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COVID-19's Effects on Transport & Mental Health

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COVID-19's Effects on Transport & Mental Health

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Since January 2020 Elsevier has created a COVID-19 resource centre with

free information in English and Mandarin on the novel coronavirus COVID-


19. The COVID-19 resource centre is hosted on Elsevier Connect, the
company's public news and information website.

Elsevier hereby grants permission to make all its COVID-19-related


research that is available on the COVID-19 resource centre - including this
research content - immediately available in PubMed Central and other
publicly funded repositories, such as the WHO COVID database with rights
for unrestricted research re-use and analyses in any form or by any means
with acknowledgement of the original source. These permissions are
granted for free by Elsevier for as long as the COVID-19 resource centre
remains active.
Journal of Transport & Health 19 (2020) 100969

Contents lists available at ScienceDirect

Journal of Transport & Health


journal homepage: [Link]

COVID-19: Impact on transport and mental health

Pandemics are more than just pathological medical phenomenon. Pandemics appear with various challenges and entail other
devastating situations. Ever since the World War II, the world did not face any extreme challenge as threatening as COVID-19. SARS-
CoV-2 (as named by ICTV) possesses a high basic reproduction number (R0) and has confirmed routes of droplet-borne air transmission
and contagious spread from one to another human. Due to no prior exposure to this pathogen (COVID 19) and unavailability of
vaccines of the same, every individual across the world has become vulnerably susceptible to SARS-CoV-2. Hence, the Worth Health
Organization (WHO) and healthcare authorities of all countries are relentlessly emphasizing on practicing basic personal hygiene, the
use of face-masks and personal protective equipments (PPEs), social distancing and self-quarantine as protective and preventive
measure against COVID-19. This is supposedly to be professed and practiced until a vaccine arrives in the market to provide herd-
immunity. Besides, most of the countries have been under the stringent internal/external movement restriction. Even though the
practice of intermittent lockdown is helping countries to flatten the epidemic curve, but its effect is not providing a satisfactory result
The gravity of the pandemic has taken toll on economy, transport industry, education, and people’s psychosomatic well-being.
Of late, the World Health Organization (WHO) urged ‘all countries to continue efforts that have been effective in limiting the number of
cases and slowing the spread of the virus’ (WHO, 2020a). The practice of complete and partial lockdown has also been taken up as an
important strategy to restrict the spread of the COVID-19 virus among the population across countries. Additionally, the individuals
who commute national and international borders are directly put into self-isolation or remain quarantined for at least 14 days before
they resume to their work place. To validate social-distancing, a ban on frequent inter-state travel and entry of international flights has
been restricted. A report stated the slump in air traffic by 63% in the last week of March 2020; much less compared to the last year (BBC
news report, 2020). In addition with the halting transport any kind of mass gatherings have been restricted. Strict vigilance of military
and police force have been employed to keep control on the frivolous movement of the civilians across the streets. Apart from extreme
emergencies airway and terrestrial transportation have been lessened in number. Certain sectors like grocery shops, banks, and
pharmacies have been exempted from remaining completely closed; the on-road transportation system i.e. from cart-pullers to the
airline industries are undergoing a major economic crisis. An empirical research conducted in Germany projected the dynamic impact
of COVID-19 on the transportation volume and bulk-goods capacity in food material trade. The bulk-goods capacity tended to depend
on the total number of arising fresh infections per day rather than the length of pandemic (Loske, 2020). An upsurge in transportation
of essential goods was found to be in proportion with the demand of groceries. Talking in terms of transportation, freight segment has
faced an ambiguous demand pattern, whereas business or profit in public transport has shown a steady fall. United Nations Economic
Commission for Europe (UNECE) reported intriguing data outcome regarding transportation of several countries as following (UNECE,
2020). Early lockdown period have witnessed a downfall in road fatality in countries such as France (− 56%), Norway (− 54%), London
(− 36%), Ireland, Israel etc. Compared to the month of 2019. Road traffic reduced considerably. In New York City vehicle miles were
approximately fifty million as per March 13 whereas it fell to ten million within April 13. Budapest confirmed 90% reduction of bus
commuters as well as 50% decline in traffic congestion. In Berlin, road traffic reduced by 40%. However, cyclists increased by 50% in
New Work city during March 2020. Countries like, Italy, Switzerland, Germany, Norway faced a sharp drop in passenger vehicle
registration in March 2020 as compared to the previous years. Nevertheless, collision rates have taken a nosedive across the globe. The
positive effect of ‘sustainable mobility’ which concerns environmental preservation in form of cycling has however gained much
priority as a mode of transportation in several countries However, in order to keep up to earn revenue and sustain transport sectors
American airlines have transformed several passengers’ flights to good-carriers (TERI, 2020). Moreover, transportation system has
well contributed during the challenging period by converting passenger trains to mobile hospitals, offering free boarding to patients
and front-liners, delivering relief goods to red zones etc.
Scientifically suitable approaches that may lead to strong policy decisions on transportation system in terms of COVID-19 pandemic
are deficient. Hence, even after the lockdown is being lifted up across countries, passenger restriction in public transport should be
prioritized as well as multiplying the number of passenger vehicles. Strict traffic control should be introduced everywhere to avoid
vehicle jam and mass gathering. Online booking facility for every public medium of transport should be mandatory. Researchers of

