DW: People all over the world have grappled with isolation as countries go into lockdown; but for elderly people, it has been particularly hard. Studies have shown that loneliness among older adults has increased during the pandemic. As European countries go back into lockdown, the elderly will again find themselves faced with the mental challenges of isolation. How is loneliness affecting people during lockdown?
Karl Lauterbach: Loneliness is a major problem for people in the coronavirus pandemic. Loneliness is, in general terms, already a big issue, but with the coronavirus pandemic lockdown: people are more isolated, people are not allowed to go out, people are not allowed to go into restaurants or pubs.
So, social activities that were already limited before the pandemic [for lonely people] are further limited by the interventions we had to come up with to protect the population. This is a major side effect of the pandemic. Loneliness is an epidemic, and it is a big problem for those who were already lonely before the pandemic started.
The elderly in particular have been advised to 'cocoon' — what effect does that have on someone who is already isolated?
The consequences of loneliness are already horrible under any circumstances. But if you are living in a time when you are lonely, are not permitted to meet friends, and are anxious about putting yourself and others at risk of becoming ill or dying — all of that combines loneliness with anxiety.
It may very well, in some people, lead to a kind of despair, because we don't have a good perspective on when old people will be allowed to live in the way they lived two years ago. There is no clear end to the pandemic.
What are the physical health effects of loneliness?
We know from the studies that loneliness can lead to cardiovascular disease, it can lead to hypertension. We know that social isolation is a risk factor for the premature development of cognitive impairment and cognitive decline and may even lead to premature dementia. In that sense the loneliness epidemic that we are currently going through during the coronavirus pandemic is also of physical importance.
What are your thoughts about quality of life versus longevity, especially for elderly people who may be living out their final years not surrounded by friends and family?
It is clear that for the elderly the coronavirus pandemic leads to major losses in their quality of life, because they are isolated, they live at risk, they are anxious, they are lonely, and they are very often in a situation where they do not see a clear end to the pandemic. Therefore, there is also some insecurity about what the future will bring. Clearly, losses in quality of life are a high price that the elderly are currently paying for the pandemic control.
Is it possible that the effects of isolation could be more harmful to an elderly person than getting the coronavirus?
Rarely, the coronavirus for the elderly is a deadly disease — in the elderly above 80 years old 10% of people who get COVID-19 die. More importantly, those who survive the disease often have long-lasting effects. Therefore, despite the fact that loneliness is, in itself, harmful and lowers the quality of life, there is just no possibility not to take the precautions that we need to take.
Do you think lockdown is harder on elderly people than other groups in the population?
Yes, lockdown is much harder on the elderly, because they often have a limited number of friends, and if they cannot see these friends anymore, that means something to their meaning of life. Also, socializing is extremely important for the elderly because socializing not only maintains their quality of life but also maintains mental health and very often even maintains cognitive function.
The elderly pay the highest price for the pandemic control. But they also have the biggest gains because otherwise many, unfortunately, would sustain major impairments, and many would die.
We don’t know how long this pandemic is going to last, and there is no vaccine yet. Do you think the elderly should live out their final years following the rules rather than taking more risks to have more socialization?
I don't see this as a tradeoff. I believe that in the early months of next year we will have vaccines, which can be used to protect the elderly, in particular. I don’t think we will face this dilemma.
In that sense, we can have it both ways — we can reduce loneliness next year and protect the lives of the elderly. We can realistically wait for successes that will help elderly people to see a glimmer of hope next year.
Loneliness was a problem before COVID-19. How can we address loneliness after the pandemic?
I am convinced that loneliness is a big issue and that after the pandemic, we should really create institutions [to reduce loneliness]. In Germany, for example, we could have a secretary of state or someone who is responsible for this in the government.
But we clearly must pay more attention to the fact that loneliness is a major threat to public health. The pandemic has taught us how important loneliness is, so we need to be prepared. This will not be our last pandemic, and loneliness is always a risk in pandemic control. The issue of creating barriers against loneliness are ever more important, ever more pertinent.
Louisa Wright conducted this interview. It has been edited for length and clarity.
Karl Lauterbach is a member of the German Bundestag and the health spokesperson for Germany's center-left Social Democratic Party (SPD). The medical doctor has previously stressed the importance of governments addressing loneliness.