The stark health and well-being impacts of 'cocooning' on older people

Findings of a new study outline the health impacts faced by older people in the US while cocooning during the COVID-19 pandemic. The same findings would apply to other countries experiencing the COVID pandemic. The study was published in the Quarterly Journal of Medicine.

Cocooning involves staying at home and reducing face-to-face interaction with other people and is an important part of the response to the COVID-19 pandemic, with an overall aim to prevent transmission to vulnerable older people. However, concerns exist regarding the long-term adverse effects it may have on their physical and mental health.

The research examines trends in physical and mental health, access to healthcare services and attitudes to COVID-19 while cocooning amongst people aged 70 years or more who did not contract COVID-19.

Among the key findings by the researchers:

• Almost 40% of participants reported that their mental health was worse or much worse since the start of cocooning.
• Over 57% of participants reported loneliness at least some of the time while cocooning with 1 in 8 reporting that they were lonely ‘very often’. Participants were almost twice as likely to report loneliness if they lived alone.
• Over 40% of participants reported a decline in their physical health since cocooning and 1 in 5 reported not leaving their house at all since being advised to cocoon.
• Despite this, over 60% of participants reported that they agreed with the government advice regarding cocooning while one quarter of participants reported that they did not agree with the advice.
• Almost 1 in 6 participants reported that while cocooning they did not seek medical attention for an illness, when they otherwise would have done so. Half of those who did not seek medical attention said this was because they were afraid of catching COVID-19.

What the researchers say: “These findings highlight the potential secondary impact of the COVID-19 pandemic on older people,” said the lead author. “While cocooning is important and reduces the likelihood of older people becoming unwell with COVID-19, there may be important adverse impacts on the health of those who cocoon that also need to be addressed. Given the possibility of further waves of COVID-19, with the likelihood of ongoing restrictions despite the rollout of vaccines, clear policies and advice for older people around strategies to maintain social engagement, manage loneliness and continue physical activity should be a priority.”

The researchers concluded: “It is a particular worry that 1 in 6 older people who were acutely unwell did not seek medical attention, often for fear of contracting COVID-19. We must give a clear message to older people that when you are unwell you should seek medical attention and that hospitals and general practices have appropriate infection control practices in place and continue to deal with non-COVID-19 related medical issues.”

So, what? Humans are, perhaps, the most socially dependent species on earth. We are designed to be surrounded by a nexus of supportive relationships. Prior research has shown that without regular and meaningful social contact our system begins the process of dying—we become more open to disease, to infection, to dementia, to depression and even to suicide.

And the really scary part of this is that the process can begin within 72 hours of lack of contact.

It’s vital, it seems to me, that as vaccination of younger adults becomes more pervasive, that they reach out to the older population to offer contact and support. Particularly, as it would seem, that at least some of the vaccines now being given or coming soon do not work that well in elderly persons and therefore the senior portion of the population may have to self-isolate for far longer than their younger brethren.