[Link]
Received 25 September 2020; Received in revised form 18 October 2020; Accepted 27 October 2020
Available online 2 November 2020
2214-1405/© 2020 Elsevier Ltd. All rights reserved.
P. Dam et al. Journal of Transport & Health 19 (2020) 100969

transport segment of different countries should stress on the concept of monetary compensation for each transport industries facing a
massive loss throughout the pandemic. A recent investigation have projected a PASS (Prepare/Protect/Provide, Avoid/Adjust, Shift/
Share, Substitute/Stop) method typically designed for transport policy making in the course of current and future threats (Zhang,
2020).
Nevertheless, this pandemic situation has adversely affected on mental well-being. Even though travelling and socialising have
therapeutic effects on mental health, all such activities have come to a standstill. It was found that quarantined individuals grow more
prone towards developing a spectrum of mental illness, where mood swing, confusion, irritability, numbness, stress, anger, anxiety,
grief, depression, insomnia are evident (Brooks et al., 2020). Beyond the social scenes, SARS-CoV-2 episodes have been fetching loads
of stressors into the locked lives of people, such as duration of the lockdown, loss of freedom, boredom and frustration, social sepa­
ration, inadequate lifestyle supplies, financial crisis, increased family issues and domestic violence, anxiety related to local news as
well as rising case numbers, stigma, fear of contracting the disease, uncertainty about life, fear of losing closed ones and fear of death
(thanatophobia).
Researchers have also reported serious case studies of stress disorders. During the outbreak of SARS in 2003 outbreak, a study
reported that quarantined individuals displayed symptoms of frustration (58.5%), annoyance (54.3%), worry (40.2%), loneliness
(38.5%), helplessness (31.7%), anger (28.6%), Fear (22.4%), nervousness (18%) and sadness (18.1%) whereas only 4.7% reported to
be happy (Reynolds et al., 2008). Other investigation also concluded that healthcare professionals, children, elderly and people with
underlying mental health issues were inevitably susceptible to psychological distress during the outbreak of any epidemic. Health-care
professionals remain at a high risk of physical and mental fragility. Insufficient testing, inadequate treatment options, lack of enough
Personal Protective Equipments (PPEs), extensive workloads, agitated public reactions etc. are certain additional stressors (Pfeffer­
baum and North, 2020). Healthcare workers who were quarantined earlier after having contact with SARS patients, developed
symptoms of acute stress disorder, exhaustion, anxiety, poor attentiveness, indecisiveness, worsening work performance and even
consideration of resignation. Moreover, post-traumatic stress disorder (PTSD) symptoms were persisted 3 years later (Brooks et al.,
2020). Also, alcohol abuse or addiction symptoms were found to be correlated with them even after 3 years (Wu et al., 2008). Later,
another study conducted after an epidemic breakout reported that mental health was much unstable among quarantined individuals.
Younger ones were vulnerable. Moreover, the married population had more mental fitness than the single counterparts (Liua et al.,
2012). In the following years a study on pandemic discovered that quarantined mothers with children needed mental health protection
or counselling services during or after the episode. Out of the total cases 16.7% of children were found to have acute stress disorder
(16.7%), adjustment disorder (16.7%), grief (16.7%), and cases of post-traumatic stress disorder (PTSD) were reported to be 6.2%.
PTSD scores were four times higher among quarantined children (Sprang and Silman, 2013).
Research conducted in China on the onset of COVID-19 showed that Chinese psychosomatic deterioration. Physical symptoms like
muscle ache; coryza and dizziness were directly related to heightened level of stress, anxiety and depression. Most of people displayed
hypochondriasis and apprehended becoming COVID patient. Also the very thought of infecting their family members was found to be
highly prevalent (Wang et al., 2020). Cases of dire panic were reported (Roy et al., 2020). The most panic stricken section of population
was youths, females and co-morbid individuals (Varshney et al., 2020). Insufficient health care and infrastructure for COVID-19
