Initial Impacts of Covid-19 Quarantine on Health and Well-Being

As digital therapy providers for thousands of chronic pain patients, here at Kaia Health we recognised that the Covid-19 crisis could adversely affect the well-being of many people, in ways beyond the immediate danger of infection.

Necessary social distancing and lock-down policies have meant that people with pre-existing health conditions may have had limited access to ongoing therapies, with the potential to further exacerbate and create consequent health issues. To understand how varying quarantine measures and isolation are impacting mental and physical welfare in different countries, we decided to conduct a survey of both our existing users as well as members of the general public. The results reveal a snapshot of the indirect and sometimes hidden ways Covid-19 quarantine is impacting the health and well-being of people around the globe.

We began the survey by asking people around the world a series of questions in relation to their personal experiences in quarantine. We then took a representative sample of the responses across multiple countries to not only see how their experience may differ depending on their degree of isolation, but also what changes are being encountered in common. The questions focused on both physical and mental health issues like musculoskeletal pain, as well as on how spending more time at home had changed their daily habits, particularly in terms of media consumption and eating. Additionally, respondents were asked about their attitudes and concerns about life during the pandemic and their opinions about government responses to the crisis, including any financial stress they may be experiencing, as these issues may contribute to overall stress and well-being.

“We were especially interested in how different forms of isolation and habits might have impacted back pain, and from the results, we are able to build a clearer picture. Those in high isolation have experienced significantly more back pain than those in low isolation, with working from the sofa, and watching TV, online streaming or gaming for extended periods of time having the largest impacts on respondents’ experiences of back pain,” comments Konstantin Mehl, Founder and President Kaia Health Software Inc. “We hope that the results of this survey can help to highlight the impacts of back pain on overall well-being and that there is help available, even in the time of a pandemic, with more and more services being offered digitally.”

Each column in the two tables below is filterable. The first table is ranked alphabetically; the second by category. The full methodology explaining how the percentages were calculated in both tables can be found at the bottom of the page.

Methodology

Subscribers to the Kaia Health user newsletter were invited to fill in a questionnaire on how isolation brought on by Covid-19 preventative measures had affected their mental and physical health; their habits; and their attitudes. As our users seek our help in response to specific medical conditions, we complemented the responses from our own users by commissioning a web panel survey collected during the same timeframe.

The results of the survey are presented in two tables. The first table breaks down the results for the age-group 25 to 55 by six major western countries that have implemented significant isolation measures to prevent the spread of Covid-19.

The second table presents the aggregate results for all respondents in the age-group 25 to 55, broken down by level of isolation:

• High Isolation: Respondents that reported that they had never left their home in the last seven days.
• Low Isolation: Respondents that had left their apartment at least once.

Table 1: Impact of Covid-19 Quarantine by Country

Anxious

The respondents were asked four questions from the PROMIS 4-item questionnaire for measuring anxiety. The responses were scored according to the PROMIS manual, giving a score between 40.3 and 81.6 where scores higher than 60 represent at least ‘moderate anxiety’.

The percentage shown for each country in table 1 indicates the percentage of respondents that scored 60 or higher.

More anxious

The respondents were asked to what extent they agreed or disagreed with the following statement:

• “All things considered, I feel that the changes to my life caused by the Covid-19 pandemic are making me more anxious”

The percentage shown for each country in table 1 indicates the percentage of respondents that answered either “agree somewhat” or “agree completely”.

Lonely

The respondents were asked four questions from the PROMIS 4-item questionnaire for measuring loneliness. The responses were scored according to the PROMIS manual, giving a score between 37.1 and 85.2 where scores higher than 60 represent at least ‘moderate loneliness’.

The percentage shown for each country in table 1 indicates the percentage of respondents that scored 60 or higher.

More lonely

The respondents were asked to what extent they agreed or disagreed with the following statement:

• “All things considered, I feel that the changes to my life caused by the Covid-19 pandemic are making me more lonely”

The percentage shown for each country in table 1 indicates the percentage of respondents that answered either “agree somewhat” or “agree completely”.

