For about six weeks, from the start of Minnesota’s COVID-19 stay-at-home order in March until just before Mother’s Day, Bonnie Mohs barely left her house.

She got her groceries through a pickup service. She didn’t go into any stores, or really out into public at all. She had her phone and iPad to keep in touch with people, but saw nary a soul in the flesh, except for a few delivery folks -- and they always stood 6 feet back.

“It was just me and my dogs,” said Mohs, of Detroit Lakes. “It was really different. I’m somebody that’s very active in the community, and I usually go out a lot.”

National and state-level news outlets are reporting on the phenomenon of “quarantine fatigue” or “COVID fatigue,” and the detrimental effect it could have on public health. Data shows that more and more people are starting to travel farther away from their homes, visit more public spaces like parks and beaches, and wear their masks less frequently.

The isolating experience of COVID-19 has made an impact on Mohs, and she’d prefer not to be holed up at home.

Over the past several weeks, she occupied her time by making face masks to donate. She also made 12 mission quilts for her church, as well as some for her new baby granddaughter, a grandson due in July, and herself. She did some reading, and played a lot of solitaire on her iPad while watching TV.

When her 70th birthday rolled around, she celebrated on a Zoom call with her family.

“That was the first time that I didn’t see another human being on my birthday,” she said. “It made me step back and take a pause, because people have always been so important in my life.”

A teacher for 35 years, Mohs has worked in senior living environments and in retail since her retirement, and she’s been an active volunteer in the community for years, “so I’ve always had that people contact,” she said.

Even so, she abides by social distancing guidelines. Memories from her youth make her “a little bit more careful” than others might be, she said.

“I remember polio when I was a young child -- I had a neighbor boy who had polio, so I had seen that,” she recalled. “And I remember when there was a flu going around and a girl, three years older than me in school, got encephalitis and died from that. So I know that viruses can be really awful, and I think ... a lot of people in society have not experienced the real critical things that can happen with viruses, so I don’t think everybody realizes what can happen.”

Since the stay-at-home order was relaxed, Mohs has ventured out a bit more, visiting her kids and grandkids in the Fargo area and going into some stores again. She still takes precautions in public, wearing a mask and making sure she only visits businesses that are practicing social distancing.

Recently, she returned to her part-time job at the local quilt shop, where she said there are strict safety guidelines in place. If those guidelines hadn’t been put in place, she said, she wouldn’t have returned to work there.

Social distancing and infection rates

As more businesses open back up and other restrictions ease, public health officials are reminding people not to think of this as the end of the pandemic, but to continue to wear masks, limit contact with other people, and abide by all the other state guidelines.

Health experts worry that "quarantine fatigue" could lead to more COVID-19 cases.

“More people ... seem to be growing weary of social distancing guidelines,” wrote Dr. Syon Bhanot, a behavioral and public economist, in a May 5 article in the New York Times . “Quarantine fatigue — exhaustion and waning discipline surrounding the restrictions to daily life needed to prevent the spread of the coronavirus — is entirely understandable. Staying home is stressful, boring and, for many, financially devastating.”

Yet adhering to those restrictions is necessary, Bhanot added, as “the coming weeks are the critical window for decreasing the number of new cases and starting to push this virus into retreat.”

Information shared by Michelle England, a Licensed Independent Clinical Social Worker at Essentia Health-St. Mary’s in Detroit Lakes, shows the impact that social distancing has on infection rates. The information comes from a research lab at the University of California San Diego and reveals that, if no social distancing is practiced, one infected person will spread the COVID-19 virus to an estimated 2.5 people within five days. Those people will then continue to spread the virus to others and, through the ripple effect, by 30 days, 406 people will be infected.

By contrast, if people reduce their social exposure by 75% (by staying home whenever possible, wearing masks in public, etc.), one infected person will lead to the infection of 2.5 people within 30 days.

“What I’m seeing and hearing from others in my practice is, we’re concerned that in some aspect, people are done with it (social distancing),” England said. “They’ve decided that they’re not very concerned, which is concerning … What I’m seeing is that people may be letting their guards down, especially in public. I’m seeing people going into stores and not masking, and that leads to problems, like breakouts.

“A lot of people are angry and impatient right now,” she added. “I encourage people to contribute more at the end of the day than they criticize, and not to underestimate the importance of social distancing.”

Quarantine fatigue “is very real,” England said, and it presents itself in various ways depending on the individual, bringing out different emotions in everyone. England has talked to a number of local clients who feel stressed, anxious, depressed, angry, scared or all of the above and then some, and said every feeling invoked is valid: “There’s not a right emotion to have.”

“It’s just dealing with a new reality ... and asking yourself how that impacts you,” she said. “We have to learn how to embrace the uncertainty of how long this is going to last. And the more we work together as a community, the better we can come through this.”

According to the Centers for Disease Control and Prevention, people who may respond more strongly to the stress of the pandemic include older people and people who are at higher risk of severe illness from the virus, children and teens, emergency responders who are on the front lines, and people with mental health conditions.

The stress can cause changes in sleep or eating patterns, difficulty concentrating, irritability, worsening of chronic health problems or mental health conditions, and increased use of alcohol, tobacco or other drugs, among other symptoms.

Coping with quarantine fatigue

Licensed Independent Clinical Social Worker Michelle England and the CDC offer several tips for dealing with the emotional demands of the pandemic:

• Talk to people you trust to share your concerns and feelings. These people may include a spouse, parent, friend or other loved one, or a professional therapist.
• Practice self care, emotionally, physically and spiritually. Take deep breaths, stretch, or meditate or pray daily. Eat healthy and exercise regularly. Get plenty of sleep, and avoid alcohol and drugs. Make time to unwind and do activities you enjoy.
• Find new ways to socialize. Arrange virtual hangouts or online dinner dates with friends and family, for example, or coordinate “social distancing walks” with loved ones, meeting up somewhere outdoors for a walk and being sure to stay six feet apart from each other.
• Find a balance between being under-informed and overwhelmed. Get need-to-know news about COVID-19 from trusted news outlets and official sources (such as the CDC or Minnesota Department of Health , England advises), and take breaks from watching, reading, or listening to the news and social media if it starts to get upsetting. “And then make space for activities and conversations that have nothing to do with the outbreak, for that balancing piece,” England suggested.
• Check in with loved ones at least once a week, asking questions like, “What do you need?”, “What do you feel?”, and “How can we collaborate to meet those needs in a healthy way?” The CDC states, “Taking care of yourself, your friends, and your family can help you cope with stress. Helping others cope with their stress can also make your community stronger.”