Accepted and to be published in: Barriers in Social Distancing during Covid19 pandemic-Is a message for forced lockdown?

Barriers in Social Distancing during Covid19 pandemic Is a message for forced lockdown? Ibad ur Rehman1, Hamza Rafique Khan2, Wafa e Zainab3, Areeba Ahmed4, Muhammad Danial Ishaq5, Irfan Ullah6 1. Shifa College of Medicine, Pakistan; 2. Quaid-E-Azam Medical College, Pakistan; 3. Tehran University of Medical Sciences, Iran; 4. Dow Medical College Karachi, Pakistan; 5. Allama Iqbal Medical College, Pakistan; 6. Kabir Medical College Peshawar, Pakistan. *Corresponding author: Irfan Ullah, MBBS, Kabir Medical College Peshawar, Pakistan Cell: +923340968239, Email: irfanullahecp2@gmail.com, https://orcid.org/0000-00031100-101X


View point
The world currently faces the predicament of the fast-spreading COVID-19 which as of 21st April 2020 affects 210 countries over the globe (1). As the disease started spreading its shadow at an alarmingly rapid rate, new information about the novel coronavirus was extracted and it has been reported to be mainly transmitted directly from person-to-person, droplet spread by cough or sneezing or by fomites (2). Given the highly contagious nature and modes of transmission of the virus, it was recommended for everyone to comply with the concepts of 'social distancing' also termed as 'physical distancing'. Till an effective vaccine becomes available the most potent preventive measure that can be taken is for people to maintain distance and avoid gatherings. Importance of social distancing has been discussed on many forums and disseminated among the public but the problem arises when the practical implementation does not encompass the entirety of the theoretical concepts. Understanding the barriers that stand between applying social distance in community is imperative if authorities and public health sectors expect a substantial change in incident cases. (As shown in Table 1).
COVID-19, the epidemic that has engulfed countless lives has recently emerged as a debilitating disease that is not only causing problems to the health departments of the third world countries but to the first world as well. We have tried to identify several barriers that are halting the implementation of social distancing. A study has reported the economic impact COVID-19 has across industries and countries and it clearly mentions the negative impact it has on service oriented economies (3).
A study conducted in 2020 has stated the how religious and social gatherings are making life harder for the governments to tackle the disease (4) and another study has shown how mass gatherings in the Middle East may prove to be a super spreader of the disease (5).
The study done in Annals of medicine has mentioned how rapid and inappropriate reporting regarding cure and treatment of COVID-19 in terms of use of Hydroxychloroquine and other antimalarial have not only raised hurdles in the current fight but has given rise to more complications in the matter (6). In terms of social basis, the misinformation spread through social media has resulted in the masses developing care-free attitude and paying no heed to social distancing. On educational ground, many universities which were in mid-academic year had to halt their activities, and it would be very difficult for them to cancel the entire academic year, and since the government universities don't have proper online portals so they can't switch to online education. The last but not the least the health barrier, people are not aware of the health benefits of social distancing, hence they don't seem to care much about social distancing.
The key to success in prevention of COVID-19 is adjourning to the laws of social distancing and following them religiously. Moreover that app also sends a text message to the entire area if any person from their locality becomes infected -hence this allowed them to quickly identify the infected individuals, and isolate them, thus stopping the spread (7). Moreover, the study done by Prem et al., (8) in which they created a simulation model for the current COVID-19 trajectory in Wuhan, China reported that if social distancing measures are implemented to full extent, the epidemic peak can be flattened -this further cements the importance of social-distancing. It's imperative that measures should be taken to stop the spread of misinformation, and guide the masses regarding the importance of social distancing. Since the virus spreads by droplet transmission, so without these proper social distancing measures, the burden will increase and it will not be possible to put a stop to this pandemic.

CONFLICT OF INTEREST:
The authors have no conflicts of interest to declare for this study.