treatment created panic among the patients and their caretakers. (Paz et al., 2020). A study held in Japan also exposed higher rate
of depressive and anxiety symptoms among the economically weak, part time workers and unemployed population, and part-time or
provisional workers (Ueda et al., 2020). Zhang, Yang and team found that more than one-third of the Chinese population faced
insomnia during this COVID-19 episode (Zhang et al., 2020). Internal migrant workers who constituted to be one of the most
vulnerable sections of the society were found to develop serious mental distress (Choudhari, 2020) and many were reported to commit
suicide.
Parenting stress also increased due to the online schooling in Japan (Hiraoka and Tomoda, 2020). Most of the children confined at
home demanded more parental attention and supervision. Eventually, it turned out to be strenuous for parents as well. It was reported
to be quite strenuous on the part of the parents to manage household chores, do online work from home as well as monitor their
children’s academic life. A surge in numbers of domestic violence and child abuse are correlated with the affected mental state of the
victims (Lee, 2020).
The social distancing almost galvanized people mentally and brought sea change in behavioural pattern of individuals across the
globe. According to the recent policy briefs by United Nations, “The mental health and wellbeing of whole societies have been severely
impacted by this crisis and are a priority to be addressed urgently” (UNSDG, 2020). World Health Organization is stressing upon
#HealthyAtHome hash tag. For psychosocial well-being biological, emotional, spiritual, social, mental and material aspects are
extremely instrumental. Family and community networks exclusively play pivotal roles in the developmental process of a human
being. Even though virtual socialization is acting as a support system by so far, but to a great extent it is mode of and faceless medium of
communication.
New research methodologies and policy making in all distressed countries should focus on short and strict lockdown at the hotspots,
adequate and rapid supplies of basic needs to the homes under lockdown, promoting trusted news-sources to cut down misinformation,
enough psychological services through e-care and telemedicine. Government bodies should support the contribution of multidisci­
plinary mental health teams at national and state levels; provide psycho-educational material and training in stress management with
special reference to pandemic stress; ensure infrastructure of alternative mental health services accessible to the public. Risk of losing
livelihoods after the period of lockdown is putting a ‘macro-stress’ on vulnerable populations. ‘Work from home’ opportunities should
be increased to mitigate the frustration after sudden change in work schedule and financial thoughts. Safe social services systems are
needed for providing surveillance and intervention following up the reports of problems by vulnerable people (such as domestic

2
P. Dam et al. Journal of Transport & Health 19 (2020) 100969

violence or child abuse) in this period of lockdown. At the individual level, intake of healthy meals and mood enhancing dietary
supplements should be augmented. Practice of mindfulness, meditation, exercise and breathing exercises can switch off the fight or
flight system.
However, in this present scenario of COVID-19 have put many nations into bewilderment, especially the nations with high density
population is somewhat facing problems in disciplining people about certain nitty-gritty like the advice on use of masks, opting for a
hygienic lifestyle and professing cleanliness morale. They should brainwash every individual about the severity and gravity of the
pandemic so as to make people become more aware and conscious. Nevertheless, it is of utmost and equal importance on the part of the
government to boost research counterparts, find out scientific and conducive ways to construct new policies for the transportation
industries as well as psychological wellbeing of citizens.

Funding

None.

Ethical approval

Not required.

Author contributions

All the authors contributed to conceptualization, data collection, writing and reviewing.

Declaration of competing interest

The authors declare no conflict of interest.

