Pandemic Isolation / Loneliness

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trader32176
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Re: Pandemic Isolation / Loneliness

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Enforced isolation can increase risk of mental health problems in children, adolescents

11/19/20


https://www.news-medical.net/news/20201 ... cents.aspx

The COVID-19 pandemic has necessitated widespread social isolation, affecting all ages of global society.

A new rapid review in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports on the available evidence about children and young people specifically, stating that loneliness is associated with mental health problems, including depression and anxiety-potentially affecting them years later.

The review, which synthesizes over 60 pre-existing, peer-reviewed studies on topics spanning isolation, loneliness and mental health for young people aged between 4 and 21 years of age, found extensive evidence of an association between loneliness and an increased risk of mental health problems for children and young people.

"As school closures continue, indoor play facilities remain closed and at best, young people can meet outdoors in small groups only, chances are that many are lonely (and continue to be so over time)," said lead author, Maria Loades, DClinPsy, Senior Lecturer in Clinical Psychology at the University of Bath, UK.


" This rapid review of what is known about loneliness and its impact on mental health in children and young people found that loneliness is associated with both depression and anxiety. This occurs when studies measured both loneliness and mental health at the same point in time; when loneliness was measured separately; and when depression and anxiety were measured subsequently, up to 9 years later,

Of relevance to the COVID-19 context, we found some evidence that it is the duration of loneliness that is more strongly associated with later mental health problems."

- Maria Loades, DClinPsy, Study Lead Author and Senior Lecturer, Clinical Psychology, University of Bath, UK

From the selected studies there was evidence that children and young people who are lonely might be as much as three times more likely to develop depression in the future, and that the impact of loneliness on mental health outcomes like depressive symptoms could last for years.

There was also evidence that the duration of loneliness may be more important, than the intensity of loneliness, in increasing the risk of future depression among young people.

For many young people, loneliness will decrease as they re-establish social contacts and connections as lockdown eases (e.g., as they return to school or college). For some a sense of loneliness may persist as they struggle to resume social life, particularly for those who were more vulnerable to being socially isolated before lockdown.

"It's key that children and young people are allowed to return to activities such as playing together, even if outdoors, as soon as possible, and that they are able to resume attending school, which gives them a structure for their day, and provides them with opportunities to see peers and to get support from adults outside of the nuclear family," said Dr. Loades. Furthermore, she added "children need more in their strategy for easing lockdown. Alongside this, the government could target children's wellbeing in public health messaging. And meanwhile, we should also continue to embrace technology as a way to keep in touch."

So whilst we do what we can to mitigate the effects of loneliness and re-establish social connections, we also need to prepare for an increase in mental health problems, in part due to loneliness, and also due to the other unintended consequences of lockdown, such as a lack of structure, physical inactivity and social and/separation anxiety that might be triggered when resuming social interactions outside of the home.

There are several levels at which we can prepare for the heightened demand:

Take a universal approach to promoting wellbeing through public messaging, and by schools doing activities to promote wellbeing in children and young people as they resume normal activities.

Seek to identify those who are struggling with loneliness as early as possible and do so by targeted interventions to help them overcome their struggles. This may be through the provision of extra support in schools, helping them overcome anxieties about returning to school, or giving them an extra hand with reconnecting socially with peers.

For those who continue to struggle over time, and can't get back to doing the things they normally do as a result of their struggles, we need to ensure that they are made aware that services are open, and can provide specialist help, and to make sure that they know how to access this help and are supported to do so.
trader32176
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Re: Pandemic Isolation / Loneliness

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Suicide Claimed More Lives in October Than 10 Months of COVID-19 in Japan Report Shows

Early in the coronavirus pandemic, scientists predicted that forced isolation would be “a perfect storm” for suicide. Evidence suggests they were right.


11/24/20

https://fee.org/articles/suicide-claime ... ort-shows/


Early in the coronavirus pandemic, scientists warned that economic lockdowns could cause serious mental health repercussions.

"Secondary consequences of social distancing may increase the risk of suicide
," researchers noted in an April 10 paper published by the American Medical Association. "It is important to consider changes in a variety of economic, psycho-social, and health-associated risk factors."

Essentially, researchers warned, forced isolation could prove to be “a perfect storm” for suicide.

Seven months later, new evidence is emerging to suggest these researchers were right.

“Far more Japanese people are dying of suicide, likely exacerbated by the economic and social repercussions of the pandemic, than of the COVID-19 disease itself,” CBS News reports. “While Japan has managed its coronavirus epidemic far better than many nations, keeping deaths below 2,000 nationwide, provisional statistics from the National Police Agency show suicides surged to 2,153 in October alone, marking the fourth straight month of increase.”

For years in Japan, suicides had been on the decline. But the arrival of COVID-19 and strict regulations designed to curb transmission of the virus have changed that trend.

The 2,153 suicides reported last month are about 600 more than the previous year, CBS reports, with the largest gains coming in women, who saw an 80 percent surge in suicide.

"We need to seriously confront reality," said Katsunobu Kato, Japan’s chief government spokesman, adding that new efforts to counsel potential victims are being made.

