A paradox of social distancing for SARS-CoV-2: loneliness and heightened immunological risk

Abstract

The World Health Organization declared the SARS-CoV-2 virus a global pandemic in March of 2020. In an effort to reduce the harms and rate of exponential spread, regional and national governments across the world instituted a variety of measures. These have included orders for citizens to practice social distancing, which in the US has affected over 300 million people. In their most extreme, these social distancing measures are isolation orders to “shelter in place”, at one point affecting ~17 million Americans. Data regarding the effects of these policies are emerging, but two outcomes include greater social isolation and likely increased loneliness. An important distinction arises between these two concepts. Social isolation is the objective lack of, or reduction in, social contact. Loneliness is the subjective discrepancy between the desired and actual levels of social connection. Objective social isolation and subjective loneliness are only weakly correlated (r ~ 0.2), but both have independent real-world health consequences and are associated with long-term increases in mortality (29% and 26%, respectively). The magnitude of these effects rival that of smoking and obesity on long-term health risks. Emerging evidence for the social repercussions of the pandemic is worrisome; a recent longitudinal study following more than 35,000 people reported that while overall loneliness has not changed during the COVID pandemic, individuals who described high levels of baseline social isolation are now experiencing significantly worse pandemic-related loneliness. Now more than ever the most socially vulnerable would likely benefit from clinical assessment and support. Our own unpublished survey data (N = 155) indicate that 60% of respondents from an online campaign in the USA, Israel, and UK report a greater sense of loneliness since the pandemic began.