What Is the Human Cost of Stopping COVID-19?
Part II: The hidden costs of social distancing and lockdowns.
Posted Apr 03, 2020
Part II (Click here to read Part 1)
The following is a sampling of actual and potential adverse effects of the physical distancing and lockdowns currently in place. The list is not meant to be exhaustive; rather, it includes those problems that have been getting some attention in the news and social media in the past couple of weeks.
There is clear evidence that prolonged social isolation is strongly linked to a host of physical and mental health problems. While people vary in their capacity to cope with isolation, it has emerged as a major risk factor for disease, akin to smoking cigarettes and more of a threat to long-term health than obesity. This seems likely due to its elevation of stress, which gradually weakens the immune system, interferes with sleep, and can lead to a host of maladaptive coping strategies. Prolonged isolation is also linked to heightened anxiety and an increased risk of depression, with the latter increasing the risk of suicidal ideation and behavior. The risks are far more likely to appear as social isolation becomes prolonged; the negative effects of short-term isolation are lower and more likely to be transitory.
People living with partners, families, or friends may be at lower risk of isolation as a result of lockdowns; in contrast, people living on their own are at greater risk of struggling with isolation and loneliness. And particularly vulnerable groups, such as elderly and disabled people who live on their own and depend on visits from family, friends, and social service workers, may be at special risk.
Similarly, residents of senior housing can no longer have visits from family and friends, further increasing their isolation. My friend Jim, who has a debilitating neurological illness, depends on long swimming sessions at a local gym to slow the spread of his disease and socialize with friends. The gyms are all closed here in Amsterdam, and Jim is alone at home, watching his health deteriorate. His situation is surely far from unique.
And then there is this: we cannot be with our loved ones who are dying of COVID-19, nor can we rightly mourn our dead. The rituals of funerals and bereavement on hold, and what this means for the grief process is simply unknown.
As a species, we seem to be hard-wired to come together in times of crisis, seeking out family, friends, neighbors, and other sources of community to confront a common enemy. It is a painful reality that what feels like our most natural response—coming together—only increases our vulnerability in this frightening pandemic.
2. Social isolation + high stress increases the risk of harsh and even violent parenting.
Several studies have shown that persistently high parental stress coupled with social isolation (which is also a source of stress) significantly increase the risk of child abuse. The majority of parents, even under such conditions, will not become abusive, but the causal relationship is clear and the risk of increased risk of abuse is real.
In fact, doctors in Cook County, Illinois, which includes the city of Chicago, have already reported a significant increase in cases of severe child abuse, which they attribute to the convergence of stressors related to COVID-19. I quote here from an article in the Cook Children’s Checkup Newsroom:
Dr. Jamye Coffman believes these unprecedented times have simply become too much for some parents. “People have so much increased stress right now,” Dr. Coffman said. “They’ve got financial stress. Some people lost their job or worried about keeping their current job. They lost their income. You’ve got stress from being overcrowded. Everyone’s cooped up together. They feel like they can’t get away from each other. These stressors can lead to abuse.”
Moreover, vulnerable children, such as those with disabilities, are at greater risk of abuse in the best of times; that risk is likely to increase now. Normally, most children are at daycare or school during the day, or in specialized programs for those with special needs, allowing parents to work and giving them some respite from child care. With daycare, schools, and specialized day-programs now mostly closed, parents are suddenly confronted with caring for their children full-time and enforcing online school participation. For those who can or must still work, this creates a childcare crisis; for those who are now at home, especially those who are expected to meet the demands of new telework routines, this is a major change in roles and responsibility. Parents of children with special needs must now do their best to address these needs, while their children adapt to the loss of the specialized structure, support, and services they were receiving.
3. For women in abusive relationships, “shelter in place” policies increase the risk of harm. And intimate partner violence seems to be increasing globally as a result of lockdowns.
The economic stress so many families are experiencing, coupled with the stress of being in lockdown, together with maladaptive coping strategies such as drinking, seem to be driving an increase in intimate partner abuse. Such a spike has already been observed in numerous countries. Intimate partner violence is strongly linked to the development of Post-traumatic Stress Disorder (PTSD) among survivors, and predicts worse short and long-term mental health and developmental outcomes among children who witness it.
4. Children from low-income families who depend on meals at school are facing a nutritional and food security crisis.
The World Food Programme notes that this is affecting millions of children and families globally:
The effects on children and their families are dire. These children are at risk of hunger and will no longer have the protection of key vitamins and micronutrients they receive in the school meals. For poor families, the value of a meal in school is equivalent to about 10 percent of their monthly income. For families with several children in school, that can mean substantial savings. The loss of the school meal means a loss of income.
5. Lockdowns and “shelter-at-home” mean a temporary end to, or an unfamiliar and untested format for, family visits for children in foster care.
To read Part III of this post, please click here.