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Finally, we need to examine the effects of social isolation itself. Beyond the fact that social isolation prevents the natural exchange of microbes that occur between humans engaging in social contact, it should be noted that social isolation is directly thought to lead to increased all-cause mortality due to worsened health outcomes across pretty much every dimension that we can examine. One review (https://www.pnas.org/content/pnas/110/15/5797.full.pdf) of the impacts of social isolation and loneliness in older adults concludes that “mortality was higher among more socially isolated and more lonely participants. However, after adjusting statistically for demographic factors and baseline health, social isolation remained significantly associated with mortality (hazard ratio 1.26, 95% confidence interval, 1.08–1.48 for the top quintile of isolation), but loneliness did not (haz-ard ratio 0.92, 95% confidence interval, 0.78–1.09). The association of social isolation with mortality was unchanged when loneliness was included in the model”.
It’s now popular to refer to what was previously called “social distancing” as “physical distancing” to note the fact physical distancing does not necessarily lead to loneliness; this is because loneliness can (perhaps) be mitigated to a limited extent by usage of social media and videoconferencing. Troublingly, we can see that it is the social isolation itself, and not the emotional feeling of loneliness, that is associated with death, and thus we can surmise, at least in older adults (but almost certainly in the broader population as well), that the widespread recommendations of social isolation (“stay at home”, “social distancing”, etc) will lead to increased all-cause mortality.
Finally, we wish to highlight that a small increase in all-cause mortality amidst the general population due to social isolation could very easily dwarf COVID-19-associated mortality, which as we have discussed is primarily constrained to a very limited subset of the population.