**3.1 Social impact**

When talking about social impact one needs to understand how a society is formed and functions. Society is like a big web of individuals who are inter-related because of friendship, families or workplace. There are visible and some invisible connections where a person relates to another person or set of person based on ideologies, principles or practice like in name of color, caste, creed or nationality. Invisible connections that often turn into sentiments of positivity or negativity. Stigmatization based on religion, social status and nationality has been a core of social discrimination in this pandemic [2, 9].

A revolution this pandemic brought was the strengthening of visible connections. Spending more time with families had both positive and negative impact. The bonding of families increased however spending too much of time together also had reportedly increased rates of divorce among couples [2, 10]. Veliyannoor coined this as 'return of the repressed' where old conflicts re-emerged during the lockdown due to prolonged forced togetherness between couples [10].

Joshi noticed in her review of psycho-social impact of COVID19 in India that adolescents and young people found it restricting and frustrating to be monitored by parents. Also, she pointed out how the conventional gender role expectations in an Indian society resulted in their overburdening leading to frustration and anger bursts. Family dynamics were also influenced by forced togetherness or separation [2].

Based on age, Dubey *et al*. showed various psychological issues that can happen in different groups and suggested intervention accordingly [7]. Authors showed that children are more prone to boredom, anxiety related to educational development, irritability and fear of infection. Indeed these fears might have been cultivated in them by their parents or guardians to prevent them from going outside. Though the psychological treatment should aim to control extreme fear, casual fear is indeed protective. Proper parenting, online education, and inculcation of healthy habits can provide a feasible solution but this can result in obsession for cleanliness sometimes which if not controlled earlier can get incorporated in psyche and lead to development of OCD (see section on pathophysiology). Young adults developed more anxiety due to low experience in coping with facing distress. Elderlies had irritability, anger issues, fear, anxiety and cognitive decline. Deprivation from pre-scheduled checkup or follow-up can lead to aggravation of their current conditions thus exacerbating the impact. Telepsychology or sessions via telephone or online consultations proved to be useful in all these cases [11]. Telemedicine has gained a lot of popularity during last 2 years and has almost replaced for physical visits except for emergencies at least at some point of time. Though it is not a true alternative to physical consultations it can have advantages in times of distress where risk–benefit ratio might be high for the physical visits for simple follow-ups or chronic illnesses.

Education builds society into a framework as we see and want to see. Conventional education has long been debated but has never been challenged at this scale. Pandemic showed the world a new perspective towards education in terms of online education system. The cellphones which were till an year back not allowed in many schools have become an integral part of education system and has also given food for thought as whether our thought process of keeping these at bay mattered? Long term effects are yet to be seen and short term reports have shown that not going to school may have psychologically affected children but again what impact it shall have on overall growth of a child is yet to be found out. Educational impact can be understood in three different ways- one on parents, one on children and one on teachers. While parents are still doubtful of new education system, it

may be difficult for teachers too as maintaining the sanctity and discipline of class could not be strictly possible in addition to the fact that it is not possible to look after every student in classroom now. Also, teachers may face a constant struggle for validation as this technique of teaching is new for many and they might be under supervision of hundreds of parents who might be listening to what they speak. For students the learning experience has changed, as the way they interact with teachers and fellows have been changed. But not only the schools, even the crucial education deliveries have changed like that of medical training program even though examination patterns have remained nearly same. How this will change the social dynamics is yet to be seen in future [12–14].

The increasing role of social media cannot be overlooked in context of COVID19. The major role it played in pandemic has both positive and negative sides. Positive side includes spreading awareness, helping out friends and locals in times of need like shortage of supplies, finding hospitals etc. seeking help in times of distress (which inculcated a sense of hope in lockdown and quarantines) and enhance bonding among people. But nothing comes without a cost, like enhanced bonding promoted stigmatization of particular community or nationality, outbursts of racism and therapeutic misadventures tried by lay people misleading the general public about treatment or prophylaxis. Coronavirus 'infodemic' is another concern that was created on social media in which panic was created by laying out unchecked mind-boggling rumors [15]. Also it helped to promote the disobedience attitude among people who failed to recognize the disease as pandemic and labeled it as hoax created by world governments to divert the commoners from daily problems.

#### **3.2 Socio-economic impact**

Economic profiles can lead to formation of two groups in society- one whose livelihood has been greatly affected like those of laborers or small businessmen and another those whose work were less affected like those of HCPs, government servants, big businessmen and those working in private sector companies that still ran work-from home. The latter group had lesser financial implications, while former group went nearly bankrupt. Financial implications along with separation from families led migrant workers into great despair. Daily wage earners could not get enough wages to support family. Movement in groups and living in poor conditions predisposed them to infection and stigmatization of being carriers. The ill planned distribution of health services and expense of medical treatment led to hoarding of supplies, black marketing and other health crimes [9].

#### **3.3 Socio-political impact**

This section shall be incomplete without the mention of social and political revolutions. Revolution does not see the face of pandemic to break out. A very crucial aspect of any society is opposition to the laid rules. Protest is common in democracy as problems do not cease to exist in democracy. These people are marginalized and unheard, complicated by existence of pandemic, media often ignore either their plea or glorify their ignorance towards safety guidelines like wearing of masks, grouping together or following proper guidelines. The protestors may also have a feeling of vulnerability and learned helplessness as described for those people who have patients admitted in hospitals and must break social protocols to be able to provide proper care.

Social inequities like belonging to marginalized sections with poor health facilities often expose to chronic diseases leading to higher mortality when contracting COVID19 which has been reported by Osofsky *et al*. They also reported how poorer connectivity can affect seeking help in times of distress [16]. The solution to this cannot be made in a day but it points towards a poor preparedness for any such catastrophic event.
