ABSTRACT
BACKGROUND: Nations throughout the world are imposing mandatory quarantine on those entering the country. Although such measures may be effective in reducing the importation of COVID-19, the mental health implications remain unclear. AIMS: This study sought to assess mental well-being and factors associated with changes in mental health in individuals subject to mandatory quarantine following travel. METHOD: Travellers arriving at a large, urban international airport completed online questionnaires on arrival and days 7 and 14 of mandated quarantine. Questionnaire items, such as travel history, mental health, attitudes toward COVID-19, and protection behaviours, were drawn from the World Health Organization Survey Tool for COVID-19. RESULTS: There was a clinically significant decline in mental health over the course of quarantine among the 10 965 eligible participants. Poor mental health was reported by 5.1% of participants on arrival and 26% on day 7 of quarantine. Factors associated with a greater decline in mental health were younger age, female gender, negative views toward quarantine measures and engaging in fewer COVID-19 prevention behaviours. For instance, travellers who stated that they rarely wore masks had nearly three times higher odds of developing poor mental health. CONCLUSIONS: Although the widespread use of quarantine may be effective in limiting the spread of COVID-19, the mental health implications are profound and have largely been ignored in policy decisions. Psychiatry has a role to play in contributing to the public policy debate to ensure that all aspects of health and well-being are reflected in decisions to isolate people from others.
ABSTRACT
OBJECTIVES: The primary objective was to estimate the positivity rate of air travellers coming to Toronto, Canada in September and October 2020, on arrival and on day 7 and day 14. The secondary objectives were to estimate the degree of risk based on country of origin and to assess knowledge and attitudes towards COVID-19 control measures and subjective well-being during the quarantine period. DESIGN: Prospective cohort of arriving international travellers. SETTING: Toronto Pearson Airport Terminal 1, Toronto, Canada. PARTICIPANTS: Participants of this study were passengers arriving on international flights. Inclusion criteria were those aged 18 or older who had a final destination within 100 km of the airport, spoke English or French, and provided consent. Excluded were those taking a connecting flight, had no internet access, exhibited symptoms of COVID-19 on arrival or were exempted from quarantine. MAIN OUTCOME MEASURES: Positive for SARS-CoV-2 virus on reverse transcription PCR with self-administered oral-nasal swab and general well-being using the WHO-5 Well-being Index. RESULTS: Of 16 361 passengers enrolled, 248 (1.5%, 95% CI 1.3% to 1.7%) tested positive. Of these, 167 (67%) were identified on arrival, 67 (27%) on day 7, and 14 (6%) on day 14. The positivity rate increased from 1% in September to 2% in October. Average well-being score declined from 19.8 (out of a maximum of 25) to 15.5 between arrival and day 7 (p<0.001). CONCLUSIONS: A single arrival test will pick up two-thirds of individuals who will become positive by day 14, with most of the rest detected on the second test on day 7. These results support strategies identified through mathematical models that a reduced quarantine combined with testing can be as effective as a 14-day quarantine.
Subject(s)
COVID-19 , Airports , Canada , Cohort Studies , Humans , Prospective Studies , SARS-CoV-2ABSTRACT
The delivery of high-quality academic programmes is central to the mission of any university. For this reason, maintaining academic continuity must be a key aspect of their response to a major disruptive event. A previously described model for ensuring academic continuity in universities presented four phases: pre-planning, approaching crisis, crisis and post-crisis. COVID-19, however, has created unique challenges thanks to its global reach, impact on all aspects of societal operations and continuously evolving nature. This article describes the implementation of a model for managing academic continuity in the initial stages of COVID-19, and the continued adaptation of the model as the crisis has continued and work towards recovery has occurred without a clear end in sight. Reflections are offered with respect to: using established policies and processes; grounding decisions in core values; implementing broad and frequent communication; acknowledging and addressing exhaustion; and taking the time mid-COVID-19 to consider lessons learned.