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      Loneliness Progression Among Older Adults During the Early Phase of the COVID-19 Pandemic in the United States and Canada

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          Abstract

          Objectives

          Older adults are at high risk for complications from coronavirus disease 2019 (COVID-19). Health guidelines recommend limiting physical contact during the pandemic, drastically reducing opportunities for in-person social exchange. Older adults are also susceptible to negative consequences from loneliness, and the COVID-19 pandemic has likely exacerbated this age-related vulnerability.

          Methods

          In 107 community-dwelling older individuals (65–90 years, 70.5% female) from Florida, the United States, and Ontario, Canada, we examined change in loneliness over the course of the pandemic after implementation of COVID-19-related physical distancing guidelines (March–September 2020; T1–T5; biweekly concurrent self-report) using multilevel modeling. We also explored gender differences in loneliness during the early phase of the COVID-19 pandemic at both data collection sites.

          Results

          Consistent across the 2 sites, levels of loneliness remained stable over time for the full sample (T1–T5). However, our exploratory moderation analysis suggested gender differences in the trajectory of loneliness between the United States and Canada, in that older men in Florida and older women in Ontario reported an increase in loneliness over time.

          Discussion

          Leveraging a longitudinal, binational data set collected during the early phase of the COVID-19 pandemic, this study advances understanding of stability and change in loneliness among a North American sample of individuals aged 65 and older faced with the unique challenges of social isolation. These results can inform public health policy in anticipation of future pandemics and highlight the need for targeted intervention to address acute loneliness among older populations.

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          Most cited references41

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          Mental Health Consequences during the Initial Stage of the 2020 Coronavirus Pandemic (COVID-19) in Spain

          Highlights: • The 18.7% of the sample (N=3480) revealed depressive symptomatology, the 21.6% anxiety and the 15.8% posttraumatic stress disorder symptoms. • Being in the older age group, having economic stability and receiving adequate information about the pandemic were negatively related to the symptomatology. • Female gender, previous diagnoses of mental health problems or neurological disorders, having symptoms associated with the virus, or those with a close relative infected were associated with greater symptomatology. • Spiritual well-being was a common protector for all symptomatology and the loneliness a predictor.
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            Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study

            Summary Background The isolation of symptomatic cases and tracing of contacts has been used as an early COVID-19 containment measure in many countries, with additional physical distancing measures also introduced as outbreaks have grown. To maintain control of infection while also reducing disruption to populations, there is a need to understand what combination of measures—including novel digital tracing approaches and less intensive physical distancing—might be required to reduce transmission. We aimed to estimate the reduction in transmission under different control measures across settings and how many contacts would be quarantined per day in different strategies for a given level of symptomatic case incidence. Methods For this mathematical modelling study, we used a model of individual-level transmission stratified by setting (household, work, school, or other) based on BBC Pandemic data from 40 162 UK participants. We simulated the effect of a range of different testing, isolation, tracing, and physical distancing scenarios. Under optimistic but plausible assumptions, we estimated reduction in the effective reproduction number and the number of contacts that would be newly quarantined each day under different strategies. Results We estimated that combined isolation and tracing strategies would reduce transmission more than mass testing or self-isolation alone: mean transmission reduction of 2% for mass random testing of 5% of the population each week, 29% for self-isolation alone of symptomatic cases within the household, 35% for self-isolation alone outside the household, 37% for self-isolation plus household quarantine, 64% for self-isolation and household quarantine with the addition of manual contact tracing of all contacts, 57% with the addition of manual tracing of acquaintances only, and 47% with the addition of app-based tracing only. If limits were placed on gatherings outside of home, school, or work, then manual contact tracing of acquaintances alone could have an effect on transmission reduction similar to that of detailed contact tracing. In a scenario where 1000 new symptomatic cases that met the definition to trigger contact tracing occurred per day, we estimated that, in most contact tracing strategies, 15 000–41 000 contacts would be newly quarantined each day. Interpretation Consistent with previous modelling studies and country-specific COVID-19 responses to date, our analysis estimated that a high proportion of cases would need to self-isolate and a high proportion of their contacts to be successfully traced to ensure an effective reproduction number lower than 1 in the absence of other measures. If combined with moderate physical distancing measures, self-isolation and contact tracing would be more likely to achieve control of severe acute respiratory syndrome coronavirus 2 transmission. Funding Wellcome Trust, UK Engineering and Physical Sciences Research Council, European Commission, Royal Society, Medical Research Council.
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              The trajectory of loneliness in response to COVID-19.

