The Psychological Impact of Quarantine During the COVID-19 Pandemic

By Sarah Singleton, Biochemistry Major, 2021

Widespread measures have been taken since March of 2020 to slow the spread of COVID-19, including stay-at-home and quarantine orders.1 While the exact measures vary based on certain criteria such as state, population, number of cases, the instance of infection, and so on, residents around the globe are experiencing or have experienced a period of quarantine. With inperson events on hold, society has adjusted to a new virtual way of life. Today, online gatherings, online school, and remote work are commonplace, but what exactly are the effects of increased screen time and isolation on the human psyche? The prevalence of this protocol, or more specifically this new distanced and isolated lifestyle, demands an evaluation of its psychological effects. To understand the impacts, a brief review of the theories on short and long-term mental health effects, as well as the resources rising up to meet psychological needs, is necessary.

The idea of quarantine is far from new. In fact, quarantining has been used as a way to isolate and slow the spread of infectious diseases since the bubonic plague, but more recently during the Spanish Flu in 1918-19 and the 2014 Ebola outbreak in West Africa.2 At the beginning of the current COVID-19 pandemic, Qiu et al. (2020) performed a countrywide survey that included 52,730 people in China and found that approximately 35% of the participants reported psychological distress.3 These results reinforce those of the Kaiser Family Foundation survey conducted in mid-July of 2020, in which 53% of adults in the USA report that their mental health has been negatively affected by the worry and stress of the pandemic, compared to the 32% reported about four months prior.4 Bonifacio et al. (2020) reflects on the fact that the, “...ambiguity and uncontrollability of the threat (e.g., the coronavirus), its invisible and unpredictable character, the lethality of the invader or the possible lack of rigor of the information given by the media may, by themselves, generate the same psychological alterations”.5 Of course, these negative emotions are not the crux of the issue, but rather the predecessors of anxiety, depression, and an increase of suicide rates.

The 2003 SARS epidemic in Hong Kong may act as a representative example of the situation, with feelings of social disengagement, anxiety, and fear of being a burden indicated as causes for the dramatic increase in suicide rates among the elderly.6 Other contributing factors include the length of the isolation period7, increase in screen time, and a predisposition to psychiatric disorders (Figure 1).8 According to Serafini et al. (2020), extended periods of quarantining create a prolonged state of stress, which can exacerbate existing conditions.7 A survey conducted with 150 physiotherapy students during the COVID-19 lockdown found that “48% of the students believe that excessive hours spent in front of the screen has affected their physical well being and 28.7% of students reported negative effects on their mental health”.8 While many students may find themselves in a situation where excessive screen time is unavoidable, the same survey found one factor that significantly decreased the negative effects of screen time: exercise.8 About 65% of the survey sample that exercised in some fashion reported positive effects on both mental and physical health.7

Figure 1: Summary of the most relevant psychological reactions in the general population related to COVID-19 infection.

Adapted directly from Oxford University Press.7

Another perspective on-screen time is posed by Saladino et al. (2020), who suggest that the rise of telepsychology and technological devices play an important role in decreasing the negative effects of the pandemic.9 These tools, which have never been as widely used as they are today, present benefits that could improve the psychological treatment of patients online and ameliorate the need for social connectedness. These benefits include the possibility to meet from home, saving money and time, and the ability to maintain a therapist-patient relationship despite the distance.9 Some suggest that the effects—both positive and negative—of quarantine and isolation associated with the pandemic will last far into the future. Although the exact long-term psychological repercussions are unknown, they may look something like PTSD.

‘‘ At the same time, online resources including online therapy have become more socially accepted and seem to be promising in terms of accessibility and consistency.

Furthermore, increased positive personal experiences, such as increased time spent with loved ones due to the conditions created by the pandemic, have been reported along with the negative.5,9

The effects of increased screen time and isolation on the human psyche during the COVID-19 pandemic may include psychological distress, feelings of anxiety and stress, depression, and in some cases, an increase in suicide rates in high-risk populations; however, there are also some positive effects. First and foremost, the need for isolation has given rise to the popularity of telepsychology and telehealth services, which may save time and resources, as well as encourage attendance due to convenience. Finally, many people have had an increase in positive personal experiences due to the conditions created by the pandemic.

Photo courtesy of everwell.10

[1] World Health Organization. (2020, December 14). Timeline: WHO’s COVID-19 Response. Timeline: WHO’s COVID-19 response. Retrieved January 13, 2021, from https://www. who.int/emergencies/diseases/novel-coronavirus-2019/ interactive-timeline?gclid=Cj0KCQiA0fr_BRDa ARIsAABw4Esu6kDnM8u1R36_HA4JWgbR9FkvtjxPqH5pIWGstS6m32935vATdMaAhKqEALw_wcB#event-1 15.

[2] Brooks, Samantha, et al. (2020, March). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet,Volume 395, Issue 10227, 2020, Pages 912-920, ISSN 0140-6736, https://doi.org/10.1016/S0140-6736(20)30460-8.

[3] Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. General psychiatry, 33(2), e100213. https://doi. org/10.1136/gpsych-2020-100213.

[4] Panchal N., et al. The Implications of COVID-19 for Mental Health and Substance Use. Kaiser Family Foundation. 21 April 2020.

[5] Bonifacio, S., Valiente, R. M., Garcia-Escalera, J., Campagne, D. M., & Chorot, P. (2020). Psychological impact of the COVID-19 pandemic: Negative and positive effects in Spanish population during the mandatory national quarantine. Journal of Psychopathology and Clinical Psychology, 25(25), 1-21. 10.5944/ rppc.27569.

[6] Yip, P. S. F., Cheung, Y. T., Chau, P. H., & Law, Y. W. (2010). The impact of epidemic outbreak: The case of severe acute respiratory syndrome (SARS) and suicide among older adults in Hong Kong. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 31(2), 86–92. https://doi.org/10.1027/0227-5910/a000015.

[7] Serafini, G. (2020, June 30). The impact of the COVID-19 pandemic on suicide rates. QJM: An International Journal of Medicine, Volume 113(Issue 10), Pages 707–712. https://doi. org/10.1093/qjmed/hcaa202.

[8] Akulwar-Tajane, I. (2020). Rethinking Screen Time during COVID-19: Impact on Psychological Well-Being in Physiotherapy Students. International Journal of Clinical and Experimental Medicine Research, 4(4), 201-216. DOI: 10.26855/ ijcemr.2020.10.014.

[9] Saladino, V., Algeri, D., & Vincenzo, A. (2020, October). The Psychological and Social Impact of Covid-19: New Perspectives of Well-Being. Frontiers in Psychology, 11(2), 2550. https://doi. org/10.3389/fpsyg.2020.577684.

[10] Fleming, C. (2021). Did You Know? Your Questions about Virtual Counseling Answered. everwell. Retrieved April 18, 2021, from https://www.everwellhamilton.ca/blog-counselling-psychotherapymental-health/questions-answered-about-virtual-counselling.