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Opinion The Checkup With Dr. Wen: 8 ideas from the surgeon general to address loneliness

Surgeon General Vivek H. Murthy testifies during a Senate Finance Committee hearing on Feb. 8. (Jabin Botsford/The Washington Post)

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U.S. Surgeon General Vivek H. Murthy, the nation’s top doctor, understands the danger of the loneliness epidemic.

Defined as a subjective feeling of wanting social contact but feeling alone, loneliness is not only associated with higher rates of depression and anxiety but also physical consequences such as cardiovascular disease, dementia and early mortality. According to a 2021 Harvard report, more than 1 in 3 Americans struggle with loneliness.

Fortunately, Murthy has some advice for how to rebuild social connection, as he laid out in a recent wide-ranging discussion with me:

1) Set aside time every day to reach out to people you love. For Murthy, that’s when he calls a close friend, plays with his kids and has a FaceTime call with his parents. Just 15 minutes can increase our sense of connectedness.

2) When interacting with people, give them your full attention. Murthy recalls the many conversations he has had when he gets distracted by emails and other alerts on his phone. “Our attention is extraordinarily powerful,” he said. Being fully present “can make five minutes feel like 50 minutes.”

3) Find ways to serve. This can range from volunteering in your community to seeking out small ways to help a work colleague or a neighbor. “Service is one of the most underrecognized antidotes to loneliness,” Murthy said. It “reaffirms to ourselves that we have value to add to the world.”

4) Form a “moai.” In 2018, Murthy and two close friends formed their own moai, which is a tradition from Okinawa, Japan, in which a small group of people serve as lifelong supports for one another. Their commitment to one another includes a two-hour call once a month and more frequent text check-ins. This moai, Murthy said, “has been an extraordinary force in my life that has helped ground me, has helped me feel connected and is also helping me make critical decisions in my life about work and family.”

Murthy also has advice for employers and managers who are navigating hybrid and remote workplaces.

5) Recognize that remote work has its challenges. “When people don’t have any face time together, there is a cost that we incur,” he said. “It can be harder to build relationships.” That’s not to say that workplaces must all be in-person; rather, it means managers must be intentional about fostering relationships.

6) Use tools to help people get know one another. Murthy recommends that employers start by talking with employees to find out what they need. Then, create opportunities to help people get to know one another “as human beings and not just skill sets.”

For instance, at the Office of the Surgeon General, Murthy has an all-staff meeting every month where two people are assigned to interview one another. For 10 to 15 minutes, the interviewee is asked questions about their childhood, hobbies and dreams.

“We learn so much about our teammates,” he told me. “We learn facts about them. We learn stories about them that humanize them. That makes us feel close to them, and that changes positively how we work together.”

7) Track how employees are doing with building relationships. “If we want to foster connection, we have to measure connection,” he said. “Then we have to adjust our strategy so that we are optimizing the level of connection that our workforce experiences.”

8) Plan some in-person gatherings. These can help, including in fully remote workplaces. “When done strategically, in the right way, those can be shots in the arm,” Murthy said. “They can be opportunities for people to build on the relationships that they’ve already been cultivating.”

I found a lot of inspiration and comfort in Murthy’s words. The “diseases of despair” manifesting as depression and substance addiction can seem so overwhelming that it’s often hard to know where to begin to address them. There’s no question that major reforms, such as reducing stigma for mental health care and increasing treatment, are needed. In the meantime, it’s empowering to find actions anyone can take as individuals that can help strengthen the social fabric.

Since our conversation, I’ve been trying some of these recommendations. Every day, I’ve been setting aside 15 minutes to call or write to someone I haven’t been in contact with for a while. My husband and I have committed to putting our phones away during dinner and around our kids’ bedtime. We are intentionally looking for ways to help people around us, such as volunteering for a community fundraiser and assisting a new parent at our son’s school.

These simple steps are helping me to feel more connected. I hope you will try them, too. Please tell me how it goes. I’d love to share your experiences and your recommendations with other Checkup readers.

Ask Dr. Wen

Newsletter subscribers are invited to submit questions to Dr. Wen. Not a subscriber yet? Click here to sign up.

“I had omicron in October. My doctor prescribed Paxlovid, but, in reading all the precautions, I didn’t take the Paxlovid at the time. Should I take it now that I am free from covid?” — Kay from Arkansas

I’m glad that you recovered from covid. You should not take Paxlovid now, since you no longer have covid. But if you become infected with the coronavirus again, you should consider taking Paxlovid if you are someone at high risk for severe illness. It’s important to note that this antiviral pill must be taken within five days of the onset of your symptoms, so if you become infected in the future, take it early in the course of your illness.

“I’m going to Cape Town and Johannesburg in South Africa next month. How concerned should I be about the Marburg virus?” — Seth from Connecticut

You shouldn’t be concerned. The current outbreak of the Marburg virus, a viral hemorrhagic fever, has so far been limited to parts of West Africa. Specifically, at least 11 people have died in Equatorial Guinea. Neighboring Cameroon was investigating two possible cases that appear not to be due to Marburg. There have been no Marburg infections detected in South Africa, where you will be visiting.

It’s always prudent to follow the latest updates in case circumstances change. The Centers for Disease Control and Prevention’s country-specific website is a good resource that also advises on other precautions to consider as you travel.

Have a terrific trip!

“I’m taking a medication, Seroquel, that has a second-level interaction with Paxlovid. Should I even consider taking it if I get covid? You could consider including in your newsletter that Paxlovid has interactions with many medications and how people can find out if they are taking such a medication.” — Donald from Maryland

Thank you for the question and the helpful suggestion. Seroquel (generic name quetiapine) is a common medication used for bipolar disorder, major depression, schizophrenia and other indications. It is one of quite a few medications that have must be adjusted and monitored closely in individuals who are prescribed Paxlovid.

In this case, Paxlovid has the effect of increasing the concentration of Seroquel. That’s why the dose of Seroquel should be reduced during Paxlovid treatment, and the patient must be closely monitored for Seroquel-associated adverse reactions.

The Food and Drug Administration has a list of medications that interact with Paxlovid. Another helpful resource is the Infectious Diseases Society of America.

The Post has also compiled Q&As from my previous newsletters. You can read them here.

What I’m reading

I appreciated this thoughtful Time op-ed by two global health experts about how we still don’t know whether non-pharmaceutical interventions such as masking, social distancing and quarantining worked to reduce coronavirus infection rates. These difficult questions “don’t win any political points, even though they are the most important ones to answer,” the authors write. “Until we can start having public discussions that focus on figuring out the best way to combat a pandemic rather than assigning blame, we’re never going to know what to do when the next novel virus comes along.”

An important study from Britain finds more evidence for the omicron variant being milder than previous variants. The paper, published in the Journal of Infection, found that the infection fatality rate for children and young people under 20 was 1 in 100,000 during the original covid surge. This dropped to 0.8 during the alpha wave and 0.2 in the omicron wave. Most of these fatalities were in individuals with “severe/life-limiting comorbidities.” This study underscores the importance of vaccination to protect high-risk individuals.

A survey from the American Nurses Foundation found that 57 percent of more than 12,000 nurses reported feeling “exhausted” over the past two weeks. Nearly half — 43 percent — reported experiencing “burnout.” Only 20 percent said they felt “valued” in their work and just 14 percent said they were “fulfilled.” As the United States faces a severe nursing shortage, we must be attentive to the factors driving these findings.