Dealing with loneliness during the pandemic

Sheltering at home is anti-instinctual behavior. Yet doing so saves lives.

man looking out from Staten Island Ferry

Tremaine Fredericks rides on an empty Staten Island Ferry to Manhattan on March 24, 2020 in New York City.

Photo by Spencer Platt/Getty Images
  • Mental health disorders are on the rise during the COVID-19 pandemic.
  • Lack of social contact is anti-instinctual behavior for humans, yet it is needed during this particular crisis.
  • How we cope with social distancing and sheltering at home will in large part dictate how long this crisis lasts.

There have been many comparisons between the COVID-19 pandemic and previous historical incidents. Obviously, the last great flu pandemic of 1918-19 has been receiving a lot of attention. There's also quantitative comparisons. Pundits compare this pandemic death toll to wars and terrorist attacks. This week, America surpassed the death toll in Vietnam. In previous weeks, rates were compares to the War in Afghanistan and 9/11.

Comparing a virus to a war isn't fair, though the headlines can be forgiven. We're trying to wrap our heads around the enormity of tragedy. One feature of consciousness is qualia, instances of subjective experience. In order to understand something—say, a glass of wine—we relate to it by stating "this is like this." This Bordeaux smells like peppercorn and chocolate. Comparison gives us a point of reference in an effort to understand concepts. We do it with everything.

While death tolls are one thing, conditions on the ground are entirely different. Consider 9/11. During the months following that day, New Yorkers were more likely to say hello to random passerby on the street. There was an uptick in kindness and charity. People were present for one another on an unprecedented scale. There was a real feeling of "we're in this together."

Feeling like you're a part of something requires presence, which is exactly what's lacking as we shelter at home. Even on 9/11, as I walked from downtown Manhattan to my girlfriend's apartment in the Upper East Side—I lived in Jersey City and had no way of returning home—I would stop to talk to people on the street. We were able to look one another in the eyes. Life was briefly upended, sure, but we could still physically be there for one another. We could even touch each other.

Why loneliness is a danger to individuals and societies | Andrew Horn

Lack of contact is driving loneliness during this pandemic. Health care workers are experiencing an increase in mental health conditions. Being on the front lines is emotionally taxing. But those forced to shelter at home, especially when living alone, are also facing increased anxiety and depression.

An avoidance of social contact is an evolutionary mismatch, argue three researchers in a recent essay published in the journal, Current Biology. Evolutionary biology dictates that we come together during times of crisis. We're social animals. The inability to make contact is frustrating and leads to trauma as self-isolation persists.

The authors (Guillaume Dezecache, Chris Frith, and Ophelia Deroy) write that the media is driving narratives counter to natural behavior. During tragedies, we tend to want to help others more than take care of ourselves. Empathy is our biological inheritance. The media, they write, has adopted a Hobbesian view of the world: every man for himself.

The focus on irrational hoarding of supplies is one example. While running from a fire is a natural reaction to danger, they note that our intuitive responses are cooperation, not selfishness. News outlets perpetuate problems by homing in on aberrant behavior. In fact, they drive the problem. We believe supplies are running short, creating this Hobbesian mentality: I must hoard as well.

This mindset seems worse in cities. As they write,

"In all likelihood, the mismatch between our misperception of the severity of the threat and its consequences is likely to become even more destructive in dense urban areas in which social isolation is a costly good."

man on Staten Island Ferry

A man rests on an empty Staten Island Ferry on March 24, 2020 in New York City.

Photo by Spencer Platt/Getty Images

Then there's the flip side: refusing to social distance or shelter at home. Because the threat is invisible we tend to downplay the risks. This is in stark contrast to 9/11, in which more fearful minds associated any Muslim with terrorism. Fortunately, this trend was relatively rare in New York City, though anti-Islam sentiments exploded across the nation, usually in regions with less diverse cultures.

Sine we cannot see this virus, and therefore don't necessarily understand how it's transmitted or concern ourselves much if we're not in a high-risk group, we don't take precautions. The short-term benefit of contact might, however, fuel the long-term detriment of increased hospitalization and death.

Nonchalance isn't the only reason for such behavior. It might be something much more ingrained in us.

