The psychological impact of quarantine and how to reduce it

The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility.

Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma.

Quarantine is often an unpleasant experience for those who undergo it. Separation from loved ones, the loss of freedom, uncertainty over disease status, and boredom can, on occasion, create dramatic effects. Suicide has been reported, substantial anger generated, and lawsuits brought following the imposition of quarantine in previous outbreaks. The potential benefits of mandatory mass quarantine need to be weighed carefully against the possible psychological costs. Successful use of quarantine as a public health measure requires us to reduce, as far as possible, the negative effects associated with it.

Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

Given the developing situation with coronavirus, policy makers urgently need evidence synthesis to produce guidance for the public. In circumstances such as these, rapid reviews are recommended by WHO.

A study  of hospital staff who might have come into contact with SARS found that immediately after the quarantine period (9 days) ended, having been quarantined was the factor most predictive of symptoms of acute stress disorder. In the same study, quarantined staff were significantly more likely to report exhaustion, detachment from others, anxiety when dealing with febrile patients, irritability, insomnia, poor concentration and indecisiveness, deteriorating work performance, and reluctance to work or consideration of resignation. In another study, the effect of being quarantined was a predictor of post-traumatic stress symptoms in hospital employees even 3 years later.

There has been extensive study on the adverse affects of quarantine, however, in times like these, we are left with no choice but to comply.