CoVID-19: Caged person syndrome?

Even before the CoVID-19 pandemic, more and more people were working remotely. Between 2012 to 2016, the number of people working remotely rose by four percent globally. In the US, 43% of workers spend some of their time working remotely. In countries such as Finland, Japan, Netherlands and Sweden, more than half the population work remotely for periods of time.

CoVID-19 is just another global pollutant

So, are we going mad at home now?  How many of us have the CPS (Caged Person Syndrome). It’s not in the International Classification of Diseases but there is ample evidence that long periods in isolation, such as we are now experiencing at home, tend to make us withdraw into ourselves. Distress, acute and post-traumatic stress, depression, anxiety, insomnia, negative feelings, and emotional exhaustion are the key symptoms. These symptoms are greater in persistently marginalized social groups such as immigrants and inhabitants of care facilities.  They are not dissimilar to the range of psychological illnesses experienced by prison inmates.

Data is now showing that adequacy of space is even more important than the length of isolation in predicting negative psychological reactions. There is reason to believe that for many (ultra-wealthy with McMansions and second homes notwithstanding), the size of living space has declined in recent years. For example, in 2019, 20% of US households were shared households, up from 17% in 2007.

 This will only result in more and more severe psychological issues unless we work to manage the isolation sensibly. Most responsible citizens have been in lockdown at least since we became aware of CoVID-19’s ability to quickly spread.  But if people have been symptom free for weeks, why can family reunions take place at safe distancing?

There’s no place like a small home with limited outlook and personal space to feed negative emotions. Sadly, there is increasing evidence of a rise in domestic violence since CoVID-19 isolation began.

Spending time outside might be seen as panacea but unclear messages about safe behaviour proliferate. Is six feet safe?  Maybe not, if it’s windy or people are running or biking.  Are masks effective?  Which kind?  N95? Homemade?  When will those on the economic sidelines get back to work, and regular income?  It is no wonder that increasing pressure in isolation is bursting out as angry anti-isolation activists are beginning to take to the streets – without masks or social distancing, public health warnings notwithstanding.

The demonstrations are predictable in the face of all this uncertainty, isolation and feeling caged, especially as there is no scapegoat to blame for the emergence of this new virus strain. We can direct our anger against leaders we perceive haven’t done enough, or quickly enough, but only elections can change that. We can displace anger on our family members, partners or roommates, however inappropriately, if we are lucky enough to have them.  It will not be surprising if pent-up rage and blame lead the outdoor environment to increasingly become a volatile place. Whether it is aggressive language to non-conformers of social distance or demonstrations in the streets of cities only marginally affected, the situation has the potential to get worse.

It is time for health promotion activists’ actions to encompass more than public health and disease prevention. CoVID-19 is just another global pollutant. Set us free – but within limits. We have strategies for major pollutants such as cars. Why not for CoVID-19? Time to think about alternate day excursions and store openings, certification of safe practices, supervised family visits, rotation of clinical staff and carers away from high infective sites can all assist with diminishing access to the critical viral load that causes the most severe consequences.

One thought on “CoVID-19: Caged person syndrome?

  1. This is absolutely brilliant. Your strategies for addressing the psychological impacts of isolation need to be explored in depth and actioned into national and local policies.


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