Unlike Japan, the United States has yet to publish national figures on suicide. But anecdotal evidence suggests the US might be struggling with its own suicide epidemic.

Prior to the arrival of the coronavirus, suicide was the tenth leading cause of death in America, claiming between 42,000 and 49,000 lives annually in recent years. Though we don’t yet know what 2020’s toll will be, surveys show more than half of Americans say they’ve suffered mentally during the pandemic, which has seen the widespread use of lockdowns and social isolation to combat the virus.

Meanwhile, some localities have reported sharp upticks in suicide. These include Dane County, Wisconsin — the second largest county in the Badger State — which saw suicides in young people nearly double so far in 2020, as well John Muir Medical Center, a health care service headquartered in Walnut Creek, California, which in May reported an “unprecedented” surge in suicide.

"We've never seen numbers like this, in such a short period of time," Dr. Michael deBoisblanc told an ABC affiliate. "I mean we've seen a year's worth of suicide attempts in the last four weeks.” (Some studies have shown relatively stable suicide rates, it should be pointed out.)

We don't yet know what the final toll of suicides in the US will be, but the sad truth is the US may very well see an increase similar to that of Japan.

As the researchers cited at the beginning of this article observed in their study, social isolation is closely linked to suicide.

“Leading theories of suicide emphasize the key role that social connections play in suicide prevention. Individuals experiencing suicidal ideation may lack connections to other people and often disconnect from others as suicide risk rises,” the researchers noted. “Suicidal thoughts and behaviors are associated with social isolation and loneliness.”

This is one of the many reasons that sweeping interventions that enforce social distancing are so dangerous. Unfortunately, human connection is nothing that can be achieved through phone calls and Zoom meetings, at least not in the same way. Moreover, an abundance of research shows that suicide is not the only deadly consequence of social isolation.

As The New York Times reported in 2016, social isolation adversely affects human health in myriad ways.


A wave of new research suggests social separation is bad for us. Individuals with less social connection have disrupted sleep patterns, altered immune systems, more inflammation and higher levels of stress hormones. One recent study found that isolation increases the risk of heart disease by 29 percent and stroke by 32 percent.

Another analysis that pooled data from 70 studies and 3.4 million people found that socially isolated individuals had a 30 percent higher risk of dying in the next seven years, and that this effect was largest in middle age.

Loneliness can accelerate cognitive decline in older adults, and isolated individuals are twice as likely to die prematurely as those with more robust social interactions. These effects start early: Socially isolated children have significantly poorer health 20 years later, even after controlling for other factors. All told, loneliness is as important a risk factor for early death as obesity and smoking.

Policy makers who continue to push lockdowns as a serious solution to the coronavirus choose to ignore these realities, the same way we’ve seen the catastrophic economic effects of the lockdowns overlooked.

These unintended consequences are too serious to ignore, however. Lockdowns come with serious costs to mental health and threaten to thrust tens of millions of people into extreme poverty.

Meanwhile, the actual benefits of the lockdowns remain elusive.

It’s time that policymakers owned up to an inconvenient truth: their policies cannot save lives, they can only trade lives, as economist Ant Davies and political scientist James Harrigan noted early in the pandemic.

In times of crisis, people want someone to do something, and don’t want to hear about tradeoffs. This is the breeding ground for grand policies driven by the mantra, “if it saves just one life.” New York Governor Andrew Cuomo invoked the mantra to defend his closure policies. The mantra has echoed across the country from county councils to mayors to school boards to police to clergy as justification for closures, curfews, and enforced social distancing.

Rational people understand this isn’t how the world works. Regardless of whether we acknowledge them, tradeoffs exist.

This is an economic reality. What’s tragic is that the tradeoffs increasingly look worse and worse, despite the refusal of many politicians and experts to acknowledge it.
trader32176
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Re: Pandemic Isolation / Loneliness

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Social Isolation and Loneliness: The Silent Pandemic

https://www.myharrisregional.com/news/s ... t-pandemic


Social Isolation and Loneliness: The Silent Pandemic


During the COVID-19 pandemic, we have been told to shelter in place. For many of us, sheltering in place has been a way of life before COVID-19. The Health Resources & Services Administration states that two in five Americans report they sometimes or always feel their social relationships are not meaningful and one in five say they feel lonely or socially isolated. And according to the U.S. Census Bureau, more than a quarter of the U.S. population (28 percent) of older adults live alone.

World Health Organization reports, social isolation can be as damaging to health as smoking 15 cigarettes a day. The problem worsens as we get older.

Social isolation significantly increased a person’s risk of premature death from all causes. A risk that may rival those of smoking, obesity, and physical inactivity.
Social isolation was associated with about a 50% percent increased risk of dementia.

Poor social relationships (characterized by social isolation or loneliness) was associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.
Loneliness was associated with higher rates of depression, anxiety, and suicide.
Loneliness among heart failure patients was associated with a nearly four times increased risk of death
, a 68% increased risk of hospitalization, and a 57% increased risk of emergency department visits.

