Psychosocial and Economic Risks of Institutional Quarantine in a Low-Resource Setting: Experiences of Affected Persons during the COVID-19 Pandemic in Uganda

Institutional quarantine was one of the key public health measures used to control the spread of the Corona Virus Disease 2019 (COVID-19). Institutional quarantine has been associated with several psychosocial and economic risks. However, little is known about the psychosocial and economic risks it poses to affected persons in low-resource countries since it is a relatively new strategy for controlling disease spread in these settings. This article provides insights into the economic and psychosocial risks encountered by affected persons in a low-resource context. Narrative interviews were conducted with 20 adults placed under institutional quarantine to contain the COVID-19 pandemic in Uganda. Individuals confined in institutional quarantine experienced an intricate range of economic and psychosocial risks including loss of livelihood and/or income, financial distress, fear, worry, anger, loneliness, and stigma. The experience of specific risks was shaped by an intersection between individual and contextual factors. However, disregard for economic and social issues and shortcomings in the implementation of institutional quarantine contributed profoundly to the occurrence of risks. Safety nets to address the emergent financial insecurities of quarantined individuals and their families and bridging gaps in the implementation of institutional quarantine may help to minimise the associated economic and psychosocial risks in Uganda and similar contexts.

[1]  Tilahun Ali,et al.  Suicidal and aggressive behavior among populations within institutional quarantine and isolation centers of COVID-19 in eastern Ethiopia: A cross-sectional study , 2023, PloS one.

[2]  D. Kyaddondo,et al.  Making Improvisations, Reconfiguring Livelihoods: Surviving the COVID-19 Lockdown by Urban Residents in Uganda , 2022, COVID.

[3]  S. Pei,et al.  Evaluating the impact of stay-at-home and quarantine measures on COVID-19 spread , 2022, BMC Infectious Diseases.

[4]  S. Prathapan,et al.  Psychological impact and coping strategies in persons who experienced institutional quarantine for COVID-19 in Sri Lanka , 2022, Sri Lanka Journal of Psychiatry.

[5]  P. Glasziou,et al.  Public health measures for covid-19 , 2021, BMJ.

[6]  Yekoyealem Desie,et al.  Psychological distress among Ethiopian migrant returnees who were in quarantine in the context of COVID-19: institution-based cross-sectional study , 2021, BMC Psychiatry.

[7]  W. Dhouib,et al.  Effective public health measures to mitigate the spread of COVID-19: a systematic review , 2021, BMC Public Health.

[8]  R. Ndejjo,et al.  Experiences of persons in COVID-19 institutional quarantine in Uganda: a qualitative study , 2021, BMC Public Health.

[9]  Majid Alabdulla,et al.  Psychological impact of the COVID-19 pandemic within institutional quarantine and isolation centres and its sociodemographic correlates in Qatar: a cross-sectional study , 2021, BMJ Open.

[10]  P. Indu,et al.  Institutional quarantine centres as a strategy in control of COVID-19 outbreak: An evolving model from Kerala, India , 2021, Journal of family medicine and primary care.

[11]  A. Gadermann,et al.  Associations between periods of COVID-19 quarantine and mental health in Canada , 2020, Psychiatry Research.

[12]  Sunil Pokharel,et al.  Anxiety and depression among people living in quarantine centers during COVID-19 pandemic: A mixed method study from western Nepal , 2020, medRxiv.

[13]  S. Hossain,et al.  COVID-19: psychological effects on a COVID-19 quarantined population in Bangladesh , 2020, Heliyon.

[14]  H. Walter,et al.  Mental health effects of infection containment strategies: quarantine and isolation—a systematic review and meta-analysis , 2020, European Archives of Psychiatry and Clinical Neuroscience.

[15]  B. Hall,et al.  Immediate and delayed psychological effects of province-wide lockdown and personal quarantine during the COVID-19 outbreak in China , 2020, Psychological Medicine.

[16]  Shraddha Patel,et al.  Quarantine an effective mode for control of the spread of COVID19? A review , 2020, Journal of family medicine and primary care.

[17]  Xiyi Wang,et al.  Quarantine experience of close contacts of COVID-19 patients in China: A qualitative descriptive study , 2020, General Hospital Psychiatry.

