Quarantine is effective but stressful tool against coronavirus

For Jennifer England, one of the worst parts of being quarantined is not knowing if she has the coronavirus.

The 51-year-old Pittsburgh resident’s symptoms resemble those of coronavirus — dry cough, fever, body aches. But they were not enough to qualify for a test, as she had not traveled internationally.

She also was unable to receive a test for the regular flu at her doctor’s office. England, who is the senior program director for 412 Food Rescue, said she would have to go to the emergency room but opted out because she had received a flu shot.

Instead, her doctor told her to go home and self-quarantine for two weeks.

“The medical community is taking this very seriously,” she said. “I don’t understand why the message in Pittsburgh is there’s no confirmed cases. My husband is immune compromised, he has asthma, and I met all but one of the criteria for testing and I live with someone who’s a high-risk population.”

There are no confirmed coronavirus cases in Allegheny or Westmoreland counties. But for England, that statement does not show the whole picture because people are unable to get tested.

“I think the lack of testing and the lack of information just exacerbates the panic,” England said. “Of the 10 anecdotal cases, maybe five, I heard of people who want to get tested who can’t, maybe one of them has covid-19 but, right now, nobody knows.”

Across the state, 16 cases have been confirmed, all on the eastern side of the state. The state Department of Health declined a Tribune-Review request for figures on people self-quarantined in Pennsylvania, citing privacy concerns.

“All those who may have come into contact with a presumptive positive case have been contacted and advised of the need to quarantine,” said spokesman Nate Wardle, noting that doctors and hospitals are not required to report to the health department when someone is self-quarantined.

England has been quarantined for a week since she came home sick from a trip to Los Angeles. Across California, there have been more than 100 confirmed cases of the coronavirus, with 20 in LA, the Los Angeles Times reported. Last Tuesday, a medical screener at the Los Angeles International Airport tested positive for the virus, NBC News reported.

“The reaction of the doctor was telling,” England said. “The medical community is concerned about this, and I don’t think we seem to be taking that seriously.” She noted that, after the doctor spoke with someone from the health department about her case, she came back wearing a mask.

Other people, including patients and doctors, backed away from England and she was asked to leave out the back door and not to touch anything, she said.

Symptoms of a quarantine

Across the country, nursing homes are limiting access, schools are closing, governments are issuing states of emergency — all in an attempt to stop the spread of the virus.

The number of cases internationally has risen beyond 121,800, The New York Times reported. U.S. cases have surpassed 1,000, with more than 30 reported deaths.

But, as the number of confirmed cases rise, so does the number of people who are quarantined.

“In the United States, we haven’t had a quarantine in place for many, many years,” said Jeff Magill, manager of emergency preparedness at UPMC Western Psychiatric Hospital. “So, this is a novel concept for most of our citizens at this point.”

What most people don’t realize, Magill said, is the emotional and mental toll a quarantine can have on people. In the case of coronavirus, symptoms can appear up to 12 days after contact. Officials recommend a two-week quarantine to help stop the spread from person to person.

“It is breaking up the normality of their routine, and we know by doing that it can increase our stress levels,” Magill said.

Stress can come in several forms, he said, including anxiety about your own health — wondering if a sneeze or sniffle is the start of something bigger — and fear over how large the epidemic could grow. For some, those fears could come out in anger over having no control over the situation. Feelings of loneliness and depression also can start to form for those who are quarantined.

To prepare for a quarantine, Magill suggested having “all your ducks in a row and things lined up,” in terms of medications, groceries, medical care and ensuring bills are paid. Staying informed about virus developments also helps people understand what is involved in a quarantine.

Dr. Jennifer Beckjord, senior director of clinical services at Western Psych, said while it is important to stay aware, it also is vital to not become obsessed with recent developments.

“I think it can be tempting in this situation to be glued to the news and that will only increase anxiety,” she said.

Things like reading, watching television and doing at-home exercises, such as yoga, can be a distraction throughout a quarantine.

The Centers for Disease Control and Prevention suggests taking deep breaths, stretching and meditating while eating healthy meals. Alcohol and drugs should be avoided.

Other aspects, like monitoring children or being confined with family members also can add to stress levels.

“Being in the same confined space for a couple weeks at a time can be challenging,” Magill said. “(Give each other) permission to go to other rooms, be on different floors.”

According to the CDC, parents should monitor children, looking for signs like excessive crying and irritation, worrying or sadness, unhealthy eating or sleeping habits, avoiding activities that were once enjoyed and a return to behaviors that were outgrown.

To help, parents can discuss the coronavirus outbreak with their children, reassure kids they are safe, create a sense of structure and be a role model by taking breaks, sleeping and exercising.

For those who could be isolated from others for weeks, feelings of loneliness, sadness and depression can arise, Beckjord said.

To help combat those emotions, Magill recommended taking advantage of technology to Skype and FaceTime family members and friends, ensuring social interaction.

“If you’re isolated from your loved ones by distance, it’s good to see them and know that they’re well,” he said.

Magill and Beckjord urged those who need it to take advantage of a crisis hotline. The 150-member UPMC crisis team offers counseling and support, referrals and intervention services for adults and teenagers. The 24-hour hotline can be reached at 1-888-796-8226.

“I think the biggest thing people can do is to be informed to understand why the quarantine is necessary … and not to see it as a sign of weakness,” Magill said. “We all have a level of stress that can overwhelm us.”

Across the country

Across the country, the cancellation of classes are in place to help stop the spread of the virus.

In New York, a one-mile containment zone was designated around the Young Israel of New Rochelle synagogue, The New York Times reported, meaning facilities like community centers and houses of worship will be closed for two weeks.

New Rochelle has emerged as the center of the New York’s outbreak, officials announced Tuesday.

Ohio Gov. Mike DeWine recommended Tuesday that indoor athletic events throughout the state continue without spectators, the Dayton Daily News reported. In Washington state, officials are expected to announce a prohibition on gatherings of 250 or more people at sports games and entertainment gatherings, according to The New York Times.

Several states, including New York, New Jersey, North Carolina, Illinois, Kentucky, Maryland, Utah and Oregon have declared states of emergencies. In Pennsylvania, Carnegie Mellon University has moved to online classes only at its Silicon Valley and Qatar campuses, university officials said Monday. On Wednesday, Pitt and Duquesne universities announced moves to online classes.

In the area, Allegheny Health Network is changing its visitation policy at hospitals to limit the number of visitors for a patient to one person at a time in the patient’s hospital room.

Wexford Healthcare Center in McCandless and Baldwin Health Center are taking similar precautions by restricting visitors and taking temperatures of visitors who do enter the nursing homes. Elderly people and those with underlying health conditions are most vulnerable to the virus, experts have said.

“I think what the big lesson here is really the weakness in our system and that we are not prepared for a true pandemic,” England said. “If this was the zombie apocalypse, we’d all be in trouble.”

In an attempt to keep her husband, who also is quarantined, from becoming sick, England said she moved into the room of her daughter, who is away at college and not coming home for spring break now that England is quarantined. Food delivery services have provided the couple with meals.

“I don’t want to incite panic,” she said. “I don’t want to come across as saying I have covid-19 or any of the people I talked to do. I just feel like it has been mishandled and that makes people panic more rather than less.”