The Pandemics within the Pandemics

The global COVID19 pandemic has sent billions of people into seclusion and isolation. This certainly has had a cascade effect in accelerating emotional isolation, loneliness, and lethargy. But even before the pandemic hit, the world was already in a sinking ship of emotional and social disconnectedness. Most of the world entered this pandemic with a booming economy, but the winds of change were already present. Banks were closing branch offices at an astonishing rate (1700 branches last year),[1] live entertainment, cinema, and sports attendance was significantly reduced. [2],[3],[4]   People do not spend time with friends and family or know their neighbors as they did in bygone years. Society was already “social distancing” long before the coronavirus arrived.

The life expectancy for Americans has dropped for the third year in a row,[5] driven by the self-inflicted inclination for drug overdoses and suicide. Even before this pandemic struck, the number of lonely people was on the rise.  Social isolation and loneliness may be a larger threat to public health than obesity[6] or smoking. There are several pandemics which have risen like opportunistic pathogens in the wake of the COVID19 pandemic.  It is possible that these concurrent conditions will reduce the life expectancy of many people who survive the COVID19 pandemic, possibly by years.  The following is a compilation of some of these concurrent maladies.

Depression

Social isolation and loneliness combined with fear and increased alcohol and drug use will certainly increase the number of people suffering from depression. Depression brings with it self-destructive behaviors such as excessive alcohol consumption, drug use, and suicidal thoughts and tendencies.

Intellectual Atrophy

Social media has actually segregated people into homogenous groups. Social media and the news networks divide individuals into groups that think just like they do, and thus eliminate the intellectual workouts of self-reflection and self-assessment. People are becoming intellectually lazy. This pandemic within the pandemic is intellectual atrophy.  Atrophy is a word that implies the loss of strength due to disuse.  People need to interact with people who think differently than they do.  If a person only interacts with people who agree with their religion, philosophy, or political persuasion, then they are in danger of developing intellectual atrophy.  

Osteoporosis

Bone strength results from challenge and adaptation. If people do not consistently place a stressful load on their bones, they lose substance and weaken. Sitting at home will cause bone weakening in most people, but especially in the elderly. Since it is hard to regain bone strength after it is lost, particularly in the elderly, there may be a rise in hip fractures and other bony injuries in the coming years.

Sarcopenia

While the word osteoporosis has entered the lexicon of most of the English-speaking world, sarcopenia is a newly introduced word. It is a term which suggests the progressive decline of muscle mass, frequently attributed to the effects of aging. Muscle mass plays a considerable role in health. Not only is it important for mobility, but it also has important roles in glucose metabolism and cardiovascular health, including regulating blood pressure.

Inactivity or a reduction in muscular challenge will result in a loss of muscle mass. Loss of muscle strength and mass (sarcopenia) has a direct effect on the quality and quantity of a person’s years.

Dementia

Loneliness contributes to the loss of cognitive dexterity and contributes to dementia.[7]  With millions of seniors in isolation, and many of them with some degree of cognitive decline already, anticipate an increase in clinical levels of dementia in that population as this extended period of isolation progresses.

Malnutrition

Many school-aged children in economically depressed communities rely on school lunch programs to obtain proper nutrition. With the suspension of school, there is a reduction in subsidized meal programs for those enduring economic hardships. Not only the poor, but also the elderly are at risk for malnutrition. They are already more predisposed to inadequate caloric or food intake, poor food choices, and the inability to shop for or prepare food.[8] These factors are now compounded by the current situation.

Substance Abuse

People stuck at home during the COVID crisis are both bored and anxious. This is a recipe for substance abuse. In the United States, “off-premise” alcohol consumption was elevated by 55% in late March 2020.[9]  The longer this isolation persists, and the more people become absorbed with the negative news stories, the greater this problem will be.

Domestic Abuse

Domestic abuse increases when families are confined together. Reports from around the world are showing that the world is facing a pandemic of domestic violence.  The stew of confined living spaces, uncertain economic outlook, and a reduction in emotional and physical outlets, combine to heighten tensions and place the vulnerable at greater risk.

