Measures to break the chain of virus transmission and to control the COVID-19 pandemic have caused major problems in the economic, social, political and psychological spheres and have affected billions of people worldwide. The COVID-19 pandemic crisis has caused widespread unrest in society and unprecedented changes in lifestyle, work and social interactions, and increasing social distance has severely affected human relations.
The COVID-19 pandemic has social consequences in certain groups can exacerbate their unfavorable situation. Special groups in crisis situations should be given more attention, and clear and precise policies and programs should be developed to support them. Descriptors: COVID-19, coronavirus, pandemics, impacts on health, systematic review.
n late December 2019, an outbreak of a new viral disease belonging to the coronavirus family was reported in Wuhan, the capital of Hubei, China.(1) The new COVID-19 belongs to the same group of coronaviruses as acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS), which has caused two outbreaks in recent years.(2) The new virus is mainly transmitted by respiratory droplets and contact(3) and affects all age groups.(4) On December, 2021, due to the rapid spread of the virus and the increase in infections, followed by alarming death tolls from the disease was declared an epidemic by the World Health Organization.(5) According to the WHO, as of December 6, 2021, 269 559 230 people worldwide have been infected and 530 5337 people have died from the virus. Also in Iran, as of December 6 in 2021, 6 137 821 people have been infected and 130 277 people have died due to this virus.(6,7)
The COVID-19 pandemics crisis has caused great unrest in society and unprecedented changes in lifestyle, work and social interactions.(8) The implementation of policies such as social distancing and the closure of gathering and interaction centers such as parks, cafes, shrines, schools, universities, etc., has had certain social consequences.(9) Prolonged stay at home, in a society with a patriarchal lifestyle, will increase the pressure for women to do housework. The economic and psychological dimensions of COVID-19 also affect family members. The issue of increasing domestic violence, including child abuse, spousal abuse, elder abuse, and disability abuse following the COVID-19 pandemics crisis, is such that the Secretary-General of the United Nations has also expressed concern.(10) The closure of schools and universities will deprive millions of children, teenagers and young people of social educational activities for a long time, after which it may not be easy to compensate.(11,12) Travel restrictions by different countries have reduced social relations in external areas and led to the isolation of individuals. Because COVID-19 affects all aspects of human life, it has increased divorce and reduced marriage in many countries.(13) In couples' lives, we have witnessed a decrease in marital relationships due to fear of contracting or transmitting the disease.(14) COVID-19 has also challenged and damaged public transport.(15,16)
The COVID-19 greatly affects people's lives. Everyone in the world directly or indirectly faces the severe consequences of this disease. Due to severe isolation and cessation of some social affairs, this disease causes problems such as social anxiety, panic due to insecurity, economic recession and severe psychological stress, which requires coordinated efforts to prevent and control them, and people should follow the advice and the suggestions of government officials and the World Health Organization to make the necessary and at the same time contrary to the internal desire in their daily plan.(17) Given that previous studies have evaluated the psychological and social consequences of other respiratory illnesses; few studies have been performed to evaluate the results of the current epidemic of COVID-19. Therefore, this review study will be conducted with the aim of estimating the social consequences of COVID-19 in order to identify them and take the necessary preventive measures to reduce the problems caused by these consequences. The present study sought to answer the following question: What are the social consequences of COVID-19 disease?
Search strategy. All stages of this research were performed based on the writing standard of systematic studies, PRISMA meta-analysis. The study population in this study included articles on the social consequences of COVID-19 that were indexed on one of the Internet sites. The Web of Science, Scopus, PubMed, Embase, and Magiran databases were searched as international databases, and the Google Scholar search engine was searched in Persian and English between 2000 and 2020. To find related articles in Persian and English language databases, the words searched in line with the research topic and based on mesh and syntax were the following items that were combined using AND and OR operators. The searching strategy used in Medline was: “(COVID-19[tiab] OR Coronavirus[tiab] OR Coronaviruses[tiab] OR Deltacoronavirus[tiab] OR Deltacoronaviruses[tiab] OR “Munia coronavirus HKU13”[tiab] OR “Coronavirus HKU15”[tiab] OR (Coronavirus[tiab] AND Rabbit[tiab]) OR “Rabbit Coronavirus*” [tiab] OR (Coronaviruses[tiab] AND Rabbit[tiab]) OR “Bulbul coronavirus HKU11”[tiab] OR “Thrush coronavirus HKU12”[tiab] OR (“Coronavirus 229E”[tiab] AND Human[tiab]) OR (“Coronavirus NL63”[tiab] AND Human[tiab]) OR “Middle East Respiratory Syndrome Coronavirus”[tiab] OR “SARS Virus”[tiab]) AND (“Social Behavior”[tiab] OR (Behavior[tiab] AND Social[tiab]) OR (Behaviors[tiab] AND Social[tiab]) OR “Social Behaviors”[tiab] OR “Competitive Behavior”[tiab] OR “Cooperative Behavior”[tiab] OR Self-Control[tiab] OR “Social Adjustment”[tiab] OR “Social Distance”[tiab] OR “Social Isolation”[tiab] OR “Social Skills”[tiab] OR “Social Stigma”[tiab] OR (Psychology[tiab] AND Social[tiab]))”.
