Transitioning out of quarantine

Impact of quarantine on wellbeing

Experiencing quarantine can be harmful to your psychological health including post-traumatic stress symptoms, confusion, and anger.¹ A survey within the general public in China that looked at the immediate effect of the COVID-19 outbreak found over half (53.8%) of respondents rated the psychological impact as moderate or severe.² Yet coming out of a period of lockdown requires further adaptation and can itself be stressful.³

Anxiety around coming out of lockdown

While it may come as a relief, it is also perfectly normal to also feel anxious about the lifting of restrictions. You had to adapt to a new routine of lockdown, now there is further change it can feel like more instability. Adjusting to changes like being outside more often, and getting used to places feeling busier again and increased noise levels can take time. Coupled with fears around yourself or loved ones contracting the virus, it understandable that a relaxation of the rules can feel a little unnerving.³

Commuting

After weeks spent mainly inside your home suddenly being back on busy trains, or other modes of transport may feel overwhelming.³ If you can, change the times you commute to reduce travelling at peak time so you can increase the social distance from other travellers.⁴ Taking something to read or using headphones can help you to zone out from others around you on public transport.

Returning to work

The return to work following the pandemic heralds a return to normal, but can also be stressful.⁵  If you are returning to your place of work you should observe the advised hygiene measures such as hand washing, catching sneezes and coughs, and not touching your face. The pandemic is likely to be the main topic of conversation at work, but if this makes you feel anxious suggest discussing other topics instead.⁴

Reopening of schools

If your child is due to return to school you may have mixed feelings. You may be pleased that they can see their friends again and return to the reassuring structure of school life, yet you may be concerned about the increased risk of them or others in your family contracting the virus. It may be reassuring to know that a recent study found that the transmission rate of COVID-19 was extremely low, less than 1%, in schools.⁶ Furthermore, the statistics show that across the USA, England, Italy, Germany, Spain, France and South Korea, only 0.117% of deaths of 0-19-year-olds over three months this year were attributed to COVID-19. While each child’s death is a tragedy, COVID-19 accounts for only a tiny proportion of children’s deaths.⁷ Ultimately your family’s wellbeing is a personal issue however, speak to your loved ones and your child’s school to choose a solution that works best for your family.

Integrating back into life

Once lockdown is eased, apart from enjoying regained freedoms, you can consider what you would like to continue from your habits during lockdown. Maybe you started an online exercise class, read more, or enjoyed gardening? It can be rewarding and even reassuring to continue with these new activities as we go into the next phase of living with coronavirus-related restrictions.

Keeping to new restrictions

Another reaction after keeping to lockdown is to find it difficult once restrictions are lifted slightly to continue to adhere to new guidelines. You may feel impatient for life to go back to how it was before the pandemic. After feeling the pressure to conform it can be tempting to break away and resist, but these actions can be harmful to your or others’ health, and you could even be landed with a fine.

Dealing with the unknown

Living with uncertainty around the possibility of another upsurge in cases and potential lockdown, plus an uncertain economic situation is unsettling and can lead to feelings of anxiety. If you’re feeling overwhelmed try to think too much about the months ahead. Instead, focus on what you have planned today and tomorrow. The following may also help:

• Focus on what you can control, and accept what you can’t. For example, you can’t control future increases of coronavirus but you can practice handwashing and other individual measures to limit contagion.
• Help yourself with positive coping strategies such as exercise or time spent outside with nature, rather than turning to potentially harmful coping strategies such as drinking too much alcohol.⁸
• Identify your stressors and take steps to limit them. For example, continual news around coronavirus can be alarming. Instead, tune into the news only a couple of times a day, and only listen to reliable sources

Sources:

1. Brooks S, Webster R, Smith L, et al. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet. 395. 10.1016/S0140-6736(20)30460-8.
2. Wang C, Pan R, Wan X, et al. (2020). Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int. J. Environ. Res. Public Health, 17(5), 1729; https://doi.org/10.3390/ijerph17051729.
3. Anxiety UK survey indicates a further rise in anxiety levels can be expected with easing of lockdown restrictions. Anxiety UK. https://www.anxietyuk.org.uk/blog/anxiety-uk-survey-indicates-a-further-rise-in-anxiety-levels-can-be-expected-with-easing-of-lockdown-restrictions. 11 May 2020. Accessed 26 May 2020.
4. Looking after your mental health while working during the coronavirus outbreak. Mental Health Foundation. https://www.mentalhealth.org.uk/publications/looking-after-your-mental-health-during-coronavirus-outbreak/while-working. 19 May 2020. Accessed 26 May 2020.
5. Tan W, Hao F, McIntyre RS, et al. (2020) Is returning to work during the COVID-19 pandemic stressful? A study on immediate mental health status and psychoneuroimmunity prevention measures of Chinese workforce [published online ahead of print, 2020 Apr 23]. Brain Behav Immun.;S0889-1591(20)30603-6. doi:10.1016/j.bbi.2020.04.055.
6. COVID-19 in schools – the experience in NSW. National Centre for Immunisation Research and Surveillance (NCIRS). 20 April 2020. http://ncirs.org.au/sites/default/files/2020-04/NCIRS%20NSW%20Schools%20COVID_Summary_FINAL%20public_26%20April%202020.pdf. Accessed 22 May 2020.
7. Bhopal SS, Bagaria J, Bhopal R. Risks to children and young people during covid-19 pandemic. BMJ 2020;369:m1669. Available: https://www.bmj.com/content/369/bmj.m1669/rr-4.
8. Policy Brief: COVID-19 and the Need for Action on Mental Health. United Nations. Published 13 May 2020. Available: https://www.un.org/sites/un2.un.org/files/un_policy_brief-covid_and_mental_health_final.pdf.