Viewing Our COVID-19 Quarantine

Al Jacobs

The concept of the quarantine is nothing new. You’ll find an early reference to it in the Torah’s book of Leviticus, written in the seventh century BC, describing the procedure for separating out infected people to prevent spread of disease. The actual term comes from the word quarantena, meaning “forty days,” used in 14th century Venice, designating the period ships were required to be isolated before passengers and crew could go ashore during the Black Death plague epidemic.

Its meaning today is somewhat broader, designating a restriction on the movement of people intended to prevent the spread of disease generally. It’s often used to prevent the movement of those possibly exposed to a communicable disease, but who are without a confirmed medical diagnosis. In this respect, it’s distinct from medical isolation, where those confirmed to be infected with such a disease are isolated from the healthy population.

Without a doubt, the separation of healthy persons from those carrying a dangerous communicable disease is a sensible practice. Some of the most virulent epidemics in history might have been prevented in this way. As one notable example, the diseases, particularly smallpox, brought to the Americas by European explorers in the early sixteenth century contributed to the collapse of the Inca and Aztec civilizations, which exhibited no acquired immunity to the organisms. Some estimates suggest 90% of the indigenous population succumbed as a result.

With an acknowledgment that quarantine can be a valuable approach to sustaining health when used prudently, there are factors to be considered. As with virtually every sort of practice we engage in, we must not ignore the possible deleterious effects which may result. We shall now consider these.

Over the centuries, effects observed and studies done confirmed the long and short-term effects of quarantines. Although isolation can be a well-established method of dealing with infectious disease, separating people from friends, relatives and broader society can impose a detrimental effect on well-being and mental health. A recent review of literature found in numerous studies concerned with SARS, swine flu and Ebola, found a link between quarantine and adverse psychological impacts. Most demonstrate an increase in such common mental disorders as anxiety, depression and confusion. Another potent source of anxiety centers on finance, with many fearing loss of jobs, or for the self-employed a complete collapse in income. And in particular, financial loss creates long-lasting socioeconomic distress and, in studies of previous disease outbreaks, was found to be a risk factor for symptoms of psychological disorder, anger and anxiety for a substantial period following the period of quarantine. This can be exacerbated if promised funds do not arrive in a timely manner.

From the experience obtained over many years, there’s evidence to indicate quarantining a substantial portion of the population will cause immediate consequences for their mental well-being. As a group, they’ll display such symptoms as frustration, boredom and anxiety about becoming ill and infecting others. Observations from previous disease epidemics point to factors which might assist in reducing psychological distress for those quarantined at this time. What may help includes clear and valid information on the actual reasons for the quarantine, adequate medical supplies for those in need and short quarantine periods, preferably voluntary and without changes in duration. In addition, it may be worthwhile in emphasizing the altruistic nature of self-isolation and its benefits to public health generally. Thus far, such information has been in short supply during this entire period of the COVID-19 lockdowns and quarantine.

An additional circumstance deserves to be considered; it’s the high rates of psychological impact among healthcare workers. Understandably, many of those who as a condition of their employment required they be quarantined suffered severe symptoms of post-traumatic stress. This may have been partly due to the work they were required to perform – often exhausting, frightening and intense – but there existed additional pressures, for example the conflict as to their duty to patients while being a potential source of infection to their families. A study in the Toronto hospital during the 2003 SARS epidemic disclosed that quarantined staff members expressed concern about their personal safety, as well as about transmitting disease to their family members. This was further complicated by a lack of clear guidelines as to how to minimize infection during the quarantine. Sadly to say, their anxiety continued for some time after the SARS outbreak ended.

This might be a fair time to contemplate what sort of collective, post-quarantine trauma response we may be in for. As most persons never lived through the sort of episode we’re now experiencing, it may prove to be more unsettling than we’re prepared for. No one will adjust comfortably to it. The loneliness we’ve experienced will leave indelible marks in our nervous system. Our social connections, invariably frayed, will be restrung in different shapes. Many jobs will be gone, or if we’re more fortunate we simply toil in isolation. And most dramatically, our relations with partners, parents and progeny are far more enmeshed. Some others among us are so profoundly isolated that reality seems to be in suspension. But what we must recognize is trauma affects everything from digestion to immune functioning to the ability to look another person in the eye. What will this pandemic do to us? We can’t know for sure; we can only speculate about it. This life-altering experience will play out in dozens of different ways, with each of us uniquely affected by the disruptions directly impinged upon us. And we’ll carry these resultant compulsions until the day we die.

Thus far we’ve confined ourselves to generalities, for the subject of quarantine is general by nature. However, its effects can become far more specific and unpleasant when taken, as it can be, to an extreme. The effect of extended confinement underscores the importance of social contact to psychological as well as physical health. In essence, humans have a basic need to establish and maintain such connection to others and deprivation results in deleterious consequences. The aspects of the quarantine experience are amplified by the length of confinement and the amount of control the individual has over whether and how they can end it.

Depending upon the person’s sensitivity and the length of the incarceration – yes, incarceration is what extended involuntary quarantine becomes – symptoms can include decreased appetite, trembling hands, sweating palms, heart palpitations, sleep disturbances, heightened levels of anxiety and panic, rage, paranoia, cognitive dysfunction, hallucinations, depression, increased suicidality and a sense of impending emotional breakdown. And as you might expect, these characteristics become more pronounced as the age of the victim – yes, victim – increases.

Another factor contributing to the adverse effects of quarantine is people of all ages require a certain level of mental and physical activity to remain healthy. Simply put, they need movement, thought and exercise to maintain normal functioning. A loss of perceptual, cognitive and mental stimulation, can result in the atrophy of vital skills and capacities. Unfortunately, many of those persons confined to their homes, as the initial coronavirus lockdown mandated, suffered in precisely that manner, as their mental and physical activity became severely curtailed.

A final comment: We cannot deny the importance of the physical isolation of persons of susceptibility during an epidemic. It’s clearly obvious they must avoid the source of the contamination. However, the decision to quarantine oneself should be made by that particular individual – not by some ideological bureaucrat or committee of ill-informed authorities. But unfortunately, when the government steps in, all rationality normally vacates the scene. And this is how our pandemic program is now functioning: as a governmental monstrosity with little concern as to the well-being of its citizens.

Al Jacobs, a professional investor for nearly a half-century, issues weekly financial articles in which he shares his financial knowledge and experience. l can be contacted at al@abjacobs.com.

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