Coping with quarantine

Brooks and colleagues (2020) conducted a rapid review of the research literature on the psychological impact of quarantine and included 24 studies conducted across 10 countries. These studies included people with SARS, Ebola, the 2009 and 2010 HIN1 influenza, Middle East respiratory syndrome and equine influenza but none with COVID-19. The review found that the impact of quarantine can be substantial and long-lasting.

Psychological impact of quarantine

Most studies reported that there were negative psychological effects of quarantine, including post-traumatic stress symptoms, confusion and anger.

Stressors due to quarantine

Longer quarantine duration was associated with more severe post-traumatic stress symptoms, anger and avoidance behaviours. The quarantine duration being compared was not always clear but in one study those people quarantined for more than 10 days showed significantly higher post-traumatic stress symptoms than those quarantined for less than 10 days. Compared to those not quarantined those who were quarantined showed a higher fear of being infected by the virus or infecting others. The loss of usual routine, confinement and reduced social and physical contact from others were frequently shown to cause frustration, boredom and a sense of isolation from the world. Frustration, anxiety and anger were also experienced due to inadequate access to basic supplies in quarantine (e.g., water, food, clothes or accommodation). Another commonly reported stressor of quarantine was receiving inadequate information from public health authorities, such as about the purpose of the quarantine, different levels of risk, or the severity of the pandemic. Financial loss due to quarantine was a source of socioeconomic distress and a risk factor for experiencing anxiety, anger and other symptoms of psychological disorders. People who had been quarantined were significantly more likely to report being stigmatised by people in their local neighbourhoods than people who had not been quarantined.

Review recommendations

The review authors recommend that if quarantine is essential it should be as short as possible and made as tolerable as possible. They recommend clear communication, including telling people what is happening and why, how long it will continue, providing meaningful activities for them to do and support (e.g., access to a support line and/or means of connecting with their social network), ensuring basic supplies are available and reinforcing the sense of altruism that people may be feeling due to the benefits of quarantine to the wider society.

https://doi.org/10.1016/S0140-6736(20)30460-8