Occupational stress of physicians and nurses in emergency departments after contracting COVID-19 and its influencing factors: a cross-sectional study.

Background: Occupational stress is one of the major occupational health hazards globally. This study investigated the current situation of and factors influencing the occupational stress of physicians and nurses in emergency departments (EDs) after contracting coronavirus disease (COVID-19). Methods: An online questionnaire survey was conducted among physicians and nurses in EDs in China between January 5 and 8, 2023. A general descriptive analysis of variables was conducted, the differences in the occupational stress of physicians and nurses in EDs with different characteristics were analyzed using the chi-square test, and factors influencing occupational stress were investigated using generalized ordinal logistic regression. Results: Of the 1924 physicians and nurses in EDs who contracted COVID-19, 64.71% considered their occupational stress high or very high, with overly intense work as the primary stressor. Those with ≥ 10 years of work tenure, working in tertiary hospitals and with higher professional titles were more stressed, while females, nurses, those with a master's degree or higher, and those who continued to work after contracting COVID-19 were less stressed. There were differences in the predictors of occupational stress between physicians and nurses. Conclusion: China's physicians and nurses in EDs had high occupational stress after contracting COVID-19. Attention should be given to the occupational mental health of physicians and nurses in EDs, and training on the prevention and treatment of COVID-19 infection should be strengthened.

Prevalence and Related Factors of Anxiety Among University Teachers 1 Year After the COVID-19 Pandemic Outbreak in China: A Multicenter Study.

Objectives: This study aimed to evaluate the prevalence of anxiety among university teachers 1 year after the onset of the coronavirus disease 2019 (COVID-19) pandemic and provide empirical evidence of psychological intervention. Methods: A multicenter study was conducted to examine the prevalence of anxiety among 10,302 teachers in 21 Chinese universities from February 12 to April 23, 2021. The generalized Anxiety Disorder 7-item Scale (GAD-7) was used to assess symptoms of anxiety. Multivariate logistic regression models were used to analyze the relationship between potential influence and anxiety symptoms. Results: The overall prevalence of anxiety was 40.0% 1 year after the onset of the COVID-19 pandemic, which was found to be higher in women than in men (41.32% vs. 38.22%; p < 0.0001). The multivariate logistic regression showed that being the female (OR = 1.207; 95%CI: 1.103-1.318), age ≥60 years (OR = 2.004; 95%CI: 1.128-3.560), being married (OR = 1.319; 95%CI: 1.150-1.513), and poor family economic status (OR = 1.580; 95%CI: 1.321-1.891) were significantly associated with anxiety. Participants with moderate, slight, or no impact of COVID-19 on life (OR for moderate, 0.557; 95%CI, 0.508-0.611; OR for slight/no, 0.377; 95%CI, 0.323-0.439) showed a reduced risk of anxiety compared to those who reported a significant effect. Conclusions: Symptoms of anxiety were found in about two-fifths of Chinese university teachers 1 year after the outbreak of the COVID-19 pandemic. Our findings suggest that the government should improve the dynamic tracking of mental health and adopt long-term intervention strategies.

Another New Year, Will the Chinese Residents Wear Face Masks Again? A Cross-Sectional Survey.

