The social consequences of the current COVID-19 pandemic are certainly a very important and pressing avenue for research. The current health crisis posed by COVID-19 constitutes a threat not only to the physical integrity of the population but also to mental health and social cohesion. The normality of the Greek population’s lives has now changed, and the new, different reality is currently expanding with indefinite evolution and unknown effects on multiple levels. In this new context in which the deregulation of society is observed, the questions raised concern deeper questions at the individual and collective levels for the Greek and international scientific community. At the same time, it is highlighted the need for progress and social cohesion on the basis of individual responsibility and collective consciousness.
In view of this, the social reaction and the impact on people’s behavior under the influence of fear and anxiety regarding the pandemic are ambiguous. Consequently, the need to investigate the social impact of COVID-19 is considered both mature and imperative, especially after the implementation of restrictive social distancing measures. The initial aim of the present research is to highlight to what extent the distancing measures and house confinement have actually affected and maybe strengthened the feeling of social isolation of the Greek population. The first research question that arises, therefore, is the following: what are the main factors that impacted this feeling during the very strict confinement imposed from 14 March until 4 May 2020, when the country gradually began to lift certain restrictive measures, especially as regards population movements? A better understanding of this phenomenon is essential since the evolution of the pandemic remains very uncertain, and therefore it is quite possible that containment measures—at least locally—will be once again imposed.
The present study consists of four sections. First, a short literature review presents the situation in Greece posed by the pandemic, and also reference is made to the main causes of social isolation feeling and its impact on the population in Greece. The Data and Methods section follows, where the authors introduce their online survey (4238 questionnaires) and the proposed methodology to explore the determinants of social isolation on the Greek population. In the third section, there are presented the results of the analysis, and finally, the study ends with the Conclusions, where the main findings are discussed.
3. Data and Methods
The main purpose of this study is to explore the determinants that affected the population in Greece in terms of social isolation feeling during the first lockdown period. Two questions are therefore examined: (i) through the perception in itself of the survey’s participants, what are the main factors which, according to them, can have a significant impact on such a feeling? (ii) is it possible to detect significant differences between specific groups of the population as, for example, urban and rural citizens, or population living in islands or inland areas?
The research initiative exploited the international literature to identify the social effects on populations, arising from the threat of a crisis or the presence of an infectious epidemic or pandemic disease (Barrett et al. 2011
; Suárez Fernández 2011
). A tool for measuring the attitudes, behavior, and perceptions of the population in relation to the measures of social isolation and house confinement was designed. The present survey, consequently, aimed to map the way Greeks lived, think, and felt during the lockdown. The questionnaire, which was initially assessed for validity and reliability through a pilot survey, consists of four sections: (a) demographic characteristics (b) assessment by the respondents about their general psychosomatic situation during the confinement measures (9 items; α = 0.90). (c) daily attitudes and behaviors before and during confinement (8 items; α = 0.72) (d) population’s perceptions about COVID-19 (5 items; α = 0.68).
More specifically, gender, age, marital status, educational status, professional function, and region of residence were collected in the first section of the survey. Regarding the second section, it is foreseen that infectious outbreaks widely impact the general psychosomatic situation of the populations and determine the isolation and loneliness feeling (Gica et al. 2020
). Emotional distress, tension and irritability increased during the pandemic compared to the period before (Ismail et al. 2020
). Furthermore, the available scientific literature and research data report increased anxiety, pressure, and exhaustion caused by the COVID outbreak (Wielgus et al. 2020
The third section, “daily attitudes, and behaviors” aims to investigate the changes in people’s lifestyle, such as changes in sleep and eating patterns as well as the usage of social media and the mode of occupation (physical presence in the workplace or teleworking) during the quarantine. Increased food intake and weight gain during the lockdown are reported (Di Renzo et al. 2020
). The same situation is observed in sleep patterns, that is, a shift in the sleeping and waking up hours (Da Silva et al. 2020
). During social distancing, the levels of social media use also increased (Wiederhold 2020
