Eighteen months into the COVID-19 pandemic: The prevalence of depression, anxiety, and stress symptoms in Southeast Asia and the associated demographic factors

Mental health has become a growing concern in the wake of the COVID-19 pandemic. We sought to determine the prevalence of mental health symptoms 18 months after the pandemic's declaration. Our cross-sectional study conducted among 18- to 65-year-old adults (N = 33,454) in October 2021 using the Depression, Anxiety and Stress Scales (DASS-21) found a high prevalence of severe to extremely severe anxiety (49%), depression (47%) and stress (36%) symptoms in Malaysia, Indonesia, Thailand, and Singapore. Multiple logistic regression showed that female and non-binary genders were associated with increased odds of severe/extremely severe symptoms of anxiety (female: aOR 1.44 [95% CI 1.37–1.52];non-binary aOR 1.46 [1.16–1.84]), depression (female: aOR 1.39 [1.32–1.47];non-binary aOR 1.42 [1.13–1.79]), and stress (female: aOR 1.48 [CI 1.40–1.57];non-binary aOR 1.42 [1.12–1.78]). In all three symptom domains, the odds of severe/extremely severe symptoms decreased across age groups. Middle- and high-income respondents had lower odds of reporting severe/extremely severe anxiety (middle-income: aOR 0.79 [0.75–0.84];high-income aOR 0.77 [0.69–0.86]) and depression (middle-income: aOR 0.85 [0.80–0.90];high-income aOR 0.84 [0.76–0.94]) symptoms compared to low-income respondents, while only middle-income respondents had lower odds of experiencing severe/extremely severe stress symptoms (aOR 0.89 [0.84–0.95]). Compared to residents of Malaysia, residents of Indonesia were more likely to experience severe/extremely severe anxiety symptoms (aOR 1.08 [1.03–1.15]) but less likely to experience depression (aOR 0.69 [0.65–0.73]) or stress symptoms (aOR 0.92 [0.87–0.97]). Respondents living in Singapore had increased odds of reporting severe/extremely severe depression symptoms (aOR 1.33 [1.16–1.52]), while respondents residing in Thailand were more likely to experience severe/extremely severe stress symptoms (aOR 1.46 [1.37–1.55]). This study provides insights into the impacts of the COVID-19 pandemic on the point prevalence of psychological distress in Southeast Asia one and a half years after the beginning of the pandemic.

'We weren't checked in on, nobody spoke to us': an exploratory qualitative analysis of two focus groups on the concerns of ethnic minority NHS staff during COVID-19.

OBJECTIVE: To gain exploratory insights into the multifaceted, lived experience impact of COVID-19 on a small sample of ethnic minority healthcare staff to cocreate a module of questions for follow-up online surveys on the well-being of healthcare staff during the pandemic. DESIGN: A cross-sectional design using two online focus groups among ethnic minority healthcare workers who worked in care or supportive roles in a hospital, community health or primary care setting for at least 12 months. PARTICIPANTS: Thirteen healthcare workers (11 female) aged 26-62 years from diverse ethnic minority backgrounds, 11 working in clinical roles. RESULTS: Five primary thematic domains emerged: (1) viral vulnerability, centring around perceived individual risk and vulnerability perceptions; (2) risk assessment, comprising pressures to comply, perception of a tick-box exercise and issues with risk and resource stratification; (3) interpersonal relations in the workplace, highlighting deficient consultation of ethnic minority staff, cultural insensitivity, need for support and collegiate judgement; (4) lived experience of racial inequality, consisting of job insecurity and the exacerbation of systemic racism and its emotional burden; (5) community attitudes, including public prejudice and judgement, and patient appreciation. CONCLUSIONS: Our novel study has shown ethnic minority National Health Service (NHS) staff have experienced COVID-19 in a complex, multidimensional manner. Future research with a larger sample should further examine the complexity of these experiences and should enumerate the extent to which these varied thematic experiences are shared among ethnic minority NHS workers so that more empathetic and supportive management and related occupational practices can be instituted.

COVID-19's impact on neglected pharmaceutical staff: wake-up call for needed research.

Discussion of the necessity of the compulsory vaccination of UK patient-facing care workers as an employment conditionality has deflected from the initial and ongoing impact of Coronavirus disease on relatively neglected occupational groups themselves, including community pharmacists. This commentary highlights the relative lack of research investigating the mental health and wellbeing impact of the pandemic on this occupational group in England and urges further study of their needs and experiences to inform evidence-based supportive psychological interventions.