Coronavirus: A Call to Arms Against the Loneliness Epidemic

Social connection is now more important than ever

Parneet Pal, M.B.B.S, M.S.
7 min readMar 20, 2020


Photo: Dia Dipasupil/Getty Images

HHow might we stay home, cancel everything, and practice social distancing, while coming out stronger and more resilient on the other side of the Covid-19 pandemic, or any other crisis for that matter?

The answer may lie in our innate survival need for belonging: a superpower capable of raising our collective global immunity and well-being. How is that possible, you ask?

Stress, immunity, and genes

The clue may be found in a particular pattern of gene expression in human immune cells called the Conserved Transcriptional Response to Adversity, or CTRA.

Simply put, our evolutionary ancestors overcame threats to their safety and well-being — think ominous predator in the wild — by turning on the fight-or- flight stress response. It’s the familiar feeling of our hearts racing, breath quickening, palms sweating, muscles tensing, and quick reflexes that enable us to get out of the way when we sense danger, like a car coming at us at top speed.

This is an appropriate and protective survival response. Once the predator was out of sight, our ancestors returned to the safety of their tribes, and their bodies relaxed back to the resting state — disengaging with the fight-or-flight stress response.

Cut to the 21st century.

Our predators look slightly different: workplace stress, social isolation, economic downturns, political uncertainty, and viral pandemics.

Our brains unfortunately can’t tell the difference between an alarming news report and a tiger in the wild. While our ancestors could escape the tiger, our 24/7 work culture, technology, and media chase us relentlessly. We engage the fight-or-flight response constantly and end up in a state of chronic stress. Nothing in this story is earth-shattering or unfamiliar so far.

But, the story takes an interesting turn at the molecular level.

A particular set of genes — in immune cells — respond to the chronic stress in a way that is called the CTRA. First, the production of inflammatory proteins is stepped up. While acute inflammation is a short-lived adaptive response of our body, which increases the activity of the immune system to fight injury or infection, chronic inflammation is maladaptive because it persists beyond the point of actual threat to the body. Second, the CTRA downregulates antiviral and antibody-related genes, thereby undermining resistance to viral infections. This is a key consideration in the context of viral pandemics.

Taken together, the CTRA has become the molecular signature for chronic stress and a sign of our times.

Loneliness worsens the cellular inflammation and compromises immunity — which then erodes health, and that, in turn, adds to social isolation.

A disconnect with self and others

Chronic stress has a particular aftermath in our daily lives.

Physically, the chronic inflammation in our cells is the starting point for lifestyle-related diseases such as diabetes, obesity, heart disease, some cancers, and autoimmune and mood disorders, among others.

Mentally and emotionally, we show up to our lives in perpetual motion: always “on,” distracted and anxious. We ruminate on past and future, losing sight of the present in front of us. This is a unique feature of the fight-or-flight brain’s survival mode: narrow vision, distanced from creativity, easily panicked, and looking for quick fixes. Our ability to make wise choices goes out the window, and we become captive to our habitual reactions and unconsidered reflexes– making lousy decisions for our health, business, and planet.

Socially, the self-focus of this survival mode often turns into selfishness (sanitizer and toilet paper hoarding during a viral pandemic, anyone?). Disconnected from our own well-being and values, it is no surprise we show less empathy and compassion for those around us. This “us versus them” mentality, distrust, and sense of separation then feeds into any existing social isolation and loneliness.

Loneliness: a silent and deadly epidemic

In a pandemic like Covid-19, self-quarantines, remote working, and the call for social distancing — while crucial for dealing with the virus — put us at risk for even greater isolation and loneliness.

But why should we even care about this?

Because loneliness kills. A cornerstone study revealed that a lack of social connection and support puts us at a greater risk for illness and death than smoking, obesity, alcohol, or lack of physical activity. Lonely people are more likely to suffer from high blood pressure, heart disease, depression, and dementia.

This should not be surprising given our discussion on chronic stress, immunity, and the CTRA. Belonging and connection are basic human needs for survival along with food, shelter, and safety. Our evolutionary ancestors trusted and depended on their tribes for protection and assistance. Finding yourself alone or isolated from the tribe signaled grave danger.

