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Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response.

ABSTRACT: Four billion people worldwide have experienced coronavirus disease 2019 (COVID-19) confinement. Such unprecedented extent of mobility restriction to curb the COVID-19 pandemic may have profound impacts on how individuals live, travel and retain well-being. This systematic review aims to identify (i) the social consequences of mass quarantine-community-wide movement restrictions-during previous and current infectious disease outbreaks and (ii) recommended strategies to mitigate the negative social implications of COVID-19 lockdowns. Considering social determinants of health, we conducted a systematic review by searching five databases (Ovid-MEDLINE, EMBASE, PsycINFO, China National Knowledge Infrastructure and the World Health Organization COVID-19 database) for publications from inception to 9 April 2020. No limitation was set on language, location or study type. Studies that (i) contained peer-reviewed original empirical evidence and (ii) focussed on non-epidemiological implications of mass quarantine were included. We thematically synthesized and reported data due to heterogeneous disease and country context. Of 3067 publications found, 15 original peer-reviewed articles were selected for full-text extraction. Psychological distress, heightened communication inequalities, food insecurity, economic challenges, diminished access to health care, alternative delivery of education and gender-based violence were identified as negative social consequences of community-based quarantine in six infectious disease epidemics, including the current COVID-19 pandemic. In contrast, altruistic attitudes were identified as a positive consequence during previous quarantines. Diverse psychological and social consequences of mass quarantine in previous and current epidemics were evident, but individual country policies had been highly varied in how well they addressed the needs of affected individuals, especially those who are socially marginalized. Policymakers should balance the pros and cons of movement restrictions, facilitate multisectoral action to tackle social inequalities, provide clear and coherent guidance to the public and undertake time-bound policy evaluations to mitigate the negative impact of COVID-19 lockdowns and to establish preparedness strategies for future epidemics.

SUBMITTER: Chu IY

PROVIDER: S-EPMC7649384 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response.

Chu Isaac Yen-Hao IY Alam Prima P Larson Heidi J HJ Lin Leesa L

Journal of travel medicine 20201101 7

Four billion people worldwide have experienced coronavirus disease 2019 (COVID-19) confinement. Such unprecedented extent of mobility restriction to curb the COVID-19 pandemic may have profound impacts on how individuals live, travel and retain well-being. This systematic review aims to identify (i) the social consequences of mass quarantine-community-wide movement restrictions-during previous and current infectious disease outbreaks and (ii) recommended strategies to mitigate the negative socia ...[more]

PMID: 33051660

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Project description:BackgroundThe health crisis caused by COVID-19 has led many countries to opt for social quarantine of the population. During this quarantine, communication systems have been characterized by disintermediation, the acceleration of digitization and an infodemic (excess and saturation of information). The following debate arises: Do the levels related to the psychotic phenotype and pseudoscientific beliefs related to the interpretation of information vary before and after social quarantine?ObjectivesThis research aims to examine the psychological effects of social quarantine on the psychotic phenotype and pseudoscientific beliefs-experiences of the general nonclinical population. The following hypothesis was posed: social quarantine alters the levels of magical thinking, pseudoscientific beliefs and anomalous perceptions due to quarantine.MethodsA pre- and posttest analysis design was applied based on the difference in means, and complementary Bayesian estimation was performed. A total of 174 Spanish subjects responded to different questionnaires that evaluated psychopathological risks based on psychotic phenotypes, pseudoscientific beliefs and experiences before and after quarantine.ResultsSignificant differences were obtained for the variables positive psychotic symptoms, depressive symptoms, and certain perceptual alterations (e.g., cenesthetic perceptions), and a significant increase in pseudoscientific beliefs was also observed. The perceptual disturbances that increased the most after quarantine were those related to derealization and depersonalization. However, paranoid perceptions showed the highest increase, doubling the initial standard deviation. These high increases could be related to the delimitation of physical space during social quarantine and distrust towards information communicated by the government to the population. Is it possible that social alarmism generated by the excess of information and pseudoscientific information has increased paranoid perceptual alterations?ConclusionsMeasures taken after quarantine indicate that perceptual disturbances, subclinical psychotic symptoms and beliefs in the pseudoscience have increased. We discuss which elements of quarantine coincide with the social marginality theory and its clinical repercussions.

