Potential threats of COVID-19 on quarantined families

The World Health Organization (WHO) has characterized¹ the new coronavirus disease (coronavirus disease 2019 [COVID-19]) as a global pandemic as it spreads in more than 114 countries, killing thousands of people. Therefore, public health authorities and governments have provided some restrictions, including commuting bans, quarantine, and isolation, as the first risk response strategies to delay the introduction and spread of COVID-19 in their communities.

In terms of public health, ‘commuting bans’ refers to the implementation of traffic restrictions at specific points in an at-risk area. ‘Quarantine’ refers to the separation of people who have been exposed to a transferable health risk. Accordingly, ‘isolation’ applies to the separation of people who are known to be affected.² Two common concepts are extracted from the strategies, staying indoors and decreasing human communication.

Despite these inevitable limitations, it is noteworthy that infectious disease outbreaks are not considered just a medical phenomenon; rather, they show more complex dimensions of human life. It has been proved that staying indoors for a long time and decreasing human communication affect personal and environmental risk factors, such as anxiety-related behaviors, stress disorders, and exposure to smoke from cooking fires.

Globally, the WHO estimated³ that exposure to indoor air pollution was responsible for approximately 3.8 million premature deaths, in 2016 alone, owing to diseases attributed to poor indoor air quality. The most common and serious diseases associated with poor indoor air quality include acute lower respiratory infections, chronic obstructive pulmonary disease, lung cancer, cardiovascular disease, and asthma. In addition, according to the Environmental Protection Agency,⁴ indoor air is around 2–5 times as polluted as the ambient air and occasionally up to 100 times as dirty. Therefore, when people are spending more time indoors than ever before, like in the current scenario of the coronavirus disease outbreak, all risks associated with indoor air must be highly considered.

The mental health of families during quarantine is another major issue that can result in various negative mental health outcomes. Therefore, countries implementing weeklong quarantine measures should consider the mental well-being of quarantined families. It has been observed that the disruption of normal daily activities is potentially stressful and anxiety provoking. Consequently, the feasibility of controlling the COVID-19 pandemic by long quarantines may be significantly affected by the impact on mental health of quarantined families.

Aiming to survey the negative mental health outcomes of quarantines to prevent all COVID-19 transmissions, a most relevant previous study was critically reviewed. Based on the reported decrease in human communication during Ebola virus isolation,⁵ it is not far from mind that COVID-19 quarantines and isolations potentially will lead to several significant mental and psychosocial effects, including (a) fear associated with the experience of intense distress, (b) anxiety and mood disorders as well as obsessive compulsive disorder, (c) psychosocial problems, and (d) social problems. Especially, recently, a record-high number of divorce requests have been observed after coronavirus quarantines in Chinese cities.