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From: Science

Social Distancing Prevents Infections, But It Can Have Unintended Consequences

In response to the coronavirus pandemic, public health officials are asking us to do something that does not come naturally to our very social species: Stay away from each other. Such social distancing—avoiding large gatherings and close contact with others—is crucial for slowing the spread of the virus and preventing our health care system from getting overwhelmed. But it won’t be easy.

The effects of short-term social distancing haven’t been well studied, but several researchers—most of them scrambling to deal with disruptions to their own lives because of the coronavirus—recently took time to share some thoughts with ScienceInsider on the potential social and psychological impacts, and how to mitigate them. Here’s what they said:

What’s known about the effects of social interaction on mental and physical health?

Over long periods of time, social isolation can increase the risk of a variety of health problems, including heart disease, depression, dementia, and even death. A 2015 meta-analysis of the scientific literature by Julianne Holt-Lunstad, a research psychologist at Brigham Young University, and colleagues determined that chronic social isolation increases the risk of mortality by 29%.

Are certain people or populations more likely to be affected?

There’s enormous individual variation in people’s ability to handle social isolation and stress, adds Chris Segrin, a behavioral scientist at the University of Arizona. It’s important to remember that not everyone is going into this with the same level of mental health, he says. “Someone who is already having problems with, say, social anxiety, depression, loneliness, substance abuse, or other health problems is going to be particularly vulnerable.”

Overall, though, people are remarkably resilient. And many have endured far worse situations. Segrin points to case studies of U.S. prisoners during the Vietnam War who were confined in tiny cells called “tiger cages,” sometimes in water up to their chin. One trait that predicted their long-term psychological health was optimism: Prisoners who believed that, no matter how bad things were, they would survive and the war would eventually be won had better mental health later on in life.

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Comments

For highly dependent people, like those in care homes, physical distancing (my choice of words) is associated not only with social distancing, but often with the loss of a lot of practical support and help. This may range from sorting routine financial affairs, to helping with arranging stays in bed, to provision of some extra, fresh food stuff. Care homes can be very basic in terms of the range, quality and freshness of food they provide. Even basic or sometimes not so basic care activities are carried out by private carers, family members of others who come into home and operate below the radar of the officially employed staff. In my view a more flexible, not laissez faire approach to distancing is needed.

So far comments have been related to age and physical issues. How about cultural issues: where individuals are raised in a group of extended family, not just the nuclear family. These are more likely isolated, rural, or remote communities. Social distancing must cause not just physical health issues, but severe emotional loss too. Just a thought.

I think that the POW analogy is a misleading choice. One thing that the Segovia, et al. (2015) article actually indicates is that people who survived captivity attributed their survival to staying positive. However, that was based on a biased sample – survivors. Many POWs died of disease or sadistic murder, regardless of hopefulness, without being interviewed. It is normal for survivors of high-fatality situations to make positive attributions once no longer facing death – e.g., “I’m alive! I must be special.” or “I must have done something right.” Some casualties probably did give up on life.

Nevertheless, warriors are not ordinary civilians. They just came from that population. War toughens one up rather quickly. Failure to find one’s “inner warrior” can result in becoming a casualty even when not a POW because normally allostasis makes one less-susceptible to distraction by the chaos of a firefight. That is likely why all combatants return from war zones with post-traumatic stress symptoms(PTSS) characterized by hypervigilance and short temper. Observation of my own crews suggests that PTSS abates within 3 months of return to safety. However, evidence is building that multiple combat deployments increases the likelihood of developing PTSD.


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