The late Dr. John Cacioppo, a psychology professor at the University of Chicago, studied the effects of loneliness for two decades before his passing in 2018. After suffering a near-fatal car crash and having what seemed to be a transformative revelation, he concluded that love and social connections are what really matters in life. He equated loneliness with a type of hunger, noting that establishing social connections is essential for human survival. He also believed that chronic loneliness can increase the incidence of early death.

Here are some Tips to Help with Social Isolation and Loneliness

Take time to talk to family and friends- phone, virtual platform, email and social media
Keep up a healthy lifestyle - eat a balanced diet, exercise and get quality sleep
Take up a new hobby you always wanted to try
Get as much sunlight, fresh air and nature as you can
Practice relaxation, meditation, and mindfulness
If new and social media makes you feel fearful or anxious, unplug
If you are socially distancing and feeling lonely because of Covid-19, remind yourself this is a temporary period of isolation
Confide in family and friends how you are feeling
Take part in an in-person support or virtual support group


If you suspect you are suffering from chronic loneliness, talk with your provider or mental health professional. They can refer you to a mental health professional to see if individual or group therapy in-person or via teletherapy is right for you. Just like a medical condition, it will only get worse if untreated.

If you or someone you know is in an emergency, call 911 immediately. If you are in crisis or are experiencing difficult or suicidal thoughts, call the National Suicide Hotline at 1-800-273 TALK (8255).

Senior Life Solutions is an intensive outpatient group therapy program designed to meet the unique needs of older adults suffering from symptoms of anxiety and depression often related to aging. For more information, or if you know an older loved one experiencing isolation or loneliness and is in need of help, contact us at 828-488-4044.

One would think that knowing if we are being affected emotionally or physically from loneliness would be easy for us, loved ones, and our health care providers to recognize; however, this is not always the case. Like chronic depression or pain, over time we start thinking and believing it’s just a normal way of life. In a recent article AARP shares, Kerstin Gerst Emerson, a clinical assistant professor at the Institute of Gerontology at the University of Georgia in Athens. “You can’t give the patient a blood test or an MRI.” Instead, diagnosis depends on asking questions. Living alone isn’t always the problem, although it can be. More important, say, experts, is a subjective feeling of social separation. “We’re all lonely from time to time, but the problems come when someone is chronically lonely, day in and day out,” says Steve Cole, a professor of medicine and genomics researcher at the University of California in Los Angeles.
trader32176
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Re: Pandemic Isolation / Loneliness

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'Community connectors' can help reduce loneliness and social isolation

12/11/20


https://www.news-medical.net/news/20201 ... ation.aspx


An existing service in the North West of England called Community Connectors, which enables adults to access social activities within their community, can help reduce loneliness and social isolation, according to an analysis published in Health & Social Care in the Community.

Interviews with 13 older adults and middle-aged adults, from 289 people who accessed the service between June 2017 and September 2018, revealed that Community Connectors provided individuals with confidence in engaging with community activities and enhanced individuals' social networks.

The investigators noted that additional research needs to quantitatively measure the impacts of the service on loneliness, depression, and social connectedness. Such studies are particularly important in light of the COVID-19 pandemic, with provision of social activities and social support services suddenly significantly reduced.

Community-support services are vital to support the well-being of older adults, who have suddenly been cut off from face-to-face and oftenany type of support due to the pandemic. Not every older adultcan access services remotely though, so it is crucial that services such as Community Connectors are able to adapt to provide face-to-face support where possible and support older adults in accessing remote support."

Clarissa Giebel, PhD, Lead author, University of Liverpool, NIHR ARC NWC, UK

Source:


Wiley

Journal reference:

Giebel, C., et al. (2020) Enabling middle‐aged and older adults accessing community services to reduce social isolation: Community Connectors. Health and Social Care. doi.org/10.1111/hsc.132288.
trader32176
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Re: Pandemic Isolation / Loneliness

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Current testing-isolation policies effectively prevent campus transmission of COVID-19

1211/20


https://www.news-medical.net/news/20201 ... ID-19.aspx


As the COVID-19 pandemic gained momentum, many countries entered lockdowns, or severely restricted the public movement of their citizens. This included school and university closures. However, the adverse impact on education induced much research on the actual role of students in the spread of the virus, leading to the reopening of these institutions in many regions.

Now a new study, which appeared on the preprint server medRxiv* in December 2020, shows that while students generally showed a high degree of compliance with restrictive measures such as masks and social distancing, they continued to contract the infection – from off the campus.

Preparations for Reopening

Many educational institutions are planning to reopen early next year, for the spring semester. On the other hand, the number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is rising rapidly over the country. Thus, educational authorities and college leaders are attempting to understand how viral spread correlates with the mode of instruction – remote or in-person – and whether the presence of students in residence on the campus affects transmission. The current study is based on open-source data from 9 such institutions in greater Boston and 4 from outside this area.

When colleges and universities in Boston expressed their intention to begin in-person classes in the fall, there was no shortage of viral testing in the form of reverse transcriptase-polymerase chain reaction (RT PCR).

The Broad Institute itself served more than 100 institutions, being able to handle over 1,00,000 tests every single day. Other large universities were able to process 6,000 tests a day for their student and faculty community.

