Posted: 20 / 03 / 2020

With COVID-19 evolving rapidly across the world we are being advised to prepare for the possibility of isolation and/or quarantine. Today we ask the question, what would be the possible psychological impact of COVID-19 and self-quarantine/isolation. There is a constant stream of information and it can be difficult to determine what might be scare-mongering and what is relevant and accurate information. This can take a real toll on your mental health.

COVID-19 is raising concerns of widespread panic and increasing anxiety in individuals subjected to the (real or perceived) threat of the virus. Importantly, these concerns arise with all infections, including the flu and other agents, and the same universal precautions are needed and indicated for safety and the prevention of further transmission. However, media coverage has highlighted COVID-19 as a unique threat, rather than one of many, which has added to panic, stress, and the potential for hysteria.

As concerns over the perceived threat grow, people may start to collect (and hoard) masks and other medical supplies. This is often followed by anxiety-related behaviours, sleep disturbances, and overall lower perceived state of health. Individuals with mental illness may be particularly vulnerable to the effects of widespread panic and threat. Although the effects of the coronavirus on mental health have not been systematically studied, it is anticipated that COVID-19 will have rippling effects, especially based on current public reactions.

 What is Quarantine?

Quarantine is defined as the separation of individuals who may have been exposed to an infectious disease from the rest of the population to determine if they are ill and to reduce their risk of infecting others.

During the coronavirus (COVID-19) outbreak, quarantine is being used as a public health strategy to reduce disease transmission. COVID-19 quarantine efforts have ranged from the mass quarantine of entire cities in China, to isolation in government-run facilities, to self-isolation at home.

While quarantine can broadly serve the public good, it is also associated with psychological challenges for those quarantined, their loved ones, and the healthcare workers caring for them.

We examine the psychological effects of quarantine, as well as strategies for how to manage your own mental well-being during periods of quarantine.

 Stressors of Quarantine and their Psychological Effects

During Quarantine

  1. Frustration and boredom related to the isolation of quarantine, involving a loss of one’s usual routine and limited social and physical contact with others.
  2. Inadequate supplies and access to regular medical care, including food, water.
  3. Insufficient information from public health authorities, often due to poor coordination among health and government officials.
  4. Longer durations of quarantine (i.e., 10 days or longer), as well as extension of quarantine length.
  5. Fears about becoming infected and/or infecting others, which can manifest as increased attention to and worry about one’s health and physical symptoms.

Following Quarantine: 

  1. Financial loss. Absence from work and other unanticipated financial burdens can result in socioeconomic distress, particularly among those with lower incomes.
  2. Stigma from others. Stigmatization and rejection by neighbours, co-workers, friends, and even family members can manifest as being treated differently or with fear and suspicion, being avoided or excluded from leisure, workplace, or school activities, and experiencing stigmatizing comments. Stigma can be exacerbated if quarantined individuals are members of a particular ethnic or religious group.
  3. Getting back to business. Returning to usual work and social routines may take anywhere from several days to several weeks or even months. Knowing that it might take time to get back into regular routines and help with concern, anxiety, and frustration.

How to preserve your mental health and wellbeing during quarantine

  1. Facilitate communication with loved ones. Knowledge of loved ones’ conditions can have a powerful impact on the emotional health of quarantined individuals and improve adherence to recommended quarantine. For example, knowing that loved ones are safe, healthy, and well-cared for can reduce stress, while increased stress should be anticipated when information is lacking or in cases of worrisome news.
  2. Before quarantine, allow sufficient time to make arrangements, reassure their loved ones, and say goodbye. During quarantine, facilitate the use of technology (e.g., phone and video calls, social media) to keep loved ones in contact with each other.
  3. Prepare for quarantine. Households and facilities under quarantine will need adequate food, household supplies, and medications to last for the duration of the quarantine. Once quarantine is imposed, there may be limited ability to move about and shop as usual. Obtain necessary resources in advance of quarantine if possible.
  4. Reduce boredom and isolation. Planning for activities during quarantine can help reduce boredom and lessen the focus on symptoms and feelings of being isolated from family and friends. As above, facilitating access to the internet and social media is important to maintaining social networks and remote communication while in quarantine. However, media exposure should be monitored, as too much exposure and exposure to unreliable sources can increase stress.
  5. Take care of yourself. Employers are also vulnerable to experiencing the psychological effects of quarantine, and this can be compounded by the stress of managing sick and distressed workforce. Make sure your own basic needs are met, including: eating, drinking, and sleeping; taking breaks at predetermined intervals; checking in with colleagues and loved ones; and ensuring that your family and organization are safe and have a plan in place for possible quarantine. If you are likely to work with infected individuals, have frank discussions with your family about the risk to you and to them and steps being taken to minimize that risk.

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