Mitigating Social Isolation Following the COVID-19 Pandemic: Remedy Messages Shared by Older People

Round 1

Reviewer 1 Report

1. The title doesn't show the specific content to be studied, it's suggested to rewrite or clearly show what epidemic disease is.

2. Figures 1 to 4 are not visible in the manuscript.

3. There is no clear explanation of the number of electronic surveys, the number of shipments, and the effective recoveries. Is it 1,327 or 1,189?

4. In the introduction, it is recommended to use tables to organize the inferences discussed in the literature for clearer reading.

5. In the results and discussion, although different categories are used to mark different topics, such as "Cultivating Community", "Making Room for What's Good", "Don't let down your guard", "Voiced out challenges", each category and topic also has more categories, and a large number of questionnaires make it more difficult to read as a whole. It is suggested to use tables with text descriptions, which will be easier to understand.

6. The study shared the remedial information collected from Canadians, which was of great significance to the practitioners and project developers engaged in population work, but lacked practical suggestions. People are gregarious animals. Living in a closed circle for the elderly or living alone will lead to psychological or physical diseases. In addition to explaining the impact on public health, it is suggested to increase group sports or social activities to reduce loneliness.

7. Compared with the published research (Low Gail, et al.,2024), it seems that the repetition is too high, and little possibility of contribution. The author should specifically explain the differences between the two studies in this manuscript.

1. Title modification.  (From line 2 to line 3)

2. Figures 1 to 4 are not visible in the manuscript. (From line 146 to line 183)

3. Is the number of questionnaires in the electronic survey 1327 or 1189? (Line 12, 20, 538, 170, 147)

4. It is suggested to use tables to organize the inferences discussed in the literature so as to read them more clearly. (From line 37 to line 111)

5. In the results and discussion, suggested to use tables with text descriptions, which will be easier to understand. (From line 169 to line 377)

6. In addition to explaining the impact on public health, it is suggested to increase group sports or social practice activities to reduce loneliness. (From line 482 to line 518) 

7. It is recommended that the differences from the study of Low Gail et al. (2024) (Mentally healthy living after pandemic social distancing: a study of older Canadians reveals helpful anxiety reduction strategies) be clearly pointed out in order to highlight the contribution of this manuscript.

Author Response

Reviewer: 1

Major comments

1. The title doesn't show the specific content to be studied, it's suggested to rewrite or clearly show what epidemic disease is.

 

Thank you for being so gracious about this. We have added ‘COVID-19 ‘to our title. In response to reviewer #2, our title now reads as: ““Mitigating Social Isolation during the COVID-19 Pandemic: Remedy Messages Shared by Older People”

 

2. Figures 1 to 4 are not visible in the manuscript.

 

For clarity purposes, I am wondering – are you referring to DPI concerns? We embedded the 4 original figures within the manuscript, under the auspices of a 300 DPI spec (as per MDPI author guidelines). I will ask Diana about this. We thank you for your patience. In keeping with Reviewer #2’s suggestion, we have now combined Figures 1 and 2 into a single Figure 1 to avoid content repetition. We now have three (as opposed to 4) figures. In keeping with COVID author guidelines (https://www.mdpi.com/2673-8112/4/1/10), each figure has a unique caption.

 

3. There is no clear explanation of the number of electronic surveys, the number of shipments, and the effective recoveries. Is it 1,327 or 1,189?

 

We do apologize for this lack of clarity on our part. We now add into Section 2.3, para 2:

 

“2.3. Data Collection

Qualtrics did not disclose the names of or contact information (and therefore the number of) for any potential responders receiving the study advertisement or consenting to and completing our e-survey. All study investigators were ethically bound to remain impartial (Pro0118512) or at arm's-length during data collection. Up to three reminders were sent to non-responders and $4 in Canadian Consumer Rewards were given to responders, regardless of how many e-survey questions they answered. To protect confidentiality and further enhance data quality, each responder was assigned a unique identifier number and a single-use link to prevent multiple completions. The Qualtrics platform also supports bot detection.

 

Six weeks after our e-survey launched, survey responses ceased. At this time, Qualtrics sent us a completely anonymized dataset collected from 1,327 responders. Among all such responders,

1,189 (89.6%) offered social isolation remedy messages.”