This allowed these institutes to set up regular surveillance programs at high frequency for their campuses. The idea was to couple such testing with isolation and contact tracing on the campus, thus compassing rapid disease control before secondary spread occurs. This mandates that close contacts be isolated within the latency period, that is before the infected individual becomes infectious.

Risk Factors for Community Transmission Among Undergraduates

The researchers sought to understand how infection acquisition on campus among undergraduate students varied with the number of students living on campus, the density of students in their accommodations, the mode of instruction, and the cadence of testing.

Many other important factors include the degree of ventilation, mask-wearing, use of dining space, turnaround time, and even sample collection methods, along with the pattern of social networking in the student population.

The regional institutions were included in the study to clarify the effect of institutional policy on the outcome. If national-level statistics were used instead, the variations in the rate of COVID-19 in the surrounding community could overwhelm the pattern of spread on such campuses. The samples in the study cover 100 days.

The researchers predicted that if all new campus infections were because of the interactions of students and the surrounding local community, the incidence among groups of students would not depend on either the total student population on campus or the density of students in the dormitory. Transmission among students themselves would be revealed by a strong correlation between the number of infections and dormitory density.

No Evidence of Campus Transmission


The incidence among the colleges in the Boston area was ~16/1,00,000 person-days, which is not sharply different from the mean case rate of ~11/1,00,000 in Middlesex county, Massachusetts, over the same period. This shows that local educational institutes are contributing only a small part of the total number of cases in the country and not a disproportionate contribution, either. Moreover, the regular campus surveillance may quite well result in a higher case detection rate due to the turning up of asymptomatic cases.

Secondly, the fractional incidence among students shows no apparent relation with the total number of students in dormitories or with the dormitory student density. Thirdly, the researchers looked at whether the college adopted remote learning, with all classes being online; or hybrid instruction, with some in-person classroom learning. They found that there was no significant difference in the infection rates with the mode of instruction.

And finally, the frequency of testing shows that schools that conducted tests two or three times a week had fewer infections relative to those which conducted weekly tests. This may not be due to more testing alone, but rather due to the association of higher test frequency with stricter limits on social interactions on campus, as well as adaptations of accommodations, for instance, to minimize the spread of infection.

Implications and Future Directions

The results are consistent with the hypothesis that most student infections were acquired outside of the dorm-residential setting, with minimal community transmission within congregate on-campus student housing.”

Further analysis is required to determine whether test-isolate-quarantine policies help to effectively break the chain of transmission. For instance, the number of new infections in the quarantined student population after being exposed to known cases should be available.

On the whole, institutions in Boston that tested at least weekly have kept their COVID-19 incidence within bounds while preventing a prolonged uncontrolled campus outbreak.

Such continuing evaluations of how institutional policy affects infection rates could help shape decision-making and implementation in the areas of reopening and campus management. This would be facilitated by publicly available data on the details of student housing, including the number of students per bathroom and per bedroom, policies and compliance rates concerning interventions like face masks and social distancing, the mode of instruction, and daily updates on the number of students in isolation and quarantine from all institutions.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:


Stubbs, C. W. et al. (2020). The Impacts of Testing Cadence, Mode of Instruction, and Student Density on Fall 2020 COVID-19 Rates On Campus. medRxiv preprint. doi: https://doi.org/10.1101/2020.12.08.20244574. https://www.medrxiv.org/content/10.1101 ... 20244574v1
trader32176
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Re: Pandemic Isolation / Loneliness

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Women suffered more than men from COVID-19 isolation

12/22/20


https://www.news-medical.net/news/20201 ... ation.aspx


A study by University of Calgary researchers with the Hotchkiss Brain Institute examining sex and gender differences on sleep, empathy and mood during months of isolation due to COVID-19 has found that women are suffering more than men with poorer sleep and more anxiety, depression and trauma, while also feeling more empathetic than men.

The findings published in Frontiers in Global Women's Health is one of the first studies to look at changes in mood and sleep quality during the pandemic. Dr. Veronica Guadagni, PhD, led an online survey of Canadians between March 23 and June 7 of this year. During this time, schools and many businesses were closed, and people stayed home as much as possible as part of a general lock down to prevent transmission of the virus.

The researchers examined data from 573 participants, 112 men and 459 women with a mean age of 25.9 years. More than 66 per cent of the volunteer participants reported poor quality of sleep, more than 39 per cent reported increased symptoms of insomnia, and anxiety and distress were increased in the whole sample. Sleep, depression and anxiety symptoms were more prevalent in women.


" Generally, the study found women reporting more anxiety and depression. Their symptoms worsened over time and with greater length of the isolation period. There was a progressive increase in anxiety, depression, poor sleep quality and trauma for males and females. But it was greater for females over time."

- Dr. Veronica Guadagni, Postdoctoral Scholar, Cumming School of Medicine (CSM)

The study also found that women reported higher scores on a scale measuring empathy, the ability to understand the emotions of others and to care for others. The greater empathy was, however, associated with greater anxiety, depression and trauma. The authors speculate women's greater concern and anxiety in relation to being caregivers reflects differences in gender roles and norms.

