Have you ever thought about how a bird feels inside a cage? It is a random question, I know.
Animal rights organizations (e.g., PETA) would argue that birds kept in captivity may suffer from malnutrition, loneliness, and stress of confinement. From a scientific perspective, studies have demonstrated that caged birds are likely to develop abnormal behaviour patterns. Furthermore, research published in the Applied Animal Behaviour Science suggests that the wellbeing of animals is linked to their “ability of animals to adapt behaviourally, emotionally and physiologically to the circumstances of confinement”.
Now imagine, you are forced to confinement in a hotel room for two weeks, usually without access to fresh air. How would you feel physically or mentally?
This is the question I asked myself as a services marketing scholar who had to spend two weeks in hotel quarantine in Brisbane. Would I gain weight or lose weight? Would I be potentially get infected through the hotel ventilation system? When I heard that there was a positive case in Brisbane in quarantine I was wondering if this person was in my hotel. In addition to my physical wellbeing, I was concerned about my mental health in quarantine. Would I get distressed from confinement in a small hotel room? How often would QLD Health call and check up on me? I felt intrigued reading comments on social media by other travellers (aka fellow inmates) and how they were coping with isolation.
Let’s take a step back
On March 28, 2020, Australia was one of the first countries to implement strict quarantine laws using government-sanctioned hotel facilities for overseas arrivals to prevent the spread of COVID-19. Within its first year, more than 210,000 travellers have been confined for two weeks in hotel rooms in Australia. The government called the program “99.99-per cent effective” to safeguard the public against the pandemic. However, hotel quarantine is not foolproof, and there has been much criticism and investigation over the past year. For example, reports indicate more than 20 leaks. Surprisingly, Australians have not shown much resistance towards mandated hotel quarantine, whereas travellers in the UK widely complained when they were forced in hotel quarantine.
Hotel quarantine and wellbeing
While the health implications of solitary confinement have received increasing attention in criminal justice, medicine and social science, research on the health impact of government-managed isolation during the COVID-19 pandemic is rare. For example, a study published in the Medical Journal of Australia found that of 2,774 people registered in quarantine hotels in Sydney during 1 June to 30 September 2020, the most frequent diagnosis (19%) at emergency departments was related to mental health; compared to only 3.6% for all emergency department presentations in Australia. The findings suggest a greater need for increased psychological support and other services for people in quarantine. Yet, this contradicts new policies of the Queensland government that have slashed mental health support for people in Covid hotel quarantine.
Understand the stressors of before, during, and after quarantine
Hotel quarantine policies during a pandemic contribute to governance wellbeing since they influence the wellbeing of all citizens in the community. But people isolating in hotel quarantine experience a myriad of stressors that affect their mental and physical wellbeing. In the pre-arrival stage, it is the “unknown” that can lead to anxieties. For example, which hotel will be assigned to you? Where is it located? In my case, I was in hotel in the CBD which made it easy for friends to drop off care packages at the reception. Stressors during quarantine include fears of infection, the actual duration of quarantine (you must test negative to be released), lack of fresh air (some travellers in 2020 were fortunate to receive 30-50 minutes each day outside in the small enclosed underground carpark, however, this policy changed in 2021), inadequate supplies and/or information (the service for ‘hotel inmates’ is minimalistic), boredom (loss of one’s usual routine), and stress/frustration due to a sense of isolation (lack of social connections). I prepared myself for a mix of outback camping inside a hotel room, packing essential kitchen utensils (plates, cutlery) and cleaning equipment (dishwashing soap, laundry powder). And I tried to keep myself busy with daily exercise, virtual social interactions, work, and entertainment. Finally, people experience post-quarantine stressors such as financial costs and burdens associated with the quarantine stay. And it is still too early to understand the long-term effects of government-managed hotel quarantine on individuals’ mental health.
From ‘Flatten the Curve’ to ‘Let it Rip’
So where are we now, at the beginning of 2022? Is there still hotel quarantine? Does this topic even matter, now that we “ride the wave” of Omicron? … Yes, it does.
While most of Australia (except Western Australia) has eased travel restrictions over the last two months (for example, a shift has occurred from hotel quarantine to home quarantine), rules still apply for unvaccinated travellers. For instance, the COVID-19 advice for international arrivals to Queensland states “Unvaccinated international arrivals must arrive in Queensland at the Brisbane International Airport and will be required to quarantine for 14 days in government-nominated accommodation”. Policymakers should adopt a service ecosystem perspective to assess the impact of hotel quarantine, not just for the community, but for individual travellers, who may experience unintended consequences far beyond those 14 days in confinement. Services marketing research can bridge the view between public health and an individual’s quarantine experience.
