Experiences of supported isolation in returning travellers during the early COVID-19 response: a qualitative interview study

Abstract

(1) To understand the experiences and perceptions of those who underwent supported isolation, particularly in relation to factors that were associated with improved compliance and well-being; (2) to inform recommendations for the management of similar supported isolation procedures.

Design

We carried out a qualitative study using semistructured interviews to capture participants’ experiences and perceptions of supported isolation. Data were analysed using the framework approach, a type of thematic analysis that is commonly used in research that has implications for policy.

Setting

Telephone interviews carried out within approximately 1 month of an individual leaving supported isolation.

Participants

26 people who underwent supported isolation at either Arrowe Park Hospital (n=18) or Kents Hill Park Conference Centre (n=8) after being repatriated from Wuhan in January to February 2020.

Results

Six key themes were identified: factors affecting compliance with supported isolation; risk perceptions around catching COVID-19; management of supported isolation; communication with those outside supported isolation; relationship with others in supported isolation; and feelings on leaving supported isolation. Participants were willing to undergo supported isolation because they understood that it would protect themselves and others. Positive treatment by staff was fundamental to participants’ willingness to comply with isolation procedures. Despite the high level of compliance, participants expressed some uncertainty about what the process would involve.

Conclusions

As hotel quarantine is introduced across the UK for international arrivals, our findings suggest that those in charge should: communicate effectively before, during and after quarantine, emphasising why quarantine is important and how it will protect others; avoid coercion if possible and focus on supporting and promoting voluntary compliance; facilitate shared social experiences for those in quarantine; and ensure all necessary supplies are provided. Doing so is likely to increase adherence and reduce any negative effects on well-being.

SciScore for 10.1101/2021.02.17.21251735: (What is this?)

Please note, not all rigor criteria are appropriate for all manuscripts.

Table 1: Rigor

Institutional Review Board Statement	not detected.
Randomization	not detected.
Blinding	not detected.
Power Analysis	not detected.
Sex as a biological variable	Half of the participants (n = 13) were male and half (n = 13) were female.

Table 2: Resources

No key resources detected.

Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

Limitations: Approximately a third of participants who were contacted about this study agreed to take part. We have no information on those who did not participate, and it is possible that they differed on key variables. Of those that did participate we reached thematic saturation within the sample. Furthermore, participants were aware of what was going on around theme, so the reports of very high compliance with supported isolation and other protective behaviours can be generalised to all those who were in quarantine. The same goes for the general finding that most people were friendly and cooperative. A second limitation is that only those who had a good understanding of English were interviewed. It is therefore possible that the experience differed for those who were less able to understand English; indeed, this was alluded to in some comments made by participants. A final limitation is that this study was jointly run by King’s College London and Public Health England, and Public Health England also assisted with the management of the supported isolation process. Although the team carrying out this research were not associated with the management of the supported isolation process, it is possible that participants were aware that PHE played a role in managing the supported isolation process, and that this affected their responses during the interview.

Results from TrialIdentifier: No clinical trial numbers were referenced.

Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

Results from JetFighter: We did not find any issues relating to colormaps.

Results from rtransparent:

Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
No protocol registration statement was detected.

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