Dear Editor,
This letter discusses the consequences of quarantine and provides suggestions to reduce or overcome the effects of quarantine described by various studies.
This letter identifies essential instructions for parenting in quarantine and other resources that are available by distinguished organizations.
It is proposed to adopt some behavioral modifications, which may play an essential role in improving mental health, resilience, and coping with COVID-19 conditions.
In early December 2019, in Wuhan, the capital of Hue Province, China, a new disease called COVID-19 with symptoms of pneumonia of unknown origin, was identified (1). This disease has become prevalent worldwide and affects all age groups, especially immunocompromised persons. The affected communities report higher rates of mortality, severe anxiety, and psychological problems (2). Severe disease outcome and fear of contagion may also occur in confirmed and suspected COVID-19 cases (3), along with many other symptoms such as loneliness, denial, anxiety, depression, insomnia, despair, increased risk of aggression, and suicide (4, 5). Simultaneously, families of confirmed and suspected cases may also suffer from many symptoms.
Quarantine is one of the necessary preventive measures during the COVID-19 pandemic; however, various adverse psychological effects are encountered during the quarantine, including post-traumatic stress symptoms, confusion, and anger. Similarly, many stressors such as prolonged quarantine, fear of infection, frustration, boredom, inadequate supplies and information, financial loss, stigma, and long-lasting effects have also been outlined in such patients (5).
Further, it is reported that due to the COVID-19 outbreak, 1.38 billion children are at home as stated by the United Nations Educational Scientific and Cultural Organization, and there is an increasing rate of child abuse, stress, fear, and unverified media exposure due to school closure (6). Social distancing from friends and separation from other activities may also cause mental distress, online and offline abuses, and negative impacts on mental health, well-being, and growth in children. Usually, children have limited understanding and coping strategies to understand the consequences of an epidemic crisis. However, a child's previous exposure to health emergencies, mental health, well-being, family status, and cultural background may help to cope with the consequences of the crisis.
It seems that, apart from interventions used to prevent the disease, spreading awareness about how to use time adequately in quarantine, nurturing resilience, and mental health and relieving boredom are equally important. It has also been suggested that psychological interventions should be involved in the health care system to face such crises of public health emergencies (7). The findings of a previous study showed that the majority of the parents had shouted, yelled, or screamed at their children due to quarantine stress, and they had slapped their children at least once in the past two weeks (8). Thus, the community needs to work together to mitigate the effects of quarantine. Nevertheless, organizations such as WHO, UNICEF, APA, and many more have introduced guidelines for parents and other concerned individuals to support children’s mental health. The American Psychological Association (9) has also offered specific tips for parenting during a pandemic, including: acknowledging your emotions, setting boundaries, establishing a routine, relaxing screen time rules, communicating with supervisors or co-workers, sharing responsibilities, and practicing self-care. Similarly, limiting the time for television (especially news), refraining from talking about COVID-19 in front of children, encouraging children to follow hygiene practices such as hand wash and using a mask, avoiding blue lights of the screen that could cause sleep disturbance, paying special attention to children with special needs through contacting doctors, and using an appropriate language to explain the rationale of social distancing in this critical period (10).
Furthermore, communities should practice healthy relationships, adopt the possible coping strategies, maintain patience, apply a team approach in the family, built constructive communication, and respect cultural values that motivate them to become spiritually strong, which could be one of the successful coping strategies.
Besides, many organizations are working together to allow open access to online parenting resources primarily on building positive relationships and managing poor behaviors and to provide concrete tips for managing parental stress during COVID-19 pandemic (6). Further, some volunteers are constructing translations of parenting resources into 55 languages, resulting in strong data from randomized controlled trials in low and middle-income countries (11-13). Moreover, provide to communities as much information as possible to clear their doubts, arrange for adequate supplies, minimize sadness and improve communication (5), and they could be one of the major strategies to reduce the impact of quarantine.
Some behavioral modifications may also provide significant changes in quarantine such as practicing mindfulness techniques, meditation, physical activities, nutritional diet, healthy lifestyle, learning new skills, exploring a new interest, using video chat to connect with family and friends, following hygiene practices, play sports and listening to music. All these activities could improve mental health, resilience, coping, and well-being of individuals as a positive outcome of the coronavirus outbreak.
In conclusion, the COVID-19 outbreak has led to a wide range of psychological issues. Although many services have been provided around the world face-to-face or online, accessibility and awareness are still insufficient, which can delay seeking medical attention and worsen the quarantine period. Thus, governments, authorities, and policymakers must continue to design and update interventions and spread awareness to help communities face and mitigate the effects of quarantine. The offered strategies should be practiced appropriately to promote resilience and physical and mental health and to encourage coping strategies to address the fears and concerns of children and parents. Practicing a positive attitude to deal with stress should also be included in the agenda.
