How the Coronavirus Pandemic Fuels America’s Loneliness Epidemic

Isolation and loneliness are already huge health-related problems among older adults. Social distancing is poised to make those problems worse.

By Joseph P. Williams

Needed social distancing measures amid the coronavirus pandemic could increase potentially dangerous loneliness among older adults.(Tetra images RF/Getty Images)

Ever since the novel coronavirus pandemic forced California to issue a stay-at-home order to prevent spread of the virus, Fred Davis' phone has been ringing almost nonstop. The callers: senior citizens who are shut in, alone and eager to know when the statewide lockdown might end.

"They're calling me because they're lonely," says Davis, 74, a retired mortgage broker and part-time minister who volunteers at the Gary and Mary West Senior Wellness Center in San Diego, his hometown. Some clients, he says, are alone after having outlived spouses or even children, while others depend on the senior center's bingo games, dances and luncheons for social contact. The shutdown order, he says, is pushing his peers further into isolation.

Avoiding others "is OK when you choose to do it, if you want to go home and rest," Davis says. The harm, he says, comes "when you are forced to do it – when you're locked out of places. It's just a sad experience for them."

For years, experts have warned that seniors in the U.S. are experiencing high rates of social isolation and loneliness, a silent problem that has quantifiable, harmful health effects – similar even to smoking 15 cigarettes a day.

But with the nationwide spread of COVID-19 forcing travel restrictions, community center closures and shutdowns of entire states, advocates for the elderly warn that social distancing could result in a second, invisible pandemic.

In normal times, the isolation of seniors "can have a detrimental effect on their health. It can be just as deadly as smoking, high blood pressure (or) diabetes," says Dr. Sharon Brangman, chair of the department of geriatrics at State University of New York Upstate Medical University in Syracuse.

Brangman says the coronavirus pandemic has created a paradox: Because data indicates the virus has a disproportionate, more severe impact on seniors – as well as those with chronic, underlying health conditions – isolation "just becomes another compounder."

In other words, the very thing society must do to slow the spread of COVID-19 and protect highly vulnerable seniors "can weaken their immune system," she says. "And right now, you need the strength of your immune system to fight the virus."

There's widespread data revealing a longstanding, wide-ranging "epidemic" of loneliness among the millions of older adults in the U.S. And it's an issue not just for those who live by themselves: According to a 2012 University of California-San Francisco study, 43% of older people felt lonely, even though only 18 percent lived alone. Among a sample of senior nursing home residents, another study showed, despair was prominent, and data pointed to a "lack of social relationships as a source of suffering."

Meanwhile, researchers have associated loneliness – if not necessarily being alone – with cognitive decline, including the potential progression of Alzheimer's disease, and have tied social isolation to an increased risk of stroke and even premature death. A 2017 study in Health Psychology found that people who reported feeling lonely also reported more severe symptoms associated with the common cold than those who said they were less lonely.

Brangman, a practicing clinician who specializes in treating older patients, notes there's a difference between being lonely and being alone.

"We have some (patients) who are content to be by themselves, but others need social interaction," she says. "I have some patients who would never want to go to a senior center because that was never their style. But I have other patients who are very used to social contact and find it hard to be alone."

Yet as the coronavirus pandemic rages on, and data shows that keeping people apart is effective at slowing the rate of transmission, social distancing may be the best prescription to fight COVID-19, Brangman says.

"We are trying to keep our patients at home," she says. "They are definitely high-risk and there is a mandate for them to stay home. We have canceled all of our office visits to keep them out of harm's way."

The measures also may mean adult children must restrict their visits, and their physical affection, during the pandemic, even if their parents might depend on both. "We try to say, 'Pick one person, be careful about washing hands, be careful about hugging, but it gets really hard," Brangman says of advice to older patients.

Then there are people with Alzheimer's or dementia; Brangman says consistency and a routine is critical to their care and keeping them safe. Stay-at-home orders, she says, can upend their routines and aggravate their condition.

"They may not understand what's happening, but can sense the anxiety around them," Brangman says.

Paul Downey, president and CEO of Serving Seniors – a San Diego nonprofit that operates the senior wellness center where Davis, the minister, volunteers – agrees that enforcing social distancing for an already marginalized demographic uses one problem to prevent another, far deadlier one. His organization also serves seniors at around a dozen "congregate dining sites" that have closed due to the pandemic, and has similarly ceased fitness and game activities.

"If you asked me three weeks ago what's the most important thing that happens at the senior center, I would say socialization," Downey says. For his clients, many of whom are living alone, he says, such a venue means "having a place to go where they belong, where they have a group of friends."

A week earlier, "you would have seen people around the table enjoying lunch" and hanging out with their friends, Downey says. The ability to socialize, he says, is "critical" to keeping older people healthy, as seniors with "a good social environment, being happy in their lives, are going to have better health outcomes."

Now, "we have had to transition all of our services to homebound, and people are more isolated than ever," Downey says. "We're now taking seniors who were otherwise active and healthy and going to Rotary and bridge club meetings – we're now taking those folks and socially isolating them. Even your next-door neighbor can't come over and have a cup of tea in the afternoon" for fear of transmitting an infection.

Both Brangman and Downey say technology and social media can help bridge the gaps, allowing seniors to keep in touch with friends and family. Among seniors who aren't tech-savvy, Downey says, a phone call or even a quick door-knock visit can help – provided that the appropriate precautions, including a 6-foot distance between visitor and resident, are maintained.

Still, "if you and I are talking in person, and I'm wearing a mask or glove and you're not, it creates a disparity," Downey says.

Only time will reveal if social distancing on top of social isolation has a lasting, detrimental impact on older adults, he says.

"None of us really understand, not even for ourselves, what the long-term impact of being cooped up in our houses will be for months, weeks at a time," Downey says. "It could exacerbate their condition greatly. We need to come up with solutions for social isolation of seniors, regardless of the coronavirus."

Brangman concurs: "It's a big testament as to how we treat the most vulnerable of our society," she says. "We are too quick to write off older adults, even though ageism is the one '-ism' we all will experience. We really have to look at it because we're all going to be there."

"Unless you die young, you will be old," she says.

Davis, the retired mortgage broker and volunteer, agrees. Everyone is struggling, he says, and although "I keep pretty positive" and read the Bible daily, the shutdown has tested his faith.

"The first two, three days I had a talk with myself – 'Shoot, I'm going to have to reboot my schedule,'" Davis says. After a period of adjustment, he concluded, "I still want to help people" so he continued making his rounds of visiting homeless camps and delivering meals to shut-ins while taking precautions and staying upbeat.

"I tell people, 'Don't give up hope. This is going to pass,'" he says. "I have one guy I have to go see. He's one of my wellness checks. If I don't check on him, his whole world will crash in. He's so worried that the government will crash and he won't get his home-delivered meal."

"He said, 'What's gonna happen with me?'" Davis says. "I reassured him: 'You've got me.'"

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How the Coronavirus Pandemic Fuels America’s Loneliness Epidemic