"I was not surprised by the findings; women are the ones who carry the additional load," says Dr. Giuseppe Iaria, PhD, the senior investigator of the study. "Taking care of family and critical situations has always been a huge load on women and females."

When it came to feeling for others, the higher scores for women on the empathy scale may mean they're more likely to follow public health guidelines, such as washing hands, social distancing, and wearing a mask. "If we see that higher empathy is connected to prosocial behavior we could expect that the people who actually care more for others would be more respectful of the rules. Future studies should test this specific hypothesis," says Guadagni.

The researchers were not able to glean any pre-pandemic sleep or anxiety issues from the participant's data. "We don't know what the interplay between sleep, mental health and empathy was before the isolation for these participants" says Iaria. He hopes the study will "trigger some insights" into the public awareness that some suffer more than others, leading to some acknowledgment and accommodation for women from their partners, employers, and institutions.

The researchers suggest sex and gender differences may play a role in psychological and behavioral reactions to the pandemic. And, they say, these differences need to be considered in planning targeted psychological interventions.
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Re: Pandemic Isolation / Loneliness

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Growing Old, Alone

Isolation has taken a tremendous emotional toll on many older Americans.

1/2/21


https://www.theatlantic.com/ideas/archi ... ly/617496/


As the country plunged into a deep and unusual economic recession last year, it also plunged into a deep and unusual social recession: atomizing families and friends, evaporating hours of laughter and care and touch.

This phenomenon hit nobody as hard as America’s seniors, who are much more likely than their younger counterparts to live in care facilities and many of whom have struggled to connect in a socially distanced or virtual fashion. The elderly bore the brunt of the pandemic’s fatalities: COVID-19 has killed nearly 250,000 people over the age of 65. They also bore the brunt of its isolation. Many older Americans spent months discriminated against, frightened, and alone.

“When we look back on this in the years to come, I imagine there’s going to be a lot of Monday-morning quarterbacking around whether it was a good idea to blockade older adults in their nursing-home rooms for eight, nine, 10 months out of the year, without letting them have access to their families,” David Grabowski, a professor of health-care policy at Harvard Medical School, told me. “I think we’re going to look back and say, What the hell were we doing?” What we were doing was failing to save seniors’ lives or maintain their livelihoods.


America’s inability to—or, really, its decision not to—control the virus has meant a precipitous decline in quality of life for its oldest and most fragile, and a catastrophic number of deaths among them. People over the age of 85 are 630 times as likely to die of COVID-19 as people in their 20s, and 95 percent of coronavirus deaths have occurred among Americans older than 50. Data compiled by the Kaiser Family Foundation show that COVID-19 has claimed the lives of more than 100,000 people in long-term care facilities, meaning roughly 40 percent of coronavirus deaths have occurred in institutions housing fewer than 1 percent of Americans.

The kind of work done and the kind of care needed—the very architecture of life lived—in nursing homes and similar facilities pose a challenge when it comes to preventing the spread of the novel coronavirus. Such facilities congregate people, and have a rotating cast of caregivers, housekeepers, food-service workers, medical experts, and others tend to them. The work is often close, intimate—bed baths, blood draws, spoon-fed meals.

Yet the United States, by any measure, has not met this challenge. Nine months into the pandemic, long-term care facilities are still facing shortages of personal protective equipment. Many are floundering financially, even with help from the government. They are still having problems getting COVID-19 tests turned around quickly. PPE shortages worsened in the third quarter of the year, with 17 percent of nursing homes reporting being low on or out of N95 masks, 11 percent out or nearly out of gowns, 9 percent short of surgical masks, and 8 percent lacking eye protection.

In this environment, care facilities have had little option but to close up. Following guidance from the CDC, many have barred in-person visits and kept residents in their rooms, among other measures. To compensate, facilities have set up Zoom and FaceTime calls, created outdoor areas for distanced visits, set up barriers that family members can talk through, helped residents play online social games, and arranged care-package drop-offs. Many of the care residents I spoke with for this article said that they had taken advantage of those options, and adapted.

Judy Friederici is a retired lawyer who proactively moved into a retirement facility a few years ago, as she is not married and does not have children. Isolation has been tough, she said, particularly given that she moved to her community in part to ensure she would not be isolated as she got older. But she has made a project of calling people in her complex who are likely to feel lonely.

Mary Anna Turner, who turns 100 next year, lives in a Virginia care facility. She indicated that her experience living through worse had given her some grit. “I remember flu epidemics!” she told me. “I remember I had a bad case, and I called a doctor and asked him to send me something for it. The nurse said no, and I asked, Why not? She said, Too many people are dying. We don’t have anything to send you.” Turner told me she misses her family, but is making do.

Still, the social recession among older adults in care facilities is Great Depression–deep. A survey conducted by Altarum, a nonprofit health-care research and consulting group, found “drastic” reductions in social connections among nursing-home residents. Just 5 percent said they had visitors three times a week, compared with more than half before the virus hit. Nearly all said they did not leave their care facility for a meal or to go shopping, compared with 40 percent before COVID-19. Only one in four was going outside for fresh air. Half said they no longer had access to activities such as art classes or group exercise. Nearly 90 percent said they could no longer eat meals in the dining room. Two in three said they no longer left their rooms to socialize with their peers.

