The Long Game: Quarantine Survival


By O2X Specialist Michael DeVries, Ph.D., ABPP
Originally written April 25, 2020

It’s a marathon not a sprint. Much has been written and said in the news and across multiple media platforms about ways to survive the negative consequences of the COVID-19 crisis. While many people are suffering extreme hardship due to the loss of or separation from loved ones or the financial crisis of losing income, many of us are trying to cope with more mundane challenges of being isolated from others, unable to keep our normal routine, and finding toilet paper or other staples at the grocery store. Stimulus packages, unemployment benefits, and reimagined work roles are attempts to help those in financial distress. Many people have taken up or returned to their hobbies, learned to post funny videos or take their meme skills to the next level or discovered the variety of opportunities to utilize video teleconferencing in order to cope with the challenges of social isolation. As many of us are approaching our second month of social distancing restrictions, cracks are starting to form. Our coping mechanisms are beginning to fail and our hobbies are growing stale just as we are being told to prepare for a second wave, or that the restrictions could last through the fall in some shape or form. Despite loosening of restrictions in some areas the future landscape remains uncertain. In short, we are finding that the challenges of dealing with COVID-19 are more akin to a marathon than a sprint.

Any marathoner will tell you that running 26.2 miles can be an emotional roller coaster. There are perils to starting too fast and being unable to maintain your pace. There are points in the race when you feel good and you think you should speed up. At other points, you feel you can’t go on. There is the infamous “hitting the wall” when somewhere between mile 16 and 24 you completely run out of energy and it feels like every step challenges your will to continue.

This analogy may be particularly applicable to our first responders. For our Fire Departments, Police and Sheriff Departments and EMS personnel, their jobs don’t take a pause due to the COVID crisis. They have to continue to serve their critical functions while contending with all the additional challenges of the crisis in their personal and professional lives. They work long hours with the increased requirements of trying to limit their exposure to the virus in jobs which are inherently exposed. Many first responders have become victims of the virus so there is the ever present additional threat to their lives in an already life threatening job. Then they return home to the ubiquitous stress we all face with not being able to find what we want at the supermarket or not being able to enjoy a workout at the gym or meal at a restaurant. First responders may also find themselves in an official, individual quarantine due to a specific exposure to the COVID-19 virus. This places additional challenges on the individual and the team. Sometimes they find that they are restricted from helping in the ways they are used to in order to limit their potential exposure. This can be particularly hard for those who are ever willing to put themselves at risk to help others.

From articles in the news, posts on social media, and data on therapy visits and tele-health, it seems that many in our society are hitting the wall when it comes to coping with the COVID 19 crisis. Now is a good time to reassess our coping strategies to see what is working and where we need to make improvements. While many people initially accepted the hardship of social distancing and restrictions on behavior, many are beginning to chafe and push back through their social media comments or formal protests. Leaders are openly disagreeing on the way forward and how much our economy can take. There are also reports that more people are turning to behavioral health resources due to the stress of the current crisis. Some marriages are struggling due to the combination of stress, broken routines, and being cooped up together without other outlets. While there is no shortage of guidance on how to cope with the challenges posed by COVID-19 and our national response, it is important to continually reassess our approaches to determine if they are still effective, are still being implemented, and if they need to change to meet the on-going, continuous challenge.

In February 2020, the Lancet published an online review of what we know about the stressors of being quarantined and the recommendations for coping. These findings are a great place to start as we re-evaluate our coping strategies for the mass quarantine we are all experiencing. Many of the studies reviewed showed that quarantined individuals reported symptoms of psychological distress such as depression, low mood, stress, irritability, anger, emotional exhaustion, insomnia and post traumatic stress symptoms. It is not hard to see many of these symptoms as an undercurrent in many social media posts suggesting frustration with family members, the government, corporate leadership, etc. While humans are quite capable of dealing with stress in the short term, these symptoms become especially worrisome as the national and local restrictions and the economic consequences drag on. The Lancet article highlighted some key suggestions on how to cope minimize the impact of quarantine to which I have added some implementation thoughts for leaders:

• Keep people informed. Communicate early and often. Communication helps manage uncertainty, anxiety, and isolation. While quarantined individuals may not always ask or may balk at communication efforts, it is important to maintain regular communication. This is where the numerous teleconferencing options can be a great tool to promote social interaction and maintain some sense of a normal routine with meetings and collaboration. The same goes for personal social interaction as well. Getting together with friends and family does not have to stop in the age of technology and video teleconferencing.

