Quarantine, ‘stir-crazy’ and what can we do?

In case you’d missed it, there’s a global pandemic of a novel coronavirus in early 2020 and various governments and organisations are suggesting a variety of things. Much of it revolves around staying away from other people; colloquially ‘quarantine’.

There’s actually something much subtler going on, as well, but much of it has the same psychological implications. If patients are staying away from others to stop sharing the virus, of staying away from others to stop catching the virus, or staying away in case they have caught the virus and are about to become ill .. it’s all about staying away.

A rapidly produced evidence synthesis explores the extent of the problem. Around one third of parents who had been in quarantine conditions with their children reported psychological distress at a level to reach a diagnosis of trauma-related mental health disorder, compared with around one twentieth of parents who were not quarantines. Those locked away describe, as you’d expect, frustration and boredom and anxiety around lack of clarity about the situation. Inadequate supplies increases worry greatly. Staff are impacted significantly too, with increased rates of mental-health disorders and unhelpful coping strategies being common.

After the quarantine finishes, the mental health ill effects don’t go away. There is anger, anxiety about the financial losses and the situation, and years out some people still meet the criteria for post-traumatic diagnoses.

(In marginally better news, undergraduates didn’t seem to have any difference in their mental health outcomes with quarantine.)

How can we address this tsunami of badness? Some stuff is possibly within our grasp, others we may influence at a systems level.  For our patients, provide as much information as possible; improve out communication routes. If we can, reduce boredom. (Maybe send TikToks or finally get around to doing that video lecture on heterogeneity assessments.) We can use or levers on the system too. Keep the duration of quarantine as short as possible and ensure adequate supplies are available. Front-line workers appear to require special attention, and improved organisational support would be helpful.

There are clearly research opportunities in abundance here; lets not forget how brilliant we are at sensibly extrapolating evidence as child health practitioners and maybe help out with this skill too?

  • Bob Phillips (with thanks Dr Karen Shimmon, Principle Clinical Psychologist, Leeds Children’s Hospital)
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