The Mental Health Impact of Quarantine – Psychological Consequences and Management Strategies
Quarantine was first used in Venice in response to plague and prevented the movement of people, animals, and goods [Tognotti E., 2013].
The Rector of Ragusa (currently Dubrovnik, Croatia), an outstanding rival sea potency of Venice, enacted in 1377 a decree officially establishing the so-called ‘trentina’ (an Italian word derived from ‘trenta,’ the number thirty), a period of isolation of 30 days for ships coming from infected, or even only suspected to be infected, places. The 30-day period became 40 days for land travellers. [Conti A., 2008]
Ships arriving in Venice from infected ports were required to sit at anchor for 40 days before landing. This practice, called quarantine, was derived from the Italian words Quaranta Giorni which mean 40 days.
Throughout history, quarantine has been the cornerstone of disease-control to limit the spread of infectious diseases including the plague, cholera, influenza, and more recently, coronavirus.
- In the 21st century, quarantine measures were used to contain SARS, which originated in Guangdong Province, China, in 2003.
- Modern containment strategies are now vastly different mainly because of how fast the contagion can spread along air-travel routes and thus cause a global public health emergency.
The recent coronavirus (COVID-19) pandemic, which originated in Wuhan, China has seen mass quarantine being effectively used, first in Wuhan and then in several towns in Veneto and Lombardy in northern Italy where it became the epicentre for COVID-19 in Europe. Furthermore, returning travellers must self-isolate while those infected also must be separated to stop further infection.
In Australia, Victoria is the only state in Stage 4 lockdown as of the time of initial publication of this article.
There are three general strategic policy responses to the challenge of coronavirus disease 2019 (COVID-19): elimination, suppression, and mitigation (or herd immunity). Each response is associated with economic, social and health harms.
On 24th July, Prime Minister Scott Morrison accepted and affirmed the Australian Health Protection Principal Committee recommendation:
The goal for Australia is to have no community transmission of COVID-19.
By this time the victorian outbreak had taken hold with a 5 day average of 500 cases per day from 29th July to 5th August. A stage 4 lockdown in Victoria was implemented on 3rd August.
Modelling suggests that elimination could have been achieved if Victoria had gone into full stage 4 lockdown immediately from 9th July, indicating the possible effectiveness of a quarantine strategy when implemented at the right stage of community transmission. [Blakely T et al., 2020]
Quarantine is often an unpleasant experience due to the loss of freedom as well as separation from family and friends. Stressors included fear of disease, frustration and boredom, inadequate information and supplies, possible financial loss, and the stigma of the disease, which together generate adverse psychological effects. [Brooks S et al. 2020]