For older Americans, virtual alternatives to in-person visits are often pale alternatives. Teresa Palmer, a geriatrician, called me with her 103-year-old mother, Berenice, who lives in a San Francisco skilled-nursing facility. Teresa has spent much of the year cajoling the local authorities to allow her more access to her mom: Berenice’s hearing troubles make masked-and-distanced visits hard.

Turner indicated she had trouble with the same. “Sitting six feet apart, people will turn and say something directly to me, and I cannot understand what they are saying,” she said. “It’s still good to get together and socialize a little bit. They probably weren’t saying anything important anyway.”

For those with more profound medical challenges, the pandemic is yet harder. New Jersey–based therapist Abby Grayson’s father, Robert Stillman, was a chemist who worked for Bristol Myers Squibb for decades. He has a degenerative neurological condition, and is now in hospice. “He has been in his room since March, 24 hours a day,” Grayson told me. “We do FaceTime, but it’s hard for him to track. He can’t manage the keys and the buttons, and it’s not a meaningful experience for him.”

As his condition has worsened, his language capabilities have declined and touch has become all the more important, she told me. “I would hug him and hold his hand and stroke his hair, and he’d just soak it in,” she said. “He’s really eager for affectionate physical contact, which of course, as humans, we all are.” But now, she said, “I don’t think anyone touches him unless it’s to do a medical procedure.”

Isolation has taken a tremendous emotional toll on many older Americans. “Oh, it’s just awful,” Berenice told me. “You go from being a human being to being something that lies in bed most of the day. The nurses don’t communicate well with you.” It has also taken a health toll. “There’s been more rapid language loss, and you see the delay in her responding and her difficulty processing,” Teresa Palmer told me. “There’s an element of depression. Social isolation, it’s just not good for the brain.”

Studies have shown that touch, talking, and social connection are crucial for both mental and physical health: Isolation and loneliness are associated with increased risk of depression, anxiety, and heart disease, among other conditions. “We expect the proximity of others, because throughout human history, we’ve needed to rely upon others,” Julianne Holt-Lunstad, a professor of psychology and neuroscience at Brigham Young University, told me. “Our brain has adapted to expect proximity to others, particularly trusted others. When left without it, it triggers this threat response—the sense that everything in our environment is going to be more challenging.”

Thankfully, for people living in care facilities, the end of the social recession and the pandemic is just a shot or two away. Nursing-home residents are among the first in line for the new COVID-19 vaccines. Still, the country’s mismanaged coronavirus response has failed seniors. “We never found the balance between safety and resident quality of life and dignity,” Grabowski, the Harvard professor, told me. Instead, we found some equilibrium that left hundreds of thousands of older Americans isolated and hundreds of thousands more dead.
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Re: Pandemic Isolation / Loneliness

Post by trader32176 »

‘Peer Respites’ Provide an Alternative to Psychiatric Wards During Pandemic

1/11/21


https://khn.org/news/article/peer-respi ... -pandemic/


Mia McDermott is no stranger to isolation. Abandoned as an infant in China, she lived in an orphanage until a family in California adopted her as a toddler. She spent her adolescence in boarding schools and early adult years in and out of psychiatric hospitals, where she underwent treatment for bipolar disorder, anxiety and anorexia.

The pandemic left McDermott feeling especially lonely. She restricted social interactions because her fatty liver disease put her at greater risk of complications should she contract covid-19. The 26-year-old Santa Cruz resident stopped regularly eating and taking her psychiatric medications, and contemplated suicide.

When McDermott’s thoughts grew increasingly dark in June, she checked into Second Story, a mental health program based in a home not far from her own, where she finds nonclinical support in a peaceful environment from people who have faced similar challenges.

Second Story is what is known as a “peer respite,” a welcoming place where people can stay when they’re experiencing or nearing a mental health crisis. Betting that a low-key wellness approach, coupled with empathy from people who have “been there,” can help people in distress recover, this unorthodox strategy has gained popularity in recent years as the nation grapples with a severe shortage of psychiatric beds that has been exacerbated by the pandemic.

Peer respites allow guests to avoid psychiatric hospitalization and emergency department visits. They now operate in at least 14 states. California has five, in the San Francisco Bay Area and Los Angeles County.

“When things are really tough and you need extra support but you don’t need hospitalization, where’s that middle ground?” asked Keris Myrick, founder of Hacienda of Hope, a peer respite in Long Beach, California.

People with serious mental illness are more likely to experience emotional distress in the pandemic than the general population, said Dr. Benjamin Druss, a psychiatrist and professor at Emory University’s public health school, elaborating that they tend to have smaller social networks and more medical problems.

That was the case with McDermott. “I don’t have a full-on relationship with my family. My friends are my family,” she said. She yearned to “give them a hug, see their smile or stand close and take a selfie.”