 

Relatedly in Section 3.2, we also now state:

 

“3.2. Identified themes

Content analysis of social isolation remedy messages yielded 4 principal remedies, under which 7 actionable categories and 10 subcategories of specific ways of behaving and thinking fell (Figure 1). These 4 remedies were: 1) Cultivating community; 2) Making room for what’s good; 3) Don’t let your guard down; and 4) Voiced out challenges. Because messages were completely anonymous, we outline the content of these overarching and subordinate categories using pseudonyms. We outline all such categories in descending frequency as shown in Figure 2.”

 

4. In the introduction, it is recommended to use tables to organize the inferences discussed in the literature for clearer reading.

 

We thank you for this suggestion. Based on my publishing with a variety of social, policy, psychological, aging, and health science journals this past 19 years, literature review claims (and therefore our introduction section, lines 37-111) are offered in a narrative form, with cited authors embedded throughout. We kindly ask that things are kept as they are now.

 

5. In the results and discussion, although different categories are used to mark different topics, such as "Cultivating Community", "Making Room for What's Good", "Don't let down your guard", "Voiced out challenges", each category and topic also has more categories, and a large number of questionnaires make it more difficult to read as a whole. It is suggested to use tables with text descriptions, which will be easier to understand.

 

We appreciate this suggestion. We have opted to create a new Figure 1 (page 5) that encapsulates the categorical framework from our inductive content analysis. To avoid repetition, we have deleted our originally-named Figure 1 (circular color-coded categorical illustration). In our newly named Section 3.2. “Identified Categories of Content”, we have removed all tedious numericising of categories (i.e. 3.2 Making Room for What’s Good, 3.2.2.1. Acting intentionally for one’s own good  3.2.2.1.1. Self-care spaces, etc.). Accordingly, we now speak only of Content Category 1: Cultivating Community, Content Content Category 2: Making Room for What’s Good, Content Category 3: Don’t let down your guard, and Content Category 4: Voiced out challenges. We opt to and thank you for understanding about leaving quotes in-text versus into tabular format (for example, see https://www.mdpi.com/2673-8112/3/2/23). If Reviewer #2 finds this unpalatable, please allow us to create an additional table.

 

6. The study shared the remedial information collected from Canadians, which was of great significance to the practitioners and project developers engaged in population work, but lacked practical suggestions. People are gregarious animals. Living in a closed circle for the elderly or living alone will lead to psychological or physical diseases. In addition to explaining the impact on public health, it is suggested to increase group sports or social activities to reduce loneliness.

 

We agree and therefore now draw attention to practical implications in Section 4.2, “Public Health Implications” on page 12, para 2:

 

“4.2. Public Health Implications

 

We hope that the practical and thoughtful strategies that older Canadians have shared resonate with a broad array of researchers, practitioners, and program planners. There is a great need for strategies to reduce older adult social isolation. About 1 in 4 older people are still living more isolated lives [21].  Prior to our study, chronically-ill older people were a socially isolated group [30,44]. They might find the messenger advised ways to be good to your body and mind helpful for eking out a more fulsome social life. For other chronically-ill older Canadians, opportunities for increased social participation and support seem to alleviate perceived isolation and loneliness [78]. Loneliness has been linked with a desire for more social, recreational, and group activities [79]. Group exercise classes and walking groups can forge social connections between older people with similar pro-fitness mindsets [80]. In addition, the virtual space known as CHIME IN brings people together to converse about topics of interest and each other [81].

 

We trust that you find the inclusion of recent, relevant literature pleasing.

 

7. Compared with the published research (Low Gail, et al.,2024), it seems that the repetition is too high, and little possibility of contribution. The author should specifically explain the differences between the two studies in this manuscript.

 

This is a wonderful recommendation that really helps us clarify what we are doing differently in this COVID-proposed manuscript and strengthens our written work. Hence, in Section 2.1, we now aver:

 

“2.1. Setting

The overarching project where this research is placed had two aims, the first being to learn from older people in any of Canada’s 10 provinces about coping behaviors statistically significantly associated with mitigating their pandemic-related anxiety [36]. This study fulfills a different aim, and namely to gather and to share later life Canadians’ recommended strategies to mitigate pandemic-related social isolation.

