Addressing loneliness and social isolation in at-risk groups during COVID-19 and beyond: a qualitative study in Switzerland

When Switzerland implemented public health measures against COVID-19, certain populations were particularly at risk of loneliness and social isolation, e.g., adolescents and young adults, older people, and migrants. This retrospective qualitative study aimed to explore stakeholders' experiences and perspectives on addressing loneliness and social isolation among these at-risk populations, with particular attention to the contextual, protective, and barrier factors shaping these experiences. It included 36 participants across six focus groups who provided social support to at-risk groups during COVID-19 in both the German- and French-speaking parts of Switzerland. The data were analysed using applied thematic analysis. Three overarching themes were developed: (1) communication and design of public health measures, (2) seizing and adapting existing resources, and (3) establishing a culture of social relationships. According to a socio-ecological framework for loneliness and social isolation during COVID-19, this study shows the interplay between the organisational and institutional levels to which participants belonged and different levels of the social system. Stakeholders perceived that their provision of social support was connected to individual initiatives, pre-existing interpersonal relationships and community support networks. Further, poor policy communication and a lack of acknowledgement of at-risk groups' social needs impacted the ability to address loneliness and social isolation. Stakeholders described opportunities to maintain social support within pandemic restrictions, noting that Swiss public health measures provided some room to meet social needs. Their accounts suggest that future preparedness should consider social relationships alongside infection prevention, pointing to specific approaches that require further safety evaluation and ethical assessment.