Quarantine causes PTSD

The argument

In a study carried out among 129 individuals quarantined during the 2003 SARS epidemic in Toronto, researchers found a higher rate of psychological distress. Almost 30% of those observed displayed evidence of PTSD. Those who had been quarantined for longer periods of time were more likely to display PTSD symptoms. In the same study, all of the individuals reported a "sense of isolation." Having in-person social interactions and physical contact are heavily restricted during quarantine. Both of these things contribute positively to recognizing and strengthening one's connection with others. When someone can't have any in-person social interactions, due to being at risk for severe COVID-19 or being a healthcare worker, the feeling of isolation can be even more intense. For people who are experiencing intense feelings of isolation, quarantine is a trauma. Feeling unsafe or feeling like the people you love are unsafe can keep you in a hypervigilant state and thus be a kind of trauma. Additionally, reactions to feeling unsafe often include self-destructive behaviors, such as drug addiction and self harm. Engaging in self-destructive behaviors can be traumatic and lead to PTSD if the traumatized individual doesn't have strong social support and a safe environment to recover in. Trauma from self-destructive behaviors is an indirect way that quarantine can cause one to develop PTSD. Another way that quarantine can increase rates of PTSD is PTSD from living in an unsafe home. If someone lives in a household that has abusive people in it, quarantine means that they will need to spend more time around the abusive people. Work, school, or friend's homes can be reprieves from abusive households. Spending more time around abusive individuals can definitely lead to a higher frequency of traumatic events. An increased frequency of abuse trauma can lead to an increase in rates of PTSD.

Context

The longer-term effects of quarantines have been observable in those affected by the 2003 SARS epidemic. Research indicates that quarantine caused higher rates of post-traumatic stress disorder (PTSD).

Premises

Counter-arguments

The evidence does not support the strong causal claim that 'quarantine causes PTSD'. The cited SARS study is small (129 people), observational and self-selected, and 'evidence of PTSD' on a screening measure is not the same as a clinical PTSD diagnosis — roughly 30% screening positive during an acute epidemic tells us that many quarantined people were distressed, not that quarantine reliably produces the disorder across populations. The correlation between longer quarantine and more symptoms is open to confounding: those quarantined longest may have been the most exposed, most bereaved or most anxious to begin with, so duration could be a marker of severity rather than its cause. The downstream chains the argument invokes — that quarantine drives self-harm, or traps people with abusive relatives, each in turn causing PTSD — are plausible mechanisms, but they are asserted, not measured pathways in the study cited, and they describe how quarantine could compound harm for specific vulnerable groups rather than establishing a general causal law. Quarantine may well worsen distress; that is weaker and more defensible than the claim that it causes PTSD.

Rejecting the premises

[Rejecting P1] A single small, self-selected observational study using a PTSD screening measure cannot establish that quarantine causes clinical PTSD; screening-positive symptoms during an acute crisis are not diagnoses. [Rejecting P3] The links to self-harm and abusive households are plausible mechanisms, not measured causal pathways; longer quarantine correlating with more symptoms may reflect who was quarantined longest rather than quarantine itself.