See more of Sven Tuzovic’s research here.
3 Comments
I had a very traumatic experience … I have claustrophobic tendencies at the best of times. I conditioned myself to 14 days hotel Q after being home in the UK for 3 months due to compassionate circumstances. On arrival at Perth we were given the Intercontinental – one of the betterhotels I believe. Nothing prepared me for the moment I stepped in the room to see it darkened with low natural light and a large window that looked out on to a white wall just 6 feet away – no view at all just a white wall. I couldn’t step into the room and basically I had a meltdown .. I told the guards through sobs that I couldn’t stay in this room but was made to “get inside and close the door , the doctor will speak to you soon “. I walked straight to the windows and thumped it! I tearfully phoned my husband and tried to calm myself down… the doctor eventually rang me and we talked .. i explained to her that I couldn’t stay in this room with no view no natural light no streetscape no outside sounds. I also explained to her that I have a voice disorder which is exacerbated by stress and eventually makes it more difficult to talk and voice tenses up and strangulated (Spasmodic Disphonia ) she empathised and apparently tried to get a room change for me. I also had support letters from my doctor and speech therapist explaining that further stress does not help my condition. These letters along with the hotel doctors and well beingteam applications to WA Health to ask for a change of room went on deaf ears .. five days later they responded and basically said on day 7 we will respond to your request if you don’t go into home quarantine — luckily I was able to home quarantine after the rules had changed. I spent 7 days in that room voice steadily getting worse. I then moved to home quarantine and at day 3 ended up having a heart attack .. my quarantine didn’t stop there .. because I was still Quarantine the medical team world not operate until I had finished my 14 days quarantine … I was kept in CCU isolation for 4 days on a heart monitor and drugs until the hour I was due out .. they then took me to RPH for an angiogram and stent insertion. Cardiologist put it down to emotional stress and blockage!! Every day in hotel Q I hoped for a phone call for a room change it never came I felt if I’d had had a room with a view at least I could breathe a bit better. It upsets me too this day at the way I was treated and the fact that WA Health didn’t give a damn !
The impact of Hotel Quarantine both pre, during and post cannot be underestimated, the government needs to be held responsible with a Royal Commission into the impact, particularly for those families where people in QT took their own lives. There is an entire community of returning Australian’s that have been significantly impacted by this process. The rhetoric may be “what’s so hard about 14 days in a 4/5 star hotel” doesn’t give any insight into the reality. Are there people suffering more, particularly detainees in Australia, yes of course. But this doesn’t make the government response to returning Australian’s any more acceptable.
The method of quarantine, with the fear and perception that we as citizens returning to Australia, were (a) just swanning around the world expecting to come back on a whim, (b) more likely to be carrying covid (c) uncaring about the impact our return to the community may have is ridiculous and still remains the perception of many.
Australian’s seem to forget that many of us have families, and commitments in multiple countries, or are expanding our futures, our careers and experience overseas. We then bring that experience and perspective home to create a more vibrant, engaging, commercially viable and beautiful Australia. But no, we were the enemy, imagine for one moment, my example, Australian born and bred, 15 years in Asia, made redundant in Hong Kong, no income, and not able to predict timeline to coming home. I recall the very moment, standing in my apartment in Hong Kong realizing I had been abandoned by my country of birth, my passport basically rendered useless. After 6 months of trying I managed to get home, I arrived on our doorstep, broke nearly spending all my redundancy on flights & cost of living while not working. I also had a broken ankle which was untreated. I had broken my ankle the week prior to leaving HK, and it wasn’t that I couldn’t afford treatment but I was terrified that if I turned up to the airport (after 3 cancelled flights) with a cast that I would be refused to board. I made the choice that it was worth the risk, and opted for no medical treatment until I returned.
I won’t give you a blow by blow account of my 15 days/14 nights in solo quarantine, in a hotel room with no balcony and no direct sunlight. What I will share with you is 4 key experiences that have profoundly affected me, my mental health, and my view on how returning Australian’s (and yes, we were citizens) have been treated, and this is just one story of many similar experiences.