"It is because our infection-avoidance mechanisms are overwhelmed by a much stronger drive to affiliate and seek close contact."

As the authors conclude, the more we can stave off loneliness for the greater good of society—at-risk populations, such as the elderly and immunodeficient; health care workers; supply chains providing hospitals with necessary resources; workers contracted to produce those supplies—dictates how we emerge on the other side of this pandemic.

Sadly, there is no easy response. Collectively we're facing a range of terrible outcomes. The best we can do is strive for the least tragic result. We passed 60,000 deaths in America today. How high that number climbs is in large part in our hands, yet keeping it low requires anti-instinctual behavior. That conundrum is shaping what our society will look like in the future.

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Stay in touch with Derek on Twitter and Facebook. His next book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."

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Credit: National Cancer Institute via Unsplash
Technology & Innovation

This article was originally published by our sister site, Freethink.

For the first time, researchers appear to have effectively treated a genetic disorder by directly injecting a CRISPR therapy into patients' bloodstreams — overcoming one of the biggest hurdles to curing diseases with the gene editing technology.

The therapy appears to be astonishingly effective, editing nearly every cell in the liver to stop a disease-causing mutation.

The challenge: CRISPR gives us the ability to correct genetic mutations, and given that such mutations are responsible for more than 6,000 human diseases, the tech has the potential to dramatically improve human health.

One way to use CRISPR to treat diseases is to remove affected cells from a patient, edit out the mutation in the lab, and place the cells back in the body to replicate — that's how one team functionally cured people with the blood disorder sickle cell anemia, editing and then infusing bone marrow cells.

Bone marrow is a special case, though, and many mutations cause disease in organs that are harder to fix.

Another option is to insert the CRISPR system itself into the body so that it can make edits directly in the affected organs (that's only been attempted once, in an ongoing study in which people had a CRISPR therapy injected into their eyes to treat a rare vision disorder).

Injecting a CRISPR therapy right into the bloodstream has been a problem, though, because the therapy has to find the right cells to edit. An inherited mutation will be in the DNA of every cell of your body, but if it only causes disease in the liver, you don't want your therapy being used up in the pancreas or kidneys.

A new CRISPR therapy: Now, researchers from Intellia Therapeutics and Regeneron Pharmaceuticals have demonstrated for the first time that a CRISPR therapy delivered into the bloodstream can travel to desired tissues to make edits.

We can overcome one of the biggest challenges with applying CRISPR clinically.

—JENNIFER DOUDNA

"This is a major milestone for patients," Jennifer Doudna, co-developer of CRISPR, who wasn't involved in the trial, told NPR.

"While these are early data, they show us that we can overcome one of the biggest challenges with applying CRISPR clinically so far, which is being able to deliver it systemically and get it to the right place," she continued.

What they did: During a phase 1 clinical trial, Intellia researchers injected a CRISPR therapy dubbed NTLA-2001 into the bloodstreams of six people with a rare, potentially fatal genetic disorder called transthyretin amyloidosis.

The livers of people with transthyretin amyloidosis produce a destructive protein, and the CRISPR therapy was designed to target the gene that makes the protein and halt its production. After just one injection of NTLA-2001, the three patients given a higher dose saw their levels of the protein drop by 80% to 96%.

A better option: The CRISPR therapy produced only mild adverse effects and did lower the protein levels, but we don't know yet if the effect will be permanent. It'll also be a few months before we know if the therapy can alleviate the symptoms of transthyretin amyloidosis.

This is a wonderful day for the future of gene-editing as a medicine.

—FYODOR URNOV

If everything goes as hoped, though, NTLA-2001 could one day offer a better treatment option for transthyretin amyloidosis than a currently approved medication, patisiran, which only reduces toxic protein levels by 81% and must be injected regularly.

Looking ahead: Even more exciting than NTLA-2001's potential impact on transthyretin amyloidosis, though, is the knowledge that we may be able to use CRISPR injections to treat other genetic disorders that are difficult to target directly, such as heart or brain diseases.

"This is a wonderful day for the future of gene-editing as a medicine," Fyodor Urnov, a UC Berkeley professor of genetics, who wasn't involved in the trial, told NPR. "We as a species are watching this remarkable new show called: our gene-edited future."

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