1 Special Section Article G E R A L D PAT R I C K M C K I N L E Y We need each other: Social supports during COVID 19
As social beings, we need each other. During stressful times that becomes more apparent. I specialise in the social determinants of mental health; specifically, social support networks and relationships. I write this not only as an academic but also as someone providing in-home care for my elderly mother as she goes through cancer treatments during COVID-19. What I see is an increased impact of stress because neither she nor I have physical and routine access to our full social support networks. For my family, the past two years have already been stressful. In October 2018 my father had a heart attack, beginning a slow process of declining health which ended with his death in December 2019. Two days after my father's funeral my mother had a complete gastrectomy to deal with stage three stomach cancer. Those were challenging and stressful times, but they were made easier by having family and friends to draw on. My mother has always maintained an active social life, which provided support for her as she figured out life after the loss of her husband of 57 years and the realities of being a cancer patient.
Academic me thinks about the stress buffering hypothesis developed by Cohen and Wills (1985) , which suggests that during time of stress we appraise the perceived support around us and, if we are satisfied that we have enough, we manage our stress. Since Cohen and Wills published their hypothesis the model has been tested and supported in several contexts, including with individuals going through cancer treatment (Gremore et al. 2011 ). The main take away is that if you have active relationships where you feel supported, you are shielded from the impact of stress.
COVID-19 has taken away the daily routines through which we interact with our social support networks, or friends and family. Social networks are active and dynamic. When we encounter stress, very few people sit down and make a list of who can provide what support. We go to people and drink tea or they come to us and we have dinner and wine. We laugh and cry with our friends. It is in the social process that support is perceived before being actualised. Living in a context of increased stress during the isolation of COVID-19 highlights this for me. It raises some important considerations as I think about my mom at the societal level. How does society respond to increased levels and length of isolation from the regular, mundane, social interactions that we are used to engaging with? Can online chats replace a hand being held by a friend during crisis? The physiological impact of stress on my own body is telling. Reflecting on the past month, I see that the only major change is that I cannot physically access my support network. Through this reflection I see the most important impacts of the virus on society as more than the biological reactions. We must consider who is impacted by the loss of each other.