Adherence to Infection Control Measures and the Psychological Effects of Quarantine during COVID-19 Pandemic in Dibrugarh District of Assam, India: A Cross-sectional Study

Introduction: Quarantine is an important means of controlling the spread of Coronavirus Disease-2019 (COVID-19) and it is essential to maintain strict adherence to infection control measures during this period. However, long periods of quarantine may be quite challenging by themselves especially in a pandemic of a new infection which might led to emotional, psychological and financial difficulties. Hence, understanding the psychological impact of COVID-19 on the quarantined people and how they have adhered to the infection control measures will help to formulate better prevention strategies. Aim: To assess the infection control measures among the people who were placed in quarantine and to understand its psychological effects during the COVID-19 pandemic in Dibrugarh District of Assam, India. Materials and Methods: This study was a community based cross-sectional study conducted among the people placed in quarantine in Dibrugarh District of Assam and was conducted from April 2020 to March 2021. During the COVID-19 pandemic, quarantine centres were set up in various educational institutions in the urban areas of Dibrugarh District of Assam. There were six such centres under the supervision of district health authorities. Taking three of these centres located at Chabua, Jokai and Lesai under Dibrugarh district, 159 quarantined subjects were enrolled for the study. Centre for Epidemiologic Studies Depression (CES-D) scale was applied for assessment of depressive symptoms and the post-traumatic stress symptoms were assessed using The Impact of Event Scale-Revised (IES-R). The adherence to infection control measures were assessed by using a predesigned, pretested questionnaire prepared for the purpose of the study, which was applied using online Google platform. Of the total 159 responses, 23 were incomplete and finally 136 were analysed. Descriptive analysis was done for the socio-demographic data. To find the association between quarantine and the psychological effects, Chi-square test was applied and p-value <0.05 was considered as significant. Results: Majority of the study subjects, 96 (70.59%) belonged to 10-29 years, 103 (75.74%) were males, and 126 (92.64%) were Hindu. About half of the participants were from urban area 72 (52.94%) and 48 (35.29%) were graduate. Majority of the participants 125 (91.91%) could manage to stay in separate room but arrangement of separate toilet was difficult. Similarly, about one-third 48 (35.29%) did not have a designated family member to look after them. Majority of the participants 135 (99.26%) practiced regular handwashing, wearing of mask 123 (90.44%) and regular disinfection of the items used by them 111 (81.62%). About 47 (34.56%) of the participants had sign and symptoms of post-traumatic stress, out of which females were affected more 14 (42.42%) and younger age group participants in the age range of 10 to 29 years 35 (36.46%) had more posttraumatic stress symptoms than the older adults. About onethird of participants 51 (37.5%) were depressed, 17 out of 33 females (51.52%) were found to be depressed and the younger age group in the age range of 10 to 29 years 42 (43.75%) were found to be more affected. Conclusion: Quarantine is an effective public health measure to control the spread of infection when people practice appropriate infection control measures. However, long periods of quarantine can cause psychological impact on the quarantined people which needs to be properly addressed.