), seeking medical information and support through these platforms (Saud et al. 2020
). Finally, there is an important change in the working mode of the people. Teleworking entered and changed the course of people’s everyday lives, ensuring wellbeing and productivity (ILO 2020
). On the other hand, the pandemic caused an increase in unemployment and suspension from work (OECD 2020b
The last section, “population’s perceptions about COVID-19“, concerns people’s worries about getting infected by the virus (Mertens et al. 2020
), perceptions about the preparedness of the government to face the pandemic (Koirala et al. 2020
), and the role of the media and their response to the pandemic (Ferreira and Borges 2020
It is necessary to clarify that the variables referring to the before COVID
period concern January and February 2020, while the variables referring to the during COVID
period concern the first lockdown period in Greece (Table 1
The data collection took place during the period 31 March 2020–23 April 2020, which concerns the first period of the lockdown, social distancing implementation, and house confinement. At that period, coronavirus restrictions on movement and social life were imposed, except for special permits as above-mentioned. Consequently, the Greek population was experiencing the effects of social distancing and isolation. Given both the critical health context and the institutional framework as regards population mobility, the survey, by force of circumstance, was conducted online. A web-based survey was designed using Google document forms. The survey was implemented through social media networks such as Facebook, Twitter and LinkedIn. In addition, having preliminarily established a list (at regional level—NUTS III) of professional organizations as well as main associations involved in cultural, sports and leisure activities, their assistance was required in order to encourage their members to participate in the survey and fulfill the online questionnaire. The objective was to ensure as far as possible the best spatial coverage of the country with individuals from different geographic areas and socioeconomic profiles. In any case, the participation was voluntary, while the individuals were initially informed about the context and the purpose of the research and the guaranty of the anonymity of responses. Participants also had the opportunity to either not answer questions they might not have wanted or to complete the entire questionnaire.
Additionally, a filter question concerning the age of the participants was applied, as the reference population retained for the survey concerned the permanent residents in Greece aged 15–65 years. The share of people 15–65 years among the total population is 63.6% (ELSTAT 2019
). The young under 15 years as well as the elderly/seniors were, therefore, not included in the analysis. If children are obviously an especially sensitive group concerned by distancing measures, the implementation of self-administered questionnaires requires a specific and adapted approach—requiring among other parental consent-and that could not be followed in the context of the present research (Borgers et al. 2000
; Fuchs 2009
; Zill 2001
). Official data also reveal that elderly (65+) in Greece are less likely to make use of the Internet than the average population (Eurostat 2017
) while they have low overall digital skills (half of the EU’s average) (Pouliopoulos et al. 2018
). It was thus more than likely obvious that the number of responses covering the elderly would have been unrepresentative. In addition, to achieve a significant participation of the elderly in Greece, face-to-face interviews would have been conducted, though the confinement measures did not allow it. Should this not be the case, people’s unprecedented fear of being infected through physical contact would deteriorate the scope of the present study.
Finally, 4305 questionnaires were collected, corresponding approximatively to a 99% confidence interval and a 2% margin of error (Table 1
). Assuming that the proportion of the Greek population for which the feeling of social isolation has greatly increased is unknown, it is generally suggested to set the proportion at 50%. This corresponds effectively to the worst scenario because for p = 50%, the variance of the binomial distribution (=pq) is maximum, whatever the size of the sample. The size of the sample then depends on the choice concerning the confidence level (α) and the margin error (e) with:
A total of 4.216 questionnaires were fully completed while 89 (2.1%) presenting quite systematic missing data as regards the central core of the questionnaire were excluded, i.e., a completion rate of 97.8%. This sample also covers all regions of Greece, urban and rural areas, remote areas (mountainous and Northern border areas) as well as most islands of the country: large islands such as Rhodes, Lesvos, Samos, Chios and smallest as Andros, Mikonos, Naxos, Paros, etc. As expected, the rural areas are underrepresented: around 17% of the individuals while the residents in such areas represent in 2019, 31% of the national population (Eurostat). Conversely, the representativeness of the islands is satisfactory with a survey’s percent of 11.3% against 12.9% at the national level.
