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May 12, 2020

COVID-19: The Impact of Social Distancing

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Muruga Loganathan, MD; Amit Ladani, MD, FACP; and Steven Lippmann, MD

​Department of Behavioral Medicine and Psychiatry (Dr Loganathan) and Department of Medicine (Dr Ladani), West Virginia University School of Medicine, Morgantown, West Virginia, and Department of Psychiatry, University of Louisville School of Medicine, Louisville, Kentucky (Dr Lippmann)

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The coronavirus disease 2019 (COVID-19) pandemic has disrupted normal life, principally due to needs for quarantining and physical distancing. The pandemic has resulted in social isolation, unemployment, and a recession with subsequent financial crisis. Economic distress correlates with physical and emotional health issues, especially increased cardiovascular mortality, respiratory pathology, depression, anxiety, and interpersonal violence. Infection control calls for physical distancing, not social separation. Social closeness should be maintained and emphasized.

As social animals, humans are not meant to be alone; isolation from others has damaging repercussions. Many people in such circumstances feel insecure. We perceive solitary confinement as a punishment, and that perception can even precipitate paranoia and panic.

Coronavirus has, by April 2020, affected less than one hundredth of the world’s population, but the fear of this virus has infected most of us. Fear of the unknown and the need to seek safety have been instilled into the human race. We plan to step on Mars, but, interestingly, now are not free to step out of our homes. Our egocentric “I am invincible” attitude has changed to “I am disposable.” An undesirable cognitive pattern with psychological worry is becoming part of our daily routine. Do we all meet adjustment disorder criteria? How should we redefine traumatic disorders while facing a long-term threat of infection? The comorbidity of anxiety and trauma has resulted in increased rates of depression, substance abuse issues, domestic violence, and conduct misbehaviors. Quarantine participants and those who refuse isolation often express antagonism toward one another.

To attenuate this epidemic, schools have closed; parents struggle to manage their children. Home-schooling has become a huge issue with positive and negative consequences. Parenting skills and relationships are challenged when children are kept indoors. This is particularly difficult in families with fewer financial or educational resources. Excessive electronic screen time might be the new norm; however, economically disadvantaged families who lack computer or internet access now face new challenges. With more isolation and unstructured time, emotional turmoil, suicide, and dangerous, including self-injurious, behaviors tend to increase.

Elderly people often refuse nursing home placement due to dread of losing independence and connection with families or friends. The coronavirus epidemic makes the likelihood of such events even more of a concern. People have become more fearful in general and are afraid of getting sick in nursing homes.

The shortage of mental health professionals and limited access to psychiatry have now worsened. However, technology, thankfully, comes in as a remediation through the availability of telemedicine, which prominently includes telepsychiatry. This form of intervention delivery is now widely offered. Telepsychiatry is popular with patients and medical staff. Health care systems are adapting to provide these remote mental health care services. Telemedicine has improved access, especially in rural communities. With the continuing COVID-19 threat, insurance and governmental rules are relaxed and service providers have responded well. The Medicare system offers wider coverage, while decreasing some restrictions and rules on privacy. Health care access is complicated by coronavirus, but universal availability is now more of an issue. Some COVID-19–related procedures are more affordable.

What is to follow once this pandemic crisis abates? What if the coronavirus only attenuates somewhat, yet globally remains for a prolonged time period? It is important that we maintain a healthy routine, as well as sleep and exercise schedules, to improve physical and emotional health. Positive attitudes, gratitude, deep breathing, and muscle relaxation techniques can diminish anxiety and mood issues. Exploring new skills and productive outlets strengthens cognitive skills and well-being. Staying connected socially is especially important during these isolation-prone times. Remember: maintain social connections even while physically distancing.

Financial disclosure: Drs Loganathan, Ladani, and Lippmann have no relevant financial relationships to report.

Disclaimer: The views expressed are those of the authors and do not represent an official position of any universities.​

Category: COVID-19
Link to this post: https://www.psychiatrist.com/blog/covid-19-the-impact-of-social-distancing/
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