The COVID-19 Prescription Your Business Can’t Afford to Underestimate

How Professionals and their Teams Can Stay Healthy, and Why it’s actually BUSINESS CRITICAL.

By Brad Bongiovanni, ND | Well-Being Architect | @DrBradBongiovanni

I believe we are underestimating the medical impact of social isolation on our psychiatric, neurological, and immune health. Scientific evidence has demonstrated the biologic underpinnings of social isolation on immune function, and it’s time we leverage psychosocial processes to influence physiological ones. Might we need Hydroxychloroquine, a Z-pack, or intravenous vitamin C, all showing promise to improve COVID-19 outcomes? Perhaps yes, but I’m betting most professionals and businesses would like to prevent the infection vs. waiting until diagnosis to debate its treatment. So, let me recommend some social prescriptions for the potential prevention of coronavirus infection as well as building general immune resilience during these surreal times.

Even before our global pandemic, social isolation was a major and prevalent health problem leading to numerous detrimental health conditions. Now with an increasing prevalence, social isolation will impact the health, well-being, and quality of life of our people now and for the next few months…at the least.

An overabundance of evidence demonstrates numerous negative health outcomes related to social isolation for individuals, and this effect naturally ripples into business productivity, revenue and profit. However, there is scarce evidence that health professionals are prescribing any form of social connection in this time of physical distancing.

Now is the time to leverage social wellness prescriptions  to influence the physiology of our bodies as well as our organizations.

The Biologic and Genomic Underpinnings of Social Isolation

There is an impressive body of work on the mechanisms of how social isolation leads to increased inflammatory and infectious processes in our bodies. The need for social wellness prescriptions could not be any more critical. PsychoNeuroImmunology (PNI) unites psychiatry, neurology, and immunology into a multidirectional communication network, whereby the brain is integrated with the body at a molecular level. Conventional medical thinking often marginalizes psychosocial stressors as “soft” variables, less important than biochemical markers of disease. People experiencing chronically high levels of social isolation are at elevated risk of infection and disease, resulting in personal and family stress as well as increased healthcare and productivity costs to employers.

Studies show that diverse social networks are associated with greater resistance to upper respiratory illness (1). Evidence across 148 independent studies indicates that individuals’ experiences within social relationships significantly predict mortality (2), corresponding with a 50% increase in the odds of survival as a function of social relationships. The magnitude of these findings may be considered quite large, exceeding that of well-established risk factors, such as smoking, alcohol, obesity or exercise. This friends…is astounding.

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Studies of social isolation concluded that those without adequate social interaction were twice as likely to die prematurely (2). Social isolation impairs immune function and boosts inflammation (3), right down to the molecular/genomic level. In my TEDx talk, I mention the field of human social genomics, where researchers study the effects of social factors on our gene expression. One study identified 209 genes that were differentially expressed between individuals who reported high versus low social isolation (4). Additional studies in human social genomics show how socially-induced effects signal gene transduction pathways that translate social threat into CTRA gene expression. Known as ‘conserved transcriptional response to adversity’, this shift is characterized by an increased expression of genes involved in inflammation and a decreased expression of genes involved in antiviral responses (5). Employers’ most valuable capital, their HUMAN capital, is at great risk, with the ugly potential to spin into a downward spiral compounding what is an already traumatic blow across almost all industries.

What’s the remedy? Prevention. All businesses must manage risk. From the perspective of a lifestyle medicine physician, we assess risk for disease and then look to promote and strengthen the health of our patients. We can make good use of the science of well-being to strengthen our patients’ individual immune response by reducing inflammatory load overall, looking at known food sources of inflammation, such as sugar, alcohol, certain grains and dairy. We teach and promote integration of simple mindfulness regimens into our daily routine. Only a minimum of 10 minutes per day is needed to have a biologic effect. And mindfulness has been shown itself to not only improve mental and emotional health factors, but also to reduce inflammation (6). We recommend exercising regularly to take advantage of its immune strengthening effects. We discuss protecting a good night’s sleep since sleep disturbances are associated with increases in markers of systemic inflammation (7). And last but not least, we can prescribe social wellness and learn to ‘get by with a little help from our friends’ since oxytocin is released when we connect in meaningful ways, even virtually. Oxytocin can induce anti-stress-like effects. It increases pain thresholds and exerts an anxiolytic-like effect (8), so very welcomed during these times of high anxiety and uncertainty.

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What is Social Wellness? It refers to one’s ability to interact with people which can be done, even while physically distanced. It involves using good communications skills, having meaningful relationships, respecting yourself and others, and creating a support system that includes family members, friends, colleagues and coworkers. While we’re sheltering-in-place at the moment, here are a few suggested activities that will support you in cultivating social wellness—use these as a starting point to inspire your own ideas!

  • Join groups of mutual interest on social networking sites (virtual meetup groups)
  • Think of a cause your business supports and ask how you can contribute remotely together, or consider virtual volunteer activities at volunteermatch.org/covid19
  • With food, being at home can become boring. Get creative and plan a virtual family restaurant night with your kids where half of you pretend you’re the restaurant workers (cooks, servers) and the other half pretend you’re the guests (it was a hit at our house)
  • Set up an afternoon game break with your team and play online via Houseparty
  • Set up a videoconference with your fantasy football league to catch up/check in on the upcoming season and the NFL’s virtual draft this month.
  • Organize a virtual spa or nail painting session with your gal pals over Facetime or Skype

Cultivating social wellness is like keeping a flower garden. You’ve got to put some love into it, if you want to get some love out of it. If decreases in social connection is the 2nd pre-eminent condition of our current world due to the pandemic, so then prescriptions and creativity around social wellness in the present-day context of physical distancing is a most rationale response if our goal is to be productive and resilient as individuals, teams, and organizations.

References:

1.    Cohen S, Doyle WJ, Skoner DP, Rabin BS, Gwaltney JM Jr. Social ties and susceptibility to the common cold. JAMA. 1997 Jun 25;277(24):1940-4.

2.    Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010 Jul 27;7(7):e1000316.

3.    Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010 Oct;40(2):218-27.

4.    Cole SW, Hawkley LC, Arevalo JM, Sung CY, Rose RM, Cacioppo JT. Social regulation of gene expression in human leukocytes. Genome Biol. 2007;8(9):R189.

5.    Cole SW. Human Social Genomics. PLoS Genet. 2014 Aug; 10(8): e1004601.

6.    Black DS, Slavich GM. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann N Y Acad Sci. 2016 Jun;1373(1):13-24.

7.    Irwin MR, Olmstead 2, Carroll JE. Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry. 2016 Jul 1;80(1):40-52.

8.    Yoon S, Kim YK. The Role of the Oxytocin System in Anxiety Disorders. Adv Exp Med Biol. 2020;1191:103-120.

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