Understanding, compliance and psychological impact of the SARS quarantine experience

TLDR

This study investigates the understanding, compliance, and psychological impact of SARS quarantine in Canada, and explores ways to improve compliance and reduce distress. The study used a mailed questionnaire to 1,912 adults, including the Impact of Events Scale–Revised to assess PTSD symptoms. Compliance was low (≈16%) and higher when the rationale was understood; health‑care workers experienced more PTSD symptoms, and difficulty, longer quarantine, and compliance were linked to higher distress, raising concerns about quarantine effectiveness.

Abstract

SUMMARY This study examines a cohort of persons quarantined during the 2003 SARS outbreak in Canada and describes their understanding of, difficulties and compliance with, and the psychological impact of the quarantine experience. A mailed questionnaire was administered to 1912 eligible adults and included the Impact of Events Scale – Revised (IES-R) to assess symptoms of post-traumatic stress disorder (PTSD). Self-reported compliance with all required quarantine measures was low (15·8±2·3%), although significantly higher when the rationale for quarantine was understood ( P =0·018). Health-care workers (HCW) experienced greater psychological distress, including symptoms of PTSD ( P <0·001). Increasing perceived difficulty with compliance, HCW, longer quarantine and compliance with quarantine requirements were significant contributors to higher IES-R scores. The low compliance with quarantine requirements introduces concerns about the effectiveness of quarantine as a public health measure. Improvements in compliance and reduced psychological distress may be possible by minimizing duration, revising requirements, and providing enhanced education and support.