General Economy

The respondents were asked to what extent they agreed or disagreed with the following statement:

• “I am worried that many companies are struggling financially”

The percentage shown for each country in table 1 indicates the percentage of respondents that answered either “agree somewhat” or “agree completely”.

Healthcare System

The respondents were asked to what extent they agreed or disagreed with the following statement:

• “I am worried that my healthcare system will not be able to adequately care for me or those close to me in the case of illness”

The percentage shown for each country in table 1 indicates the percentage of respondents that answered either “agree somewhat” or “agree completely”.

Personal Finances

The respondents were asked to what extent they agreed or disagreed with the following statement:

• “I am worried about my financial situation this year”

The percentage shown for each country in table 1 indicates the percentage of respondents that answered either “agree somewhat” or “agree completely”.

Personal Health

The respondents were asked to what extent they agreed or disagreed with the following statement:

• “I am worried that I will contract Covid-19”

The percentage shown for each country in table 1 indicates the percentage of respondents that answered either “agree somewhat” or “agree completely”.

Early Lifting of Sanctions

The respondents were asked to what extent they agreed or disagreed with the following statement:

• “I am worried that lifting restrictions put in place against the spread of Covid-19 will be lifted too early”

The percentage shown for each country in table 1 indicates the percentage of respondents that answered either “agree somewhat” or “agree completely”.

Protecting Elderly

The respondents were asked:

• “Do you feel your government has mobilised an adequate response to the Covid-19 pandemic, with regards to protecting the elderly?”

The percentage shown for each country in table 1 indicates the percentage of respondents that answered “The government should have done more”.

Overall Health Decline

The respondents were asked to what extent they agreed or disagreed with the following statement:

• “All things considered, I feel that the changes my life caused by the Covid-19 pandemic are making my existing health issues worse”

The percentage shown for each country in table 1 indicates the percentage of respondents that answered either “agree somewhat” or “agree completely”.

Cancelled Medical Appointments

The respondents were asked:

• “Since the start of the Covid-19 pandemic (March 12, 2020) have you had to cancel or postpone any planned medical appointments?”

The respondents were prompted to indicate whether they had missed any general medical appointments; specialist appointments, surgeries or physiotherapy.

The percentage shown for each country in table 1 indicates the percentage of respondents that indicated that they had had at least one kind of medical appointment cancelled or postponed.

No Access to Medicine

The respondents were asked:

• “Since the start of the Covid-19 pandemic (March 12, 2020) have you had problems renewing your medications?”

The respondents were prompted to indicate whether they had been unable to renew their prescriptions; been unable to travel to a pharmacy; and or unable to find an open pharmacy stocking their prescription.

The percentage shown for each country in table 1 indicates the percentage of respondents that indicated that they had had at least one issue preventing them from accessing their medication.

Table 2: Impact of Covid-19 Quarantine by level of isolation

Mental Health

Mental Well-being

The respondents were asked to what extent they agreed or disagreed with three statements about their mental health:

• “All things considered, I feel that the changes to my life caused by the Covid-19 pandemic have improved my mental well-being”
• “All things considered, I feel that the changes to my life caused by the Covid-19 pandemic are making me more anxious”
• “All things considered, I feel that the changes to my life caused by the Covid-19 pandemic are making me more depressed”

The column “Decreased” shows the percentage of respondents that answered that they either “Agree completely” or “Somewhat agree” to either of the statements about becoming more anxious or depressed–while answering “Disagree completely” or “Somewhat disagree” to the statement about improved mental well-being.

Conversely, the column “Increased” shows the percentage of respondents that answered that they either “Agree completely” or “Somewhat agree” to the statement about improved mental well-being–while answering “Disagree completely” or “Somewhat disagree” to both of the statements about becoming more anxious or depressed.

