The Washington PostDemocracy Dies in Darkness

Singles say they’re better prepared to self-quarantine, but many fear getting shortchanged in medical treatment

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“This is the moment I’ve been training for all my life!” an unnamed introvert asserts in a Facebook post, as covid-19 sends much of the world into seclusion.

Edie Jarolim, a freelance writer and editor in Arizona, can relate to that sentiment — that adults who have chosen to live alone may be better adapted than many to the stay-at-home restrictions in place in large parts of the United States and elsewhere.

“I know many/most people find comfort in other people’s company in situations like this,” she said in an email. “Me, I am eternally grateful that I am not stuck at home with someone else.”

Others contacted through the Community of Single People, a Facebook support group for adults who are single by choice, agree. Ranging in age from 35 to 73, they responded by email to questions about what the lockdown means to men and women who thrive on living solo even in normal times.

While rejecting what they see as the widespread belief that all well-adjusted adults would ­couple-up if they could, these voluntary singles did express fear that social prejudice could affect their medical treatment.

As Christina Campbell, a writer in Virginia who co-founded the singles advocacy blog, said: “The main problem is the assumption that because I am not married I don’t have a support system.”

Others worry that patients who are single may be viewed as less important when it comes to medical treatment than those who have partners.

Nevertheless, they consider their lifestyle an advantage during the covid-19 lockdown. London psychologist Eva Papadopoulou put it this way: “I think those who are single by choice and loving having time to themselves are very well equipped to deal with isolation.” But, she reiterated, only “provided that living alone is a lifestyle choice.”

Choice is important, experts confirm. “How single people are faring probably depends a lot on whether they have embraced single life,” psychologist Bella ­DePaulo, who pioneered the scientific study of unmarried adults, said in an email. To those who have, “staying home for long periods may feel more like comfortable cocooning than anxious isolation,” she said.

Elyakim Kislev, a sociologist at the Hebrew University of Jerusalem, agrees. “Singles might have an advantage in this crisis, but it really depends on how they treat their singlehood,” he said in an email. “I found in my research that those who accept and embrace their singlehood also know how to turn aloneness into solitude instead of loneliness.”

That comfort with solitude, which research has associated with qualities such as creativity and personal growth, is a key element in adapting to a lockdown.

“The ability to be alone with yourself and your thoughts is an underappreciated skill,” said Campbell. And Craig Wynne, an English professor in Virginia, feels “quite skilled at enjoying my own company, which is crucial for my well-being during this time.”

Deeply engaging interests also play a role.

To Papadopoulou, extended solitude offers “an opportunity to finish that book, do some art, clean the loft, archive those travelling photographs, and do all those things on our ever ending to-do list with no interference from others.”

Nor do solo dwellers have to worry about being infected by a housemate or infecting anyone else. “Once I close my front door, I am self-isolating,” said Caroline Hanson, a scientist and educational administrator who lives near London.

Although such a strong preference for solitude may sound like social isolation, these voluntary singles also enjoy active social lives based on a range of relationships. In so doing, they defy the social norm that, in Campbell’s words, “discourages reaching out to friends for help, whereas leaning heavily on a spouse is seen as ok, even required.”

“Many coupled people rely on each other, but this is almost the only resource they have,” Kislev said. “In contrast, singles are closer to their relatives, they join more clubs, and they even know their neighborhood better. All of these are resources at [crisis] times, and they can rely on a more diverse network of social support.”

Jarolim, for instance, described a check-in system with friends, including someone who will care for her dog if necessary. Ketaki Chowkhani, a sociologist in Manipal, India, identified her birders’ group and the staff of her building as elements of her support system.

Freelance writer Kristin Noreen occupies a tiny house in a “small intentional community” in Washington state, where residents look after one another.

“Coupled people may have ‘the one,’ but single people often have ‘the ones,’ ” DePaulo summed up. “That can serve them well in times like this.”

Online resources also play an important role, especially for individuals capable of feeling emotionally connected to friends who are not physically present. Papadopoulou pointed to “many friends near me and all around the world,” as well as “an online neighbourhood support network where people offer help to each other.”

Hanson relies on “a lot of friends and neighbors who have simply said, please let me know if you need anything, plus we are checking in with each other electronically — including friends in Australia, Germany, and the U.S.”

And yet, as the covid-19 crisis deepens, these single adults express a growing unease.

It’s not about how they’ll manage alone at an unsettled time, or even about the possibility of dying alone. To those who genuinely prefer living solo, those risks are worth it — just as people living together accept the downsides of that way of life. Rather, their concern is that social bias might impede their access to treatment if they get sick.

If you are a single person with cancer, you may get less aggressive treatment than a married person

Their concern is well-founded. Studies have shown, for instance, that unmarried patients with cancer receive surgery and radiotherapy at lower rates than married patients do, even when factors such as age and tumor stage are taken into account. And medical authors persistently disseminate the inaccurate belief that unmarried patients lack the social support necessary to handle aggressive care, although research findings in psychology and sociology overwhelmingly contradict that assumption.

“I won’t be surprised to discover that experimental treatments for covid-19 are given to singles less frequently than to partnered people based on the false assumption they won’t have enough support in case of failure,” Kislev said. And yet, “Singles may actually have a better support system in such cases, with more people to chip in for help.”

Shortages of medical resources also raise concerns.

“Whose life will be deemed more important, a single woman’s or one with a husband and little child?” Chowkhani said. Wynne agreed. “Much of the rhetoric I’ve heard around medical care revolves around treating ‘families,’ ” he noted. “I’d rather it say ‘individuals.’ ”

“If anything, the rhetoric of families has gotten worse during the pandemic,” DePaulo said. “The Coronavirus Response Act is called ‘Families First.’ Is that a way of telling me, right in the title, that as a solo single, I’m a second-class citizen?”

That’s probably not a concern with respect to official guidelines for treating covid-19, infectious disease specialist and author Anand Panwalker said. “I think that [discrimination on the basis of marital status] would be illegal, unethical and immoral,” he said in an email. “And no one would dare face legal responsibility for such a guideline, which would be challenged immediately.”

But even if official guidelines don’t discriminate, might individual medical providers still give priority to spouses? “Yes,” Panwalker said. “I do believe that might happen.”

The singles interviewed for this article believe that, too. Just as some older people aren’t willing to die for the economy, they fear that their lives may be undervalued by medical decision-makers who won’t even ask whether they’re caregivers for friends or extended family, or mainstays of the wider community, or valued contributors to their professions.

“I’m a little nervous about if I have to go to the hospital and need a ventilator,” says Noreen. “My age [56] and single status might demote me in the triage queue.”

“I wish it weren’t a competition.”

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