Changes in Temporal Properties of Notifiable Infectious Disease Epidemics in China During the COVID-19 Pandemic: Population-Based Surveillance Study.

BACKGROUND: COVID-19 was first reported in 2019, and the Chinese government immediately carried out stringent and effective control measures in response to the epidemic. OBJECTIVE: Nonpharmaceutical interventions (NPIs) may have impacted incidences of other infectious diseases as well. Potential explanations underlying this reduction, however, are not clear. Hence, in this study, we aim to study the influence of the COVID-19 prevention policies on other infectious diseases (mainly class B infectious diseases) in China. METHODS: Time series data sets between 2017 and 2021 for 23 notifiable infectious diseases were extracted from public data sets from the National Health Commission of the People's Republic of China. Several indices (peak and trough amplitudes, infection selectivity, preferred time to outbreak, oscillatory strength) of each infectious disease were calculated before and after the COVID-19 outbreak. RESULTS: We found that the prevention and control policies for COVID-19 had a strong, significant reduction effect on outbreaks of other infectious diseases. A clear event-related trough (ERT) was observed after the outbreak of COVID-19 under the strict control policies, and its decreasing amplitude is related to the infection selectivity and preferred outbreak time of the disease before COVID-19. We also calculated the oscillatory strength before and after the COVID-19 outbreak and found that it was significantly stronger before the COVID-19 outbreak and does not correlate with the trough amplitude. CONCLUSIONS: Our results directly demonstrate that prevention policies for COVID-19 have immediate additional benefits for controlling most class B infectious diseases, and several factors (infection selectivity, preferred outbreak time) may have contributed to the reduction in outbreaks. This study may guide the implementation of nonpharmaceutical interventions to control a wider range of infectious diseases.

The Prevalence and Correlative Factors of Depression Among Chinese Teachers During the COVID-19 Outbreak.

Background: Epidemiological data on outbreak-associated depression of Chinese teachers are not available. This study aimed to investigate the prevalence and correlates of depression among teachers during the coronavirus disease 2019 (COVID-19) outbreak in mainland China. Methods: A large cross-sectional online survey was conducted during the COVID-19 outbreak. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). The Connor-Davidson Resilience Scale 25 (CD-RISC 25) and Perceived Stress Scale-10 (PSS-10) were used to measure the mental resilience and stress of participants. The correlative factors of depression were analyzed. Results: In this study, 1,096 teachers were analyzed with a median (range) age of 41 (20-65) years. Of them, 624 (56.9%) suffered from depression (PHQ-9 total score of >4). The multivariate analyses showed that participants with aged ≥41 years (OR = 0.752, 95% CI:0.578-0.979, p = 0.034), participating in epidemic prevention and control (OR = 1.413, 95% CI:1.070-1.867, p = 0.015), thinking prolonged school closure have bad effect (OR = 1.385, 95% CI:1.017-1.885, p = 0.038), sleep duration/day of <6 h (OR = 1.814, 95% CI:1.240-2.655, p < 0.001), physical exercise duration/day of <30 min (OR = 1.619, 95% CI:1.247-2.103, p < 0.001), spending less time with family (OR = 1.729, 95% CI: 1.063-2.655, p = 0.002), being concerned about COVID-19 (OR = 0.609, 95% CI:0.434-0.856, p = 0.004), having poor mental resilience (OR = 6.570, 95% CI:3.533-12.22, p < 0.001) and higher PSS-10 scores (OR = 9.058, 95% CI:3.817-21.50, p < 0.001) were independently associated with depression. Conclusion: During the COVID-19 outbreak, depression was common among teachers. Age, participating in epidemic prevention and control, opinions toward distant teaching and prolonged school closure, sleep duration/day, physical exercise duration, spending time with family, attitude toward COVID-19, mental resilience and stress represented the independent factors for suffering from depression.

The proportion and associated factors of anxiety in Chinese adolescents with depression during the COVID-19 outbreak.

BACKGROUND: Given the serious impact of the COVID-19 outbreak on the mental health of Chinese adolescents, this study aimed to examine the proportion of anxiety and its correlates among Chinese adolescents with depression during the pandemic. METHODS: This cross-sectional online survey was conducted from February 20th to February 27, 2020 in China. Symptoms of depression and anxiety were assessed by the 20-item Center for Epidemiological Studies-Depression (CES-D) and 7-item Generalized Anxiety Disorder (GAD-7), respectively. RESULTS: In this study, 3,498 adolescents with depression were identified. Of them, the proportion of anxiety was 45.1% (95% confidence interval [CI]=43.5%-46.8%). Multiple logistic regression analysis revealed that being concerned about graduation (OR=1.25, P=0.002, 95% CI=1.09-1.43), sleep duration <6hr/day (OR=1.80, P<0.001, 95% CI=1.38-2.34), study duration >8hr/day (OR=1.21, P=0.02, 95% CI=1.03-1.42), and quantity of homework higher than before (OR=1.68, P<0.001, 95% CI=1.40-2.02) were positively associated with anxiety; the number of confirmed COVID-19 cases at a provincial level of 100-999 (OR=0.70, P<0.001, 95% CI=0.59-0.83) and 1,000-9,999 (OR=0.69, P=0.001, 95% CI=0.55-0.87) were negatively related to anxiety in adolescents with depression. LIMITATIONS: Because this was a cross-sectional online study, the causality between variables and anxiety could not be examined among depressed adolescents. The use of self-reported scales may lead to an underestimation of the proportion of anxiety among adolescents with depression. CONCLUSIONS: The symptoms of anxiety were common in adolescents with depression during the COVID-19 outbreak. Timing screening and targeted interventions are necessary to mitigate the risks of mental illness of adolescents.

Prevalence of depression and its correlative factors among female adolescents in China during the coronavirus disease 2019 outbreak.

BACKGROUND: The outbreak of 2019 coronavirus disease (COVID-19) could increase the risk of depression. However, epidemiological data on outbreak-associated depressive morbidity of female adolescents are not available. This study determines the incidence and correlates of depression among female adolescents aged 11-18 years during the COVID-19 outbreak in mainland China. METHODS: A large cross-sectional sample, nationwide online survey was conducted during the COVID-19 outbreak. Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), and the correlative factors of depression were analyzed. RESULTS: In this study, 4805 female adolescents were enrolled with a median (range) age of 15 (11-18) years. Of them, 1899 (39.5%) suffered from depression with a CES-D score of > 15. The onset of depression was significantly related to age, grade, distant learning, attitude toward COVID-19, sleep duration, and physical exercise duration. Furthermore, participants aged 15-18 years (OR = 1.755, 95% CI: 1.550-1.987, p < 0.001), participating in distant learning (OR = 0.710, 95% CI: 0.564-0.894, p = 0.004), concerned about COVID-19 (OR = 0.414, 95% CI: 0.212-0.811, p = 0.010), with sleep duration/day of < 6 h (OR = 2.603, 95% CI: 1.946-3.483, p < 0.001),and with physical exercise duration/day < 30 min (OR = 1.641, 95% CI: 1.455-1.850, p < 0.001) represented to be independent factors for suffering from depression. CONCLUSION: During the COVID-19 outbreak, depression was common among female adolescents. Older age, distant learning, concern about COVID-19, short sleep duration, and physical exercise duration represented the independent factors for suffering from depression.