Cardiovascular Disease

A sedentary lifestyle affects cardiovascular health in many ways. The rate at which cardiovascular health diminishes with inactivity is astounding. Loss of movement will certainly accelerate the decline of cardiovascular health of those with a propensity toward cardiovascular disease, but anyone who is sedentary can expect a decline in cardiovascular fitness as well.

Obesity

It appears that obese patients are having some of the worst outcomes and more severe complications when they contract the COVID virus.[10] Ironically, the inactivity, constant access to food, and increased alcohol consumption will most likely lead to weight gain, one of the most predisposing factors for a negative outcome in COVID patients.  

Solutions are Multifactorial

Fortunately, solutions exist for most of these conditions. 

Reject passivity. The primary prevention method is for individuals to take an active role in their own health and scope of influence. Do not passively accept this time as a time of social and physical isolation; be proactive. Exercise, engage in social activities [while maintaining proper protective measures], get outside, and make a concerted effort to eat properly and drink responsibly.  

Engage socially with others, even those with different opinions, and keep it friendly. Accept their differences while maintaining a cordial relationship with them.  Everyone needs social interaction and engagement, but that engagement should not become a source of stress. Engage them on topics of mutual interest. Do not engage in discussing who is to blame for what is happening. Use technology and find new ways to connect. There are many ways to communicate with both audio and video interactions.  Avoid watching the news obsessively and interacting negatively on social media.

For those who cannot think of anything else to do, go for a walk. Walking stimulates neuronal activity, preserves muscle and bone strength, pumps lymph fluid, and supports cardiovascular health and a positive mental attitude. Walking outside will also provide a boost in vitamin D levels. Walking helps almost everything mentioned in this article.

Finally, look out for others. Encourage those who interact within the same social spheres of influence to walk and to socially engage. Reach out to shut-ins and talk to them. Ensure that family and friends are eating correctly. By being a source of light in this dark time, an individual will not only help others, but also improve their own mental health. Albert Schweitzer may have said it best:

"I don't know what your destiny will be, but one thing I know: the only ones among you who will be really happy are those who have sought and found how to serve." 

William E. Morgan is president of Parker University in Dallas, Texas.  He has served as a consultant to the medical departments in the U.S. Capitol and the White House.

About Parker University: 

Parker University (Parker.edu) was founded in 1982 by Dr. James W. Parker, DC, originally as Parker College of Chiropractic. In 2011, the name was changed as its curriculum expanded. Today, Parker University has 1,600 students and 29 academic programs, including its famed chiropractic program along with master’s degrees in neuroscience, clinical neuroscience, and functional nutrition. Currently, Parker University’s chiropractic cohort is the second largest of any campus in the world. 

[1] https://www.wsj.com/articles/banks-double-down-on-branch-cutbacks-1517826601

[2] https://www.usatoday.com/story/sports/mlb/2018/10/02/mlb-attendance-down-4-percent-as-6-ballparks-set-lows/38023565/

[3] https://www.wsj.com/articles/college-footballs-growing-problem-empty-seats-1535634001

[4] https://variety.com/2018/digital/news/global-box-office-hits-record-40-6-billion-in-2017-u-s-attendance-lowest-in-23-years-1202742991/

[5] https://abcnews.go.com/US/us-life-expectancy-drops-3rd-year-row-fueled/story?id=59489724

[6] https://www.sciencedaily.com/releases/2017/08/170805165319.htm

[7] https://www.ncbi.nlm.nih.gov/pubmed/30914351

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396084/

[9] https://www.healio.com/primary-care/infectious-diseases/news/online/%7B79dee5a1-efaf-4522-bf7a-19941f68b422%7D/alcohol-consumption-during-covid-19-pandemic-what-pcps-need-to-know

[10] https://www.nature.com/articles/s41574-020-0364-6