Therefore, today, when we find ourselves short of meaningful connections (loneliness is not about the quantity but the perceived lack of quality relationships), our bodies sense that same grave danger and go into self-preservation mode. Anxious and hypervigilant, we become overly sensitive to the responses of others.

This defensive stance raises distrust and hostility, and others perceive us as unapproachable, thus perpetuating and worsening our own loneliness. Loneliness and the CTRA propel, and are predictive of, each other even one year down the line. In other words, loneliness worsens the cellular inflammation and compromises immunity — which then erodes health, and that, in turn, adds to social isolation.

This is a sobering thought, given that 61% of Americans reported feeling lonely in a recent survey of 10,000 adults (71% of millennials, 79% of Gen Z and 50% of boomers felt lonely). In the workplace, remote workers were more likely to always or sometimes feel alone. Loneliness has also been shown to decrease job performance, creativity, engagement, and commitment to the organization.

By no means is this only an American phenomenon. Loneliness is rising globally, with the United Kingdom having gone so far as to appoint a Minister for Loneliness in 2017.

So, the question then becomes: In the middle of a crisis like the coronavirus pandemic, how might we emerge resilient, without worsening social isolation and loneliness?

Relying on the most valuable well-being asset we have — each other — let’s start a pandemic of belonging instead.

The wisdom of our biology

When we heed the call of our innate need for belonging and reach out, connect to, and care for others, our biology responds in kind.

Giving to others, volunteering, and being compassionate ironically helps us the most. We live longer, have stronger immune systems, and are happier and more satisfied with our lives. Strong social networks and relationships are a key factor in strengthening our resilience to bounce back quickly and adaptively from adversity.

And though our minds may report similar levels of happiness, our cells seem to discriminate between instances of hedonic well-being (self-gratification or self-focused pleasure) and eudaemonic well-being (self-transcendent actions connected to meaning, purpose, and contributing to the greater good). The response is illuminating: Our immune systems are stronger and the CTRA is downregulated only with eudaemonic well-being, not hedonic happiness.

It’s as if our bodies want to remind us of our interdependence as social beings. Our personal well-being is inextricably linked to those around us and our natural surroundings. When we distance ourselves or ignore our neighbor’s pain, we suffer the most. But when we care and collaborate with each other, our health improves.

Our biology, then, points us toward the best way to lead our lives.

Responding to crisis with the power of social connection and community

When we pause and look past the panic, we realize we are powerful. Even while working from home and engaging in physical distancing, we can take small or big steps to contribute to our collective well-being. Here’s how.

  • Practice impeccable physical hygiene as advised by medical experts, but don’t forget your mental and emotional hygiene. Take a few minutes for quiet time, reflection, and meditation. Mindfulness is especially powerful in health conditions that are stress sensitive. Not only does it turn down the CTRA and sympathetic nervous system that is on overdrive, but it also strengthens the rest-and-digest parasympathetic nervous system. This helps us relax, feel calm, and reconnect with our focus, creativity, empathy, and compassion. The fact that we are able to make wiser decisions in this mind state allows us to problem-solve effectively.
  • Use technology in a way that reflects our human values for caring and connection. Create and participate in online communities that support and give to each other. Text, call, or video-conference with friends and colleagues. Check in on elders (remember, they are doubly at risk from the virus and loneliness) in your family and neighborhoods. Get creative with your work teams and make time for virtual teas, meals, and celebratory gatherings.
  • Leverage the power of emotional contagion through social networks. Yes, panic spreads like wildfire, but so do positive emotions and acts of kindness. When we observe a kind act, we experience a burst of happiness termed “elevation.” This makes it more likely that we, in turn, and then our friends — up to three degrees of separation — will pay the kindness forward.

We have an unprecedented opportunity to upend our collective, isolating, business-as-usual. Let’s not let this crisis go to waste.

Relying on the most valuable well-being asset we have — each other — let’s start a pandemic of belonging instead.



Parneet Pal, M.B.B.S, M.S.

Harvard-trained physician-educator | Advancing personal and planetary health |