In order to detect and evaluate the factors that affected the social isolation feeling of the Greek population during the home confinement, a multivariate analysis was conducted. Specifically, through exploratory factor analysis, an attempt was made to reduce the volume of the 27 initial variables (Table 2
) to a limited number of composite and more comprehensive indexes, with as little information loss as possible. The factors were extracted on the basis of principal component analysis method (PCA), and the rotation method chosen was Varimax with Kaiser normalization. The initial conditions for performing factor analysis are met; the number of observations greater than 1000 is considered as “ideal” (Comrey and Lee 1992
) while the ratio of initial variables to the total observations is adequate (4216 observations, 27 variables) (Hair et al. 1995
; Garson 2008
Finally, in order to examine possible differences in the assessment of the above factors depending on whether individuals live in urban or rural areas or in regions with relative geographical isolation (island environment), nonparametric tests were implemented. As well known, nonparametric tests do not require that the data be normally distributed. The implementation of Kolmogorov–Smirnov and Shapiro–Wilk tests confirmed that any one of the seven factors was normally distributed (Appendix A
, Table A1
). The question addressed here is the following: to what extent the place of residence and the relative geographical isolation can generate significant differences in the population’s assessment of the impact of the factors highlighted through PCA?
Of the 4216 participants (M age = 36.8, SD = 12.0), 1228 were male (M age = 40.1, SD = 12.05) and 2988 were female (M age = 35.5, SD = 12.04). The gender distribution of the sample confirms that quite often, women are more willing to respond to social surveys than men (Bayart and Bonnel 2008, p. 55
). More than one-third (35%) of the entire sample reported moderate to a high feeling of social distancing, 20.3% of the sample reported moderate to extreme satisfaction from its life during confinement, and 36% of the sample reported moderate to extremely severe symptoms of sadness.
The implementation of PCA indicates seven principal components addressing the feeling of social isolation of the Greek population. The Kayser–Meyer–Olkin criterion justifies the suitability of data as they indicate high consistency (KMO = 0.792) while each one of the 27 initial variables shows significant communality (>0.4), justifying its contribution to the final model. The volume of the initial variables is reduced at 74% (27 initial variables shaped seven principal components), interpreting 63.2% of the total variability. The number of principal components was based on the criterion of eigenvalues (λ > 1). Finally, in terms of decreasing importance, psychosomatic disorders, employment situations, changes in sleep habits, socialization through the Internet, demographic status, health concerns, and trust in government and the media are the main components impacting the Greeks’ social isolation feeling (Table 3
4.1. First Component: Psychosomatic Disorders (20.4% of Total Variance)
The first component, which contributes to the highest percentage in the interpretation of social isolation feel, highlights the psychological aspect of the phenomenon. Psychosomatic feelings during social distancing measures with high correlation rates, namely muscle pain, migraines/headaches, insomnia, concentration difficulties, attention deficit disorder, anger, fatigue, irritability, and sadness, impact the composition of the first component.
4.2. Second Component: Employment Situation (12.9%)
Variables reflecting the employment conditions of the population during the pandemic are merged in the composition of the second component. Taking for granted that the COVID crisis deteriorated the employment situation in Greece, the second component, therefore, reflects the significance of keep working at 12.9% of the total variability. The variables combined concern both the teleworking and the physical presence in the workplace in the outbreak of the pandemic and correlate positively. It is evident that there is an inverse relation to the population on suspension or the unemployed. The educational level, although low loading, is negatively correlated with the factor.
4.3. Third Component: Changes in Sleep Patterns (7.6%)
The third component consists of four variables and reflects the changes in sleep habits before and during the lockdown measures. The loadings of these variables are positive– suggesting positive correlations among them. The shift in sleep time resulted in waking up later, disrupting the daily routine. This dimension indirectly captures the people’s overall functioning, as sleep is critical for physical and mental health.
4.4. Fourth Component: Socialization through the Internet (7.0%)
This component contains the variables that reflect the need for socializing during social distancing and home confinement. These variables have considerably high loadings and correlate with the factor positively. Despite the limited number of variables, this factor describes the choice of using social media through smartphones, tablets, and computers to contact friends and maintain a minimum level of social interaction.
4.5. Fifth Component: Demographic Situation (6.3%)
A critical aspect of the sense of isolation in the pandemic involves the demographic profile of the Greek population. The fifth component refers to a factor that partly reflects the individuals’ demographic situation. The variables comprising this component, namely marital status, age, and the number of children residing in a house, correlate positively. This component indirectly reflects the need for interaction with as few people as possible inside the house, avoiding the stain and tension the confinement provokes.
4.6. Sixth Component: Health Concern (4.7%)
The sixth component reveals the worry and anxiety of the respondents about the possibility to infect with the virus themselves or their families. It consists of three variables with moderate factor loadings. The individuals are disturbed by the new reality and consider that there is a cause of concern followed by the risk of catching the coronavirus.
