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Country Quarantine During COVID-19: Critical or Not?

Published online by Cambridge University Press:  13 October 2020

Noosha Samieefar
Affiliation:
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran USERN Office, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Reza Yari Boroujeni
Affiliation:
USERN Office, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mahnaz Jamee
Affiliation:
USERN Office, Alborz University of Medical Sciences, Karaj, Iran
Melika Lotfi
Affiliation:
USERN Office, Zanjan University of Medical Sciences, Zanjan, Iran
Mohammad Rasul Golabchi
Affiliation:
USERN Office, Isfahan University of Medical Sciences, Isfahan, Iran
Alireza Afshar
Affiliation:
USERN Office, The Persian Gulf Biomedical Sciences Research Institute, Bushehr, Iran
Hamidreza Miri
Affiliation:
USERN Office, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Mohammad Amin Khazeei Tabari
Affiliation:
USERN Office, Mazandaran University of Medical Sciences, Sari, Iran
Pouya Darzi
Affiliation:
USERN Office, Mazandaran University of Medical Sciences, Sari, Iran
Morteza Abdullatif Khafaie
Affiliation:
Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran USERN Office, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Bagher Amirheidari
Affiliation:
Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran USERN Office, Kerman University of Medical Sciences, Kerman, Iran
Amin Tamadon
Affiliation:
USERN Office, The Persian Gulf Biomedical Sciences Research Institute, Bushehr, Iran The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
Niloofar Rambod Rad
Affiliation:
USERN Office, Islamic Azad University Medicine Faculty, Mashhad, Iran
Nastaran Samimi
Affiliation:
USERN Office, Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
Mojtaba Farjam
Affiliation:
USERN Office, Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
Fatemeh Shiravi
Affiliation:
USERN Office, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Narges Farshidi
Affiliation:
USERN Office, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Mojtaba Hedayati Ch
Affiliation:
Department of Microbiology, Faculty of Medicine, Guilan, University of Medical Sciences, Rasht, Guilan, Iran USERN Office, Guilan University of Medical Sciences, Guilan, Iran
Donya Doostkamel
Affiliation:
USERN Office, Ardabil University of Medical Sciences, Ardabil, Iran
Radin Alikhani
Affiliation:
USERN Office, Ardabil University of Medical Sciences, Ardabil, Iran
Mahboobeh Razmkhah
Affiliation:
USERN Office, Shiraz University of Medical Sciences, Shiraz, Iran
Saeed Abdollahifard
Affiliation:
USERN Office, Shiraz University of Medical Sciences, Shiraz, Iran
Rasoul Nasiri Kalmarzi
Affiliation:
USERN Office, Kurdistan University of Medical Sciences, Kurdistan, Iran
Roya Kelishadi
Affiliation:
Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran USERN Office, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
Hosseinali Khazaei
Affiliation:
Clinical Immunology Research Center of Zahedan University of Medical Sciences, Zahedan, Iran USERN Office, Zahedan University of Medical Sciences, Zahedan, Iran
Asghar Aghamohammadi
Affiliation:
Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran USERN RCI Lab, Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
Farzaneh S. Jafari Mousavi
Affiliation:
USERN Office, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Morteza Shamsizadeh
Affiliation:
Department of Medical Surgical Nursing, School of Nursing and Midwifery, Hamedan University of Medical Sciences, Hamedan, Iran USERN Office, Hamadan University of Medical Sciences, Hamedan, Iran
Arash Khojasteh
Affiliation:
USERN Office, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Nima Rezaei*
Affiliation:
Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran USERN Headquarters, Universal Scientific Education and Research Network (USERN), Tehran, Iran
*
Correspondence and reprint requests to Nima Rezaei, Research Center for Immunodeficiencies, Children’s Medical Center Hospital, Dr Qarib St, Keshavarz Blvd, Tehran14194, Iran (e-mail: rezaei_nima@tums.ac.ir).
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Abstract

