Intended for healthcare professionals

Letters Covid-19: mitigating the effects of the pandemic response

Covid-19: social distancing or social isolation?

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2399 (Published 18 June 2020) Cite this as: BMJ 2020;369:m2399
  1. Rajeev Gupta, chair1,
  2. Rajinder K Dhamija, professor and head2
  1. 1Department of Preventive Cardiology and Internal Medicine, Eternal Heart Care Centre and Research Institute, Mount Sinai New York Affiliate, Jaipur 302017, India
  2. 2Department of Neurology, Lady Hardinge Medical College and SSK Hospital, Delhi 11001, India
  1. rajeevgg{at}gmail.com

Governments across the globe have promoted social distancing as part of multilevel strategies to tackle covid-19. There is a short path from social distancing to social isolation. Studies have found that social isolation is associated with increased risk of inactivity, smoking, alcohol abuse, unhealthy diet, depression, introversion, poor social skills, and post-traumatic stress disorder leading to greater risks of cardiovascular diseases, dementia, and premature mortality, especially in elderly people.12

In India, loneliness is a risk factor for a variety of psychological conditions.3 Most of the elderly people in developing countries are frail and dependent on younger people for community services, living in cohesive family systems. Socially isolating or shielding these people from their kin could have deleterious effects on physical, social, and psychological wellbeing, especially for those with poor ambulation and cognitive impairment. Most of these seniors either have no access to technology or are not conversant with it. Social isolation and distancing in lockdown have led to economic hardship in most developing countries.4

We need multidisciplinary research to evaluate interventions that tackle the adverse consequences of social isolation and loneliness, especially among elderly people. A meta-review reported that interventions that were found useful incorporated promotion of accessibility and acceptability of care, ongoing contact, use of trusted local providers, family involvement, and economic benefits.5 Interventions include screening for isolation, counselling, emotional disclosures, physical activity promotion, maintaining social interaction and social prescribing, and using digital support with access to the internet and smartphones.2 Specific interventions for resource limited countries include better use of digital technology leading to better point-of-care services in rural and urban areas, treatment compliance, disease surveillance, data collection, and appropriate distant health education.2 We think that social cohesion while maintaining physical distancing—not social distancing—is the way forward for the covid-19 pandemic.

Footnotes

This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

References

View Abstract