 

8. We wish to respond to your expressed concern: “The contribution provided by this study to the scientific discussion on this topic is too weak (seemingly just the collection, induction, and organization of questionnaires), whether it is theoretical advancement or practical contribution.”

 

With respect to contributory potential, we have strengthened our abstract to set the stage in reader’s minds about our position that older Canadians are equally credibly positioned to recommend strategies to help their peers mitigate social isolation, albeit pandemic related or otherwise:

 

“Abstract: At the beginning of July 2022, when public health restrictions were lifted, we deployed a country-wide e-survey about how older persons were managing now after COVID-19 pandemic-related anxiety. Our responder sample was stratified by age, sex, and education to approximate the Canadian population. E-survey responders were asked to share open-text messages about what contemporaries could do to live less socially isolated lives at this tenuous turning point following the pandemic as the COVID-19 virus still lingered.  Contracting COVID-19 enhanced older Canadians’ risk for being hospitalized and/or mortality risk. Messages were shared by 1,189 of our 1,327 e-survey responders. Content analysis revealed four calls to action: 1) Cultivating community; 2) Making room for what’s good; 3) Don’t let your guard down; and 4) Voiced out challenges. Responders with no chronic illnesses were more likely to endorse making room for what’s good. Those with no diploma, degree or certificate least frequently instructed others to not let their guard down. While COVID-19 is no longer a major public health risk, a worrisome proportion of older people across the globe are still living socially isolated. We encourage health and social care practitioners and older people to share messages identified in this study with more isolated persons.”

 

Relatedly, we further reiterate the contributory potential of our work in Section 4.3, para 2:

 

“4.3. Limitations and Strengths

Among the strengths of this study were strategies from contemporaries that are suited to a variety of social palates; these should appeal to practitioners and program planners, perhaps as a conversation starter with more isolated older people. One might have reservations about recommending strategies based on a single e-survey question. In the first year of the COVID-19 pandemic, older Canadians helped researchers raise awareness of the detrimental effects of social isolation [9,12,19]. This year’s pressing call from the Women’s College Hospital for local, provincial, and national stakeholders to work together to identify solutions also rightly includes older Canadians [83]. Older Canadians used our e-survey space to offer contemporaries practical ways to mitigate social isolation, and rightly so. People living at risk of an infectious disease are credible purveyors of practical solutions [26].  Perhaps, then, it is not the number of questions that is important, but rather the number of responses to a resonant question. Tackling social isolation resonated with nearly 9 out of 10 of the older Canadians in this study.. We are eager to learn more about what older people, practitioners, and program planners think about peer-driven remedy sharing, and how to best study and communicate its impacts. With social isolation now being a post-pandemic global health concern, all such work is important work [21].”

 

In keeping with our internationally revered guiding framework (UN DESA & UNITAR, 2020), please help us to position older Canadians’ wisdom in the public eye, at the forefront of strategic planning. Given the 2024 across-Canada call to action, our paper could inform and influence program planners and policy makers.  

 

We sincerely thank Reviewer # 1 for helping us strengthen our manuscript and for their supportive comments.

 

Reviewer 2 Report

Reading the title of the article "From Isolation to Inclusion... in pandemic" I had hoped that the article would report an intervention that had reduced the isolation of the elderly during the pandemic. Unfortunately, this is not the case, the study limits itself to reporting the answers to a single question that a sample of elderly people gave in an online questionnaire.

1.       The article does not indicate the date of the survey. This is very important to understand if the pandemic has anything to do with the isolation of the aged people, or if the respondents were actually referring to their condition of isolation which is independent of the pandemic.

2.       The investigation was conducted by a private company. The authors state that the sample has the same composition as the general population, however there is an excess of responses in the younger age group. This is not surprising, because the use of electronic resources in older adults is not very common. The authors do not tell us how many people were contacted, how many responded, and whether they used incentives to encourage response. Furthermore, they do not indicate any systems to prevent person substitution. It's good to know that in Canada 15.6% of people over 80 use computers and answer online questionnaires.