Mental Health Habits

The respondents were asked:

• “In the past seven days, to what extent have you changed your habits as a result of the Covid-19 pandemic”

This question was in relation to habits that can be expected to impact a person’s mental health. The column “Decreased” shows the percentage of respondents that answered “Significantly less than before” or “Somewhat less than before”; while the column “Increased” shows the percentage of respondents that answered “Significantly more than before” or “Somewhat more than before”:

• Keeping my home tidy
• Maintaining a regular daily routine
• Reading books and magazines
• Pursuing a creative outlet
• Continuously scrolling through social media and newsfeeds
• Drinking alcohol

Social Health

Relationships

The respondents were asked to what extent they agreed or disagreed with three statements about their relationships and social health:

• “All things considered, I feel that the changes to my life caused by the Covid-19 pandemic have improved my relationships with members of my household”
• “All things considered, I feel that the changes to my life caused by the Covid-19 pandemic have improved my relationships with friends and family”
• “All things considered, I feel that the changes to my life caused by the Covid-19 pandemic are making me more lonely”

The column “Decreased” shows the percentage of respondents that answered that they either “Disagree completely” or “Somewhat disagree” to both of the statements about improved relationships–while answering “Agree completely” or “Somewhat agree” to the statement about more loneliness.

Conversely, the column “Increased” shows the percentage of respondents that answered that they either “Agree completely” or “Somewhat agree” to either of the statements about improved relationships–while answering “Disagree completely” or “Somewhat disagree”  to the statement about more loneliness.

Social Health Habits

The respondents were asked:

• “In the past seven days, to what extent have you changed your habits as a result of the Covid-19 pandemic”

This question was in relation to habits that can be expected to impact a person’s social health. The column “Decreased” shows the percentage of respondents that answered “Significantly less than before” or “Somewhat less than before”; while the column “Increased” shows the percentage of respondents that answered “Significantly more than before” or “Somewhat more than before”:

• Talking to friends and family
• Communicating online

Physical Health

Social Health Habits

The respondents were asked:

• “In the past seven days, to what extent have you changed your habits as a result of the Covid-19 pandemic”

This question was in relation to habits that can be expected to impact a person’s physical health. The column “Decreased” shows the percentage of respondents that answered “Significantly less than before” or “Somewhat less than before”; while the column “Increased” shows the percentage of respondents that answered “Significantly more than before” or “Somewhat more than before”:

• Regular outdoor walks
• Regular outdoor exercise/sports
• Light indoor exercise
• Moderate indoor exercise
• Eating healthy food
• Smoking

Lower back pain

Remote working ergonomics

Respondents who had indicated that they were either working or studying remotely from home were asked whether their working situation was ergonomically appropriate.

The respondents were asked to what extent they agreed or disagreed with three statements about their home workspace:

• “My home workspace is appropriate for working extended periods”
• “When working from home, I am spending more time working in uncomfortable poses compared to before the pandemic”
• “I regularly experience pain or discomfort  as a result of working from home”

The column “Decreased” shows the percentage of respondents that answered that they either “Disagree completely” or “Somewhat disagree” to both of the statements about uncomfortable poses, pain and discomfort–while answering “Agree completely” or “Somewhat agree” to the statement about appropriate workspace.

Conversely, the column “Increased” shows the percentage of respondents that answered that they either “Agree completely” or “Somewhat agree” to either of the statements about uncomfortable poses, pain and discomfort–while answering “Disagree completely” or “Somewhat disagree” to the statement about appropriate workspace.

Lower back pain Health Habits

The respondents were asked:

• “In the past seven days, to what extent have you changed your habits as a result of the Covid-19 pandemic”

This question was in relation to habits that can be expected to cause a person to develop lower back pain. The column “Decreased” shows the percentage of respondents that answered “Significantly less than before” or “Somewhat less than before”; while the column “Increased” shows the percentage of respondents that answered “Significantly more than before” or “Somewhat more than before”:

• Working from bed
• Working from sofa
• Watching TV or online video for extended periods
• Playing computer games for extended periods

Lower back pain

The respondents were asked:

• “Compared to BEFORE the Covid-19 pandemic started (before 12 March), how would you say your experience of your back pain has changed, with regards to pain interfering with your day to day activities”.

The column “Decreased” shows the percentage of respondents that answered “Significantly less than before” or “Somewhat less than before”; while the column “Increased” shows the percentage of respondents that answered “Significantly more than before” or “Somewhat more than before”.