              Social distancing and ‘stay-at-home’ orders are essential to contain the coronavirus outbreak (COVID-19), but there is concern that these measures will increase feelings of loneliness, particularly in vulnerable groups. The present study examined change in loneliness in response to the social restriction measures taken to control the coronavirus spread. A nation-wide sample of American adults ( N = 1,545; 45% women; age 18 to 98, M = 53.68, SD = 15.63) was assessed on three occasions: in late-January/early-February 2020 (before the outbreak), in late-March (during the President’s initial ‘15 Days to Slow the Spread’ campaign), and in late-April (during the ‘stay-at-home’ policies of most states). Contrary to expectations, there were no significant mean-level changes in loneliness across the three assessments ( d = .04, p > .05). In fact, respondents perceived increased support from others over the follow-up period ( d = .19, p < .01). Older adults reported less loneliness overall compared to younger age groups but had an increase in loneliness during the acute phase of the outbreak ( d = .14, p <.05). Their loneliness, however, leveled off after the issuance of stay-at-home orders. Individuals living alone and those with at least one chronic condition reported feeling lonelier at baseline but did not increase in loneliness during the implementation of social distancing measures. Despite some detrimental impact on vulnerable individuals, in the present sample, there was no large increase in loneliness but remarkable resilience in response to COVID-19.
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                Author and article information

                Contributors
                Role: Decision Editor
                Journal
                J Gerontol B Psychol Sci Soc Sci
                J Gerontol B Psychol Sci Soc Sci
                geronb
                The Journals of Gerontology Series B: Psychological Sciences and Social Sciences
                Oxford University Press (US )
                1079-5014
                1758-5368
                April 2022
                14 December 2021
                14 December 2021
                : 77
                : 4
                : e23-e29
                Affiliations
                [1 ] Department of Psychology, University of Florida , Gainesville, Florida, USA
                [2 ] Department of Epidemiology, University of Florida , Gainesville, Florida, USA
                [3 ] Department of Psychology, York University , Toronto, Ontario, Canada
                [4 ] Department of Neurology and Neurosurgery, McGill University , Montreal, Quebec, Canada
                Author notes
                Address correspondence to: Tian Lin, PhD, Department of Psychology, University of Florida, Gainesville, FL 32611, USA. E-mail: lintian0527@ 123456ufl.edu

                Share first authorship.

                Author information
                https://orcid.org/0000-0002-2705-7520
                Article
                gbab229
                10.1093/geronb/gbab229
                8974322
                34905015
                64122b37-5b90-4e36-b15f-dc668262eccb
                © The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

                This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                History
                : 26 March 2021
                : 01 December 2021
                : 17 January 2022
                Page count
                Pages: 7
                Funding
                Funded by: National Institute on Aging, DOI 10.13039/100000049;
                Award ID: 1R01AG057764
                Award ID: R01AG068563
                Funded by: National Institutes of Health, DOI 10.13039/100000002;
                Funded by: Natural Science and Engineering Research Council of Canada;
                Funded by: National Institute on Drug Abuse, DOI 10.13039/100000026;
                Award ID: T32DA035167
                Categories
                THE JOURNAL OF GERONTOLOGY: Psychological Sciences
                Virtual Collection: Covid-19 and Aging 2.0
                AcademicSubjects/SOC02600
                AcademicSubjects/SCI02100

                Geriatric medicine
                aging,gender,longitudinal,physical distancing,social isolation
                Geriatric medicine
                aging, gender, longitudinal, physical distancing, social isolation

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