The experience of quarantine for individuals affected by SARS in Toronto
Abstract
Abstract Objective: The purpose of this study was to explore the experience of home quarantine during the severe acute respiratory syndrome (SARS) outbreak in Toronto in 2003. Design: Qualitative descriptive design. Sample: Stratified random sampling techniques were used to generate a list of potential participants, who varied in terms of gender and closeness of exposure to someone with suspected SARS (contact level). Twenty‐one individuals participated in the study. Measurements: All interviews were audiotaped and followed a semistructured interview guide. Participants were invited to describe their experience of quarantine in detail including their advice for Public Health. Results: The experience followed a trajectory of stages beginning before quarantine and ending after quarantine. Despite individual differences, common themes of uncertainty, isolation, and coping intersected the data. Conclusions: Public Health has a dual role of monitoring compliance and providing support to people in quarantine. This study has implications for public health policy and practice in planning for future public health emergencies in terms of the information and the resources required to mount an effective response.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Eleven articles highlighted the psychological implications of mass quarantine as emotional distress and symptoms of mental illness.
“Eleven articles from various geographical and disease contexts highlighted the psychological implications of mass quarantine as emotional distress and symptoms of mental illness.22–25,27–32,35”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Altruistic attitudes during mass quarantine were reported in three studies.
“In contrast, altruistic attitudes during mass quarantine were reported in three studies.”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
People in or after quarantine experienced emotional distress including annoyance, anxiety, boredom, disappointment, life dissatisfaction, fear of infection, isolation, loneliness and mistrust.
“Among people in or after quarantine, some experienced emotional distress, including: annoyance,32 anxiety,25,29 boredom,23,25,32 disappointment and life dissatisfaction,24,32,35 fear of infection,23,25,30,34 isolation,23,25,32 loneliness25,32 and mistrust.31”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Interviewees mentioned community members offered emotional support and took care of orphans during mass quarantine in the Toronto SARS epidemic and Liberia EVD outbreak.
“Interviewees mentioned how community members offered emotional support and took care of orphans during the mass quarantine in the Toronto SARS epidemic and in the Liberia EVD outbreak, respectively.23,29”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Nine studies stressed how mass quarantine aggravated inequalities in individuals' access to, understanding of, and actions on prevention and control of infections.
“Nine studies stressed how mass quarantine aggravated inequalities in individuals’ access to, understanding of, and actions on prevention and control of infections.21,23–26,31–34”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
A Canadian study found that racial and linguistic minorities might suffer a higher risk of having inaccurate information on measures of SARS confinement.
“A Canadian study found that racial and linguistic minorities might suffer a higher risk of having inaccurate information on measures of SARS confinement,23”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Interviewees in Sierra Leone worried about their own food stock, whereas some Canadians were concerned about how others in economic difficulties preserved food under movement restrictions.
“Regarding food storage, interviewees in Sierra Leone worried about their own food stock,29 whereas some Canadians were concerned about how others in economic difficulties preserved food under movement restrictions.23”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Mass quarantine-induced mobility restrictions impacted every step of the food supply chain, including production, transportation, access and storage.
“Mass quarantine-induced mobility restrictions impacted every step of the food supply chain, including production,29 transportation,24,29,30 access22–24,27,29,31,34 and storage.23,29”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Identifying trustworthy information became challenging for the public due to diverse and unverified sources as well as heightened uncertainty during disease outbreaks.
“In addition, identifying trustworthy information became challenging for the public due to diverse and unverified sources as well as heightened uncertainty during disease outbreaks.23,25,27”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Participants from three studies of the SARS outbreak in Toronto stressed that authorities did not provide clear and consistent messages on why, how and how long to enact quarantine, and that they were unable to contact designated public health staff.
“Participants from three studies of the SARS outbreak in Toronto stressed that authorities did not provide clear and consistent messages on why, how and, how long to enact quarantine, and that they were unable to contact designated public health staff.23,25,27”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
The review found negative psychological impacts of mass quarantine, such as low life satisfaction, emotional isolation and fear of infection.
“Consistent with previous studies,10,36,37 our review presents a range of negative psychological impacts of mass quarantine, such as low life satisfaction, emotional isolation and fear of infection.23–25,30,32,34,35”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Altruism was identified as a positive consequence from research on the EVD and SARS outbreaks.
“In contrast to negative implications, altruism was identified as a positive consequence from research on the EVD and SARS outbreaks.23,29,33”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Communication inequalities are often compounded by poor information governance across authorities during outbreaks, such as non-justified decision-making, inconsistent instructions and non-synchronized implementation of mass quarantine.
