During the COVID-19 pandemic, public health guidance has advised physical distancing as a protection from the virus. A major side effect of this has been a loss of those things we take for granted, such as social interaction, connection and support. Some 500 people in the UK responded to a homeworker survey after 2 weeks of lockdown, where 20% described themselves as lonely and isolated (Bevan et al, 2020). Being socially connected in meaningful ways is important to health and survival and is a determinant of wellbeing and longevity; the impact of loneliness on mortality is similar to moderate smoking (Holt-Lunstad et al, 2010). In addition, poor mental and physical health can contribute negatively to quality-of-life outcomes (Luo et al, 2012). Xai and Li (2018) also reported that social relationships can be preventative for heart disease, and Hawkley et al (2010) found an association between loneliness and high blood pressure.
Through the peak of the pandemic, the extremely vulnerable had been shielding. This has been paused, and it is now a personal choice to follow this Government guidance (Public Health England, 2020). Life for some has returned to normality, with the opening of hairdressers, pubs, restaurants, places of worship and leisure centres. However, even small everyday encounters have dissipated for others, where a social disconnect continues due to age, ill health, fear and pre-existing reduced social contact. Internet access and skills are often lacking in these groups.
Nurses are the main care providers for COVID-19-infected individuals, highlighting their importance in the global pandemic. Nurses represent 59% of global health professionals (World Health Organization (WHO), 2020a), and are often the first and only healthcare point of care in a community (WHO, 2020b). Yet, they can also be considered frontline carers of the most vulnerable people in communities pre-, during and post-lockdown. Fanning (2019) said nurses could diagnose social isolation, prevent crises and act as social prescribers. The Buurtzorg social enterprise piloted in the UK combines self-managing teams of visiting nurses with a focus on patient- and carer-centred neighbourhood care (Drennan et al, 2018). Closer to home in Frome, Somerset, Compassionate Communities UK (2020) combined community development with routine medical care and reduced emergency admissions to hospital (Abel et al, 2018). Loneliness and social isolation will increase as care is moved out of hospitals and into the community. Allied with this, the growing ageing population with frailties and long-term conditions emphasises the importance of community nursing as a vital service (Ham et al, 2012). Indeed, if nurses and their wider teams replicate and encourage a sense of community belonging by placing social connectedness at the heart of their care, peoples' lives and health will improve.