4.7. Seventh Component: Trust in Government and the Media (4.3%)
The latter component has the least weight in the impact on social isolation feeling; however, as is evident by its high loadings, it is a classic reason affecting peoples’ sense of safety. The initial variables that form the last component concern the peoples’ perception of the government emergency preparedness for pandemic as well as the information on COVID-19. By trusting the government’s response for tackling the pandemic, people refrain from feelings of confusion and stress.
To test the hypothesis of differences in the factors affecting social isolation between urban and rural residents, Mann–Whitney test was performed, highlighting significant differences (p
-value < 0.001) as regards three of the seven factors (Employment situation, changes in sleep patterns, and demographic status) and also, but in a less extent (p
-value < 10%), Health concern (Table 4
Examining more specifically the mean ranks, it appears that the impact of employment and demographic situation, as well as the health concern, is relatively more important for residents living in rural areas compared to urban residents, while sleep disturbances are more intense for urban residents than rural ones. The fact that the rural population gave a higher score in health concern can be explained in part by a relative lack of local health structures, especially hospitals that are located in the main regional city (the administrative center). No significant differences can be detected in terms of psychosomatic disorders, socialization through the Internet, and trust in government and media.
Regarding the population living in islands, significant differences are once again observed for three factors (Table 5
). Demographic situation and employment situation present a higher score in island areas. The higher importance attributed to the employment situation in island areas can be explained by the fact that their main economic activity (tourism) was suddenly stopped, paralyzing the entire local economy. Conversely, sleep disorders seem to be more moderate in island areas compared to other regions. It is finally interesting to mention that, despite the relative geographical isolation, no significant differences can be observed as regards health concerns. It is true that at least the main islands of the country have health infrastructure (including hospitals), which is not the case for many inland rural areas.
Home confinement, the avoidance of social contacts and the adoption of hygiene and self-protection measures due to the spread of the coronavirus have inevitable psychological side effects in a great part of the population in Greece. Research suggests that quarantine and long-term isolation can lead to post-traumatic stress, anxiety, depression, but also to fatigue, widespread demoralization, and, eventually, public reaction (Brooks et al. 2020
). These findings become stronger, realizing that social isolation and hunger leave about the same neuronal imprint on the brain (Tomova et al. 2020
This paper is among the first general reviews on social isolation determinants in Greece, posed by COVID-19. After examining 4216 Greek people, the results indicate that a large range of factors has contributed to developing social isolation feeling among the Greek population. Among them, the psychosomatic disorders, as well as the employment situation, are obviously predominant. To a lesser extent, three other factors follow changes in sleep habits, socialization through the Internet, and demographic status. Finally, health concerns and trust in government and media have a relatively limited role—comparatively with the five above-mentioned factors—in determining the Greeks’ social isolation feeling. These ominous changes impact the feeling of social isolation and, consequently, the wellbeing of the population.
As regards the factors that determined the social isolation feeling, insightful findings are reported on the differences between urban and rural residents, as well as inland and island ones. The impact of employment and demographic situation, as well as the health concern, is relatively more important for residents living in rural areas compared to urban residents, while sleep disturbances are more intense for urban residents than rural ones. Unequal “social-COVID” geographies are also observed in the Greek islands presenting a higher score in both demographic and employment situations. Conversely, sleep disorders seem to be more moderate in island areas compared to other regions. The relative geographical isolation of the islands, though, does not imply further health concerns compared to the inland regions. In line with the findings, the regions need to engage further with equity issues and sustainable development to support populations’ wellbeing during the pandemic (Chattu and Chami 2020
The present study highlighted the factors the determined the social isolation feeling of the Greek population during the lockdown period. Though, the short time period available to collect (two months), analyze and present data, as well as the changing nature of the pandemic, begs the question of whether these results are differentiated in the meantime.
Considering the second transmission wave of the virus, updated research data are urgently needed to support interventions and strategies for preventing further social isolation feeling. Multidisciplinary research is needed to evaluate interventions on preventing and/or addressing the social isolation feeling posed by COVID-19, as social cohesion with parallel physical distancing is the key to confront the pandemic (Gupta and Dhamija 2020