We are all in a somewhat surreal and unsettling situation; what began as an item of some news interest in China has inexorably become increasingly relevant for Malta, caught between the distressing news coming out of Italy and the relative nonchalance still evident in other countries, near and far.

For every video of youngsters thumbing their noses at contagion with the arrogance and sense of invulnerability of youth, we are sobered by news of the disproportionate susceptibility of the elderly and those with chronic medical conditions to the coronavirus. And especially since the older generations are the source of love, tenderness, family values and wisdom for our children. For many of us the elderly in our lives are our moral compass, our rational mind as well as the repository of our memories, our culture and our social conscience. Naturally would like to protect them from suffering and illness. Unfortunately, as well all know too well, the only means we have of keeping vulnerable people safe is to interrupt the chains of physical human contact.

And yet this simple directive leads to cascading consequences. For years, the experience of social isolation has been recognised as a major public health problem, and the elderly taken as a group have always been more likely, due to a variety of reasons, to suffer social isolation, which in turn is linked to emotional disorders (depression and anxiety), dementia, suicide, heart disease, cancer and susceptibility to infectious diseases. One report calculated the longer-term health effects of social isolation is equivalent to that of smoking 15 cigarettes a day.

Thus, as a society, we should be aiming for responsible social distancing, while all are doing our bit to avert the destructive experience of isolation consciously. There are a few steps that could help both those who are confined in fear and also their relatives, who are themselves reasonably confident of surviving an eventual infection. The most obvious first step – easiest done by phoning – is to prevent people from feeling forgotten, and it is also an essential first step to get into the habit of staying in touch. Texting/chatting is another technique that is easy to underestimate, and modern technologies such as video calling from our phones are even better and strongly encouraged. Video chatting, relatively easy for anyone who has a connected smartphone, additionally allows us to assess whether our relatives are looking groomed, changing their clothes, and appear to cope. However, not everyone is tech-savvy, and while it would be ideal if we were able to provide our relatives or friends with the gadgets to video call, we

“I am convinced that keeping in touch is not simply going to help older people stave off a sense of isolation. Perhaps predictably, in my practice, it has to date been the younger generations who appear to have been mostly unnerved by the enforced confinement.”

should also be ready to be patient with people who might struggle to adapt to new technologies.

I am convinced that keeping in touch is not simply going to help older people stave off a sense of isolation. Perhaps predictably, in my practice, it has to date been the younger generations who appear to have been mostly unnerved by the enforced confinement. Thus, creating a routine whereby family members stay in touch and do things together, benefits the extended social unit. There are few limits on what can be done remotely: people can have Sunday lunch together (each in their own home, concurrently via video calling), exercise together (YouTube), or even play games together (board games, or word games such as Boggle, or through sites such as Jackbox). We can plan to watch the same show, or read a book, and then discuss it later. And children would undoubtedly appreciate having grandparents read to them, even if remotely.

It becomes easier to share chores like shopping if family members are in frequent communication, rather than allow these to fall onto one single person who could then feel burdened. We should encourage relatives who are still independent to do their shopping online, but we could also offer to do part of it ourselves, for example, to buy their meat if we are still going to the butchers. And by sharing the load, we then have more time to think about provisions of puzzle books, word games, or other interests.

If a relative is not following guidelines, it is preferable to explain in what way we are ourselves being limited, rather than to become authoritarian and forceful. We should remember that we are all individuals and that none of us will react in the same way, either to the threat of illness or to having our liberties curtailed. However, we are all vulnerable to the effects of isolation and feeling that someone is looking out for you is an important part of being connected. Therefore, we could consider retired co-workers, older neighbours, family members who are in quarantine, and anyone else who we think might be struggling with the realities around us and make ourselves available according to their – and our – individual needs.