Throughout history, quarantine has been a classic public health intervention to curb the spread of infectious diseases. Although an effective measure, quarantine has always been controversial because it raises political, ethical, and socioeconomic issues and requires a careful balance between public interest and individual rights. This article brings to debate some of the socio-psychological, economic, political, security and education
challenges of the Covid-19 quarantine.
Quarantine is defined as the separation and/or restriction of movement of persons who are not ill but are believed to have been exposed to infection to prevent transmission of diseases. The practice dates back to the mid-14th century when officials in Venice forced ships that were arriving from infected ports to sit anchored for 40 days before landing in order to prevent the spread of plague. Since the 14th century, quarantine has been the cornerstone of a coordinated disease-control strategy, including isolation, sanitary cordons, bills of health issued to ships, fumigation, disinfection, and regulation of groups of persons who were believed to be responsible for spreading the infection.
Short History of ‘Quarantine’
Healthcare officials have often turned to quarantine in the early days of an epidemic, when the infectious agent remains unknown, and when vaccines, antibiotics, and anti-viral drugs are either useless or of little-known utility. Even if prophylaxis or treatments were effective, they would likely be in short supply in the first stage of the disease’s development. Because of these obstacles, which limit the effectiveness of modern medicine, quarantine is a fast and useful infection containment mechanism in the early days of an outbreak.
The Covid-19 Quarantine
Beyond the short-term benefits of quarantine during epidemics, this restrictive measure also provides a great variety of challenges to modern society and to the daily life of people in affected areas. Although most of them have not been yet considered, the long-term effects of the Covid-19 quarantine period are much deeper and variated than the ability of any government to foresee at this moment.
Social and Psychological Challenges
There are many studies of the psychological impact of quarantine in scientific literature. Most of these demonstrated an increase in common mental disorders (such as anxiety, depression and confusion) compared to expected levels in the general population. Bearing in mind the average of 2.6 billion people quarantined until now around the world, we are currently undertaking the largest psychological experiment ever, that will probably result in a wide range of symptoms of psychological stress and disorder, including low mood, insomnia, stress, anxiety, anger, irritability, emotional exhaustion, depression and post-traumatic stress symptoms. Low mood and irritability specifically stand out as being among the most common side-effects of being locked down for a long period of time, stressing for reasons such as the fear of becoming sick or of losing loved ones, as well as the prospect of financial hardship. All these have been fuelled by a so-called “infodemic” spread via different platforms social media. Outbursts of racism, stigmatisation, and xenophobia against particular communities are also being widely reported. The COVID-19 outbreak may also give rise to stigmatising factors like fear of isolation, racism, discrimination, and marginalisation with all its social and economic ramifications. Various radical groups have already started spreading their extremist messages, taking advantage of the opportunity presented by the pandemic through a large audience locked to their computers, easily exposed to propaganda. Another relevant aspect to be considered is societal rejection regarding the quarantined cordon in forms of discrimination, suspicion and avoidance by neighbourhood, insecurity regarding properties, workplace prejudice, and withdrawal from social events even after containment of epidemics. Such phenomena have already been witnessed in some European countries where communities of a certain ethnic origin and the health workers have been targeted. Moreover, the psychosocial aspects of older people, their caregivers, psychiatric patients and marginalised communities are affected by this pandemic in different ways and need special attention. Post quarantine psychological effects may include significant socioeconomic distress and psychological symptoms due to financial losses.
Economic and Political Challenges
The Covid-19 pandemic has triggered the most severe recession in nearly a century and is causing enormous damage to people’s health, jobs and well-being, according to the OECD’s latest Economic Outlook. The economic impact of strict and relatively lengthy lockdowns in Europe will be particularly harsh. Euro area GDP is expected to plunge by 11,5% this year if a second wave breaks out, and by over 9% even if a second hit is avoided, while GDP in the United States will take a hit of 8.5% and 7.3% respectively, and Japan 7.3% and 6%.
Emerging economies such as Brazil, Russia and South Africa, meanwhile, face particular challenges of strained health systems, adding to the difficulties caused by a collapse in commodity prices, and their economies plunging by 9.1%, 10%, and 8.2% respectively in case of a double hit scenario, and 7.4%, 8% and 7.5% in case of a single hit. China’s and India’s GDPs will be relatively less affected, with a decrease of 3.7% and 7.3% respectively in case of a double hit and 2.6% and 3.7% in case of a single hit. In both scenarios, the recovery, after an initial, rapid resumption of activity, will take a long time to bring output back to pre-pandemic levels, and the crisis will leave long-lasting scars – a fall in living standards, high unemployment and weak investment. Job losses in the most affected sectors, such as tourism, hospitality and entertainment, will particularly hit low-skilled, young, and informal workers.
