A summary of research on social distancing, quarantine and isolation, as well as recommendations on how people can cope if asked to take such measures.
Overview of Social Distancing
With the number of COVID-19 cases increasing every day, we offer insights on how to separate yourself from others, while still getting the social support you need.
Around the world, public officials are asking people who have contracted or been exposed to the new coronavirus to practice social distancing, quarantine or isolation measures to slow the disease’s spread.
Social distancing means keeping a safe distance (approximately 2 metres / 6 feet) from others and avoiding gathering spaces such as schools, pubs, bars, churches, concert halls and public transportation.
Quarantine involves avoiding contact with others if a person has been exposed to coronavirus to see if they become ill.
Isolation involves separating an individual who has contracted COVID-19 to prevent them from spreading it to others.
Spending days or weeks at home with limited resources, stimulation and social contact can take a toll on wellbeing and mental health. Though controlled studies on interventions to reduce the psychological risks of quarantine and isolation are lacking, psychologists have established best practices for handling these challenging circumstances.
What to Expect
You are asked to take great care of yourself and others around you.
People asked to stay home due to illness, exposure or active community spread of COVID-19 will likely be cut off from their regular routines for at least two weeks, the estimated incubation period for the virus.
Common sources of stress during this period include a drop in meaningful activities, sensory stimuli and social engagement and a lack of access to typical coping strategies such as going to the gym, busy pubs, parties or attending religious services.
During a period of social distancing, quarantine or isolation, you may experience:
Fear and anxiety
You may feel anxious or worried about yourself or your family members contracting COVID-19 or spreading it to others. It’s also normal to have concerns about obtaining food and personal supplies, taking time off work or fulfilling family care obligations. Some people may have trouble sleeping or focusing on daily tasks.
Depression and boredom
A hiatus from work and other meaningful activities interrupts your daily routine and may result in feelings of sadness or low mood. Extended periods spent at home can also cause feelings of boredom and loneliness.
Anger, frustration or irritability
The loss of agency and personal freedom associated with isolation and quarantine can often feel frustrating. You may also experience anger or resentment toward those who have issued quarantine or isolation orders or if you feel you were exposed to the virus because of another person’s negligence.
If you are sick or have been exposed to someone who has COVID-19, you may feel stigmatized by others who fear they will contract the illness if they interact with you.
People with pre-existing mental health conditions and health-care workers helping with the response to the coronavirus may have an increased risk of experiencing psychological distress when they engage in social distancing, quarantine or isolation.
People with disabilities who require specialised diets, medical supplies, assistance from caregivers and other accommodations are also at risk for psychological challenges during a pandemic because of the increased difficulties in receiving the care they require.
How to Cope
Psychological research also points to ways to manage these difficult conditions. Experts recommend planning ahead by scheduling how you might spend your time, who you can contact for psychosocial support and how you can address any physical or mental health needs you or your family may have.
Limit news consumption to reliable sources
It is important to obtain accurate and timely public health information regarding COVID-19, but too much exposure to media coverage of the virus can lead to increased feelings of fear and anxiety. Psychologists recommend balancing time spent on news and social media with other activities unrelated to quarantine or isolation, such as study, revision, reading, listening to music or learning a new skill. Trusted organizations—including the U.S. Centers for Disease Control and Prevention and the World Health Organization—are ideal sources of information on the virus.
Create and follow a daily routine: KISS Keep it Simple and Structured
Maintaining a daily routine can help you preserve a sense of order and purpose in your life despite the unfamiliarity of isolation and quarantine. Try to include regular daily activities, such as work, exercise or learning, even if they must be executed remotely. Integrate other healthy pastimes as needed. Spend time on things that make your heart sing NOW.
Stay virtually connected with others
Your face-to-face interactions may be limited, but we suggest using phone calls, text messages, video chat and social media to access social support networks. If you are feeling sad or anxious, use these conversations as an opportunity to discuss your experience and associated emotions.
Reach out to those you know who are in a similar situation. Facebook groups have already formed to facilitate communication and support among individuals asked to quarantine.
Relying on pets for emotional support is another way to stay connected. However, the Centers for Disease Control and Prevention recommend restricting contact with pets if you contract COVID-19 until the risks of transmission between humans and animals are better understood.
Maintain a healthy lifestyle
Get enough sleep, eat well and exercise in your home when you are physically capable of doing so. Try to avoid using alcohol or drugs as a way to cope with the stresses of isolation and quarantine.
Use psychological strategies to manage stress and stay positive
Examine your worries and aim to be realistic in your assessment of the actual concern as well as your ability to cope. Try not to catastrophise; use Healthy Thinking and instead focus on what you can do and accept the things you can’t change. One way to do this is to keep a daily gratitude journal. You may also choose to download smartphone applications that deliver mindfulness and relaxation exercises. For example, PTSD Coach is a free application developed by the U.S. Department of Veterans Affairs’ National Center for PTSD and the Department of Defense’s National Center for Telehealth and Technology. It contains coping and resilience resources such as exercises for deep breathing, positive imagery, muscle relaxation and more.
Focusing on the altruistic reasons for social distancing, quarantine or isolation can also help mitigate psychological distress. Remember that by taking such measures, you are reducing the possibility of transmitting COVID-19 and protecting those who are most vulnerable. Remember your role as one of Tomorrow’s Doctors.
Tools and Resources
Mental Health and Coping During COVID-19, Centers for Disease Control and Prevention
Parent/Caregiver Guide to Helping Families Cope with the Coronavirus Disease 2019, The National Child Traumatic Stress Network
Coronavirus Disease (COVID-19) Advice for the Public, World Health Organization
Taking Care of Your Behavioral Health: Tips for Social Distancing, Quarantine, and Isolation During an Infectious Disease Outbreak, Substance Abuse and Mental Health Services Administration
The psychological impact of quarantine and how to reduce it: rapid review of the evidence, Brooks, S.K., et al., The Lancet
Act to Protect
For a while we have to ACT TO PROTECT ourselves and others. The best thing, the only thing to stop spreading this virus further is to practice social distancing and stay at home, not just to protect ourselves, but to protect others who may be a little more fragile than we are.
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