COVID-19 and Isolation
In the U.S., testing for COVID-19 got off to a slow start, limiting efforts to isolate those with the disease.1 Public health experts now say the most important goal is to slow the spread of the coronavirus so that the number of people who require medical attention doesn't overwhelm hospitals and the rest of the U.S. healthcare system.
Early data and trends
The data gathered from Asia and parts of Europe indicate that 10% to 20% of the U.S population could end up in a more serious condition.2 Fortunately, evidence from these countries further along in the outbreak suggests that most people who contract this virus will have mild cases.3 Let's hope that’s true. But it is also true that those of us with pre-existing medical conditions like COPD are more susceptible to the virus’ effects.4
The impact of isolation
No one wants that to happen. That is why there have been recommendations about how to conduct oneself in the midst of the pandemic. Terms like social-distancing, quarantine, isolation, and shelter in place are being tossed around with not much explanation. But what is the emotional impact of these measures on those of us with COPD, many of whom are already socially isolated?
Isolation is defined as a state or situation characterized by being physically separated from other people, whether intentional or not.5 Obviously, in the case of COVID-19, it’s intentional. And it is possible for one to socially isolate or separate oneself from other people, when necessary – like now - and not necessarily feel alone or lonely. But it is helpful to understand how isolation, even when well-intentioned or needed, can sometimes lead to total loneliness.
Loneliness and mortality
A recent study published in the journal Health Psychology found that a higher level of social isolation usually produces higher levels of loneliness (makes sense); higher levels of loneliness make people prone to socially isolate themselves, as well. When the two are present together, a higher risk of mortality is associated.6
A “Health and Retirement Study”, estimated that 19.3% of noninstitutionalized or community-dwelling U.S. adults over the age of 65 years already report feeling lonely for much of the previous week. This was well before the introduction of COVID-19 to our lives.7 And a recent study by the AARP compared the effects of prolonged isolation to those of smoking 15 cigarettes a day.8
There are strategies to lessen the negative emotional impact in times of imposed “self-isolation” and even positive opportunities that may not otherwise have occurred. These strategies include (but are not limited to) keeping current connections strong and staying informed through reliable sources (like the CDC).9
If you find yourself isolated for reasons of COVD-19 or any other reason, reaching out to people you trust is one of the best ways to reduce anxiety, depression, loneliness, and boredom during social distancing, quarantine, and isolation.
If we can reach out to those we know who are isolated/quarantined, not necessarily in person, try to find out if they are familiar with digital communication. If so, encourage them to email, text, and use social media to connect with friends, family, and others. Talking “face to face” with friends and loved ones using Skype or FaceTime is also a good strategy. But, again, many of us with COPD are not familiar with these apps/web sites.
Connected but not exposed
It’s good to get outside while using social distancing. For urban residents battling COPD, finding an empty path can be challenging. But for those in more remote areas, being outside is a great way to cope. Getting outside and walking, if possible, in uncrowded locations, is a healthy thing to do.
However, if there is any suspicion at all, that there may be too many others using the same area for the same purpose – I suggest you avoid it. With every additional social contact, the risk of encountering an infected person goes up. So I suggest strictly minimize the number of people you interact with.
Obviously, visitation to people who are in assisted-living facilities and nursing homes has been limited. That has to be very difficult for those in these settings. On a BBC report the other evening, it was suggested that if we are fortunate enough isolated our own families, then one person should be designated to go and visit. Remember – it’s important to be connected but not exposed.
Do you have a COPD exacerbation tool kit?