Background: As more and more countries enter the low-transmission phase, maintaining prevention awareness among the population is critical to prevent a secondary outbreak. With large-scale interpersonal communication, whether Chinese residents can maintain a high awareness of prevention and control and adhere to the use of masks during the Chinese New Year of 2021 is worth studying. Methods: A cross-sectional survey was conducted in China from February 4 to 26, 2021. A convenient sampling strategy was adopted to recruit participators. Participants were asked to fill out the questions that assessed the questionnaire on face mask use. Descriptive statistics were used to assess the mask-wearing behaviors of the public. A binary logistic regression analysis was performed to identify the risk factors affecting mask-wearing behaviors. Results: A total of 2,361 residents filled out the questionnaire. In the mixed-effect logistic regression analysis, Chinese residents who were older (OR = 7.899, 95%CI = 4.183-14.916), employed (OR = 1.887, 95%CI = 1.373-2.594), had a chronic disease (OR = 1.777, 95%CI = 1.307-2.418), reused face masks (OR = 22.155, 95%CI = 15.331-32.016) and have read the face mask instructions (OR = 3.552, 95%CI = 1.989-6.341) were more likely to use face masks in interpersonal communication during the Spring Festival; while people who have breathing discomfort caused by face masks (OR = 0.556, 95%CI = 0.312-0.991) and considered that using masks repeatedly is wasteful (OR = 0.657, 95%CI = 0.482-0.895) were more unlikely to use face masks. Conclusions: Our results revealed that 83.86% of people wore face masks during the Chinese New Year; however, some aspects require further promotion. By investigating the use of masks by Chinese residents during the Spring Festival and its influencing factors, we can reflect the prevention awareness of the residents during the low transmission period of COVID-19, which can provide a reference for Chinese and global public health policymakers.

Post-traumatic Stress Disorder and Associated Factors 1 Year After the Beginning of the COVID-19 Pandemic Among Chinese Residents.

Background: By investigating the incidence of post-traumatic stress disorder (PTSD) among residents during a period of low transmission, this study reflects the long-term impact of coronavirus disease 2019 (COVID-19) and identify which categories of residents are more likely to develop PTSD due to an acute infectious disease crisis, facilitating the development of targeted strategies to protect mental health after outbreaks of similar acute infectious diseases in the future. Methods: A cross-sectional survey was conducted in China from 4 to 26 February 2021. A convenience sampling strategy was adopted to recruit participants. Participants were asked to complete the PTSD Checklist for DSM-5 (PCL-5). A multivariable linear stepwise regression analysis model was used to identify which factors were associated with PTSD in residents of China. Results: A total of 2,361 Chinese residents completed the questionnaire. The mean PCL-5 score for the respondents was 13.65 (SD = 8.66), with 219 (9.28%) patients having probable PTSD symptoms. Respondents who were female (ß = 0.038), had a relative or friend who had contracted COVID-19 (ß = 0.041), and had poor health (ß = 0.184) had higher PCL-5 scores, while the population aged over 60 years (ß = -0.063), who agreed that COVID-19 information was released in a timely manner (ß = -0.347), who had experienced a relatively limited impact of COVID-19 on their life (ß = -0.069), and who agreed that the local prevention initiatives were sophisticated (ß = -0.165) had lower PTSD scores. Conclusions: Outbreaks of acute infectious diseases can have long-term psychological health effects in the general population. In addition, health policy makers need to be concerned about and implement measures to support the mental health of vulnerable groups.

Current Status and Associated Factors of Depression and Anxiety Among the Chinese Residents During the Period of Low Transmission of COVID-19.

Background: The outbreak of coronavirus disease 2019 (COVID-19) has contributed to depression and anxiety among the general population in China. The purpose of this study is to investigate the prevalence and associated factors of these psychological problems among Chinese adults during the period of low transmission, which could reflect the long-term depression and anxiety of the COVID-19 outbreak. Methods: A cross-sectional survey was conducted in China from 4 to 26 February 2021. Convenient sampling strategy was adopted to recruit participators. Participants were asked to filled out the questions that assessed questionnaire on the residents' depression and anxiety. Results: A total of 2,361 residents filled out the questionnaire. The mean age was 29.72 years (SD = 6.94) and majority of respondents were female (60.10%). Among the respondents, 421 (17.83%), 1470 (62.26%), and 470 (19.91%) were from eastern, central, and western China, respectively. 1704 (72.17%) consented COVID-19 information has been disclosed timely. 142 (6.01%) and 130 (5.51%) patients suffered from depression and anxiety symptoms. Furthermore, some influencing factors were found, including marital status, place of residence, employment status. Conclusion: This study revealed that anxiety and depression still are potential depression and anxiety for some residents, which suggested early recognition and initiation of interventions during the period of low transmission is still indispensable.

Dynamic Changes of Antibodies to SARS-CoV-2 in Close Contacts.