Infectious disease pandemics, including SARS and COVID-19, demand intrapersonal behaviour change and present highly complex challenges for public health.1 A pandemic of an airborne infection, spread easily through social contact, assails human relationships by drastically altering the ways through which humans interact. In this essay, we draw on theories of social relationships to examine specific ways in which relational mechanisms key to health and well-being were disrupted by the COVID-19 pandemic. Relational mechanisms refer to the processes between people that lead to change in health outcomes.
At the time of writing, the future surrounding COVID-19 was uncertain. Vaccine programmes were being rolled out in countries that could afford them, but new and more contagious variants of the virus were also being discovered. The recovery journey looked long, with continued disruption to social relationships. The social cost of COVID-19 was only just beginning to emerge, but the mental health impact was already considerable,2 3 and the inequality of the health burden stark. 4 Knowledge of the epidemiology of COVID-19 accrued rapidly, but evidence of the most effective policy responses remained uncertain.
Social support, referring to the psychological and material resources provided through social interaction, is a critical mechanism through which social relationships benefit health. In fact, social support has been shown to be one of the most important resilience factors in the aftermath of stressful events.12 In the context of COVID-19, the usual ways in which individuals interact and obtain social support have been severely disrupted. One such disruption has been to opportunities for spontaneous social interactions. For example, conversations with colleagues in a break room offer an opportunity for socialising beyond one’s core social network, and these peripheral conversations can provide a form of social support .13 14 A chance conversation may lead to advice helpful to coping with situations or seeking formal help. Thus, the absence of these spontaneous interactions may mean the reduction of indirect support-seeking opportunities. While direct support-seeking behaviour is more effective at eliciting support, it also requires significantly more effort and may be perceived as forceful and burdensome.15 The shift to homeworking and closure of community venues reduced the number of opportunities for these spontaneous interactions to occur, and has, second, focused them locally. Consequently, individuals whose core networks are located elsewhere, or who live in communities where spontaneous interaction is less likely, have less opportunity to benefit from spontaneous in-person supportive interactions. However, alongside this disruption, new opportunities to interact and obtain social support have arisen. The surge in community social support during the initial lockdown mirrored that often seen in response to adverse events (eg, natural disasters16). COVID-19 restrictions that confined individuals to their local area also compelled them to focus their in-person efforts locally. Commentators on the initial lockdown in the UK remarked on extraordinary acts of generosity between individuals who belonged to the same community but were unknown to each other. However, research on adverse events also tells us that such community support is not necessarily maintained in the longer term.16
Meanwhile, online forms of social support are not bound by geography, thus enabling interactions and social support to be received from a wider network of people. Formal online social support spaces (eg, support groups) existed well before COVID-19, but have vastly increased since. While online interactions can increase perceived social support, it is unclear whether remote communication technologies provide an effective substitute from in-person interaction during periods of social distancing.17 18 It makes intuitive sense that the usefulness of online social support will vary by the type of support offered, degree of social interaction and ‘online communication skills’ of those taking part. Youth workers, for instance, have struggled to keep vulnerable youth engaged in online youth clubs, 19 despite others finding a positive association between amount of digital technology used by individuals during lockdown and perceived social support.20 Other research has found that more frequent face-to- face contact and phone/video contact both related to lower levels of depression during the time period of March to August 2020, but the negative effect of a lack of contact was greater for those with higher levels of usual sociability.21 Relatedly, important inequalities in social support exist, such that individuals who occupy more socially disadvantaged positions in society (eg, low socioeconomic status, older people) tend to have less access to social support,22 potentially exacerbated by COVID-19.
