CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Psychological Effects of Quarantine
During Infectious Disease Outbreaks:
What Healthcare Providers Need to Know
Quarantine is defined as theseparation of individuals who
may have been exposed to an
infectious disease from the rest ofthe population to determine if they
are ill and to reduce their risk ofinfecting others. While quarantine
can broadly serve the public good, it
is also associated with psychological

Described here are the psychological effectsof quarantine, as well as strategies forhow healthcare providers can care for theirpatients’ and their own mental well-being
during periods of quarantine.

Stressors of Quarantine and their PsychologicalEffects
Stressors during quarantine include:
1. Frustration and boredom related to the isolation ofquarantine, which involves loss of one’s usual routine(e.g., regular home and work activities, shopping fornecessities) and limited social and physical contact withothers.
2. Inadequate supplies and access to regular medicalcare, including food, water, or change of clothes as wellas masks, prescriptions, and thermometers.
3. Insufficient information, such as lack of, or delayed,
information from public health authorities, often due
to poor coordination among health and government
officials; unclear guidance; confusion about reasons forquarantine; and perceived lack of transparency.
4. Longer durations of quarantine (i.e., 10 days orlonger), as well as extension of quarantine length.
5. Fears about becoming infected and/or infecting
others, which can manifest as increased attention to andworry about one’s health and physical symptoms, andmay be particularly concerning for pregnant womenand parents of young children.
Stressors following quarantine include:
1. Financial loss. Absence from work, healthcare costs,
and other unanticipated financial burdens can result insocioeconomic distress, particularly among those withlower incomes.

challenges for those quarantined,
their loved ones, and the healthcare
workers caring for them. Describedhere are the psychological effects ofquarantine, as well as strategies forhow healthcare providers can carefor their patients’ and their own
mental well-being during periods ofquarantine.

2. Stigma from others. Stigmatization and rejection
by neighbors, co-workers, friends, and even family
members can manifest as being treated differently orwith fear and suspicion, being avoided or excluded fromleisure, workplace, or school activities, and experiencing
stigmatizing comments. Stigma can be exacerbated if
quarantined individuals are members of a particularethnic or religious group.
3. Getting back to one’s “normal” routine. Returning tousual work and social routines may take anywhere fromseveral days to several weeks or even months. Knowingthat it might take time to get back into regular routines
can help with concern, anxiety, and frustration.
Promoting Psychological Wellbeing During
Quarantine
1. Use communication as an intervention. Clear,understandable, and practical communication canreduce adverse psychological responses and increase
behavioral adherence. Provide rapid, repeated,and developmentally and culturally appropriate
communications about the nature of the disease, thereasons for quarantine, and other essential information.
2. Facilitate communication with loved ones. Knowledgeof loved ones’ conditions can have a powerful impact
on the emotional health of quarantined individuals andimprove adherence to recommended quarantine. ForContinued

example, knowing that loved ones are safe, healthy, andwell-cared for can reduce stress, while increased stressshould be anticipated when information is lacking
or in cases of worrisome news. Before quarantine,
allow sufficient time (within the limits of public healthconcerns) for patients to make arrangements, reassure
their loved ones, and say goodbye. During quarantine,
facilitate the use of technology (e.g., phone and videocalls, social media) to keep loved ones in contact witheach other.
3. Prepare for quarantine. Households and facilities
under quarantine will need adequate food, household
supplies, and medications to last for the duration of
the quarantine. Once quarantine is imposed, there may
be limited ability to move about and shop as usual.
Obtain necessary resources in advance of quarantine
if possible, e.g., by making this part of a family’s ororganization’s disaster preparedness planning.
4. Reduce boredom and isolation. Planning foractivities during quarantine can help reduce boredom
and lessen the focus on symptoms and feelings ofbeing isolated from family and friends. As above,
facilitating access to the internet and social media is
important to maintaining social networks and remotecommunication while in quarantine. However, media
exposure should be monitored, as too much exposureand exposure to unreliable sources can increase stress.
5. Take care of yourself. Healthcare providers are also
vulnerable to experiencing the psychological effectsof quarantine, and this can be compounded by thestress of caring for sick and distressed patients. Make
sure your own basic needs are met, including: eating,drinking, and sleeping; taking breaks at predeterminedintervals; checking in with colleagues and loved ones;
and ensuring that your family and organization are safeand have a plan in place for possible quarantine. If you
are likely to work with infected individuals, have frank
discussions with your family about the risk to you andto them and steps being taken to minimize that risk.
Plan for the possibility that you may be quarantined
separately from them if they are not exposed.
6. Keep quarantine as short as possible. When advisingpatients on length of time in quarantine, restrict thelength to what is scientifically reasonable and take care
not to adopt an overly cautious approach. In addition,
do not extend quarantine length unless absolutely
necessary, and if this occurs, provide patients with upto-date information as soon as possible.
Resources
Centers for Disease Control and Prevention (CDC).

https://www.cdc.gov/Brooks, SK et al. The psychological impact of quarantine
and how to reduce it: rapid review of the evidence. TheLancet. Published online February 26, 2020.
https://www.thelancet.com/journals/lancet/article/PIIS01406736(20)30460-8/fulltext#%20

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org