[18]  K. Rothman,et al.  Lockdown timing and efficacy in controlling COVID-19 using mobile phone tracking , 2020, EClinicalMedicine.

[19]  O. Franco,et al.  Long-term strategies to control COVID-19 in low and middle-income countries: an options overview of community-based, non-pharmacological interventions , 2020, European Journal of Epidemiology.

[20]  D. Travis,et al.  Preparedness of health care systems for Ebola outbreak response in Kasese and Rubirizi districts, Western Uganda , 2020, BMC Public Health.

[21]  E. Liu,et al.  The psychological impact of quarantine on coronavirus disease 2019 (COVID-19) , 2020, Psychiatry Research.

[22]  M. Fawaz,et al.  The psychosocial effects of being quarantined following exposure to COVID-19: A qualitative study of Lebanese health care workers , 2020, The International journal of social psychiatry.

[23]  K. Saurabh,et al.  Compliance and Psychological Impact of Quarantine in Children and Adolescents due to Covid-19 Pandemic , 2020, The Indian Journal of Pediatrics.

[24]  Yan Guo,et al.  Mental Health Disorders and Associated Risk Factors in Quarantined Adults During the COVID-19 Outbreak in China: Cross-Sectional Study , 2020, Journal of medical Internet research.

[25]  Sweta,et al.  Psychological impact of quarantine period on asymptomatic individuals with COVID-19 , 2020, Social Sciences & Humanities Open.

[26]  Jinrong Yang,et al.  Comparison of Prevalence and Associated Factors of Anxiety and Depression Among People Affected by versus People Unaffected by Quarantine During the COVID-19 Epidemic in Southwestern China , 2020, Medical science monitor : international medical journal of experimental and clinical research.

[27]  K. Chatterjee,et al.  Epidemics, quarantine and mental health , 2020, Medical Journal Armed Forces India.

[28]  P. Kaleebu,et al.  Uganda’s experience in Ebola virus disease outbreak preparedness, 2018–2019 , 2020, Globalization and Health.

[29]  A. Sultana,et al.  Mental health outcomes of quarantine and isolation for infection prevention: a systematic umbrella review of the global evidence , 2020, Epidemiology and health.

[30]  Ling Zhang,et al.  Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed , 2020, The Lancet Psychiatry.

[31]  G. Rubin,et al.  The psychological impact of quarantine and how to reduce it: rapid review of the evidence , 2020, The Lancet.

[32]  G. Sprang,et al.  Posttraumatic Stress Disorder in Parents and Youth After Health-Related Disasters , 2013, Disaster Medicine and Public Health Preparedness.

[33]  K. Newman.  Shutt Up: Bubonic Plague and Quarantine in Early Modern England , 2012, Journal of social history.

[34]  D. Frost.  Social stigma and its consequences for the socially stigmatized. , 2011 .

[35]  M. K. Moran,et al.  Understanding, compliance and psychological impact of the SARS quarantine experience , 2007, Epidemiology and Infection.

[36]  Laura Johnson,et al.  How Many Interviews Are Enough? , 2006 .

[37]  Troy Day,et al.  When Is Quarantine a Useful Control Strategy for Emerging Infectious Diseases? , 2006, American journal of epidemiology.

[38]  M. Cetron,et al.  Public health and ethical considerations in planning for quarantine. , 2005, The Yale journal of biology and medicine.

[39]  H. Beanlands,et al.  The experience of quarantine for individuals affected by SARS in Toronto. , 2005, Public health nursing.

[40]  C. Fraser,et al.  Epidemiology, transmission dynamics and control of SARS: the 2002-2003 epidemic. , 2004, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[41]  S. Galea,et al.  SARS Control and Psychological Effects of Quarantine, Toronto, Canada , 2004, Emerging infectious diseases.

[42]  C. DesRoches,et al.  The public's response to severe acute respiratory syndrome in Toronto and the United States. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[43]  C. Digiovanni,et al.  Factors influencing compliance with quarantine in Toronto during the 2003 SARS outbreak. , 2004, Biosecurity and bioterrorism : biodefense strategy, practice, and science.