Lockdown can work – but only with good internet and clear government messaging on how long it will last

Providing the British public with an accurate estimate of how long the UK lockdown will last and ensuring we all have good internet access will prove key to its success, according to new research.

A systematic review of more than 3,000 academic papers on the psychological impacts of quarantine by the department of Psychological Medicine, King’s College London, found that lockdowns of the type now in place in Britain and around the world cause a wide range of “negative psychological effects” including post-traumatic stress, confusion, and anger.

“Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma,” the authors said.

But the negative effects of quarantine - and adherence to it - can be significantly improved by enabling people to communicate easily with one another and remaining consistent about how long people should expect to be locked down for.

“The quarantine period should be short and the duration should not be changed unless in extreme circumstances,” the study warns.

Providing “robust” internet access to allow people to communicate directly with loved ones is also likely to “reduce feelings of isolation, stress, and panic”, the report says.

Of the 3,166 papers identified by the research team, 24 were reviewed in detail. These studies were conducted across 10 countries and included people’s experience of quarantine during epidemics of severe acute respiratory syndrome (Sars), Middle East respiratory syndrome (Mers), Ebola and influenza.

They showed that the longer a quarantine or lockdown lasts the more stress people experience - but this is made much worse if the authorities send mixed messages about how long restrictions will last.

Last week the Prime Minister said the current UK lockdown, instituted seven days ago, would be “reviewed” after three weeks, but yesterday the Deputy Chief Medical Officer for England told the country that it could be as long as six months before life returns to “normal”.

The epidemiological modelling from Imperial College, London that the government’s “suppression” strategy is based also suggests that the lockdown will need to be in place for many months - and potentially until a vaccine can be found.

“Longer quarantine is associated with poorer psychological outcomes, perhaps unsurprisingly, as it stands to reason that the stressors reported by participants could have more of an effect the longer they were experienced for,” says the Kings College analysis.

It therefore recommends that governments restrict the length of quarantine to a “scientifically reasonable” period and avoid adopting an “overly precautionary approach”.

However, it stresses the importance of “authorities adhering to their own recommended length of quarantine”, and not extending it.

“For people already in quarantine, an extension, no matter how small, is likely to exacerbate any sense of frustration or demoralisation,” it says.

Overall, the study says “information is key” to success. People need to “understand the situation” through “effective and rapid” government communication. This will maximise adherence to the rules and minimise psychological harm, it says.

“Most of the adverse effects come from the imposition of a restriction of liberty”, the authors add. “Voluntary quarantine is associated with less distress and fewer long-term complications. Public health officials should emphasise the altruistic choice of self-isolating.”

But even well managed lockdowns can have adverse psychological impacts. People quarantined during the 2003/4 Sars outbreak reported various negative responses. Over 20 per cent reported fear, 18 per cent nervousness, 18 per cent reported sadness, and 10 per cent guilt.

Only 5 per cent reported feelings of happiness.

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