“Often, communication inequalities are compounded by poor information governance across authorities during outbreaks, such as non-justified decision-making, inconsistent instructions and non-synchronized implementation of mass quarantine.23,25,27,51”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [23]
Cites
Lincoln, Y. S., Guba, E. G., & Pilotta, J. J. (1985) · International Journal of Intercultural Relations · doi:10.1016/0147-1767(85)90062-8 · Cited by 45,787 · see citing works
SARS control and psychological effects of quarantine, Toronto, Canada
Hawryluck, L., Gold, W. L., Robinson, S., Pogorski, S., Galea, S., & Styra, R. (2004) · Emerging Infectious Diseases · doi:10.3201/eid1007.030703 · Cited by 1,929 · see citing works
Chatzopoulou, E. (2023) · Routledge eBooks · doi:10.4324/9781003107774-12 · Cited by 1,573 · see citing works
The public’s response to severe acute respiratory syndrome in Toronto and the United States
Blendon, R. J., Benson, J. M., DesRoches, C. M., Raleigh, E., & Taylor‐Clark, K. (2004) · Clinical Infectious Diseases · doi:10.1086/382355 · Cited by 393 · see citing works
Ethics and SARS: lessons from Toronto
SINGER, P. A., Benatar, S. R., Bernstein, M., Daar, A. S., Dickens, B. M., MacRae, S. K., Upshur, R. E. G., Wright, L., & Shaul, R. Z. (2003) · BMJ · doi:10.1136/bmj.327.7427.1342 · Cited by 273 · see citing works
Gostin, L. O., Bayer, R., & Fairchild, A. L. (2003) · JAMA · doi:10.1001/jama.290.24.3229 · Cited by 240 · see citing works
Tang, C. S., & Wong, C.-Y. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.11.1887 · Cited by 211 · see citing works
Public Health Spaces and the Fabrication of Identity
Armstrong, D. (1993) · Sociology · doi:10.1177/0038038593027003004 · Cited by 183 · see citing works
Large-Scale Quarantine Following Biological Terrorism in the United States
Barbera, J. A., Macintyre, A. G., Gostin, L. O., Inglesby, T., O’Toole, T., DeAtley, C., Tonat, K., & Layton, M. (2001) · JAMA · doi:10.1001/jama.286.21.2711 · Cited by 165 · see citing works
Gammon, J. (1998) · International Journal of Nursing Practice · doi:10.1046/j.1440-172x.1998.00084.x · Cited by 131 · see citing works
Use of Quarantine to Prevent Transmission of Severe Acute Respiratory Syndrome—Taiwan, 2003
(2003) · JAMA · doi:10.1001/jama.290.8.1021 · Cited by 112 · see citing works
Responses to Plague in Early Modern Europe: The Implications of Public Health
Slack, P. (2020) · Social research · doi:10.1353/sor.2020.0046 · Cited by 82 · see citing works
The experience of infectious patients in isolation.
Knowles, H. (1993) · PubMed · Cited by 66 · see citing works
Tuberculosis and Stigma: Predictors of Prejudice Against People with Tuberculosis
Jaramillo, E. (1999) · Journal of Health Psychology · doi:10.1177/135910539900400101 · Cited by 63 · see citing works
Stigma and HIV: Does the Social Response Affect the Natural Course of the Epidemic?
Madru, N. (2003) · Journal of the Association of Nurses in AIDS Care · doi:10.1177/1055329003255112 · Cited by 60 · see citing works
The psychological consequences of source isolation: a review of the literature
Gammon, J. (1999) · Journal of Clinical Nursing · doi:10.1046/j.1365-2702.1999.00201.x · Cited by 56 · see citing works
(2003) · PubMed · Cited by 54 · see citing works
Health Workers and Aids: Research, Intervention and Current Issues in Burnout and Response
Bennett, L., Miller, D., & Ross, M. W. (1995) · Cited by 42 · see citing works
QUARANTINE AND ISOLATION: LESSONS LEARNED FROM SARS
Rothstein, M. A. (2003) · Cited by 42 · see citing works
Chau, P. H., & Yip, P. S. F. (2003) · Journal of Epidemiology & Community Health · doi:10.1136/jech.57.10.766 · Cited by 39 · see citing works
Lesko, L. M., Kern, J., & Hawkins, D. R. (1984) · Medical and Pediatric Oncology · doi:10.1002/mpo.2950120111 · Cited by 35 · see citing works
Reverse isolation: what patients perceive.
