People have been spending a lot of time alone during the COVID-19 pandemic, with entire countries shutting down for months. Since then, exposure to the actual virus has sent millions back into quarantine for self- or government-imposed isolation. And the second wave may be underway, health authorities warn.

For some people, being alone is a dream come true or not that much different than their normal routine. But for most, self-isolation has been a shocking new reality and in some cases has led to depression and suicide.

Even before the pandemic hit, researchers knew that loneliness and social isolation were serious health threats. A 2018 survey by Cigna, showed that nearly half of the 20,000 adults surveyed always felt alone, while 40% reported that they felt isolated or that their relationships weren’t meaningful.

And that’s dangerous, says Julianne Holt-Lunstad, a professor of psychology and neuroscience at Brigham Young University, who says a lack of social connection is the same as smoking 15 cigarettes per day or having problems with alcohol. Loneliness and social isolation are twice as detrimental to physical and mental health as being obese, she says.

People over age 50 report higher levels of social isolation and loneliness, with a 50% increased risk of dementia, 68% increased risk of hospitalization and 57% risk of emergency room visits, according to the Centers for Disease Control and Prevention (CDC).

And those statistics were before the COVID-19 pandemic.

The CDC maintains that limiting face-to-face contact is the best way to reduce the spread of this virus. That means staying home if you can, keeping at least 6 feet away from people who are not from your household, plus wearing a mask, avoiding touching your face and frequently washing your hands.

So how can you stay safe and still feel connected? Reach out! Thanks to 21st-century technology, this is much easier than it was in the early 1900s during the Spanish influenza pandemic that killed 50 million people worldwide, according CDC stats.

People who feel alone can still safely socially distance while using email, text messages and social media. Pick up the phone and actually call a friend or relative. Talk with your loved ones over Skype or FaceTime. Write a letter or send a card. Get on the internet, listen to the radio or watch TV.

If you have an elderly parent, grandparent, friend or neighbor, you should definitely be in touch with them. Check in frequently by phone or email. Ask them to come out on the front porch while you do a slow drive-by or while you stand at the end of their driveway and visit. Make sure they’re eating properly by delivering food or having it delivered by a grocery service. Get creative on ways to visit or let them know you’re thinking about them.

One friend’s elderly neighbor had a socially distant picnic in her front yard. Her three daughters and their kids each set up a blanket with food — all 6 feet apart — but they could still talk and the grandparents got to see the kids.

Call your local library and check out books and movies. During the pandemic, many public libraries have instituted curbside pickup and drop-off. And many will let you check out books remotely and download to your electronic devices, like Kindle.

If you’re feeling really isolated and starting to worry about your mental health, if you’re having trouble sleeping, eating too much or not enough, using drugs or alcohol to deal with stress, it’s time to consult your physician or a mental health professional. Many can schedule Skype or FaceTime appointments.

If you are feeling overwhelmed or like you might hurt yourself or others, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.