"Shielding," An Extreme Form of Social Distancing, Hard on Mental, Physical Health

Strict social distancing, or “shielding,” of patients with rheumatic diseases to prevent COVID-19 infection doesn’t reduce the incidence of infection and is associated with worse mental health, researchers reported.

“Shielding” is a strict form of social distancing that requires people to remain in their homes and have minimal contact with others, even members of their own household. The European League Against Rheumatism and the British Society of Rheumatology recommended shielding for patients taking immunosuppressive medications.

British researchers looked at the effects of shielding among 1,693 patients who agreed to fill out questionnaires. Half (50%) had rheumatoid arthritis; 16%, psoriatic arthritis, and 5%, ankylosing spondylitis.

When they compared the 61 patients in the group that contracted COVID-19 with the 1,632 patients who didn’t, they found that roughly the same percentage of the COVID-19 patients had shielded as those non-COVID-19 patients (24 of 61, or 40% vs. 768 of 1,632, or 47%), although the comparison did not meet the usual standard for statistical significance.

“Our study suggests that overall strict social isolation had little impact on the incidence of COVID-19 infection,” wrote Natasha Cleaton and her co-authors in the report published in the Annals of the Rheumatic Diseases.

Cleaton also looked at the mental and physical heath effects of shielding, comparing the 722 who shielded to the 823 who did not among the patients who didn’t contract COVID-19. They found the mental and physical health of shielding patients to be significantly lower than those who didn’t shield.

“Patients are likely to require increased mental and physical support as result of the COVID pandemic,” wrote Cleaton and her co-authors, adding that further study is needed on the efficacy and effects of shielding.