In early 2020 when the WHO declared a virus pandemic governments around the world, introduced a number of restrictive measures that included reducing social mixing in the community, not having friends and family visiting the house, and minimising the use of public transport. Individuals with certain high-risk conditions and older adults were advised to not leave their home at all.
One of the main objectives for the introduction of these restrictive interventions at the time was the protection of senior citizens as the latter were considered to be a vulnerable group within society. While undoubtedly well intentioned these measures carried, and still carry, both physical and mental health risks.
This is the subject matter of a UK-based study by Thomas Beaney et al. called “The effects of isolation on the physical and mental health of older adults” published in April 2020.
As the WHO pandemic declaration spread fear and panic around the globe unprecedented restrictions were placed on personal freedoms. It was then thought that there was no time to conduct a harms-benefit analysis on government imposed restrictive measures and for this reason the adverse health effects of forced isolation in confined spaces or mask wearing were all but ignored.
The study looks at adults aged 50 to 81 years and points out that “Social isolation is associated with increased morbidity from chronic disease and with higher all-cause mortality that may be further exacerbated by behaviours, such as smoking, reduced physical activity and increased sedentary time.” It is important to note that whilst the health measures were then implemented with the intention to save lives, the fact that the measures themselves would likely cause harm and loss of life appears to not have been sufficiently considered.
The study very pointedly specifies that “Furthermore, the current situation is different from previous studies of social isolation given the additional impacts of fear and uncertainty, with no certain endpoints from the pandemic.”
Governments are at this time gradually unwinding the restrictions that limit freedom of movement and unhindered association between people. They are however slow to openly acknowledge that the Covid-19 virus is now endemic and that it has joined the virus biomes made up of an odd hundred other corona, influenza and common cold viruses, and their associated many thousands of variants, against which the vast majority of people have inbuilt natural immunity and that we have to contend with every winter season.
Social isolation and resulting loneliness has significant implications for mental health in older adults and leads to a wide range of psychological symptoms, including depression and anxiety. It also impacts negatively on quality of life. Moreover, enforced social isolation coupled with fear of harm is different to isolation arising in normal circumstances. A rapid review conducted at the time of the study on the psychological impact of quarantine in disease outbreaks found links to anxiety, depression and symptoms of post-traumatic stress, with some evidence that these could persist long-term.
When we talk of fears we are not just referring to the fear of being infected by a virus but also fears associated with negative outcomes including quarantine, fears relating to infection, frustration and boredom, and lack of information and scarcity of supplies.
The Gerontological Society of America published an article in January 2018 in which was stated that “there is now substantial evidence documenting that being socially connected significantly reduces risk of premature mortality, and lacking social connection significantly increases that risk”.
On the 9th December 2020 the WHO published statistics on the main causes of deaths worldwide and stated that “at a global level, seven of the ten leading causes of deaths in 2019 were non-contagious diseases. These seven causes accounted for 80% of the top ten. All non-contagious diseases together accounted for 74% of deaths globally in 2019.”
There are lessons to be learnt from the past two years of WHO declared pandemic. Firstly, people die of many different illnesses and not just from viruses. Secondly, health measures imposed to protect people carry their own risks and these may well be greater than the risks of contagion from a germ. Finally, governments are not quick to relinquish powers that have been surrendered to them on trust.
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This article was published in the Senior Times of The Times of Malta on the 23rd March 2022