INTRODUCTION: Close contacts of individuals with COVID-19 may directly gain immunity against SARS-CoV-2 despite lacking a detectable infection. This study examined SARS-CoV-2-specific antibodies levels based on gender, age, and exposure source in close contacts of individuals with COVID-19 and compared antibody levels to patients with an asymptomatic or symptomatic COVID-19 infection. METHODS: Two patients had confirmed COVID-19 infections at a community hospital in Qiongzhong, Hainan province. Contact tracing identified all individuals in the community who had been exposed to the two patients during the 14 days before their diagnoses. Close contacts quarantined for 14 days, underwent two SARS-CoV-2 tests, and were screened for SARS-CoV-2-specific antibodies at 7 and 12 weeks after the end of quarantine. SARS-CoV-2-specific antibody levels for the close contacts were compared to those for patients with an asymptomatic or symptomatic COVID-19 infection at 7 and 12 weeks after their diagnoses. RESULTS: Contact tracing identified 10,573 individuals in the community, including 360 (3.4%) close contacts. At 7 weeks, 30 (8.33%) close contacts were positive for SARS-CoV-2-specific antibodies (IgG, n = 26 [7.22%]; IgM, n = 4 [1.11%]), which were lower than the proportion of patients with an asymptomatic (IgG, 100% [12/12]) or symptomatic (IgG, 93.6% [44/47]) COVID-19 infection. SARS-CoV-2-specific IgM antibody levels were significantly higher in close contacts who were exposed through a relative compared to a doctor-patient relationship (P = 0.032). SARS-CoV-2-specific IgG antibody levels were significantly higher in close contacts aged <18 years vs 18-64 years (P = 0.014). At 12 weeks, SARS-CoV-2-specific IgG antibody levels among close contacts were significantly lower than among patients with an asymptomatic (P = 0.004) or symptomatic COVID-19 infection (P < 0.001). CONCLUSION: Immune protection conferred by close contact is short term and unlikely to contribute to herd immunity. There remains an unmet public health need for mass vaccination of populations to increase levels of protective antibodies and achieve and maintain herd immunity.

Public Opinion and Expectations: Development of Public Health Education in China After COVID-19 Pandemic.

Background: Policymakers must promote the development of public health education and human resources. As a feature of the political environment, public opinion is essential for policy-making, but virtually the attitudes of Chinese citizens toward human resources development in public health is unknown. Methods: This study conducted a crosssectional survey from February 4, 2021 to February 26, 2021 in China. We adopted a convenient sampling strategy to recruit participators. Participants filled out the questions, which assess the attitudes of the expanding public health professionals. A logistic regression analysis was given to identify the predictors associated with the attitudes of the subjects. Results: There were 2,361 residents who have finished our questionnaire. Chinese residents who lived in urban (OR = 1.293, 95% CI = 1.051-1.591), "themselves or relatives and friends have participated in relevant epidemic prevention work" (OR = 1.553, 95% CI = 1.160-2.079), "themselves or family members engaged in medical-related work" (OR = 1.468, 95% CI = 1.048-2.056), and those who "were aware of public health before the outbreak of COVID-19" (OR = 1.428, 95% CI = 1.125-1.812) were more likely to support the promotion of public health education and training. Conclusions: The present study found that 74.50% of Chinese citizens supported the promotion of public health education and training in China, in which economic status, personal perception, and comprehension are the crucial factors that influence public opinion. COVID-19 has aroused the attention of Chinese residents to public health education, with only 22.11% of residents being aware of public health before the outbreak of COVID-19. The COVID-19 pandemic has profound implications for human society. Literally, this impact will feed back into future public health policies based on public opinion. This innovative perspective will also help us better understand the potential social impact of COVID-19 on human resources and development for health in the modern world.

Assessing the COVID-19 vaccine hesitancy in the Chinese adults using a generalized vaccine hesitancy survey instrument.

