The first thing I want to say, is that I sincerely hope that you are doing fine? We are at a crossroads in history and the knock-on effects from SARS CoV 2 will likely travel as both waves and ripples across life as we know it from now on.
There are many ways to examine SARS CoV 2 but the issue concerning me at the moment is the social isolation that has been forced upon us.
Now, the circumstances around SARS CoV 2 are a serious issue, but just as in treatment sessions with you, I often pause to feel the path of least resistance within a problem, and this morning, I decided to embody the spirit of Steve McQueen. I was thinking about the greatest self-imposed or imposed isolation movies of all time and added the ‘Great Escape’ to that list (is that irony?)
Take a moment to escape the gravitas of the Corona virus and imbibe the Steve McQueen cool. Double click on the clip and cue the theme music ...
So, you’ll still be here when I get out, right?
The social isolation that has been forced upon us is a serious issue. Despite having a more than reasonable understanding of the immune system and virology and having had to accept the mandate around social distancing, it is still perturbing for me, as a human being, to remain isolated for months and to have people jump back when they suddenly realise I’m in the vicinity or to be faced with the open palm upon approach; and to have to deal with the defensively raised voice and the constant wide-eyed analysis over what you’re next move might be in the shopping isle. Little things they might be, but they have a snowballing effect on your psyche.
When you spend time exploring the plethora of research papers comparing social isolation with various health issues and outcomes, you realise the magnitude of this situation. To be fair, there is research arguing both sides of the coin: social isolation does and does not affect health outcomes. However, the majority of evidence ups in favour of poorer health for those that are isolated. Most of us will not need to read through research statistics to know this.
It doesn’t matter whether the outcomes are emotional, mental physical or otherwise. When you analyse all-cause morbidity (this means it doesn’t matter what you die from), those that are socially isolated die sooner within a given time frame than those who have regular social contact. You can smoke, drink, have high blood pressure, diabetes or heart disease – it doesn’t matter what you die from, you are much more likely to die earlier than if you have these issues but maintain your connections.
The following points I wish to stress here are highlighted in an article - Social Isolation: A Predictor of Mortality Comparable to Traditional Clinical Risk Factors (2013).
- Social isolation factors predicted mortality at hazard ratio levels similar to or higher than those of several standard clinical risk factors. The paper goes on to suggest that social isolation affects mortality just as much as smoking and more than other clinical benchmarks, including ethnicity, age, education levels, and income.
- In models comparing social isolation variables, unmarried status and infrequent religious activity are predictive of mortality in both men and women.
- A lack of group memberships predicted mortality amongst men and infrequent social contact predicted mortality amongst women.
- A point to note: amongst socially isolated people, only smoking and high blood pressure were (constantly) predictive of mortality amongst other variables measured. Obesity and cholesterol levels were not.
The point we have to understand here in relation to SARS CoV 2, is that social isolation affects your health. Does this matter? You bet.
The paper Social regulation of gene expression in human leukocytes (2007) clearly highlights some of the biological mechanisms produced by social isolation. For example, gene expression alters when you are socially isolated. This means the make-up of your genes change such they (and therefore, your cells and organs) produce different by-products or that they don’t produce their normal by-products at all. To be specific:
- Isolated individuals had greater expression of genes producing pro-inflammatory cytokine signalling and prostaglandin synthesis. In short, you house more inflammation. If prolonged, it’s a sure pathway towards autoimmune issues and chronic disease.
- Isolated people had under-expression of genes related to antiviral resistance, antibody production and lymphocyte function. This last sentence is worth reading again.
My point here is that there is a cost-benefit analysis to be done comparing protective biological mechanisms with social isolation. I haven’t even touched on the mental and emotional issues, but they need to be included here, as well.
This is just information, but information is power. What you do with it is up to you. My goal here is to have people think, and when it comes down to it, make informed decisions for the greater good around the Corona Virus.
I have noticed in my clinic, that people want to talk about the Corona Virus. People NEED to talk about it. VENT about it, even. Whilst people are towing the isolation line, there is a sense of fear, frustration and a lack of trust. People have questions. And rightly so!
So, stay connected. Observe reasonable and common-sense restrictions but stay connected with what it means to be human. Get out and get some sun and exercise. You can still exercise with another. Grab a coffee on the way back. Be in touch. Don’t give in to the fear. Encourage others to do the same.
I’ll still be here when you get back!