3.       The study classifies and organizes the advice provided by respondents. Since the study is based on a single question, there is no way to know whether the proposed recommendations have been implemented, in part or in full, by the proponents. This is a substantial limitation of the study, which needs to be discussed.

4.       It is not known when exactly the investigation was carried out, so it is not possible to know if the references to the pandemic and the lock-down are pertinent.

5.       The article is not written according to editorial standards. The abstract is longer than indicated, although it is not very informative. The references are not listed in order of citation and contain numerous inaccuracies. For example, the first citation, Chirico 2021 p.154, is not traceable. Other quotes contain a double order number, for example 76 72.

6.       The Discussion does not follow the typical scheme of this part of the article, which involves reporting the summary of the results obtained and comparing them with those of the literature. The authors deal with some considerations on the behavior of the general population during the lockdown that do not fit the topic of the study. If we think about the older people, we can hardly say that “Reliable neighbors and courageous spouses became everyday errand runners (line 393-394)”. Evidently, the authors have derived sentences that have nothing to do with the study presented here. The authors should stick to the findings of their investigation.

7.       The limitations of the study are much more substantial than the only one the authors acknowledge, of being a qualitative analysis of a single question. The poverty of the results presented does not allow publication in a scientific journal.

Reading the title of the article "From Isolation to Inclusion... in pandemic" I had hoped that the article would report an intervention that had reduced the isolation of the elderly during the pandemic. Unfortunately, this is not the case, the study limits itself to reporting the answers to a single question that a sample of elderly people gave in an online questionnaire.

1.       The article does not indicate the date of the survey. This is very important to understand if the pandemic has anything to do with the isolation of the aged people, or if the respondents were actually referring to their condition of isolation which is independent of the pandemic.

2.       The investigation was conducted by a private company. The authors state that the sample has the same composition as the general population, however there is an excess of responses in the younger age group. This is not surprising, because the use of electronic resources in older adults is not very common. The authors do not tell us how many people were contacted, how many responded, and whether they used incentives to encourage response. Furthermore, they do not indicate any systems to prevent person substitution. It's good to know that in Canada 15.6% of people over 80 use computers and answer online questionnaires.

3.       The study classifies and organizes the advice provided by respondents. Since the study is based on a single question, there is no way to know whether the proposed recommendations have been implemented, in part or in full, by the proponents. This is a substantial limitation of the study, which needs to be discussed.

4.       It is not known when exactly the investigation was carried out, so it is not possible to know if the references to the pandemic and the lock-down are pertinent.

5.       The article is not written according to editorial standards. The abstract is longer than indicated, although it is not very informative. The references are not listed in order of citation and contain numerous inaccuracies. For example, the first citation, Chirico 2021 p.154, is not traceable. Other quotes contain a double order number, for example 76 72.

6.       The Discussion does not follow the typical scheme of this part of the article, which involves reporting the summary of the results obtained and comparing them with those of the literature. The authors deal with some considerations on the behavior of the general population during the lockdown that do not fit the topic of the study. If we think about the older people, we can hardly say that “Reliable neighbors and courageous spouses became everyday errand runners (line 393-394)”. Evidently, the authors have derived sentences that have nothing to do with the study presented here. The authors should stick to the findings of their investigation.

7.       The limitations of the study are much more substantial than the only one the authors acknowledge, of being a qualitative analysis of a single question. The poverty of the results presented does not allow publication in a scientific journal.

Author Response

Reviewer: 2

Major comments

1. Reading the title of the article "From Isolation to Inclusion... in pandemic" I had hoped that the article would report an intervention that had reduced the isolation of the elderly during the pandemic. Unfortunately, this is not the case, the study limits itself to reporting the answers to a single question that a sample of elderly people gave in an online questionnaire.

 

This is a good point. Our study is the first study looking at social isolation remedies after social distancing was lifted. As we now point out in Section 4.3 “Limitations and Strengths” para 2: “We are eager to learn more about what older people, practitioners, and program planners think about peer-driven remedy sharing, and how to best study and communicate its impacts.”

In the meantime, our title now rightly reads as follows: “Mitigating Social Isolation during the COVID-19 Pandemic: Remedy Messages Shared by Older People”

 

2. The article does not indicate the date of the survey. This is very important to understand if the pandemic has anything to do with the isolation of the aged people, or if the respondents were actually referring to their condition of isolation which is independent of the pandemic.

