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pandemic paradox: loneliness keeps us safe, but at risk

isolation works in stopping the spread of covid-19, but loneliness is really, really bad for our health.

the pandemic paradox: loneliness keeps us safe, but at risk
the findings provided the first indication that a social risk factor (perceived social isolation) could increase inflammation and decrease antiviral and antibody-related gene expression in our bodies’ cells. getty
it’s one of the great paradoxes of the pandemic: social distancing — the very thing that’s keeping us from getting covid-19 — may actually be making us more susceptible to it.

“our social life builds our immunity,” says susan pinker, montreal psychologist and author of  the village effect . “we’re between a rock and a hard place. essentially, what’s good for us in terms of living a connected life…is bad for us in terms of infection transmission.”

the lonely have higher inflammation

steve cole, a genomics professor and researcher at ucla, began researching the biological effects of loneliness 15 years ago with the late john cacioppo, a social neuroscience professor at the university of chicago. in their first study , the researchers compared how genes are expressed in the immune cells of lonely people with those of highly social ones.

“the lonely people had way higher levels of inflammatory genes and way lower levels of antiviral genes,” he says. “it was the biggest signal i’ve ever seen in any human samples anywhere.
“it was just so clear and so striking, but also, frankly, terrifying because i hadn’t really taken loneliness that seriously.”
the findings provided the first indication that a social risk factor (perceived social isolation) could increase inflammation and decrease antiviral and antibody-related gene expression in our bodies’ cells.

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“the paper hit the mainstream…. i would get all these emails from people saying, ‘you know, i’m so thankful that you guys are doing this research,’” says cole, and then they would share their own experiences about how loneliness affected their physical health.
“people would just really express a very deep, sometimes painful, appreciation for the work we were doing,” he says.

cole, cacioppo and colleagues repeated these findings time and time again and identified the cellular mechanisms of how it happens — that social adversity consistently activates a “conserved transcriptional response to adversity” (ctra) process in our bodies that increases the expression of genes that promote inflammation and decreases the expression of antiviral and antibody-related genes.

cole explains that our evolutionary history sets off an alarm when we’re apart from our tribe. “togetherness is the most defining feature of human beings as animals…. this is the reason we don’t get eaten by all kinds of things bigger, better and stronger than us,” he says.
“so the flip side is that if you are a fundamentally togetherness-based organism and you suddenly lack togetherness, you’re about as naked and dead as possible. you’re going to get eaten…. the thing to know about loneliness is it’s a surprisingly strong danger signal for the human brain.”

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this “signal” is part of the reason that social isolation triggers a social craving with a similar neural signature on brain imaging to hunger.

“loneliness, as john [cacioppo] described it, is basically a hunger to reconnect with the food of social life,” says cole.
it’s a concept that makes perfect sense, according to pinker.
“it feels like hunger or thirst or lack of sleep might because it’s a biological need,” says pinker. “so according to our human brains, we’ve evolved to need this social contact…and if we don’t get it, our bodies are going to let us know.”
cole describes the effect of this danger signal like this: the danger signal sets off a stress response that signals to every tissue —including immune cells — in our bodies to favour inflammation and sacrifice antiviral response to get ready for a wounding injury, says. “i’m about to be injured, stop doing what i’m doing now and pivot towards inflammation…and sacrifice antiviral activity…. you can fight the virus another day.”
this system works well if what you are fighting is a sabre-toothed tiger, says cole, but not if the threat is a virus such as covid.
it’s also problematic when the threat is ongoing. cole’s research shows that chronic loneliness worsens our risk of inflammatory-mediated diseases such as heart disease, alzheimer’s, cancer and many other illnesses.

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“if what frightens you is…the constant low-grade drizzle of threats to our security that characterizes modern life, if that’s going on every day and not just on rare occasions, and then you’re feeling lonely, disconnected, mistrusting and disenfranchised from the rest of humanity every day…
“all of that kind of chronic threat signalling is constantly undermining this kind of optimal antiviral stance and ramping up this inflammatory biology,” he says.
social isolation lowers survival

julianne holt-lunstad, a researcher and professor at brigham young university in provo, utah, studied these broader health effects of social isolation by reviewing 148 studies on the topic in 2010. she found a 50 per cent decreased likelihood for all-around survival for people who were socially isolated, compared with those with stronger social ties. social isolation exceeded the health risks associated with obesity, inactivity, heavy drinking, air pollution and smoking 15 cigarettes a day.

loneliness doesn’t just have profound health consequences, it’s also really uncomfortable.

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but what do we do about it right now, when we need to stay apart to keep each other safe?
“i’m not going to say, ‘don’t believe those public health people; get together and have parties.’ … we have to listen to public health,” pinker says.


but she also notes the we need to be creative to stay socially connected even while staying physically apart.

while connecting with others virtually doesn’t compare to in-person contact, pinker describes it as a spare tire that can get us to the other side of the pandemic. “the vaccine is really going to be the saving grace, ultimately. but in the meantime, we need a spare tire in the form of all the electronic and phone communication that we can muster,” she says.
lonely, but okay

part of this “spare tire” is finding purpose in your life. in 2015, cole began studying whether someone’s sense of purpose and meaning in life – a well-researched resiliency factor — could protect against the negative health effects of loneliness. like his other studies, he found that loneliness increased crta gene expression (the increased expression of pro-inflammatory genes and decreased expression of antiviral genes), but the opposite was true for people who reported purpose and meaning in life. surprisingly, the negative effects of being lonely were completely reversed when people reported meaning and purpose in life, despite still being lonely.

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“what seems to work best is getting people to focus on something they care about in life. something aspirational and generative, and then getting them to essentially collaborate with others in bringing about this desired value,” he says.
a sense of purpose shifts our brains away from the threat response towards a different neural network of “hoping, seeking, and wanting neurobiology — one of the few circuits in the brain that seems to be able to elbow aside threat signalling,” says cole. “so, there’s something about going after what you really care about that’s even more powerful than avoiding what you’re afraid of.”
one project he is currently studying is an intergenerational mentoring program in los angeles where isolated older adults go to local schools to help as teacher’s aides for children who come from challenging home environments. “this kind of project done over a nine-month school year is really impressive in terms of its impact on not only boosting antiviral biology and clamping down some of that inflammatory biology, but [also] having a great impact on psychological and social wellbeing,” cole says.

in his famous book,  man’s search for meaning , austrian physician viktor frankl famously documented how his focus on purpose and meaning allowed him to survive the torturous conditions as a prisoner of the nazi concentration camps that killed his wife, brother, father and mother. “those who have a ‘why’ to live, can bear with almost any ‘how,’” he wrote.

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cole agrees.
“working to help those who need help even more than you do can turn out to be the best recipe for helping yourself.”
joanna cheek is a fellow in global journalism at the dalla lana school of public health at the university of toronto.
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