Project description:BackgroundEffective strategies of prevention have been and can aid in reducing and overcoming contagious diseases including COVID-19, still there is dearth of knowledge regarding general public awareness and perception. The current study aims to determine the existing knowledge and perception of people living in Karachi about isolation, quarantine, social distancing and community containment.MethodsThis cross-sectional online survey was conducted during the months of March and April 2020. The study included men and women of age 18 years and above quarantined during COVID-19. Convenience sampling followed by snowball sampling technique was used. An online structured questionnaire was developed using Google Form. It included questions on socio demographic information, public knowledge and perception about isolation, quarantine, social distancing and community containment. Chi-square test was used for categorical variables and p value of < 0.05 was considered statistically significant.ResultsA total of 548 participants were involved in this survey, 34% (n = 184) males with a mean age of 28 ± 10 years ranging from 18 to 75 years. The major source of hearing about COVID-19 was social media (72%, n = 393). Overall knowledge scores revealed that 27% (n = 146) participants had excellent knowledge about symptoms and prevention of the COVID-19. Excellent knowledge of quarantining, isolation and community containment and social distancing was 38% among participants. Participants who had good and excellent knowledge were more likely to have positive perception of isolation (p-value < 0.001). Majority participants (89%, n = 487) felt isolation may or may not be against human rights and this perception was found significantly associated with moderate to excellent knowledge about community mitigation measures (p-value = 0.009).ConclusionThis study concludes that optimal public knowledge and perception related to certain aspects of isolation, quarantine, social distancing and community containment exists however knowledge gaps and misperceptions prevail that need to be addressed.

Project description:BackgroundThe health impact of COVID-19 may differ in African settings as compared to countries in Europe or China due to demographic, epidemiological, environmental and socio-economic factors. We evaluated strategies to reduce SARS-CoV-2 burden in African countries, so as to support decisions that balance minimising mortality, protecting health services and safeguarding livelihoods.MethodsWe used a Susceptible-Exposed-Infectious-Recovered mathematical model, stratified by age, to predict the evolution of COVID-19 epidemics in three countries representing a range of age distributions in Africa (from oldest to youngest average age: Mauritius, Nigeria and Niger), under various effectiveness assumptions for combinations of different non-pharmaceutical interventions: self-isolation of symptomatic people, physical distancing and 'shielding' (physical isolation) of the high-risk population. We adapted model parameters to better represent uncertainty about what might be expected in African populations, in particular by shifting the distribution of severity risk towards younger ages and increasing the case-fatality ratio. We also present sensitivity analyses for key model parameters subject to uncertainty.ResultsWe predicted median symptomatic attack rates over the first 12 months of 23% (Niger) to 42% (Mauritius), peaking at 2-4 months, if epidemics were unmitigated. Self-isolation while symptomatic had a maximum impact of about 30% on reducing severe cases, while the impact of physical distancing varied widely depending on percent contact reduction and R0. The effect of shielding high-risk people, e.g. by rehousing them in physical isolation, was sensitive mainly to residual contact with low-risk people, and to a lesser extent to contact among shielded individuals. Mitigation strategies incorporating self-isolation of symptomatic individuals, moderate physical distancing and high uptake of shielding reduced predicted peak bed demand and mortality by around 50%. Lockdowns delayed epidemics by about 3 months. Estimates were sensitive to differences in age-specific social mixing patterns, as published in the literature, and assumptions on transmissibility, infectiousness of asymptomatic cases and risk of severe disease or death by age.ConclusionsIn African settings, as elsewhere, current evidence suggests large COVID-19 epidemics are expected. However, African countries have fewer means to suppress transmission and manage cases. We found that self-isolation of symptomatic persons and general physical distancing are unlikely to avert very large epidemics, unless distancing takes the form of stringent lockdown measures. However, both interventions help to mitigate the epidemic. Shielding of high-risk individuals can reduce health service demand and, even more markedly, mortality if it features high uptake and low contact of shielded and unshielded people, with no increase in contact among shielded people. Strategies combining self-isolation, moderate physical distancing and shielding could achieve substantial reductions in mortality in African countries. Temporary lockdowns, where socioeconomically acceptable, can help gain crucial time for planning and expanding health service capacity.

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Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response.

Publications

Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response.

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