How does quarantine actually work?

Reacting to the escalating number of confirmed COVID-19 cases, Italy has placed its entire 60 million population under tightened quarantine restrictions.

In a move to encourage what’s known as social distancing, cafes, restaurants, gyms, museums, schools and other institutions across the country have closed. All shops – except food stores and pharmacies – will close too.

And public gatherings like religious services and business, social and sporting events have been cancelled.

People are not supposed to enter or leave quarantined areas and only work-related internal movement is permitted.

Italy has seen the largest number of COVID-19 infections outside of China, with more than 12,000 reported cases. The number of daily new cases continues to rise.

The hardline quarantine measures emulate a similar approach adopted by authorities in China, during an earlier stage of the global outbreak.

Dramatic decline

With daily cases of COVID-19 soaring in the Chinese province of Hubei, strict restrictions were put in place to quarantine nearly 60 million people. People were confined to their homes, while buses, railways, ferries and flights stopped running and factories, offices and schools closed their doors.

The result was a dramatic decline in the disease’s spread. Within a month of the social distancing measures taking effect, the number of new cases fell from more than 1,600 each day to just 36.

COVID-19 can be transmitted when people with the virus cough or exhale, releasing tiny contaminated droplets into the air, which others can breathe in or pick up when their hands touch surfaces the droplets have landed on.

Placing people in quarantine reduces social contact to limit opportunities for transmission of a virus, helping to avoid a huge spike in cases that would overwhelm health services.

Home alone

But living under lockdown for lengthy periods can take its toll on the people affected. Aside from fear of infection and boredom, studies show living in isolation can produce post-traumatic stress symptoms, confusion and frustration. These feelings can be aggravated by inadequate supplies and financial loss.

To keep negative feelings to a minimum, it is important individuals are confined no longer than necessary and given a clear rationale for their quarantine. People also need regular information updates so they know what to do, as well as access to sufficient food and supplies.

To alleviate some of these concerns, Italy is encouraging internet companies and publishers to offer its quarantined population free services aimed at helping people work or study at home. Other offers on the government’s Digital Solidarity site include mobile phone companies offering additional data allowances and a major publisher giving away 50,000 free magazine subscriptions.

However unpleasant the experience, quarantine has been a useful tool in slowing outbreaks in the past. During the influenza pandemic of 1918, US cities like St Louis closed churches, schools and movie theatres and cancelled sporting events at the early stages of the outbreak. Research shows that as a result fewer fatalities were recorded than other cities where no such measures were taken.