A more comprehensive analysis of the social quarantine
«The effects of Covid-19 have not yet been fully investigated; as a result, it is uncertain what the future development of our societies will be». This is the crucial point of reflection by Professor Ka Lin*, director of the Department of Social Security and Risk Management at the College of Public Administration at Zhejiang University in China, in the latest 2022 Precariousness Report published by the SUPI. Network. «This uncertainty», according to Ka Lin, «is linked to several aspects of the pandemic crisis, including the quality and pace of production of vaccines and drugs and changes in people’s lifestyles and attitudes in daily life». During the pandemic crisis, governments worked to avert the public health threat but often forgot to consider people’s behavioral and psychological patterns, focusing only on the clinical aspects. Instead, pandemic response policies should be designed to address public health problems and stabilize social systems in the new conditions brought about by the crisis. What needs to be established is the relationship between clinical and social approaches, to be assessed in terms of the social cohesion of a system; this is the condition for building what is called intelligent public care.
Modes of social quarantine
Ka Lin starts from an in-depth analysis of the different approaches that countries around the world have adopted in managing the pandemic crisis with social quarantine measures and identifies four main modes:
- Clinical mode: quarantine as a measure to protect public health. It is introduced to stop infection, detect, isolate and examine any suspected cases, and provide timely and appropriate treatment to Covid-19 patients.
- Mode of community action: Quarantine as a measure to reduce the spread of the virus in the population by closing schools and organized facilities, restricting travel, curfews, and restricting gatherings. In this case, four factors are needed to make quarantine effective: attuning to the views of the local community, creating interaction and collaboration with the various community stakeholders, organizing the provision of the services needed for quarantine, maintaining social distancing, and finally, building a conducive environment for health and hygiene practices to be implemented.
- Mode of individual behaviors: For social quarantine to function as an effective tool, it must take into account the behavioral patterns of individuals. It can only work when community members adhere to the restrictions and voluntarily apply social distancing. To achieve this goal, the media plays a key role with information and public awareness. When people are well informed about the nature and risks of a disease, they voluntarily adopt behavioral changes without falling into uncertainty and confusion.
- Psychological mode: a social quarantine has consequences for the psychological characteristics of individual behavior. It can do so in positive terms, directing people towards discipline, collective action, social responsibility, and solidarity, or in negative terms, bringing out prejudices and especially inequalities. Therefore, it is essential to analyze the instrument of social quarantine through the psychological modality, considering that the phenomenon can bring disorders and mental health problems related to depression and frustration, exacerbating the sense of loneliness and negatively affecting long-term health.
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Macro and micro aspects of quarantine
Concerning these modes of social quarantine, Ka Lin compares different experiences in some countries, such as Germany, China, and the Northern European states. It emerges that the best results have been recorded in those countries, such as Germany, where the social quarantine measures adopted to reduce the pressure on clinical activities have been accompanied by the development of an intelligent healthcare system. Particularly successful has been strengthening the role of the family doctor, of services able to provide remote advice, analysis, treatment, and care. But there is another problem: analyses of the effects of quarantine are currently limited to assessing only the clinical and community aspects, which operate at the macro-level while, neglecting the behavioral and psychological elements, which operate at the micro-level. «According to the World Health Organisation, applying the macro approach to analysis makes it clear that the Covid-19 pandemic is not only a public health crisis, but also a socio-economic emergency», Professor Lin recalls, adding that «to achieve the best results in public health management, specific behavioural and psychological measures must also be incorporated into social quarantine measures». The measures taken by states in response to Covid-19 have in practice also caused significant psychological effects on people’s mentality and the level of their consent to adopt social quarantine measures; among the immediate results are various symptoms, such as trauma and anxiety of pandemic victims.
The psychological effects of Covid and the spread of existential precarity
Loneliness and social isolation increase the stress load and can have detrimental effects on people’s psychological, cardiovascular and immune health. Indeed, quarantined people often report experiencing depression, isolation, anger, and negative feelings associated with the stigmatization they face. In the specific case of Covid-19, the risk of infection can still cause anxiety and fear, mental health damage that also affects those infected with the virus. Over the past two years, the clinical need for social isolation has decreased, and community barriers have been partly removed. Thus, the psychological effects of quarantine in the long term have emerged: control rules have been integrated into people’s behavior and have influenced the pace of rehabilitation. Confusion, fear, and uncertainty about the future are still the predominant emotional states and result from the new conditions of human interaction, the high degree of isolation from the public, and the limits imposed on close contacts between individuals. People are finding it difficult to return to normal conditions. The psychological consequences of this situation are bound to have a major impact on the functioning of the economy and the social cohesion of any system. Existential insecurity is thus emerging as a structural phenomenon in our societies. This is one of the main consequences of the pandemic crisis that should be assessed and addressed with great care.
*Ka Lin, Professor, Head, Dept. of Social Security and Risk Management College of Public Administration, Zhejiang University (China). Vice Chair, International Association of Social Quality Zhejiang – PRC China (IASQ). Reference: SUPI European Network on Social Precarity 2022 (Berlin-Rome)
**Ida Nicotera, Eurispes International Dept.