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[Link]

Paulami Dam, MSca, Sanjib Mandal, PhDb, Rittick Mondal, MSca, Abdul Sadat, PhDc, Suvashree Roy Chowdhury, PhDd,*, Amit
Kumar Mandal, PhDa,e,**

3
P. Dam et al. Journal of Transport & Health 19 (2020) 100969

a
Chemical Biology Laboratory, Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
b
Department of Economics, Raiganj University, North Dinajpur, West Bengal, 733134, India
c
Insect Ecology and Conservation Biology Laboratory, North Dinajpur, West Bengal, 733134, India
d
Department of Education, Baneswar Sarathibala Mahavidyalaya, Baneswar, Cooch Behar, West Bengal, 736133, India
e
Centre for Nanotechnology Sciences, Raiganj University, North Dinajpur, West Bengal, 733134, India

*
Corresponding author. Department of Education, Baneswar Sarathibala Mahavidyalaya, Baneswar, Cooch Behar, West Bengal,
736133, India.

**
Corresponding author. Chemical Biology Laboratory, Department of Sericulture & Centre for Nanotechnology Sciences, Raiganj
University, North Dinajpur, West Bengal-733134, India.
E-mail addresses: suvashreeroychowdhury@[Link] (S.R. Chowdhury), amitmandal08@[Link] (A.K. Mandal).

Common questions

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Reports from the SARS outbreak illustrated similar psychological effects to those seen during the COVID-19 pandemic, such as frustration and annoyance. However, the scale of impact during COVID-19 has been more extensive, potentially due to the heightened global reach and severity of the outbreak, as well as prolonged quarantine measures .

The pandemic has intensified mental health issues by increasing stressors such as lockdown duration, financial insecurity, and fear of illness. Vulnerable demographics include healthcare workers, children, the elderly, those with pre-existing mental health issues, and lower socio-economic groups, such as part-time workers facing economic hardships . Young people and single individuals presumably face more instability compared to married individuals .

The pandemic affected different population groups in varied ways. Youths and females experienced heightened panic and anxiety, with economically weaker groups, like part-time workers, facing higher rates of depression and anxiety due to job instability. Quarantined children were especially at risk, with increased reports of stress disorders and PTSD .

Interventions include enforcing short and strict lockdowns at hotspots, ensuring rapid provision of essential supplies, and maintaining psychological support services via e-care systems. Encouraging healthy lifestyle practices such as balanced diets, meditation, and physical exercises are also recommended to alleviate stress caused by lockdowns .

The PASS (Prepare/Protect/Provide, Avoid/Adjust, Shift/Share, Substitute/Stop) method is recommended for creating effective transportation policies during pandemics. It includes measures like online booking requirements, passenger restrictions, and increasing public transport vehicles to manage social distancing . Emphasis is placed on monetary compensation for transport industries hit hard by the pandemic .

Inadequate testing and insufficient PPE supply contribute significantly to mental health issues among healthcare workers by heightening stress and anxiety levels due to increased risk of infection and overwhelming workloads. This can lead to burnout, acute stress disorder, and even long-lasting PTSD symptoms .

The COVID-19 pandemic significantly impacted mental health among quarantined individuals, leading to increased susceptibility to a range of psychological issues such as mood swings, anxiety, and depression. Quarantined persons reported feelings of frustration, annoyance, and loneliness, similar to findings from the 2003 SARS outbreak . Healthcare professionals were especially vulnerable, experiencing acute stress disorder, exhaustion, and PTSD symptoms due to insufficient Personal Protective Equipment and extensive workloads .

International organizations prioritize mental health due to the widespread psychological distress caused by the pandemic, with significant implications for societal well-being. The urgency is rooted in the complex challenges faced by different demographic groups and the potential long-term mental health consequences requiring coordinated global responses .

Governments are encouraged to support multidisciplinary mental health teams, provide psycho-educational resources, and ensure the availability of rapid response health services. They should also encourage work-from-home opportunities and disseminate trusted information to reduce uncertainty and stress among the public .

Community and family networks are crucial in providing emotional and social support, essential during the pandemic when social distancing measures can lead to isolation. These networks help fulfill biological, emotional, and spiritual needs, supporting mental health resilience amidst the crisis .

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