Background Self-isolation is a key public health strategy for infectious disease control. Globally implemented during the COVID-19 pandemic, it remains an essential strategy in ongoing mitigation efforts. Healthcare workers (HCWs) often face isolation due to occupational exposure to infectious diseases and may face unique psychological challenges.

Aims This systematic review synthesized evidence on (1) the impact of isolation on HCWs’ psychological wellbeing, (2) factors associated with wellbeing, and (3) the effectiveness of interventions to improve wellbeing during or after isolation for COVID-19.

Methods A pre-registered systematic review (PROSPERO: CRD42024559971) was conducted in accordance with PRISMA and Cochrane guidelines. Searches in PsycInfo, Embase, MEDLINE, PubMed, and grey literature included studies on HCWs’ psychological wellbeing during or after self-isolation. Risk of bias was assessed using ROBINS-E or CASP tools.

Results From 20,798 records screened, 19 studies (10 quantitative, 7 qualitative, 2 mixed methods) were included. Quantitative findings on anxiety, depressive, and stress symptoms were inconsistent. Qualitative studies consistently reported distress, loneliness, and stigma. Factors associated with wellbeing included socio-cultural influences and protective factors. No studies assessed interventions targeting wellbeing during self-isolation.

Conclusion Self-isolation appears to have variable effects on HCWs’ wellbeing, including significant challenges and opportunities for resilience. Public health strategies should prioritize timely, clear communication, accessible evidence-based psychological support, and practical resources. Future research must prioritize evaluation of interventions to mitigate psychological harm and support HCWs during infectious disease outbreaks.

Teaser text Self-isolation is vital for infectious disease control but poses psychological challenges for healthcare workers (HCWs). We synthesized findings on the impact of self-isolation on HCWs’ wellbeing, associated factors, and interventions to enhance wellbeing. Quantitative studies reported inconsistent wellbeing findings, while qualitative data highlighted distress, stigma, and resilience. Public health strategies must ensure psychological and practical support, clear communication, and intervention development to mitigate harm and enhance HCWs’ wellbeing during future infectious disease outbreaks.

This work was carried out at King's College London. LES, RA, and GJR were participants of the UK's Scientific Advisory Group for Emergencies or its subgroups. GJR advised the UK's Office for National Statistics on self-isolation policies-papers related to this work were considered in our review. All authors co-authored papers included in the review process. LES and RA are employees of the UK Health Security Agency. NG has provided advice to NHS England in relation to staff health and runs March on Stress Ltd, which provides mental health-focused training for some NHS organisations. MVS, SKB, and AFM report no competing interests.

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=559971

This study was funded by the National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between the UK Health Security Agency, King's College London and the University of East Anglia. The views expressed are those of the authors and not necessarily those of the NIHR, UKHSA or the Department of Health and Social Care. For the purpose of open access, the author will apply a Creative Commons Attribution (CC BY) licence] to any Author Accepted Manuscript version arising. This research was supported by the The Wellcome Trust through the British Academy/Leverhulme Small Research Grants Scheme (SRG2324\240763) awarded to AFM and GJR. The Health Protection Research Unit in Emergency Preparedness and Response Unit is funded by NIHR as part of award no: NIHR200890 (awarded 1 April 2020).

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