Psychological Distress, Fear and Coping Strategies During the Second and Third Waves of the COVID-19 Pandemic in Southern Germany.

Background: The COVID-19 pandemic has imposed enormous psychological discomfort and fear across the globe, including Germany. Objectives: To assess the levels of COVID-19 associated psychological distress and fear amongst Southern German population, and to identify their coping strategies. Methods: A cross-sectional survey using an online questionnaire was conducted in healthcare and community settings in the region of Ulm, Southern Germany. Assessment inventories were the Kessler Psychological Distress Scale (K-10), the Brief Resilient Coping Scale (BRCS), and the Fear of COVID-19 Scale (FCV-19S), which were valid and reliable tools. Results: A total of 474 Individuals participated in the study. The mean age was 33.6 years, and 327 (69%) were females. Most participants (n = 381, 80.4%) had high levels of psychological distress, whereas only 5.1% had high levels of fear, and two-thirds of participants showed higher levels of coping. Moderate to very high levels of psychological distress were associated with being female, living alone, distress due to employment changes, experiencing financial impact, having multiple co-morbidities, being a smoker, increased alcohol use over the previous 6 months, contact with COVID-19 cases and healthcare providers for COVID-19-related stress. Individuals who were ≥60 years, lived with non-family members, had co-morbidities and visited a healthcare provider had higher levels of fear. Higher levels of education and income showed better coping amongst participants. Conclusion: Psychological distress was very high during the COVID-19 pandemic in Germany and associated with low levels of coping. This study identified vulnerable groups of people, who should be given priorities for addressing their health and wellbeing in future crisis periods.

Psychological Distress, Fear and Coping Strategies During the Second and Third Waves of the COVID-19 Pandemic in Southern Germany

Background The COVID-19 pandemic has imposed enormous psychological discomfort and fear across the globe, including Germany. Objectives To assess the levels of COVID-19 associated psychological distress and fear amongst Southern German population, and to identify their coping strategies. Methods A cross-sectional survey using an online questionnaire was conducted in healthcare and community settings in the region of Ulm, Southern Germany. Assessment inventories were the Kessler Psychological Distress Scale (K-10), the Brief Resilient Coping Scale (BRCS), and the Fear of COVID-19 Scale (FCV-19S), which were valid and reliable tools. Results A total of 474 Individuals participated in the study. The mean age was 33.6 years, and 327 (69%) were females. Most participants (n = 381, 80.4%) had high levels of psychological distress, whereas only 5.1% had high levels of fear, and two-thirds of participants showed higher levels of coping. Moderate to very high levels of psychological distress were associated with being female, living alone, distress due to employment changes, experiencing financial impact, having multiple co-morbidities, being a smoker, increased alcohol use over the previous 6 months, contact with COVID-19 cases and healthcare providers for COVID-19-related stress. Individuals who were ≥60 years, lived with non-family members, had co-morbidities and visited a healthcare provider had higher levels of fear. Higher levels of education and income showed better coping amongst participants. Conclusion Psychological distress was very high during the COVID-19 pandemic in Germany and associated with low levels of coping. This study identified vulnerable groups of people, who should be given priorities for addressing their health and wellbeing in future crisis periods.

Underrepresentation of older adults in clinical trials on COVID-19 vaccines: A systematic review.

During the COVID-19 pandemic older subjects have been disproportionately affected by the disease. Vaccination is a fundamental intervention to prevent the negative consequences of COVID-19, but it is not known if the needs and vulnerabilities of older people are adequately addressed by their inclusion in randomized clinical trials (RCTs) evaluating the efficacy of vaccines for COVID-19. Given this background, we aimed to evaluate if current and ongoing phase II-III RCTs evaluating the efficacy of COVID-19 vaccines included a representative sample of older people. A systematic literature search in PubMed and Clinicaltrials.gov was performed until May 01st, 2021. Among 474 abstracts initially retrieved, 20 RCTs (ten already published, ten ongoing) were included. In the ten studies already published, the mean age of participants was 45.2 ± 11.9 years and only 9.83% of the participants were more than 65 years, 1.66% more than 75 years and less than 1% (0.55%) more than 85 years. In the ten ongoing RCTs, many of the studies aimed at including participants older than 18 years, with one study including participants between 18 and 84 years, and two between 21 and 100 years. In conclusion, our systematic review demonstrates that in published and ongoing phase II-III randomized clinical trials evaluating the efficacy of COVID-19 vaccines only a tiny fraction of the most vulnerable group of older people was included, although they clearly were the first population that had to be vaccinated.

[COVID-19 pandemic-related burden and SARS-CoV-2 prevalence in care facilities]. / COVID-19-Pandemie-bedingte Belastungen und SARS-CoV-2-Prävalenz in Pflegeeinrichtungen.

BACKGROUND: Care facilities are particularly challenged by the COVID-19 pandemic. Besides others this includes human and structural resources. OBJECTIVE: This cross-sectional study evaluated the occurrence of infections, psychosocial stress and the different strategies to handle the COVID-19 pandemic in care facilities. MATERIAL AND METHODS: Data collection took place in 7 care facilities in Baden-Württemberg, Germany between 17 July and 25 August 2020. This included a SARS-CoV­2 PCR and antibody testing and a questionnaire for residents and staff. Care facilities were questioned on interventions and preventive measures taken. RESULTS: Out of 829 SARS-CoV­2 PCR tests all remained negative. Only 2 asymptomatic subjects had detectable SARS-CoV­2 antibodies. All subjects (n = 6) with a history of positive PCR had no detectable antibodies. Healthcare workers were mainly worried about infecting family, friends and especially residents (54.4%) with less fear to infect themselves (27.2%). Individual stress caused by the COVID-19 pandemic: 17.1% exhaustion, 16% financial burden and 13.1% sleeping disorders. Coping strategies included a moderate increase of harmful behavior (+3.3% alcohol, +4.3% nicotine). This was relevantly more important in staff aged under 35 years (+13% alcohol, +12.7% nicotine). Women reported a 2.4% increased use of medication, 49.8% of respondents reduced their social contacts, 76.8% changed their individual hygiene behavior. Care facilities felt prepared to a limited extent for the challenges faced by the pandemic. CONCLUSION: Even with a low prevalence of infections at the time of the survey the COVID-19 pandemic challenged care facilities at multiple levels. This should result in better preventive management and coping strategies.