Social isolation is human despair. We evolved down from primates who were all blessed and sometimes cursed with group membership. Simply put: no (hu)man is an island.The strangest, and some ways most disturbing, example of social isolation I ever experienced was as a senior officer on a Coast Guard ship were I was sent for a very brief tour. It was during the Vietnam war and I was serving in the Public Health Service. A requirement of that service was to do a 3-week junket providing medical coverage for a small sector, in the North Atlantic —the Sea of Labrador—as part of America's commitment to NATO.

"Now as the coronavirus is forcing unprecedented isolation and physical as well as social distance many of us will suffer its potentially debilitating effects."

This was not a case of physical distancing but true social distancing. As Lieutenant-Commander I was second in rank, the first being the ship captain. Tradition requires that he live and dine alone in his cabin. From the moment the ship sailed out of Governor's Island, NY, I was perpetually seasick. But I had to show up at the head of table at every meal as officers are served in order of rank and I had to be present so everyone else could be fed. At least that is how it was explained to me.

The overwhelming feeling of isolation was probably partly my own fault. I tend to be shy and diffident. In the company of those mostly younger officers committed to a life of service at sea whose talk was mostly about experiences and interests that I did not share, And I missed my family, my home, my life that seemed far and foreign on that little cutter ship. I felt utterly alone. And virtually and actually at sea. Being seasick added a physical sense of detachment and inwardness.

Now as the coronavirus is forcing unprecedented isolation and physical as well as social distance many of us will suffer its potentially debilitating effects. While these may seem merely psychological, there is scientific evidence that such distancing from almost all face-to-face forms of usual and customary engagement can involve significant biologic changes.Science, the craft that people have forged always collectively, now is demonstrating that isolation disturbs brain function and radiates to affect the health of the whole body. Indeed, isolation can be its own form of trauma."Humans, born to the longest period of abject dependency of any species and dependent on conspecifics across the lifespan to survive and prosper, do not fare well, either, whether they live solitary lives or they simply perceive they live in relative isolation." Perceived social isolation is called loneliness....[It] is a risk factor for, and may contribute to, poorer overall cognitive performance, faster cognitive decline, poorer executive functioning, more negativity and depressive cognition, heightened sensitivity to social threats, a confirmatory bias in social cognition that is self-protective and paradoxically self-defeating, heightened anthropomorphism, and contagion that threatens social cohesion. These differences in attention and cognition impact emotions, decisions, behaviors, and interpersonal interactions that may contribute to the association between loneliness and cognitive decline and between loneliness and morbidity more generally.

While the perception of isolation begins in the brain and spreads within it to compromise mood and cognition, its effects also extend to the endocrine and cardiovascular systems through downward connections from the brain. General inflammatory processes are also set up and reflect back on brain function. Ultimately even micro brain structures are altered.As the coronavirus crisis continues we can expect these potentially devastating effects to begin to appear, worse in those who mental conditions that can be exacerbated by isolation. And that group is very widely and commonly distributed: from people with major psychiatric illnesses to those with depression, anxiety, trauma histories and even PTSD, ADHD, autism, and dementia. One group, male survivors of sexual abuse, is among the potentially vulnerable and, as I include myself among them, I have posted a blog on the MaleSurvivor.org site. So, almost everyone will be affected to some degree by a prolonged state of social isolation. Add to this the lack of adequate or sufficient medical care, as well as economic hardship, and the disaster will expand even further.

This is a time when mutual support will become critical, now, fortunately, more available than in the past through internet connectivity. We must lean on one another and we also would benefit from support from authorities we humans have always relied on—our societal leaders. One of the greatest failures of our current national leadership is our president who seems innately incapable of broadly experienced empathy. Truth leavened with compassion and understanding is the best medicine in any crisis.We need that now more than ever before.