Self-Isolation and Quarantine during the UK's First Wave of COVID-19. A Mixed-Methods Study of Non-Adherence

Self-isolation and quarantine measures were introduced by the UK Government on 12 March 2020 as part of the 'delay' phase to control the spread of SARS-CoV-2. Non-adherence to self-isolation for 7 days after the development of symptoms is considered suboptimal and little is known about adherence to quarantine for 14 days if a co-habitant developed symptoms. This study aims to analyse non-adherence behaviours to self-isolation and quarantine measures by identifying their potential psycho-social and demographic predictors and by exploring people's accounts of their experiences with these measures. A mixed-methods convergent design was used, comprising an online survey (n = 681) completed by residents in six North London boroughs and qualitative interviews with a subsample of participants (n = 16). Findings identified not accessing community support, lack of control over leaving the house, and lack of perceived benefit and need to follow the rules as behaviours associated with non-adherence to quarantine (42.7%). Non-adherence to self-isolating measures (24.4%) was associated with individuals' perceived lack of control over responsibilities, lack of control over leaving the house, uncertainty about symptoms experienced, lack of access to tests, and distrust in the Government. Adherence to self-isolation and quarantine could be improved through strengthening perceived benefit to self-isolate with messages emphasising its effectiveness, by implementing a two-way information system to support symptoms identification, and with Government-funded, locally supported packages at different levels (financial, food, and practical needs).