The next best thing was Second Story, located in a pewter-gray split-level, five-bedroom house in Aptos, a quaint beach community near McDermott’s Santa Cruz home.

Peer respites offer people in distress short-term (usually up to two weeks), round-the-clock emotional support from peers — people who have experienced mental health conditions and are trained and often certified by states to support others with similar issues — and activities like arts, meditation and support groups.

“You can’t tell who’s the guest and who’s the staff. We don’t wear uniforms or badges,” said Angelica Garcia-Guerrero, associate director of Hacienda of Hope’s parent organization.

Peer respites are free for guests but rarely covered by insurance. States and counties typically pick up the tab. Hacienda of Hope’s $900,000 annual operating costs are covered by Los Angeles County through the Mental Health Services Act, a policy that directs proceeds from a statewide tax on people who earn more than $1 million annually to behavioral health programs.

In September, California Gov. Gavin Newsom signed a bill that would establish a statewide certification process for mental health peer providers by July 2022.

For now, however, peer respite staff members in California are not licensed or certified. Peer respites typically don’t offer clinical care or dispense psychiatric drugs, though guests can bring theirs. Peers share personal stories with guests but avoid labeling them with diagnoses. Guests must come — and can leave — voluntarily. Some respites have few restrictions on who can stay; others don’t allow guests who express suicidal thoughts or are homeless.

Peer respite is one of several types of programs that divert people facing behavioral health crises from the hospital, but the only one without clinical involvement, said Travis Atkinson, a consultant at TBD Solutions, a behavioral health care company. The first peer respites arose around 2000, said Laysha Ostrow, CEO of Live & Learn, which conducts behavioral health research.

The approach seems to be expanding. Live & Learn counts 33 peer respites today in the U.S., up from 19 six years ago. All are overseen and staffed by people with histories of psychiatric disorders. About a dozen other programs employ a mix of peers and laypeople who don’t have psychiatric diagnoses, or aren’t peer-led, Atkinson said.

Though she had stayed at Second Story several times over the past five years, McDermott hesitated to return during the pandemic. However, she felt reassured after learning that guests were required to wear a mask in common areas and get a covid test before their stay. To ensure physical distancing, the respite reduced capacity from six to five guests at a time.

During her two-week stay, McDermott played with the respite’s two cats and piano — activities she found therapeutic. But most helpful was talking to peers in a way she couldn’t with her mental health providers, she said. In the past, McDermott said, she had been involuntarily admitted to a psychiatric hospital after she expressed suicidal thoughts. When she shared similar sentiments with Second Story peers, they offered to talk, or call the hospital if she wanted.

“They were willing to listen,” she said. “But they’re not forceful about helping.”

By the end of the visit, McDermott said that she felt understood and her loneliness and suicidal feelings had waned. She started eating and taking her medications more consistently, she said.

The small number of studies on respites have found that guests had fewer hospitalizations and accounted for lower Medicaid spending for nearly a year after a respite stay than people with similar conditions who did not stay in a respite. Respite visitors spent less time in the hospital and emergency room the longer they stayed in the respite.

Financial struggles and opposition from neighbors have hindered the growth of respites, however. Live & Learn said that although five peer respites have been created since 2018, at least two others closed because of budget cuts.

Neighbors have challenged nearby respite placements in a few instances. Santa Cruz-area media outlets reported in 2019 that Second Story neighbors had voiced safety concerns with the respite. Neighbor Tony Crane told California Healthline that guests have used drugs and consumed alcohol in the neighborhood, and he worried that peers are not licensed or certified to support people in crisis. He felt it was too risky to let his children ride their bikes near the respite when they were younger.

In a written response, Monica Martinez, whose organization runs Second Story, said neighbors often target community mental health programs because of concerns that “come from misconceptions and stigma surrounding those seeking mental health support.”

Many respites are struggling with increased demand and decreased availability during the pandemic. Sherry Jenkins Tucker, executive director of Georgia Mental Health Consumer Network, said its four respites have had to reduce capacity to enable physical distancing, despite increased demand for services. Other respites have temporarily suspended stays because of the pandemic.

McDermott said her mental health had improved since staying at Second Story in June, but she still struggles with isolation amid the pandemic. “Holidays are hard for me,” said McDermott, who returned to Second Story in November. “I really wanted to be able to have Thanksgiving with people.”
trader32176
Posts: 1535
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Re: Pandemic Isolation / Loneliness

Post by trader32176 »

Study aims to halt further isolation of people aging with HIV during COVID-19 pandemic

1/11/21


https://www.news-medical.net/news/20210 ... demic.aspx


The School of Medicine at the University of California, Riverside, has received a grant aimed at halting further isolation of people aging with HIV during the COVID-19 pandemic.

The two-year, $245,000 grant from the multinational pharmaceutical company Merck will enable a study, starting later this month, involving the participation of people living with HIV, or PLWH, in Riverside County, Los Angeles, and the Tampa Bay area in Florida.

" This is a very timely study with enhanced isolation due to the COVID-19 pandemic. High levels of social isolation, anxiety, and depression during this pandemic differentiates PLWH from others. We are interested in finding out ways to keep people engaged with each other and with care while isolated and identifying low-intensity methods for reducing depression. Importantly, the idea for this study came from the HIV community itself and builds upon our previous PCORI-funded work engaging the community."