Type
Letter to the Editor
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© Society for Disaster Medicine and Public Health, Inc. 2020

The new coronavirus, or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease (COVID-19), emerging from Wuhan, China, is the subject of attention in these days and the world news headlines.Reference Chen, Liu and Guo1 The first case was reported on December 31, 2019, and the disease was declared a Public Health Emergency of International Concern by the World Health Organization (WHO), a month later, on January 30, 2020.2

Iran is one of the most affected countries with more than 290 000 confirmed cases of COVID-19 (in April 29) and unfortunately more than 15 000 associated deaths. According to the geographic distribution data, all 31 provinces in Iran have been affected. The first 2 cases were announced in Qom and then north-central provinces became the hotspot regions, mainly capital cities.

There is no specific medication or vaccine available for this infection, and other COVID-19 outbreaks seem to be inevitable; this emphasizes the need for finding the most beneficial preventive measures.Reference Chen, Liu and Guo1 Isolation, quarantine, social distancing, and community containment are now the available options. Isolation for the purpose of symptomatic and non-infected individuals’ segregation does not appear to be sufficient alone due to the long incubation period of COVID-19. Quarantine as a previous successful measure during the SARS epidemic control in 2003, aiming to restrict the movement of suspected persons (maybe not infected or infected but without symptoms), could be beneficial. Social distancing is another option in which gatherings are reduced in order to avoid close contact of non-detected cases and with the community. The last strategy is community containment, as chosen by the Government of China. It is the restriction of the whole society and limiting the traffic to vital needs only.Reference Wilder-Smith and Freedman3 However, a mass quarantine may increase anxiety, especially among those having previous psychiatric problems and the elderly, even causing other health problems.Reference Lima, de Medeiros Carvalho and Lima4

In Iran, there is community transmission, which means the infection is expanding in numerous independent cluster.5 Therefore, social distancing as done with the closure of schools and universities is beneficial and was fulfilled on February 23. Education guidelines, traveler screenings, charitable donations, the self-assessment system, and travel control may have also contributed to this outcome. The result was the decreasing number of confirmed cases in April. From the beginning of the epidemic, the government has emphasized social distancing rather than mass quarantine. Traveling between cities, although in a decline compared with that during previous years, was still taking place. In April 2020, the government decided to move the policy to smart social distancing while resuming social activities as before.Reference Abdi and Mirzaei6 However, due to the reopening of the offices and increased hubbub, the number of infected individuals has been increasing with a stable trend.

Some Asian countries have implemented successful strategies of pandemic control. The strategies were based on mostly transmission control via isolation and lockdowns, like what the Chinese Government did in Wuhan.Reference Lu, Cheng and Qamar7 Although quarantining faces numerous obstacles, evidence supports its efficacy with emerging infectious diseases.Reference Taghrir, Akbarialiabad and Marzaleh8 In Iran, the increased rate of transmission after returning the society to normal social activities resulted in an incremental trend. In conclusion, the best option available right now is transmission control. Infection cases must be detected promptly, isolated, and treated. However, isolation alone is not the answer; quarantine seems to be an advantageous tool, but its implementation needs resources. Furthermore, the entire society must be responsible and also educated about the disease. They should be aware of the alarming signs of the infection and should voluntarily quarantine themselves when having dubious mild symptoms or if they become exposed to a person who is infected with the new coronavirus.

A group collaboration and awareness are needed to fight the pandemic successfully. “May the disease be controlled by all working side by side, as human beings are members of one another.”

Conflict of Interest Statement

The authors have no conflicts of interest to declare.

Author Contributions

All of the authors had substantial contributions to the conception of the work. The drafting of the work was done by NS and NR; the remaining authors did critical revision. All approved the final draft and agree to be accountable for all aspects of the work.

References

REFERENCES

Chen, Y, Liu, Q, Guo, D. Emerging coronaviruses: genome structure, replication, and pathogenesis. J Med Virol. 2020;92(4):418-423.CrossRefGoogle ScholarPubMed
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