1. Fear – I requested medical assistance for my ankle, and it was deemed that I needed to go to hospital for x-rays/treatment. Prior to me leaving the hotel in patient transport, the Police Officer in charge reminded me NOT to escape the ambulance, or try to escape at the hospital or it was a $10,000 fine, and to remember I was a risk to the community. I confirmed, I would not try and escape, and perhaps wasn’t not possible with the visible injury I had. On arriving at the hospital, I was locked in the ambulance while they arranged for me to be transported in (again being reminded not to escape). On being driven back to Hotel by Patient Transport, the lovely driver told me about his kids, and the fact that other kids wouldn’t play with them at school because his dad was a driver specifically assigned for people in Hotel Quaratine and may transmit Covid, even though he was in full PPE, and regularly tested, I was speechless.
2. Welfare – I had taken some face paint with me for some “therapeutic” arts & crafts… each morning I would paint onto my window number of days I had remaining, creating a routine, showering, making the bed was important to stay sane. One particular day I also painted “HELP ME” on the window. I didn’t think that through, I admit. Was I depressed? Yes, probably, I’d been trapped, made redundant, nearly broke and just generally a broken shell of a human. But at that time I wasn’t suicidal. The police came to my door as a passer by had seen my sign and advised the police. The police told me to “stop being a nuisance” or they’d take my daily alcohol allowance away (it was 10am and I was clearly sober). At no point did they ask me if I was okay, or arrange for the Psych team to call me (apparently these people were available to help). No-one ever contacted me again on this matter, only to check on my covid status.
We have seen some particularly difficult stories of individuals, particularly in Brisbane who had serious mental health issues, there have been suicides and escapes by several people in Quarantine. There was no genuine (in my experience) support or input for people who had issues (please note I was not in a medical hotel just a standard hotel, but we all know people with mental health issues, particularly depression are the first to say “I’m okay”, also as most detainees knew, the medical hotels were often worse than the standard hotels, so withholding information to try and get a “better hotel” was likely for many). While my sign was a brain snap, I cannot imagine the impact this lack of concern or welfare checking had on individuals with much more serious issues than mine, particularly for those doing solo quarantine.
3. Hygiene – We were not permitted to borrow hotel vacuum cleaners, had to buy our own cleaning products, had to wash dishes and clothes in the same basin, and were only permitted 1 sheet and towel change after 7 days, and yes this was at the cost of $3000 per person. Again, it’s not the money (well it is) but imagine what it does to your own mind (particularly when you’re isolating for two weeks alone).
4. Perception of Returnees even after release – My departure, I had had 3 negative covid tests during my stay, on Day 13 I had been confirmed as Covid free, had a letter from Police and Dept of Health, confirming I was free to rejoin the world, and I was ready to leave. In preparation for my departure I had requested some help with my luggage (the Army had helped me into the room with luggage, albeit laughed when they closed the door on me saying “we don’t give you a key ’cause you can’t leave… see you in 2 weeks”). I had requested a trolley and a porter to help me as I had a lot of luggage (90kgs) and a broken ankle. The trolley was dumped at my door, and there was no porter. I called asking for help and they said NO, it’s a health risk for us to touch your luggage. I reminded them I’d done my 14 nights and had tested Negative.. they still refused to help given the “high risk”. I had been so strong during the 14 days, I hadn’t cried, I hadn’t tried to take my own life, I’d been polite to all the staff as I knew being angry at individuals was unhelpful and unfair. But I lost it, I stood in that corridor with my crutches, baggage, and staff (watching me at a safe distance) and I had a full blown meltdown, I cried and I yelled, and I felt so strangely disorientated after being locked in a room for 14 days. Then I remembered, as a Stranded Aussie, myself, and all of us, had strength, courage and a fortitude that those who haven’t stood in our shoes could never begin to understand. I gathered myself, my crutches, and my luggage, and walked out alone, just as I’d come back into our country, my country of citizenship, completely alone, unsupported and unfairly judged.
I was in hotel quarantine in Cairns and barely got by with a structured day of walking 5000 steps in the morning and running up and down my room for 5000 steps in the afternoon/evening. I worked my day the same way every day, ‘cleaned’ the bathroom, ate my breakfast, did my online work, etc etc. The mental anguish and aftermath of the whole experience of firstly being in Melbourne lockdown, having to wait to be accepted into the quarantine, all the while my aged mother being extremely ill and I was “not allowed/didn’t qualify” get to be with her and then the hotel quarantine itself has left me with a severely heightened level of anger, an almost diminished self worth, I am slowly regaining some form of self worth, however I am still struggling with many areas of my ‘being’. I no longer run a business in the industry I had been in for over 30 years and am now working two jobs (one as a waitress) to pay my debts that have been caused by covid and ofcourse, will also be paying off this damn compulsory and unnecessary hotel quarantine. So unnecessary and so damaging, hotel quarantine should never have been considered humane.