Minimising Negative Biopsychosocial Impacts as Lockdown Measures End: A Systematic Review

Background: Infectious outbreaks, most recently Coronavirus disease 2019 (COVID-19), have required public health strategies, termed lockdown measures, including quarantine and closure of public institutions. Although evidence analysing immediate effects is expanding, repercussions following lockdown measures remain poorly understood. This review aims to analyse the biopsychosocial consequences after lockdown measures end according to short, medium, and long-term impacts. Methods: Eligible studies analysed biopsychosocial functioning following lockdown measures secondary to infectious outbreaks. Studies exclusively researching outcomes during lockdown, review articles, or those analysing lockdown measures not pertaining to an infectious outbreak were excluded. Data was extracted from published reports with further information requested where necessary. The mixed methods appraisal tool assessed study quality, a protocol was registered with PROSPERO (CRD42020181134), and narrative synthesis was applied. Findings: Of 3495 identified studies, 27 were eligible. Psychological distress, economic repercussions, social, and behavioural ramifications were observed. Short to medium-term effects comprised reactions relating to early trauma processing whereas medium to long-term repercussions manifested in maladaptive behaviours and mental health deterioration. High-risk groups included healthcare workers, children, elderly, inpatients, those with pre-existing psychiatric diagnoses, and socially isolated individuals. Interpretation: Supporting vulnerable groups and offering education, workplace modifications, financial, and social assistance may mitigate negative repercussions. Establishing a rapid and comprehensive evidence base appraising the efficacy of such interventions and identifying areas for development is essential. This review was limited by heterogeneity and lack of randomisation in available literature. Given the unprecedented nature and progression of COVID-19, the relevance of previous outcomes remains uncertain. Funding: None.Declaration of Interests: The authors declare no competing interests.