Interactional norms are key relational mechanisms which build trust, belonging and identity within and across groups in a system. Individuals in groups and societies apply meaning by ‘approving, arranging and redefining’ symbols of interaction.23 A handshake, for instance, is a powerful symbol of trust and equality. Depending on context, not shaking hands may symbolise a failure to extend friendship, or a failure to reach agreement. The norms governing these symbols represent shared values and identity; and mutual understanding of these symbols enables individuals to achieve orderly interactions, establish supportive relationship accountability and connect socially.24 25 Physical distancing measures to contain the spread of COVID-19 radically altered these norms of interaction, particularly those used to convey trust, affinity, empathy and respect (eg, hugging, physical comforting).26 As epidemic waves rose and fell, the work to negotiate these norms required intense cognitive effort; previously taken-for-granted interactions were re-examined, factoring in current restriction levels, own and (assumed) others’ vulnerability and tolerance of risk. This created awkwardness, and uncertainty, for example, around how to bring closure to an in-person interaction or convey warmth. The instability in scripted ways of interacting created particular strain for individuals who already struggled to encode and decode interactions with others (eg, those who are deaf or have autism spectrum disorder); difficulties often intensified by mask wearing.27 Large social gatherings—for example, weddings, school assemblies, sporting events—also present key opportunities for affirming and assimilating interactional norms, building cohesion and shared identity and facilitating cooperation across social groups.28 Online ‘equivalents’ do not easily support ‘social-bonding’ activities such as singing and dancing, and rarely enable chance/spontaneous one-on-one conversations with peripheral/weaker network ties (see the Social networks section) which can help strengthen bonds across a larger network. The loss of large gatherings to celebrate rites of passage (eg, bar mitzvah, weddings) has additional relational costs since these events are performed by and for communities to reinforce belonging, and to assist in transitioning
Intimacy relates to the feeling of emotional connection and closeness with other human beings. Emotional connection, through romantic, friendship or familial relationships, fulfils a basic human need32 and strongly benefits health, including reduced stress levels, improved mental health, lowered blood pressure and reduced risk of heart disease.32 33 Intimacy can be fostered through familiarity, feeling understood and feeling accepted by close others.34 Intimacy via companionship and closeness is fundamental to mental well-being. Positively, the COVID-19 pandemic has offered opportunities for individuals to (re)connect and (re)strengthen close relationships within their household via quality time together, following closure of many usual external social activities. Research suggests that the first full UK lockdown period led to a net gain in the quality of steady relationships at a population level,35 but amplified existing inequalities in relationship quality.35 36 For some in single-person households, the absence of a companion became more conspicuous, leading to feelings of loneliness and lower mental well-being.37 38 Additional pandemic-related relational strain39 40 resulted, for some, in the initiation or intensification of domestic abuse.41 42 Physical touch is another key aspect of intimacy, a fundamental human need crucial in maintaining and developing intimacy within close relationships.34 Restrictions on social interactions severely restricted the number and range of people with whom physical affection was possible. The reduction in opportunity to give and receive affectionate physical touch was not experienced equally. Many of those living alone found themselves completely without physical contact for extended periods. The deprivation of physical touch is evidenced to take a heavy emotional toll.43 Even in future, once physical expressions of affection can resume, new levels of anxiety over germs may introduce hesitancy into previously fluent blending of physical and verbal intimate social connections.44 The pandemic also led to shifts in practices and norms around sexual relationship building and maintenance, as individuals adapted and sought alternative ways of enacting sexual intimacy. This too is important, given that intimate sexual activity has known benefits for health.45 46 Given that social restrictions hinged on reducing household mixing, possibilities for partnered sexual activity were primarily guided by living arrangements. While those in cohabiting relationships could potentially continue as before, those who were single or in non-cohabiting relationships generally had restricted opportunities to maintain their sexual relationships. Pornography consumption and digital partners were reported to increase since lockdown.47 However, online interactions are qualitatively different from in-person interactions and do not provide the same opportunities for physical intimacy.
In this article, comprehensive analyses of energy, environmental pollution, and socio-economic impacts in the context of health emergency events and the global responses to mitigate the effects of these events have been provided. COVID-19 is a worldwide pandemic that puts a stop to economic activity and poses a severe risk to overall wellbeing. The global socio-economic impact of COVID-19 includes higher unemployment and poverty rates, lower oil prices, altered education sectors, changes in the nature of work, lower GDPs and heightened risks to health care workers. Thus, social preparedness, as a collaboration between leaders, health care workers and researchers to foster meaningful partnerships and devise strategies to achieve socio-economic prosperity, is required to tackle future pandemic-like situations. The impact on the energy sector includes increased residential energy demand due to a reduction in mobility and a change in the nature of work. Lockdowns across the globe have restricted movement and have placed people primarily at home, which has, in turn, decreased industrial and commercial energy demand as well as waste generation. This reduction in demand has resulted in substantial decreases in NO2, PM, and environmental noise emissions and as a consequence, a significant reduction in environmental pollution. Sustainable urban management that takes into account the positive benefits of ecological balance is vital to the decrease of viral infections and other diseases. Policies that promote sustainable development, ensuring cities can enforce recommended measures like social distancing and self-isolation will bring an overall benefit very quickly. The first generation of COVID-19 vaccines is expected to gain approval by the end of 2020 or in early 2021, which will provide immunity to the population. It is necessary to establish preventive epidemiological models to detect the occurrence of viruses like COVID-19 in advance . In addition, governments, policymakers, and stakeholders around the world need to take necessary steps, such as ensuring healthcare services for all citizens, supporting those who are working in frontline services and suffering significant financial impacts, ensuring social distancing, and focussing on building a sustainable future. It is also recommended that more investment is required in research and development to overcome this pandemic and prevent any similar crisis in the future.