Keep Calm and Carry On : Quarantine and Isolation

photo by Swarna Bandara

In preparation for the arrival of COVID-19, we incorporated hand hygiene, cough etiquette and social distancing into our daily routines. Now that the disease has landed on our shores, we need to become familiar with quarantine and isolation. Currently, in Jamaica, confirmed COVID-19 patients are isolated in health facilities. We also have patients in quarantine facilities and all travellers from regions with local transmission are being asked to self-quarantine at home. The general public with flu-like symptoms (cough, fever, sore throat) are also being asked to stay home and call their family doctors or the Ministry of Health and Wellness (MOHW) hotlines for further advice.

As more people become infected,  isolation at home will become necessary for  cases that do not need hospital care. Isolation is not simply staying at home and watching TV with your family in the living room. It requires ideally no contact with others while you are sick.  If contact is unavoidable, appropriate personal protection measures must be taken. The isolation period is 14 days or more, depending on how long your symptoms last. Quarantine is essentially the same process but applied to people who have been exposed to SARS-CoV-2, but are not yet sick. The prospect of completely avoiding all human contact  for an extended period of time is likely to be one of the hardest parts of coping with COVID-19. Making informed preparation for the future is one way to keep calm and carry on. It can be helpful to address this preparation from physical, mental and spiritual perspectives.

How do I prepare physically for isolation?

One aspect of the physical preparation is the actual space that you will be isolated in. If you are in a health care facility these details will already be taken care of. But if you have to isolate at home, this is what you will need to do:

  • Identify a room that gets plenty of fresh air, and has a closable door, or a space in your home that can provide at least 1 metre distance between the patient and other householders. This will be your isolation room/space.
  • Provide separate  bed, towels and sheets, eating and drinking utensils, and toothpaste, and soap.
  • Access to a separate bathroom is ideal. If the bathroom has to be shared, the patient uses it last and disinfects surfaces after each use.
  • Provide a bin with a plastic bag liner for collecting used tissues and any other disposables that may be contaminated by droplets.
  • Have mop, rags, disposable disinfecting wipes  for cleaning only the isolation area.
  • Provide disposable surgical masks to be worn by the patient if she needs to access shared areas of the house.
  • If a caregiver is needed, provide personal protective equipment or PPE (mask, gown, gloves) and instructions for putting on and taking off PPE.
  • Make arrangements for doing the patient’s laundry separately from the rest of the household.
  • Provide access to a cell phone if possible so that the patient can communicate remotely.

It helps to make these preparations before you or someone in your family gets sick, so that you can  keep calm and carry on when you are actually faced with illness.

How do I prepare mentally for isolation?

For many of us who are used to being in perpetual motion, the thought of severe restrictions on our daily movements, work and interactions with people for a prolonged period can be scary. The first step in preparing your mind for isolation is to remember that you are doing this to protect a vulnerable loved one from getting sick. With that motivation firmly established, there are a few other things you can do in advance to prepare mentally:

  • Think of the isolation period as a retreat and an opportunity to catch up on sleep and much needed rest and “me time” instead of “bitter medicine” to be taken.
  • Plan a daily routine for how you will spend the time. Include adequate sleeping time, some physical activity (stretches, yoga, push ups etc), catching up on the news/email, prayer/devotions/meditation time, checking in with family and friends by phone etc.
  • Identify and acquire some books or other reading material to occupy your time. Load up your Kindle or get real books and magazines.
  • Download some movies or if you have Netflix, make sure you have access through an electronic device that can remain in your room. This can be a good time for guilt free binge watching.
  • Load up your phone or tablet with games, including online ones that allow you to interact with others.
  • Identify somebody who can do supermarket and pharmacy trips for you if needed.

Maintaining a healthy mental state may be the hardest part of dealing with a COVID-19 infection, especially if your symptoms are mild. So planning for mental health during this forced “holiday” from regular activities is crucial for us to keep calm and carry on.

How do I prepare my spirit for isolation?

Although we focus a lot on physical symptoms and their treatment, in my opinion, the most important part of an individual is their spirit. This is the part that determines how an individual responds to any challenge, and transcends physical limitations. Human beings are wired to connect to others, and isolation goes against this natural tendency to connect especially in times of distress, such as being diagnosed with COVID-19. It is critical to fulfill this need for connection, which helps the healing process, while still following the protocol for physical isolation to prevent the spread of disease. You can sustain your spirit through the isolation period by:

  • Ensuring that you have access to either WiFi or a data plan or at the very least a basic telephone. This allows you to connect with other people while not putting them at risk of being infected with the virus.
  • Looking for ways to see the bigger picture instead of dwelling on your individual discomfort.
  • Keeping a daily journal of your experience. The last time the world experienced a pandemic was in 1918 with the Spanish flu, hence you are living through a historic moment in time.
  • Listening to music can not only lift your spirits but also assist your body to recover from illness. So create some music playlists  that you can listen to for calming, healing and relaxing while in isolation.
  • Creating a chat group using one or more of the many social media sites to connect with others who are also under isolation.
  • Actively seeking the blessings in your life (e.g. that you are well enough to require only home isolation) and explicitly acknowledging and sharing them with your friends and family through any medium that does not violate the physical isolation requirements.

Gratitude, compassion and a sense of one’s place and purpose in the world are the things that sustain spirit. They do not require physical contact to be nurtured and experienced.

Jamaica is now about 19 days into its COVID-19 encounter. With 30 people confirmed as infected, we await the start of the community transmission phase, defined by the appearance of a patient with COVID-19 who has no identifiable connection to another known patient or a relevant history of travel. The swift actions of the government, and the cooperation (even if grudgingly given) of the population in general have allowed us to keep these numbers very low compared to our nearby neighbours. As our journey continues, physical isolation and social distancing will continue to play a large role in keeping this epidemic within our capacity to cope. We are fortunate to be living in a time where modern communication technologies allow us to connect instantaneously with people who are in a different room or on a different continent. We can use this technology to help us transcend the physical isolation required  to contain this disease and find ways to support the spiritual and mental connections with each other that are vital for health. Working together, and knowing that we are not alone, even in the midst of isolation, is how we keep calm and carry on in these trying times.

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