Social and Cultural Impact during an Emerging Infectious Covid-19 Outbreak: A Review Study

. A novel coronavirus (Covid-19) was a global


Introduction
The coronavirus diseases (Covid-19) outbreak was a global pandemic and profoundly impacted the daily life aspects. World Health Organization (WHO) declared that the COVID-19 epidemic as a global emergency on Jan 30, 2020 (1). Over 1.4 million people worldwide were confirmed as positive Covid-19 and over 83,000 deaths globally (2). In response to reducing the spread transmission, travel restrictions, physical distancing, and quarantine should be enforced (3,4). However, it is sparking fears of an impending social and cultural. Anxiety, stress and social impact is a normal reaction to an evolving threat, preparing the individual, both physically and mentally, for an acute response to possible harm (5) Recently, there was still being a gap in the social and cultural impact of Covid-19. There has been only a few literature reviews concerning this issue to deeply understand the effect of the Covid-19 outbreak on Indonesian social and cultural aspects. We summarize the impact of COVID-19 to obtain valuable information for developing strategies to solve the problem and improve the quality of life among Covid-19 patients

Objective
This study aimed to explore and describe narratively related studies toward people's social and cultural impact during an emerging infectious Covid-19 outbreak period.

Data sources and search strategy
The electronic databases, including google scholar, PubMed, and Science Direct, were retrieved to extract the relevant articles. Initially, terms to extract related studies were "social impact," "cultural impact," "Covid-19". The keywords of social and cultural impact were the primary search terms and entered as the medical subject heading (MeSH) in the abstract and title fields 3.2 Eligibility criteria of the study The study's eligibility was design based on the inclusion criteria, including; Indonesia and English language articles. The researchers included several study design types, including a survey study, a descriptive study, a qualitative design, a quasi-experimental study, a randomized control trial, and a mixed-method design in the screening process.

Synthesis of the results
This study's findings were described narratively according to the thematic framework compromised of 1) social and cultural impact of the Covid-19 outbreak, and 2) recommended strategies to manage the socio-cultural implications of the Covid-19 epidemic. Detailed of subthemes are described as follows

Social vulnerability and community resilience
The Covid-19 outbreak has the potential to threaten people's lives, such as social, economic, health, and psychological. The condition of social vulnerability is the real reality that occurs in the community in the face of the Covid-19 pandemic. Social vulnerability makes the position of community resilience experienced a shock due to the Covid-19 epidemic. Community resilience is related to Indonesia's ability to use available resources to fulfill the basic needs and carry out their social functions. However, the current conditions make community resilience experiencing social vulnerability. Social vulnerability decreases productivity, livelihoods are disrupted, and social anxiety disorders in society arise.

Stigma, prejudice, and discrimination
Stigma, prejudice, and discrimination are other concerns of Covid-19 issues in Indonesia. Fear and anxiety from Covid-19 lead to social stigma (6). The shame and discrimination related to Covid-19 occur from people of Asian descent, a traveler from the pandemic area, and emergency responders or healthcare providers who treated Covid-19 patients (6). Stigma also occurs when people have been released from COVID-19 quarantine. Despite they are not considered as the sources of virus spreading.

Social avoidance, rejection and denials of healthcare providers
Social avoidance, denial, and rejection by the community reach a crisis point among healthcare providers during the Covid-19 situation. Many nurses and medical doctors in Indonesia are rejected and avoided by the community because they are considered sources of infection (8). However, nurses and medical doctors are frontlines of the battle with Covid-19. However, being shunned by the community is also confronted by health workers for fear of being infected. Adequate information and correct rumors and stereotypes can raise awareness, de-stigmatize the illness, and reassure the public to hear their experiences (9).

Family dynamics: Domestic violence
Lockdown and social distancing are associated with stress intensify escalations, domestic violence, and child abuse (10). Also, Loneliness and being alone with personal problems, without social interaction during this crisis can lead to other trauma complaints. World Health Organization indicated that 1 in 3 women experience physical or sexual violence during their lifetime (11). Also, an UK's domestic abuse charities reported that a 25% increase of calls made to its helpline since lockdown policies enforced (12). The European Family Justice Center Alliance has recommended managing the domestic violence and child abuse by the multidisciplinary collaboration to provide an overview of the availability of housing options for survivors of domestic violence and child abuse (10).

Severe projection of the poverty rate
The impact of Covid-19 spreading declines the economic aspect of world wide. The financial implications begin from the negative supply shock (13). Atkeson's study confirmed that when 10% of the population are infected from Covid-19, the community income will face severe shortages (14). Resulting, people would fall into the poverty line and unemployment. Indonesia statistic data (BPS) confirmed that unemployment people increased to be 7.05 million out of the workforce. Meanwhile, 24.79 million people lived in the poverty line (15). Therefore, the Indonesia government needs to enlarge its social protection programs to assist the new poor and existing poor people (16). A study reported that thousands of workers worldwide had been placed on a temporary and unpaid leave of absence. Thus, it would impact personal income and ability to pay rent and other household expenditures (2).

Germ panic
Germ panic had been identified in the social response from anti-Asian racism during the COVID-19 pandemic. Historically, there is an exaggerated fear of communicable diseases than other conditions (5). The main reasons for germ-panic rise because they considered that infectious diseases are invisible, quickly passed from person to person, and imminent. Their perception of contagious diseases and perceived risk of the threat at hand heightens. Therefore, it is essential to be aware of the pattern of blaming to work against in our communities actively.

Recommended strategies to manage the socio-cultural impact of Covid-19 outbreak
Researchers propose specific recommended strategies to manage the socio-cultural impact of the Covid-19 epidemic. 1. Maintaining the personal privacy and confidentiality of those people who may be part of any contact investigation. 2. Adequate information and good communication for the broad community are highly needed to help medical doctors and nurses counter the stigma.
3. Raising awareness about COVID-19 without increasing fear, stress, and stigmatized. 4. Engaging with stigmatized groups and providing emotional support for people who have returned from pandemic areas

Strength and Limitation
The findings of this review were updated information. It can be used as inputs for healthcare providers and policymakers to design appropriate strategies for managing the socio and cultural impact of the Covid-19 outbreak. However, some limitations are still found in this study because we decided results in a narrative form rather than meta-analysis. This is due to a limited number of articles and the difficulty of accessing data from databases.

Conclusion
This review describes and confirms the Covid-19 outbreak's impact on the socio and cultural aspects in emerging situations.

Conflict of interest
We declared there is no conflict of interest to write this paper.