A mixed-methods evaluation of advice on isolation and health-seeking to contain transmission

To help reduce the spread of COVID-19 during the containment phase, people retuning from affected countries and contacts of cases were advised to stay at home and avoid contact with others (self-isolate). In addition, people who were repatriated from affected countries were advised to stay in supported isolation facilities. During the delay phase, additional advice has been issued for anyone with symptoms to self-isolate and the whole population to stay at home and only leave their house if necessary (social distancing). Anyone with underlying health conditions has been advised to self-isolate for 12 weeks, regardless of symptoms.
We know that people do not always follow advice and experiencing isolation can have a negative impact on mental health and wellbeing. We will conduct surveys and interviews to assess whether people follow this advice, what might make following this advice difficult, what can be done to support people who are advised to isolate and the impact of isolation on mental health and wellbeing. We will also explore how UK and Chinese communities have responded to public health advice. Our findings will help with the management of the current COVID-19 outbreak and any future disease outbreaks requiring people to distance themselves from others.

This COVID-19 Rapid Response award is jointly funded (50:50) between the Medical Research Council and the National Institute for Health Research. The figure displayed is the total award amount of the two funders combined, with each partner contributing equally towards the project.

Measures to contain and delay COVID-19 in the UK include supported isolation for repatriated individuals, targeted advice to self-isolate for confirmed cases, contacts and symptomatic people, “shielding” for extremely vulnerable people and social distancing for the rest of the population. Evidence suggests that advice to self-isolate is not always adhered to and experiencing supported or self-isolation can have detrimental effects on mental health and wellbeing. We aim to assess the effectiveness, acceptability and impact of isolation and distancing interventions to strengthen the current management of COVID-19.
We propose to implement a series of mixed-methods evaluations, focusing on supported and self-isolation and social distancing. This includes a rapid evaluation of supported isolation to assess adherence to advice and impact on mental health and wellbeing, using quantitative surveys and semi-structured interviews. We will also evaluate self-isolation and social distancing advice during the containment and delay phases, using a quantitative survey and follow-up interviews with people identified through contact tracing activities, extremely vulnerable “shielded” individuals and the general population, to determine barriers and facilitators to adherence and assess the impact of advice on health and wellbeing, including identifying any differences between the different groups. Finally, an ethnographic study will focus on community responses in the UK and China through a series of narrative interviews and analysis of documentary sources.
We will produce interim and final reports, focusing on policy and practice implications for management of supported isolation facilities, communicating advice to self-isolate and socially distance and the development of a communications strategy.