As the COVID-19 pandemic progresses, people around the world are being asked to self-isolate for at least a period of 14 days, and socially distance from one another. A rapid review by Brooks et al examined mental health impacts during five recent outbreaks in 11 countries, and found that those under quarantine or in isolation experienced higher levels of stress, post-traumatic stress disorder, anxiety, and symptoms of depression . Several studies have shown that those experiencing greater psychological distress are more likely to be non-compliant with restriction protocols [1,2,3,4,5,6]. In order to increase compliance to isolation procedures, governments, communities and individuals need to address causes of mental health distress.
As entire cities go into lockdown, and industries shut down, many may feel a financial strain from income loss, layoffs, and inadequate insurance coverages. These financial stressors can lead to increased psychological distress, and non-compliance of isolation measures [7,8,1,4]. Those who are unable to work from home, are self-employed, working part-time, or in affected industries are impacted the most [1,9]. As of April 6, in Canada and the US, over 1 million claims for employment insurance had been made, and many workers are experiencing temporary or permanent layoffs [10,11]. During this time, and for a period of time after, governments and employers could mitigate anxiety by allowing for payment deferrals, offer income compensation for those affected, provide medical insurance coverage and/or waive healthcare costs .
The media, public health units, organizations, friends/family and the internet provide information on isolation protocols . Having these fragmented voices led to confusion, anger and non-compliance among those quarantined during the 2003 SARS and 2014 Ebola outbreaks [4,5,6]. Similarly, each day during COVID-19, new guidelines are put forth regarding the use of personal protective equipment, hygiene, lockdown procedures, and business closures . Despite these protocols, many continue to gather in groups, panic and stockpile food and medical supplies, and misuse personal protective equipment for fear of infection [13,14,15,16]. During this incredibly fluid and complicated situation, public health officials can continue to provide cohesive and centralized information that is understandable in order to increase compliance and lessen panic and anxiety [1,4,6,17,18,19].
Long and indefinite quarantine periods can result in boredom. Many under quarantine experienced fear, isolation, and depression, however being bored and frustrated were major reasons for breaking quarantine [4,20]. To help ease these feelings, the World Health Organization recommends that individuals create and stick to routines, virtually keep in touch with loved ones, limit consumption of the constant stream of information and exercise in your home or neighbourhood .
In times like these, it is more important than ever to take care of each other and of ourselves. Everyone, from the government to organizations to community members and individuals have a duty to ensure compliance by providing mental health support and easing psychological distress among the general public.
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