 

We agree and offer the following new clarification in Section 2.3 “Data Collection” para 1:

 

“2.3. Data Collection

The first week of July 2022, after social distancing requirements were lifted across Canada, older people were transitioning into open spaces although COVID-19 lingered. At this time, the principal investigator and team co-designed a 36-item e-survey for the overarching project with Qualtrics, a survey research company with expertise in nation-wide health and social surveys [36]. Qualtrics sent a study advertisement about our e-survey to its survey panel members across all 10 Canadian provinces. Potential responders were first taken to an information letter identifying our research aim and their role, with assurances of complete anonymity and contact information for a national support resource. This letter is presented in the Supplementary Materials as Exhibit S1.”

 

3. The investigation was conducted by a private company. The authors state that the sample has the same composition as the general population, however there is an excess of responses in the younger age group. This is not surprising, because the use of electronic resources in older adults is not very common. The authors do not tell us how many people were contacted, how many responded, and whether they used incentives to encourage response. Furthermore, they do not indicate any systems to prevent person substitution. It's good to know that in Canada 15.6% of people over 80 use computers and answer online questionnaires.

  

We thank you for these informative discussion points. Qualtrics is a private company. We chose this company because of its stellar reputation (https://www.qualtrics.com/ ) and world-renowned clientele, like Under Armour, BMW, and Dow (https://www.qualtrics.com/customers/).

 

The largest age-specific proportion of responders in our study were 60- to 64 years of age. This is in keeping with our intention to seek proportions of people that match national frequency distributions, including age (see Section 2.2 “Sample” on page 3, para 4).

 

We agree that we did not tell us how many people were contacted, how many responded, and whether they used incentives to encourage response, or indicate any systems to prevent person substitution. We apologize for these oversights. In Section 2.3 “Data Collection”, we therefore further apprise readers as follows:

 

 “2.3. Data Collection

The first week of July 2022, after social distancing requirements were lifted across Canada, older people were transitioning into open spaces although COVID-19 lingered. At this time, the principal investigator and team co-designed a 36-item e-survey for the overarching project with Qualtrics, a survey research company with expertise in nation-wide health and social surveys [36]. Qualtrics sent a study advertisement about our e-survey to its survey panel members across all 10 Canadian provinces. Potential responders were first taken to an information letter identifying our research aim and their role, with assurances of complete anonymity and contact information for a national support resource. This letter is presented in the Supplementary Materials as Exhibit S1.

Qualtrics did not disclose the names of or contact information (and therefore the number of) for any potential responders receiving the study advertisement or consenting to and completing our e-survey. All study investigators were ethically bound to remain impartial (Pro0118512) or at arm's-length during data collection. Up to three reminders were sent to non-responders and $4 in Canadian Consumer Rewards were given to responders, regardless of how many e-survey questions they answered. To protect confidentiality and further enhance data quality, each responder was assigned a unique identifier number and a single-use link to prevent multiple completions. The Qualtrics platform also supports bot detection.

Six weeks after our e-survey launched, survey responses ceased. At this time, Qualtrics sent us a completely anonymized dataset collected from 1,327 responders. Among all such responders, 1,189 (89.6%) offered social isolation remedy messages.”

 

4. The study classifies and organizes the advice provided by respondents. Since the study is based on a single question, there is no way to know whether the proposed recommendations have been implemented, in part or in full, by the proponents. This is a substantial limitation of the study, which needs to be discussed.

 

We agree that this is a substantial limitation. We therefore concede in Section 4.3 “Limitations and Strengths”, para 2, the following:

 

“4.3. Limitations and Strengths

Among the strengths of this study were strategies from contemporaries that are suited to a variety of social palates; these should appeal to practitioners and program planners, perhaps as a conversation starter with more isolated older people. One might have reservations about recommending strategies based on a single e-survey question. In the first year of the COVID-19 pandemic, older Canadians helped researchers raise awareness of the detrimental effects of social isolation [9,12,19]. This year’s pressing call from the Women’s College Hospital for local, provincial, and national stakeholders to work together to identify solutions also rightly includes older Canadians [83]. Older Canadians used our e-survey space to offer contemporaries practical ways to mitigate social isolation, and rightly so. People living at risk of an infectious disease are credible purveyors of practical solutions [26].  Perhaps, then, it is not the number of questions that is important, but rather the number of responses to a resonant question. Tackling social isolation resonated with nearly 9 out of 10 of the older Canadians in this study. We are eager to learn more about what older people, practitioners, and program planners think about peer-driven remedy sharing, and how to best study and communicate its impacts. With social isolation now being a post-pandemic global health concern, all such work is important work [21].”

