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What Does a Coronavirus 'Lockdown' or 'Shelter in Place' Order Mean?

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Neha Pathak, MD - Blogs
By Neha Pathak, MDBoard-certified internistMarch 18, 2020

The COVID-19 coronavirus has now reached every state in the US. And the number of confirmed cases continue to grow.

Many countries dealing with this pandemic have sought to slow down the spread of the infection by instituting some form of “lockdown” – China, Italy, South Korea, Ireland, Spain, France, and many other countries have taken these drastic steps to protect people and prevent their healthcare systems from becoming overwhelmed.

Now many states and cities in the US are looking at “lockdowns,” or orders to “shelter in place” or "stay in place."  From San Francisco to New York City, these orders have either already been put in place or are being strongly considered. This raises many questions. First, what does it mean to be on “lockdown” or an order to “shelter in place”? Do “lockdowns” actually help? How can I take care of myself and my loved ones during a “lockdown”?

What does a “shelter in place” or "stay in place" order, or “lockdown,” actually mean?

The idea is to make sure that people self-isolate where they live to prevent the spread of the virus in the community. San Francisco’s Department of health, the first in the US to issue a “shelter in place” order, has taken the lead to make sure that people stay home except for “essential activities, business, or travel.”

  • Essential activities are things like grocery shopping, filling medications, doctor’s appointments, and outdoor exercise (but you must stay at least 6 feet away from other people.)
  • Essential businesses include grocery stores, gas stations, hospitals, and healthcare facilities.
  • Essential travel is any movement that’s required to get you to an essential activity or business, returning travelers, or activity that you need to do to care for a dependent.

Besides these activities and business, everything else is closed. That means no schools, no restaurants (except takeout), bars, or movie theaters. Everyone who can work from home, should work from home.

This is similar to what’s happening in Italy, Spain and France, though each country varies in how they’re handling the specifics. In Italy, there is a strict curfew; in Paris, people have to carry forms showing the reason for being outside; and in China, millions of citizens are not even allowed to go to the grocery store.

It isn’t clear exactly how lockdown rules will be enforced in this country, but the aim is to stress to everyone how seriously we should be taking this crisis to avoid infecting each other – especially since we don’t know exactly who is sick without massively ramping up our testing capabilities.

Do “Lockdowns” Help?

If we look closely at research from Italy as an example for what a timely “lockdown” can do to combat new infections, there is a lot we can learn.

New research shows us the difference between two areas that had different response times to COVID-19. Lodi shut down February 23rd, while Bergamo shut down two weeks later, on March 8th. Though Bergamo started out with fewer cases, they soon surpassed Lodi by approximately double. So the sooner it’s done, the more lives that are saved.Lockdown graphic

Shutting down early slows the spread of the coronavirus and "flattens the curve." (graphic courtesy of University of Oxford & Nuffield College, UK)

How can I take care of myself and my family during a “lockdown”?

If a “lockdown” order is put in place for where you live, there are a lot of things you can do to stay healthy (medically, physically, and emotionally).

In most cases, grocery stores and pharmacies will remain open, so come up with a plan for how often you will need to go. In general, planning for 2-week supplies of groceries is reasonable – and low stress. If you know people that cannot travel out for groceries, try to plan picking up for them at the same time you pick up for yourself.

Also, call your doctor’s office well in advance for refills of medications so you know you will have it before your prescription runs out. Many healthcare providers are offering appointments over telephone and video so take advantage of those appointments when necessary.

To stay physically healthy, make a plan for exercising, eating, and sleeping – and try to stick with it. Take regular walks around your neighborhood – just keep a safe distance from others (about 6 feet). Many gyms are offering remote classes, so try to sign up for some of those. Schedule regular meals, and remember when you do go out for groceries, to pick healthy snacks, fruits, vegetables, and whole grains as staples for your diet. Plan for a regular bedtime and wake up time for yourself and other family members.

These schedules and routines can be very helpful for emotional health, as well. I know that it’s been a lifesaver with my husband and kids. But it’s also important to remember that flexibility can help as well. When my children don’t want to follow the schedule because they need a little alone time, we give it to them so that they can come back refreshed.

Reach out to your loved ones and friends regularly – we’ve had many video chat playdates for our kids, and we are checking in with our elderly relatives almost daily. Remember, distancing should not mean isolating.

As the situation changes (sometimes on an hourly basis), we must do our best to adjust to follow safety recommendations. During this time, it’s key to understand that “lockdowns” may absolutely be necessary to protect our loved ones and ourselves, but they don’t have to take away from our day-to-day joys.

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About the Author
Neha Pathak, MD

Neha Pathak, MD, is a board-certified internal medicine doctor and part of WebMD's team of medical editors responsible for ensuring the accuracy of health information on the site. Before joining WebMD, Pathak worked as a primary care physician at the Department of Veterans Affairs and was an assistant professor of medicine at Emory University in Atlanta.

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