Collins, C., Upright, C., & Aleksich, J. (1989) · PubMed · Cited by 28 · see citing works
SARS: A Local Public Health Perspective
Basrur, S. V., Yaffe, B., & Henry, B. (2004) · Canadian Journal of Public Health · doi:10.1007/bf03403628 · Cited by 24 · see citing works
Quarantine and Social Inequity
Edelson, P. J. (2003) · JAMA · doi:10.1001/jama.290.21.2874 · Cited by 19 · see citing works
Isolation practices: A historical perspective
Jackson, M. M., & Lynch, P. (1985) · American Journal of Infection Control · doi:10.1016/0196-6553(85)90005-7 · Cited by 18 · see citing works
Quarantine in Severe Acute Respiratory Syndrome (SARS) and other Emerging Infectious Diseases
Speakman, J., González‐Martín, F., & Perez, T. (2003) · The Journal of Law Medicine & Ethics · doi:10.1111/j.1748-720x.2003.tb00755.x · Cited by 17 · see citing works
Bernstein, M. (2003) · Healthcare Quarterly · doi:10.12927/hcq..16475 · Cited by 4 · see citing works
Grazier, S. (1989) · PubMed · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
The psychological impact of quarantine and how to reduce it: Rapid review of the evidence
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30460-8 · Cited by 16,378 · see citing works
The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020) · doi:10.2139/ssrn.3532534 · Cited by 16,394 · see citing works
The psychological impact of COVID-19 on the mental health in the general population
Serafini, G., Parmigiani, B., Amerio, A., Aguglia, A., Sher, L., & Amore, M. (2020) · QJM: An International Journal of Medicine · doi:10.1093/qjmed/hcaa201 · Cited by 1,187 · see citing works
Ozamiz-Etxebarria, N., Dosil-Santamaria, M., Picaza-Gorrochategui, M., & Idoiaga-Mondragon, N. (2020) · Cadernos de Saúde Pública · doi:10.1590/0102-311x00054020 · Cited by 892 · see citing works
Physical interventions to interrupt or reduce the spread of respiratory viruses
Jefferson, T., Del Mar, C. B., Dooley, L., Ferroni, E., Al-Ansary, L. A., Bawazeer, G. A., van Driel, M. L., Nair, N. S., Jones, M. A., Thorning, S., et al. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006207.pub4 · Cited by 805 · see citing works
Life in the pandemic: social isolation and mental health
Usher, K., Bhullar, N., & Jackson, D. (2020) · Journal of Clinical Nursing · doi:10.1111/jocn.15290 · Cited by 580 · see citing works
Saurabh, K., & Ranjan, S. (2020) · The Indian Journal of Pediatrics · doi:10.1007/s12098-020-03347-3 · Cited by 468 · see citing works
Boursier, V., Gioia, F., Musetti, A., & Schimmenti, A. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.586222 · Cited by 309 · see citing works
Physical interventions to interrupt or reduce the spread of respiratory viruses
Jefferson, T., Dooley, L., Ferroni, E., Al-Ansary, L. A., van Driel, M. L., Bawazeer, G. A., Jones, M. A., Hoffmann, T. C., Clark, J., Beller, E. M., et al. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006207.pub6 · Cited by 291 · see citing works
Ozamiz-Etxebarria, N., Idoiaga Mondragon, N., Dosil Santamaría, M., & Picaza Gorrotxategi, M. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01491 · Cited by 246 · see citing works
Chu, I. Y.-H., Alam, P., Larson, H. J., & Lin, L. (2020) · Journal of Travel Medicine · doi:10.1093/jtm/taaa192 · Cited by 247 · see citing works
Teasdale, E., Santer, M., Geraghty, A. W. A., Little, P., & Yardley, L. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-589 · Cited by 109 · see citing works
Peltz, J. S., Daks, J. S., & Rogge, R. D. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.07.001 · Cited by 48 · see citing works
Shafiq, S., Nipa, S. N., Sultana, S., Rahman, M. R.-U., & Rahman, M. M. (2021) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105789 · Cited by 44 · see citing works
Ebrahimi, O. V., Hoffart, A., & Johnson, S. U. (2020) · doi:10.31234/osf.io/kjzsp · Cited by 37 · see citing works
An analysis of mother stress before and during COVID-19 pandemic: The case of China
Tchimtchoua Tamo, A. R. (2020) · Health Care for Women International · doi:10.1080/07399332.2020.1841194 · Cited by 39 · see citing works
Salud Mental En Epidemias: Una Perspectiva Desde La Atención Primaria de Salud Española
Buitrago Ramírez, F., Ciurana Misol, R., Fernández Alonso, M. D. C., & Tizón García, J. L. (2020) · Atención Primaria · doi:10.1016/j.aprim.2020.09.004 · Cited by 35 · see citing works
Muehlschlegel, P. A., Parkinson, E. A., Chan, R. Y., Arden, M. A., & Armitage, C. J. (2021) · Journal of Global Health · doi:10.7189/jogh.11.05008 · Cited by 31 · see citing works
- Authors
- Cava, M. A., Fay, K. E., Beanlands, H. J., McCay, E. A., & Wignall, R.
- Affiliations
- Toronto Public Health (CA)
- Toronto Metropolitan University (CA)
- Corresponding author
- Cava, Maureen A.
- Venue
- Public Health Nursing
- Publisher
- Wiley
- Published
- 2005-09
- Volume
- 22
- Issue
- 5
- Pages
- 398-406
- ISSN
- 0737-1209 (ISSN-L)
- 1525-1446
- OpenAlex
- W2092611456
- Cited by
- 394
- References
- 29
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 10 · 2023: 33 · 2022: 73 · 2021: 130 · 2020: 109 · 2019: 1 · 2017: 1 · 2016: 3 · 2015: 2 · 2014: 2 · 2012: 1
- FWCI
- 3.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Public Health Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › Emergency Medical Services › Disaster Response and Management
- Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
- Keywords
- SARS, quarantine, home quarantine, quarantine experience, uncertainty, social isolation, coping, public health compliance, public health support, public health emergencies
- MeSH terms
- Adult, Aged, Disease Outbreaks, Female, Humans, Male, Middle Aged, Ontario, Policy Making, Quarantine, Public Health Practice, Qualitative Research, Severe Acute Respiratory Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
