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March 17, 2020

'A new period of social pain': How to help patients, and yourself, survive social distancing

Daily Briefing

    Americans throughout the country are practicing social distancing to stem the spread of the new coronavirus. But as Americans isolate themselves, they should be aware of the potential for a "social recession," Ezra Klein reports for Vox.

    Loneliness is deadly—but hard to spot. Here's how the Leeds County Council identifies hotspots.

    About the pandemic

    Reports of COVID-19, the disease caused by the new coronavirus, first surfaced in early December 2019 in Wuhan, China, and quickly spread to other countries. 

    The United States saw its first COVID-19 case in late January, and cases have spiked since then. As of Tuesday morning, state and federal officials had reported 4,482 cases of COVID-19 and 86 deaths linked to the new coronavirus in the United States. 

    CDC is now recommending that all Americans, particularly those over the age of 60, "avoid crowds," cancel "all nonessential travel," and "stay home as much as possible." In fact, CDC on Sunday advised against any in-person events with at least 50 people for the next eight weeks, and on Monday, President Trump recommended people avoid gatherings of more than 10 people.

    Williams Schaffner, an advisor for CDC and an infectious disease expert at Vanderbilt University, said, "The single most important thing you can do to avoid the virus is reduce your face-to-face contact with people."

    Social distancing could exacerbate social isolation, loneliness

    While public health officials say the social distancing is essential to curbing the spread of the new coronavirus and protecting the nation's health system, Klein reports that it could exacerbate an existing public health problem: loneliness.

    Those hit hardest by social isolation will be older populations or those without family or friends who can advocate for them, Klein reports.

    For several years, researchers have been documenting a loneliness epidemic in the United States. A National Academies of Sciences (NAS) report found, before the social distancing efforts began, about 25% of older adults were socially isolated, and 43% said they felt lonely.

    And research has found a link between loneliness and negative health risks. For instance, the NAS report found that social isolation was associated with "a significantly increased risk of premature mortality from all causes," as well as a:

    • 59% increased risk of functional decline;
    • 50% increased risk of developing dementia;
    • 32% increased risk of stroke;
    • 29% increased risk of incident coronary heart disease; and
    • 25% increased risk of cancer mortality.

    The researchers also found a consistent correlation between social isolation and cases of anxiety, depression, and suicidal ideation, Klein reports.

    Carla Perissinotto, associate chief for geriatrics programs at the University of California, San Francisco and a contributor to the report, said, "The health effects of loneliness are astounding. At any point across the life span, the things we're most worried about is losing our independence, losing our minds, and heart attack, and these are all affected by loneliness independent of other risk factors."

    With the latest social distancing recommendations in place, Eric Klinenberg, a sociologist at New York University, said, "[W]e've … entered a new period of social pain. There's going to be a level of social suffering related to isolation and the cost of social distancing that very few people are discussing yet."

    How we can ease social isolation (while still practicing social distancing)

    Fortunately, experts say there are ways to practice social distancing in the wake of the new coronavirus, without falling prey to social isolation.

    Cynthia Boyd, a geriatrics specialist at Johns Hopkins University who contributed to NAS' research, said, "[W]e want to try and enable people to remain as connected as possible. We need to be thinking about what individuals can do, but also what we as neighbors and a society can do, to not make it worse than it might otherwise feel for people."

    For instance, Klein reports that people could mitigate the risks of social contact by choosing to walk outside or have a picnic instead of having dinner in a crowded restaurant.

    Health experts also recommend utilizing virtual options to help with social isolation. Former U.S. Surgeon General Vivek Murthy, who's written about loneliness, recommended friends and familystay connected via video chat and phone calls, which he said are "more rich than texting or emailing alone."

    "When we rely on our personal networks, we guarantee the most isolated and disadvantaged people will be excluded," Klinenberg said. "By definition, they are not in our networks; they are the least likely to get assistance. This is an area where government can help by funding and supercharging community organizations" (Klein, Vox, 3/12; McCaskill, Politico, 3/16).

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