• Keep people well supplied. Nothing adds insult to injury quicker than being asked to isolate and running out of the basics (toilet paper.) While few leaders can affect the global supply chain, if you have someone in a formal quarantine ensure that they have as many creature comforts as practical. Wifi, good food, exercise equipment, puzzles, etc. can go a long way to taking the edge off a frustrating situation. Providing extra items is also a good way to communicate concern for those making the sacrifice to quarantine. Ensuring that team members outside of formal quarantine conditions are well supplied is also important. Anything we can do to support each other will help counter the social isolation and lack of community. The same goes with our home environment. If we can do our best to stay stocked with the basics as well as activities and things to keep us interested, we will be less focused on what we can’t do or have.

• Emphasize altruism. People in general and first responders in particular are more willing to accept sacrifice when they are doing it for others. This can make it feel more like a choice to sacrifice to help someone else. Quarantine helps keep others safe and those asked to quarantine tend to do better if they feel like it is a choice and that they are doing it to help others.

Many of the recommendations for dealing with isolation and the mandatory change to our routine involve things that are just good habits applied to a new situation. Humans often fear or stress about change because it upsets our routines. We have to find new patterns and sometimes we fall into patterns that are unhealthy. Make use of the following strategies to develop good routines as you adjust to your current situation and the months to come, whatever they hold:

Build a routine. Humans like to have routines. Most of us don’t like uncertainty. When our normal routine is busted, we do best when we develop a new schedule. Plan your activities each day so you know what to expect and you are not faced with an empty slate. As you plan your new routine, incorporate the practices below to maintain or even improve your habits.
Limit exposure to stressful information. Early in a crisis, we understandably often find ourselves glued to the news. We want to know the latest. The problem is that this is stressful and the news is often sensationalized. For first responders, their daily work may be stressful enough. Overtime, exposure to stressful information is compounded. Social media is often polarizing and littered with inaccuracy that can draw us into arguments or just make the blood boil. It’s best to limit exposure to the news each day and to social media which is distressing. Diverse ideas are important, but consider blocking, for a time, sources that get you upset.
Keep a positive attitude. Negative thinking leads to negative emotions and often negative behaviors. Break the cycle by focusing on the positive. Think of what you can do now, or things that make you thankful. “Hunt the good stuff” is a motto used to keep us looking for the positive each day, in the news, in social media, in our work, and at home.
Think of change to your routine as an opportunity. People are using the change to their routine to exercise more, take a free class, start a hobby, learn to cook, etc. Whether you start something and stick with it or try lots of new things, use the opportunity to improve yourself. How can you get 1 percent better everyday?
Find a way to help someone else out. Nothing makes us feel better than helping out. It is also pretty hard to focus on the negative in your life when you are focused on finding ways to help others who are less fortunate.
Exercise. Routine exercise is one of the best stress management tools. Exercise dissipates the hormones which build up under stress. It also makes us more physically and mentally ready for challenges. Be careful to ramp up slowly as too much exercise too soon can lead to injury or decreased immune system functioning so build up gradually.
Build good sleep patterns into your routine. It is easy to get in the habit of sleeping more or at odd hours when your routine is busted. Set regular sleep and wake times for yourself as best you can. This is always hard for first responders, but it is worthwhile to do the best you can with the schedule you have. Prioritize sleep and exercise.
Nutrition is literally the fuel for everything else. Be aware of how your eating habits have changed. Make sure you are eating regular meals of the right amounts and of the right things. There are plenty of diets to choose from. Do some research and find one that is balanced and sustainable for you. A balanced diet with the right amount of calories is a good 90 percent solution.
There are some good tidbits of information floating around so be on the lookout for sage advice among the opinions and speculation. One that is good to remember is, we are not all in the same boat. There are some ideas here on how to survive and thrive in these new and uncertain times. We all do well to remember that we are all in slightly or even drastically different situations. Some have more time at home while others are working extra shifts. Some are pretty safe while others face increased risk. Some have steady income and others have to look for ways to make it through. We have to chart a course that works for each of us individually and look out for each other along the way. While our situations may differ, we are all in the same race for the long haul. Just like a marathon, if we follow a good plan we will post a good performance.

1 Brooks, S.K., Webster, R.K., Smith, L. E., and Woodland, L. (2020) “The Psychological Impact of Quarantine, and how to Reduce it: A Rapid Review of the Evidence.” Lancet. 395: 912-20.