 

5. It is not known when exactly the investigation was carried out, so it is not possible to know if the references to the pandemic and the lock-down are pertinent.

 

Thank you for raising this point with us. We have added the date of the study into Section 2.3 “Data Collection”, para 1:

 

“2.3. Data Collection

The first week of July 2022, after social distancing requirements were lifted across Canada, older people were transitioning into open spaces although COVID-19 lingered. At this time, the principal investigator and team co-designed a 36-item e-survey for the overarching project with Qualtrics, a survey research company with expertise in nation-wide health and social surveys [36]. Qualtrics sent a study advertisement about our e-survey to its survey panel members across all 10 Canadian provinces. Potential responders were first taken to an information letter identifying our research aim and their role, with assurances of complete anonymity and contact information for a national support resource. This letter is presented in the Supplementary Materials as Exhibit S1.

 

6. The article is not written according to editorial standards. The abstract is longer than indicated, although it is not very informative. The references are not listed in order of citation and contain numerous inaccuracies. For example, the first citation, Chirico 2021 p.154, is not traceable. Other quotes contain a double order number, for example 76 72.

 

We sincerely apologize for these oversights and thank you for being gracious. In keeping with author guidelines (https://www.mdpi.com/journal/covid/instructions), we have done the following:

 

• Regarding the abstract, we have removed all headings and have a word count of 200 words.
• Regarding the Chirico work, we now cite the “original” proffers of the crisis-oriented characterization of COVID-19, and namely, the Independent Panel for Pandemic Preparedness and Response. Hence our addition in Section 4.1 Main findings and interpretation, page 10, para 1: “The COVID-19 pandemic has been called “the worst combined health and socioeconomic crisis in living memory, and a catastrophe at every level” [47].” We have referenced this work in the reference list.
• Regarding other quotes containing a double order number, for example 76 72, we have removed all repeat numberings of referenced works from our reference list.
• References are now formatted in keeping with COVID author guidelines.

 

7. The Discussion does not follow the typical scheme of this part of the article, which involves reporting the summary of the results obtained and comparing them with those of the literature. The authors deal with some considerations on the behavior of the general population during the lockdown that do not fit the topic of the study. If we think about the older people, we can hardly say that “Reliable neighbors and courageous spouses became everyday errand runners (line 393-394)”. Evidently, the authors have derived sentences that have nothing to do with the study presented here. The authors should stick to the findings of their investigation.

 

We thank you for this valuable advice. As you can see, we have a newly revised and much streamlined discussion. We now present our findings and then compare them with those of the literature. We have removed a number of claims about the behavior of the general population. For example, Fiocco et al., 2021 (Reliable neighbors and courageous spouses became everyday errand runners) and AgeUK 2023 (others yearned to find pleasure in once-pleasurable activities). We stick to the findings of our investigation.

 

8. The limitations of the study are much more substantial than the only one the authors acknowledge, of being a qualitative analysis of a single question. The poverty of the results presented does not allow publication in a scientific journal.