The containment measures brought in by most governments were necessary to slow the spread of the virus and limit the death toll, but they have also closed down business activity in many sectors and caused widespread economic hardship. As restrictions begin to be eased, the path to economic recovery remains highly uncertain and vulnerable to a second wave of infections.
At the political level, an extended national and international strategy to strengthen healthcare systems and support people and businesses to help adapt to a post-Covid world needs to be developed based on a multidisciplinary assessment. Policymakers have used a vast array of exceptional measures to support healthcare systems and people’s incomes, as well as to help businesses and stabilise financial markets. But there is still much to be done, while we all need to understand that decisions that are taken today, in the time of the pandemic, will have a great impact on our individual and common future.
While the whole world has been focusing on the fight to contain the virus, many of the security issues faced at national, regional and international level have been left in the shadow of the Covid-19 crisis. In fact, whatever security challenges nations were facing before the pandemic have only been aggravated since the spread of the virus. For instance, terrorist groups have enlarged their online presence, reaching to a wide and vulnerable audience. Conflicts and power vacuums have been amplified by the spread of the disease taking advantage of weak sanitation and lack of local health infrastructure. Cybersecurity has gained more and more importance with most of the work being transferred to the online environment. In the same way, cyberattacks and terrorist activity over the internet have increased.
The school closures are one of the most visible – and controversial – means by which Covid-19 is affecting young people. According to UNESCO, the education of nearly 1.6 billion pupils in 190 countries has so far been affected – that’s 90% of the world’s school-age children. And at the time of writing, there are still no definite plans for opening the schools of around half of these children. The school closures are one of the most visible – and controversial – means by which Covid-19 is affecting young people. If schools don’t reopen until September, many children will have spent more than 20 weeks in a row away from school – an unprecedented amount of time away from education, meaning we can’t simply extrapolate from the existing data. Given that time spent in education appears to shape adult IQ – this could result in serious, lifelong effects on their cognitive ability. For those in the most critical periods of adolescence, it may even increase the risk of mental illness, delaying their cognitive, emotional and social development. Moreover, bearing in mind that the poorest will be hardest hit by all of these effects, lockdowns are expected to widen the existing inequalities across the globe, with repercussions for years to come.
Covid-19 has hit our modern world harder than any terrorist attacks or natural disaster up to present. The effects of the virus are developing beyond the physical direct effects and the number of cases and deaths. In order to combat the long-term consequences of the pandemic, a national and international strategy should be developed accordingly, based on a multidisciplinary assessment of effects and policy recommendations.
Psychological and social preparedness of this pandemic are now among the main assets to be developed on both short and long run. The government and stakeholders must appreciate the psychosocial morbidities of this pandemic and assess the burden, fatalities and associated consequences. Stigma and blame targeted at communities affected by the outbreak may hinder international trade, finance and relationships, instigating further unrest and providing opportunities for terrorist groups to spread hate and violence. Due care needs to be taken to erase the stigma associated with disease, racism, religious propaganda and psychosocial impact and needs to be implemented by regular discussion with trained and specialist health care personnel by making task force and execution teams who are directly engaged in health care delivery systems without creating any communication gaps between policy makers and ground level workers.
Although hard to recover in the short-term, the economy worldwide has to adapt to the new reality brought by the pandemic. As some argue that digitalisation is the future, many still hope to get back to the old-style work schedule, although it is still unclear when and how all the business that have been put on hold are to resume. It is important to underline that the keyword of the quarantine and post-quarantine period should be ‘adaptability’, meaning that the more people and businesses increase their adaptability to new contexts, the easier the transition will be.
Last, but not least, misinformation and disinformation have proved more dangerous than the virus per se and governments need to develop strict measures regarding fake news, propaganda and social media rumours. ‘The internet of things’ is today as dangerous as it is helpful in going on with our daily lives. Hard times need courageous decisions and we all have to agree that the strategies that we develop today during the Covid-19 crisis are framing our common future.
Dr. Andreea Stoian Karadeli is an independent researcher based in Turkey, an Associate Fellow at the Geneva Centre for Security Policy and a Visiting Researcher at the University of South Wales. Her interdisciplinary research varies from cultural and intercultural studies to conflict resolution and focusses on national security and terrorism, with a specific expertise in the Middle East.