted from the remaining 46 papers, and the data extraction results were rechecked to ensure
consistency
26
3.1. Search strategy
A systematic search was conducted of seven databases—PubMed®, Embase®, Emcare®, Global
Health, Cochrane Library, PsycInfo®, CINAHL and Africa Journals Online (AJOL)—for studies
on the socioeconomic impact of Social Distancing. Studies on Covid-19 and handwashing were
also identified, as an initial scanning of documents indicates that a high ratio of such research
reports on the prevalence of Covid-19 (search terms are shown in Table 1). Google Scholar and
Google searches were used to source unpublished (grey) materials. Abstracts and titles of studies
were examined, and full texts of suitable studies were accessed for additional screening. The
reference lists of screened documents were hand-searched for additional studies.
3.2. Selection criteria
Studies were selected if they were;
(i)
Original studies reporting on the impact of Social distancing in the UK.
(ii)
Published on or after November 30, 2019.
(iii)
Providing estimates on the impact rates by socioeconomic status, age, sex and
ethnicity (separate and in combination) of Social distancing in the UK.
Hospital-based reports, reviews, studies on British citizens in the diaspora, commentaries,
and viewpoints were excluded.
3.3. Case definitions
27
The main outcome measures in this study were;
(i)
The impact of social distancing in the UK.
(ii)
The effects of social distancing and handwashing on environmental sustainability and
human well-being.
(iii)
The government policies that have resulted from COVID-19 that constrains the social
and economic wellbeing of the population.
(iv)
To determine approaches that ensure the wider public is recovering from the
economic influence of the COVID-19 pandemic are available in the UK.
Recently published studies define social distancing, also known as physical distancing, as a term
used in public health. [Hensley, 2020, Venske, 2020]. It refers to a set of non-pharmaceutical
interventions or measures designed to prevent the spread of a contagious disease by maintaining
physical distance between people and reducing the number of times people come into close
contact with one another. [Harris et al., 2020, Johnson, Sun and Freedman, 2020]. It usually
entails keeping a certain distance from others (the distance specified varies by country and can
change over time) and avoiding gathering in large groups [Pearce, 2020, Centers for Disease
Control and Prevention, 2020].
By reducing the likelihood of an uninfected person coming into physical contact with an infected
person, disease transmission can be reduced, resulting in fewer deaths [Harris et al., 2020].
These precautions can be combined with others, such as good respiratory hygiene, face masks,
and hand washing [GOV.UK 2020, WHO, 2009]. Several social-distancing measures, such as
closing schools and workplaces, isolation, quarantine, restricting people's movement, and
cancelling mass gatherings, are used to slow the spread of infectious diseases and avoid
28
overburdening healthcare systems, particularly during a pandemic [Pearce, 2020, Kinlaw, Kathy;
Levine, 2007]. Loneliness, reduced productivity and the loss of other benefits associated with
human interaction are some of the disadvantages of social distancing [Brooks et al., 2020]. When
an infectious disease spreads through one or more of the following methods, social distancing
measures are most effective: droplet contact (coughing or sneezing), direct physical contact
(including sexual contact), indirect physical contact (such as touching a contaminated surface),
and airborne transmission (if the microorganism can survive in the air for long periods). When an
infection is spread primarily through contaminated water or food, or by vectors such as
mosquitoes or other insects, the measures are less effective. [Centers for Disease Control and
Prevention, 2007]. During the COVID-19 pandemic, authorities encouraged or mandated social
distancing because it is an important method of preventing COVID-19 transmission. COVID-19
spreads much more rapidly over short distances than over long ones. However, in enclosed,
poorly ventilated areas and with prolonged exposure, it can spread over distances greater than 2
m (6 ft). [CDC, 2020]
3.4. Data extraction
Literature searches and reviews of qualified studies were completed independently, according to
the selection measures to ensure consistency in the conclusive selection of studies. Data on the
study setting (the UK), period, sample size, mean age of the population, site and design
(Randomized or descriptive cross-sectional) were extracted and compared with interrelated data
in each study.
3.4.1. Assessment and Data Extraction:
29
The data extracted from individual studies were: impacts of social distancing, country, year of
survey, publication year, total study sample size, author, journal in which the article was
published, age of subjects in years, the proportion of men and women and risk factors associated
with social distancing.
30
TABLE 1: TIME FRAME FOR THE RESEARCH STUDY
S/N
Start
Duration
Task name
Date
End Date
(Days)
1
Initial Research
01/09/2022 05/09/2022 5
2
Proposal
29/09/2022 31/09/2022 3
3
Introduction Chapter
03/10/2022 05/10/2022 2
4
Literature Review Chapter
08/10/2022 14/10/2022 7
5
Methodology Chapter
14/10/2022 17/10/2022 3
6
Presentation 1
18/10/2022 20/10/2022 2
7
Analysis
22/10/2022 28/10/2022 7
8
Results evaluation
02/11/2022 07/11/2022 5
9
Discussion Chapter
07/11/2022 14/11/2022 7
10
Conclusion chapter
14/11/2022 19/11/2022 5
11
Project management chapter
19/11/2022 23/11/2022 4
12
Abstract and Report Compilation
23/11/2022 27/11/2022 4
13
Report Proofreading
27/11/2022 29/11/2022 2
14
Presentation 2
29/11/2022 31/11/2022 2
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