By Dr. Anuradha Ellepola
The contagious coronavirus disease (Covid-19) was first discovered in December 2019 in Wuhan, China. Its spread has created a global emergency, and the infection has been categorised as a pandemic. The main mode of transmission is through close contact of people, often via respiratory droplets. Some infected individuals may remain asymptomatic, while others could show mild respiratory symptoms to progressive, potentially lethal viral pneumonia. There are millions of reported positive cases around the world since its onset. There are more than three million cases in the world, and approximately 230,000 deaths in Sri Lanka at the time of writing this article.
Preventive measures
Many governments have taken a number of steps to control the contagion of the virus, where some countries show success in containing the infection. The Sri Lankan Government too has executed a series of measures as a response to the Covid-19 pandemic. In March 2020, all passenger flights and ship arrivals into the country were temporarily stopped until the pandemic was brought under control. Public gatherings in places like museums and movie theatres were closed indefinitely. Gatherings and events that involve large crowds of people were temporarily prohibited.
The Ministry of Education announced the closure of all schools from March 2020. Quarantine centres were established with the help of the relevant Presidential Task Force, the health sector, the tri-forces, and the Police, covering most of the regions of Sri Lanka. The Government also took a timely decision to impose curfew in the country; high-risk areas were placed under lockdown to prevent the further spread of the infection to vulnerable groups. Public movements were restricted, and media attention was given to make the public aware of the risks and preventive measures. Instructions such as thorough hand washing, physical distancing, wearing proper face masks, and staying at home have been regularly conveyed to the public through the media, healthcare workers, and the Police and the tri-forces.
Quarantine
The term “quarantine” was not very familiar among Sri Lankans until the onset of the current pandemic. The term generally implies a strict isolation to prevent the possible spread of a contagious disease. During the ongoing pandemic, some people have been quarantined in established quarantine centres, while others experienced self-quarantine or restricted movements by staying at home. This is a mandatory measure prudently taken by the Government, albeit having adverse consequences.
It was reported that some people rebelled against the stay-at-home order or quarantine order, plunging themselves as well as others to risk. There was also desperation to move out of isolation among some, especially in certain epicentres of the infection spread.
Quarantine fatigue and cabin fever
Though not categorised as a disorder, quarantine fatigue, conceptually similar to cabin fever, is a distressing feeling as a result of strict isolation. It can be explained as a feeling of claustrophobic restlessness caused by isolation in a confined place for a prolonged period of time. An individual may experience disturbance in the sleep wake cycle, craving for food, anxiety, depression, the lack of concentration, fatigability, decreased motivation, boredom, irritability, worthlessness, and a strong desire to go out despite knowing its risk.
Similar features have been reported among people working in lighthouses and submarines and also individuals isolated due to epidemics or adverse weather. The 2016 award-winning movie The Lighthouse depicts the effects of cabin fever on people stranded in an island lighthouse.
Coping strategies
The stay home order, curfew, quarantine, and lockdown could result in similar distress among the public. It is a need of the hour to identify coping strategies to tackle quarantine fatigue or cabin fever during this time when people stay at home to avoid contracting Covid-19. There are direct and indirect advantages of coping styles. Some strategies may boost immunity and reduce interpersonal conflicts.
Chill out
It is a good idea to find time to relax completely. Relaxation helps improve one’s psychological health. Distressing emotions related to social isolation can effectively be reduced by activities such as breathing and relaxation exercises or leisurely playing an instrument. Sri Lankans, being in a tropical country, may place a comfortable chair in the garden under a shade, and just sit and rest, or hum a song. Or one may watch and enjoy a movie or listen to tranquil music. It gives one time out from the stressors and anxieties. Consider it as a time for oneself, or “me time”.
Socialise
We are social animals. However, social life is difficult to maintain during this period where social distancing is of paramount importance. But technology permits us to communicate with each other and the outside world. Social media, video services, and telephones help us keep social contacts virtually. It is better to avoid distressing topics, such as the current pandemic, during audio, video, or text conversations.
Some schools in Sri Lanka conduct virtual classes online that help children to maintain an interactive social life. People working from home experience socialising with their colleagues. Harmless gossiping with friends may contribute to avoiding the distress of cabin fever. Expressing one’s emotions – for example, through a Facebook post – could improve one’s mental wellbeing.
Physical exercise
Regular physical activities reduce one’s stress hormones and release endorphins. This is very helpful in improving one’s physical and mental health. Going to a gym or a jogging track is not possible during this difficult time. Instead, working in the garden, walking or running on a treadmill, cleaning the house, washing one’s vehicle, dancing, working out using simple equipment, etc. would help one to maintain physical and mental wellbeing. If the necessary facilities are available, structured exercise programmes are available online. Sedentary life should be avoided as much as possible during this stay at home period.