- Brandon Brown, Epidemiologist, Associate Professor, Department of Social Medicine, Population, and Public Health, and Principal Investigator

Brown said he will start the study by forming a steering committee composed of community members living with HIV in Riverside County, Los Angeles, and Tampa Bay. His team of researchers will partner with them and co-develop all study materials including initially helping the researchers characterize issues related to depression, isolation, and basic needs of people aging with HIV during the COVID-19 pandemic.

The researchers will develop ideas also for a virtual village, including whom the village will include, how it will connect PLWH with each other and providers, and what the most useful content would be for users.

"The virtual village, which will be accessible on smartphones and computers, will provide ample resources to participants," Brown said. "Seniors aging in place with HIV can log into the virtual village, connect with peers, share resources with one another, access providers and community-based organizations, and stay socially connected in this time where we are all physically distanced. The plan is to pilot the virtual village in a low-cost platform."

Brown explained the platform will be low-tech so people with older computers and limited technological skills can access it.

"We will create an initial platform and explore how it can be enhanced to make the virtual village more accessible and more user friendly," he said. "We are optimistic that people will use and build upon the virtual village to stay connected with peers, providers, and community-based organizations in different ways. Initially, we envision it will feature message boards, office hours with doctors, virtual meetings, telehealth, and a buddy system. Over time, participants will increase content to improve and strengthen the village. We're thinking: If they build it, they will use it."

This study will be conducted in close collaboration with Jerome Galea at the University of South Florida; Jeff Taylor and Christopher Christensen at the HIV + Aging Research Project--Palm Springs; and Annie Nguyen at the University of Southern California.

Source:

University of California - Riverside
trader32176
Posts: 1535
Joined: Fri Jun 26, 2020 5:22 am

Re: Pandemic Isolation / Loneliness

Post by trader32176 »

Young people experience the highest levels of loneliness during COVID-19 lockdown

1/19/21


https://www.news-medical.net/news/20210 ... kdown.aspx


People under 30 and people with a history of mental illness experience the highest levels of loneliness and anxiety during COVID-19 lockdown. Researchers from the University of Copenhagen and their international collaborators investigate how mental health is affected by the pandemic across Europe.

Fear of losing your job, worrying about you or a loved one getting sick, and online meetups with family and friends you have not seen for months. The COVID-19 lockdown has completely changed everyday life for most people around the world. Physical distancing is the new normal and an extremely important tool in the fight against the pandemic.

However, the effects of the lockdown on mental health are alarming - especially for young people under 30 and people with preexisting mental health issues. This is the conclusion of a new study from the University of Copenhagen, University College London, Sorbonne University, INSERM and the University of Groningen. The study builds on data from 200,000 citizens across Europe.

As part of the collaborative network COVID-Minds, researchers have collected and analyzed mental health data from four different countries (Denmark, France, the Netherlands and the UK) during the first lockdown in the spring and early summer of 2020.


" We have studied different mental health factors such as loneliness, anxiety and COVID-19 related worries. The highest levels of loneliness were observed amongst young people and people with preexisting mental health illness."

- Tibor V. Varga, Assistant Professor, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen

'Psychological stress is a prominent risk factor for future long-term and severe mental illness. Therefore, it is very important to know how lockdowns affect people, so we have a better chance of preventing long-term consequences.'

The researchers suggest that the subgroups identified by the study as particularly prone to experiencing loneliness and anxiety should be closely followed to prevent future challenges.

Mental health should be a concern parallel to containing the virus

The study consists of mental health data from 200,000 citizens from the four European countries during the first lockdown (March 2020 to June 2020). In all four countries, the highest levels of loneliness and anxiety were observed in March and early April, in the very beginning of the lockdown. These outcomes slowly subsided over the next few months as the countries gradually reopened.

Even though the four countries have had different approaches to handling the pandemic, it seems that the mental health reactions are quite similar and very important to take notice of to avoid long-term consequences.

'Mental health has emerged as a quite important parallel concern of this pandemic. While we of course need to contain the spread of the virus and deal with the obvious emergencies at hand, we also need to pay attention to the potential damaging psychiatric aftermath', says Professor Naja Hulvej Rod from Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen.

'People under 30 and people with a history of mental illness could benefit from tailored public-health interventions to prevent or counteract the negative effects of the pandemic'.

The research project 'Standing together - at a distance' continuously collects Danish data to track the mental health status and consequences during the COVID-19 pandemic. The assembled data from June 2020 until now confirm the results of the study: Lockdown has a negative impact on anxiety, loneliness and worries concerning COVID-19.

Source:


University of Copenhagen - The Faculty of Health and Medical Sciences

Journal reference:

Varga, T.V., et al. (2021) Loneliness, worries, anxiety, and precautionary behaviours in response to the COVID-19 pandemic: a longitudinal analysis of 200,000 Western and Northern Europeans. The Lancet Regional Health - Europe. doi.org/10.1016/j.lanepe.2020.100020.
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