 

Thank you for raising this important issue. Our study was undertaken at a very stressful time in the COVID-19 pandemic, at time during which social distancing lifted and older Canadians were transitioning into open spaces with COVID-19 still lingering. We were duly concerned about responder mental health burden; hence our provision of national support resource information in our study information letter (see Section 2.3 Data Collection, page 3, para 4)

 

We now point out in Section 4.3 “Limitations and Strengths”, para 2:

 

“4.3. Limitations and Strengths

Among the strengths of this study were strategies from contemporaries that are suited to a variety of social palates; these should appeal to practitioners and program planners, perhaps as a conversation starter with more isolated older people. One might have reservations about recommending strategies based on a single e-survey question. In the first year of the COVID-19 pandemic, older Canadians helped researchers raise awareness of the detrimental effects of social isolation [9,12,19]. This year’s pressing call from the Women’s College Hospital for local, provincial, and national stakeholders to work together to identify solutions also rightly includes older Canadians [83]. Older Canadians used our e-survey space to offer contemporaries practical ways to mitigate social isolation, and rightly so. People living at risk of an infectious disease are credible purveyors of practical solutions [26].  Perhaps, then, it is not the number of questions that is important, but rather the number of responses to a resonant question. Tackling social isolation resonated with nearly 9 out of 10 of the older Canadians in this study.. We are eager to learn more about what older people, practitioners, and program planners think about peer-driven remedy sharing, and how to best study and communicate its impacts. With social isolation now being a post-pandemic global health concern, all such work is important work [21].”

 

Given the new Canada-wide call to action, our paper can inform and influence program planners and policy makers. Hence our addition in Section 5 “Conclusion”:

 

“5. Conclusions

This paper shares messages from 1,189 older Canadian people about how to combat social isolation at a pivotal turning point in the COVID-19 pandemic. At least in the specific context of this study, an e-survey was a furtive gathering space to share ideas and insights, albeit as self-affirmations or practical strategies for seeking more social connectedness. That actionable shares came from a majority of e-survey responders is a testament to older people’s pandemic-related social philanthropy and other-oriented nature. We hope that researchers, practitioners, program developers, and older people themselves find solace in knowing that the bearers of these messages similarly endorsed them, regardless of their age, sex, gender identity, and perceived health circumstances.  Education- and illness-related differences in perspective could be ice-breakers for peer-to-peer social recovery support. “

 

Reviewer 3 Report

Thank you for asking me to review this interesting and scientific manuscript: entitled: 

From Isolation to Inclusion: Seniors' Remedy Messaging in the Pandemic 

This study described situation of seniors: Seniors' Remedy Messaging in the Pandemic.

useful manuscript:

The e-survey included a question asking responders what other older Canadians should do to live less isolated lives when public health measures had been lifted, and COVID-19  still lingered. Objectives: When public health restrictions were lifted in the Summer of 2022, we solicited older Canadians' advice about what contemporaries could do to be less socially isolated.

The method and the results are clearly described.

very well structured manuscript. 

4.3. Limitations and Strengths -  excellent (lines 524-540) 

accepted - no problem 

Accepted. 

 

Author Response

Reviewer: 3

Major comments

Thank you for asking me to review this interesting and scientific manuscript: entitled:

From Isolation to Inclusion: Seniors' Remedy Messaging in the Pandemic. This study described situation of seniors: Seniors' Remedy Messaging in the Pandemic. Useful manuscript: The e-survey included a question asking responders what other older Canadians should do to live less isolated lives when public health measures had been lifted, and COVID-19  still lingered. Objectives: When public health restrictions were lifted in the Summer of 2022, we solicited older Canadians' advice about what contemporaries could do to be less socially isolated. The method and the results are clearly described. Very well structured manuscript.  4.3. Limitations and Strengths -  excellent (lines 524-540)  Accepted - no problem

Detail comments: Accepted.

 

We are delighted to hear that you are pleased with this study. In keeping with our guiding framework (UN DESA & UNITAR, 2020), please help us put lay wisdom where it belongs: in the public eye.

Round 2

Reviewer 1 Report

Based on the life experience of the seniors, this work puts forward that the remedial measures of social isolation are important. The conclusion points out that although COVID-19 is no longer the main public health risk, there is still a worrying proportion of the elderly in the world who are still socially isolated. The study further encourages health and social care practitioners and seniors themselves to share the information identified in this study with more isolated people.

Although the author did not answer my question, the first version of the manuscript only included textual descriptions of Figure 1 to Figure 4, but did not see the actual figures, the revised second version of the manuscript has been added.

The author has revised this manuscript one by one according to all suggestions.

The author has revised the content based on all suggestions.

Reviewer 2 Report

The authors have done what they can to illustrate the study, but it contains many flaws

The authors responded to the critical points that had been reported, as best they could