The MV Hondius left Ushuaia, Argentina, on April 1. Within days, one passenger had become ill. Within weeks, the voyage had become the focus of an international health response after cases of Andes virus, a type of hantavirus, were identified among passengers and crew. By early May, several people had died. Passengers and crew have since left the ship, but many are now facing quarantine and monitoring elsewhere, along with intense public scrutiny.
For those affected, the threat is not only medical. It is psychological too. Quarantine asks people to live with a difficult combination of fear, uncertainty and loss of control. Research tells us that our ability to tolerate uncertainty is broadly related to our levels of distress , so the uncertainty surrounding Andes virus could influence how worried people feel about their health and safety.
Hantaviruses are a family of viruses usually spread to humans through contact with infected rodents or their urine, droppings or saliva. Andes virus is unusual because limited person-to-person transmission has also been recorded. For passengers and crew, this means living with a threat that is serious, unfamiliar and difficult to judge. They are also doing so under the watchful eye of the world's media, at the centre of an international emergency medical response, while facing unplanned isolation away from home. This is a particular kind of psychological strain.
A similar incident occurred during the COVID-19 pandemic, when the Diamond Princess cruise ship was quarantined for several weeks. During that time, passengers experienced fear of infection, hypervigilance - being constantly on alert, scanning the body or the environment for signs of danger - about their physical symptoms and difficulty sleeping. These are all common features of anxiety.
Outbreak guidance often asks people to keep their distance, isolate, ventilate shared spaces, wear masks and wash their hands to reduce the risk of transmission. However, social isolation brings psychological costs. People who are isolated in quarantine facilities, hotels, hospitals or other controlled settings may be more likely to experience low mood, anxiety and disturbed sleep, especially if they cannot go outside or maintain ordinary contact with others.
Over the longer term, many people recover well after quarantine. Recovery is helped by clear communication, trust and contact with others. During an outbreak, accurate and consistent information matters, and honestly acknowledging what is not yet known can build trust more effectively than false reassurance. Informal support networks, including WhatsApp groups, video calls or shared daily routines, may also help protect people psychologically.
The common-sense model of self-regulation could help explain what passengers might be thinking and feeling, and how they might cope. This model suggests that when people face illness, they try to make sense of two things at once: what the illness means to them and what emotions they experience. These perceptions will determine which coping strategies will be used to manage the illness.
For example, when control is taken out of people's hands and they believe the consequences of infection could be serious, distress and panic are more likely. A passenger may think: "I have been exposed; I could become ill; I could die." Thoughts like these can intensify emotional reactions and increase the perception of danger, creating a cycle of fear and the use of unhelpful coping strategies such as symptom checking, rumination, anger or withdrawal.
This is where clear information and psychological support can help. Passengers can be supported to build an accurate understanding of the virus based on reliable medical information. This can help them develop realistic action plans and adopt positive problem-based coping strategies, such as following testing guidance, isolating when necessary, seeking medical help if symptoms emerge, and staying connected with others where possible.
The World Health Organization has made clear that this is not the start of a pandemic similar to COVID-19. The wider public health risk is assessed as low. However, for passengers and crew, the risk assessment is different, which is why monitoring and quarantine measures have been recommended.
As passengers continue with up to six weeks of monitoring or quarantine after leaving the ship, the psychological strain may continue too. The incubation period is the time between exposure to a virus and the appearance of symptoms. Because Andes virus can have an extended incubation period, symptoms may not emerge immediately. This means passengers may remain in a heightened state of bodily alert for several weeks, prolonging stress and exhaustion.
Some passengers may need follow-up care as they return to normal life after a highly controlled and stressful experience, especially if they have witnessed severe illness or are grieving. As the public receives confirmation of further cases among passengers, there is a chance that they may be stigmatised or treated by others as contagious. This carries two risks. First, passengers may be socially excluded by their communities, which could affect relationships or work. Second, they may experience guilt or grief if they fear they have unwittingly exposed others to the virus.
Managing uncertainty
Psychological research shows that people vary widely in how they respond to the same event. It is entirely normal to experience stress in response to uncertainty, isolation and fear. For many people, recovery is likely. But some will need ongoing support during and after quarantine.
In practical terms, people in quarantine need meaningful social contact, even if that contact is virtual. Simple coping strategies can help: maintaining a predictable daily routine, protecting sleep, eating healthily, taking exercise where possible, and using grounding techniques to calm the nervous system. Breathing exercises, meditation, having a shower or making a cup of tea may sound small, but small acts of routine and control can matter when so much else feels uncertain.
An experience like this really matters. Deaths, quarantine, media scrutiny and the fear of infection are not psychologically trivial. But recovery is also shaped by what happens around it: whether people receive clear information, whether they remain connected to others, whether their distress is normalised and whether support continues after quarantine ends. Uncertainty cannot be removed entirely; it is how we manage it that protects us from a fear of the unknown taking hold.
Jilly Gibson-Miller receives funding from ESRC, Triumph and UK Research and Innovation funds.
