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Covid-19: Why We Can’t Ignore Social Isolation

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Social isolation can have significant effects on both mental health and the risk of other illnesses including coronary heart disease, stroke, diabetes- and premature death.

Covid-19 is perceived as a profoundly physical illness. The first thing most of us think of when Covid is mentioned are images of patients on ventilators, people coughing and the ubiquitous face mask- a daily, visible reminder of how this virus spreads and what it does to our body. And having this appreciation is important- working in one of the busiest Covid hospitals at the peak of the U.K. outbreak, I saw first hand how devastating this illness can be and how it must not be underestimated. However, there is another dimension that also can’t be ignored.

Covid has led to a pandemic of social isolation. Social distancing, social bubbles, restrictions on meeting others…all of these were inconceivable this time last year, and have had an enormous impact on our personal and collective mental health. However, the repercussions extend even further. A robust collection of evidence supports a link between social isolation and physical illness. Meta-analyses suggest a 29% increase in the risk of premature death in those experiencing social isolation, with an increased risk of type 2 diabetes, musculoskeletal conditions, obesity and a striking 32% increase in the risk of stroke and 29% increase in the risk of coronary heart disease. Even if we just consider physical health outcomes, which are often easier to quantify, and then we take the most binary outcome of all- death- social isolation is undeniably bad for our health. The exact mechanism is unclear, but probably due to a combination of factors including effects on activity level, behaviour and adherence to medical treatments and screening. Interestingly, these effects seem largely independent of age or initial health status. The Covid bubble is both friend and foe- for all of us.

A particular challenge is that many of those most at risk of becoming unwell from Covid are also those at greatest risk of social isolation, especially the elderly. The warmth of a hug from a loved one, seeing a smiling face, being able to physically meet with friends and relatives - all of these are critical to both mental and physical well-being. Jumping on a video call, meeting friends in the park or seeing others at work are important outlets for many of us, but may not be so easy for the elderly lady living alone whose usual social interaction is confined to a weekly meeting with friends, now postponed due to Covid.

In these strange times, we must remember that whilst protecting the elderly from the virus is important, it is also critical that we shield them from social isolation. Innovation may be key to achieving this. ‘Social distancing’ is perhaps the wrong expression- to truly safeguard health, physical distancing is needed but we must make every effort to ensure that all of us, especially our most vulnerable, remain very much socially connected.

Please note that the views expressed here are those of the author alone and not necessarily those of any other person or organisation

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