Indoor activities
Indoor activities such as board games are good ways of spending quarantine time. Sri Lankans are familiar with games such as checkers, cards, snakes and ladders, chess, and carrom. It helps one to alleviate boredom and distress. Games like sudoku and checkers are simple games that enhance one’s cognition while reducing lockdown anxiety. Solitaire and dominos can improve one’s patience. Others may read a book or a newspaper. These strategies also assist one to get rid of undesirable habits such as drinking alcohol and smoking nicotine.
Outdoor time
Spending time outside home is helpful in improving mental health and immunity in addition to giving vitamins. It may alleviate one’s Covid-19 associated stress. Integration with nature is a good mood enhancer. In areas where the curfew or lockdown rules have been imposed, people can spend time within their garden. Watering and looking after plants are a good way of spending time outdoors. Or feed the birds and squirrels in one’s garden. People with ample space can grow vegetables or fruits in the backyard.
If one is under strict self-quarantine, one may grow indoor plants such as bonsai. Allow the outdoor breeze into one’s house by keeping the windows open. Enjoy the scenery, or take photographs and draw sketches.
Structure the day
Maintaining a structured schedule is important to avoid demotivation. Having a routine consisting of daily activities, projects, physical activities, leisure activities, chill out time, etc. will keep one well occupied. One will be able to maintain the momentum of life. It is easier to resume normal work once the isolation rules are relaxed.
Hobbies
Everyone does have one or more innate skills. One can use one’s talents to make one’s day productive and busy. Most of us had no time for previously done hobbies as a result of being involved in the rat race, until the current pandemic severely restricted us. Activities such as cooking, painting, reading, and writing may keep one occupied. One can rearrange one’s childhood collections like coins, stamps, perfume bottles, or boxes of matches. Children can create a play or a song. One may post one’s work on social media to get self satisfaction. It is a good solution for quarantine fatigue, and one will feel that the time passes faster.
It is not forever
There is always a silver lining. One will not have to stay under restrictions forever. The best thing we can do right now is to obey the decisions of the Government and the health officials. Help oneself and the community to minimise the viral spread. Spend one’s time productively. See positive aspects of the pandemic. Get ready for the future. Do not give up one’s aims. Seek help from experts when necessary.
Stay safe!
(The writer is a consultant psychiatrist at the Anuradhapura Teaching Hospital)
Indoor activities such as board games are good ways of spending quarantine time. Sri Lankans are familiar with games such as checkers, cards, snakes and ladders, chess, and carrom. It helps one to alleviate boredom and distress. Games like sudoku and checkers are simple games that enhance one’s cognition while reducing lockdown anxiety. Solitaire and dominos can improve one’s patience. Others may read a book or a newspaper. These strategies also assist one to get rid of undesirable habits such as drinking alcohol and smoking nicotine.
Outdoor time
Spending time outside home is helpful in improving mental health and immunity in addition to giving vitamins. It may alleviate one’s Covid-19 associated stress. Integration with nature is a good mood enhancer. In areas where the curfew or lockdown rules have been imposed, people can spend time within their garden. Watering and looking after plants are a good way of spending time outdoors. Or feed the birds and squirrels in one’s garden. People with ample space can grow vegetables or fruits in the backyard.
If one is under strict self-quarantine, one may grow indoor plants such as bonsai. Allow the outdoor breeze into one’s house by keeping the windows open. Enjoy the scenery, or take photographs and draw sketches.
Structure the day
Maintaining a structured schedule is important to avoid demotivation. Having a routine consisting of daily activities, projects, physical activities, leisure activities, chill out time, etc. will keep one well occupied. One will be able to maintain the momentum of life. It is easier to resume normal work once the isolation rules are relaxed.
Hobbies
Everyone does have one or more innate skills. One can use one’s talents to make one’s day productive and busy. Most of us had no time for previously done hobbies as a result of being involved in the rat race, until the current pandemic severely restricted us. Activities such as cooking, painting, reading, and writing may keep one occupied. One can rearrange one’s childhood collections like coins, stamps, perfume bottles, or boxes of matches. Children can create a play or a song. One may post one’s work on social media to get self satisfaction. It is a good solution for quarantine fatigue, and one will feel that the time passes faster.
It is not forever
There is always a silver lining. One will not have to stay under restrictions forever. The best thing we can do right now is to obey the decisions of the Government and the health officials. Help oneself and the community to minimise the viral spread. Spend one’s time productively. See positive aspects of the pandemic. Get ready for the future. Do not give up one’s aims. Seek help from experts when necessary.
Stay safe!
(The writer is a consultant psychiatrist at the Anuradhapura Teaching Hospital)