The objectives of this study were to determine coronavirus disease 2019 (COVID-19) vaccination hesitancy and influencing factors in China, while broadening the applicability of the Vaccine Hesitancy Scale (VHS). A cross-sectional survey was conducted in China from 4th to 26th February 2021. Convenience sampling method was adopted to recruit participants. A total of 2,361 residents filled out the questionnaire. Confirmatory factor analysis was used on the validation set to confirm the latent structure that resulted from the exploratory factor analysis, which was conducted on the construction set. Multiple linear regression model analyses were used to identify significant associations between the identified the revised version of VHS subscales and hypothesized explanatory variables. Two subscales were identified within the VHS through data analysis, including "lack of confidence in the need for vaccines" and "aversion to the risk of side effects." The results indicated that the hesitancy of the participants in our sample was both driven the two mainly aspects. In addition, more than 40% of the participants expressed hesitation in half of the items in VHS. This study characterized COVID-19 vaccine hesitancy in China, and identified disparities in vaccine hesitancy by socio-demographic groups and knowledge about the vaccine. Knowledge of the vaccine was statistically linked to respondents' answers to the clustered 'lack of confidence' and 'risks perception' items. Our results characterize Chinese citizens' COVID-19 vaccine concerns and will inform targeted health communications.

Post-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China.

Stringent COVID-19 control measures were imposed in Wuhan between January 23 and April 8, 2020. Estimates of the prevalence of infection following the release of restrictions could inform post-lockdown pandemic management. Here, we describe a city-wide SARS-CoV-2 nucleic acid screening programme between May 14 and June 1, 2020 in Wuhan. All city residents aged six years or older were eligible and 9,899,828 (92.9%) participated. No new symptomatic cases and 300 asymptomatic cases (detection rate 0.303/10,000, 95% CI 0.270-0.339/10,000) were identified. There were no positive tests amongst 1,174 close contacts of asymptomatic cases. 107 of 34,424 previously recovered COVID-19 patients tested positive again (re-positive rate 0.31%, 95% CI 0.423-0.574%). The prevalence of SARS-CoV-2 infection in Wuhan was therefore very low five to eight weeks after the end of lockdown.

Mental health of college students during the COVID-19 epidemic in China.

OBJECTIVES: To assess the psychological status of college students in China during the COVID-19 outbreak, and offer some theoretical evidence for psychological intervention of college students. METHODS: An online survey was conducted from May 10, 2020 to June 10, 2020. Anxiety symptoms were measured by the Generalized Anxiety Disorder 7-Item Scale (GAD-7). Categorical data were reported as number and percentage, while continuous data were reported as mean ± SD. Multivariate logistic regression models were used to evaluate the association between different factors and anxiety symptoms. RESULTS: A total of 89,588 college students participated in the current study, among which 36,865 students (41.1%) reported anxiety symptoms. Multivariate logistic regression analysis revealed that the risk factors for anxiety symptoms included the age of 26-30 (OR=1.456), sophomore (OR=1.038), junior (OR=1.087) and senior grades (OR=1.161), a higher paternal education level (OR=1.055), low economic status (OR=1.520), and low social support (OR=1.542). CONCLUSIONS: About two-fifths of Chinese college students experienced anxiety symptoms during the COVID-19 epidemic. Timely and appropriate psychological interventions for college students should be implemented to reduce the psychological harm caused by COVID-19 epidemic.

Sleep disturbances among Chinese residents during the Coronavirus Disease 2019 outbreak and associated factors.

OBJECTIVES: Sleep status can affect the body's immune status and mental health. This study aims to investigate the sleep status of Chinese residents during the outbreak of Coronavirus Disease 2019 (COVID-19) and to evaluate its related risk factors. METHODS: This research carried out a cross-sectional survey in February 2020 (during the COVID-19 outbreak) to investigate the sleep status of residents nationwide in the form of an online questionnaire. Of the 8151 respondents, 6437 were eventually included in the analysis. Logistic regression is applied to analyze the associated factors affecting residents' sleep quality. RESULTS: During the COVID-19 outbreak, the incidence of sleep disturbances in residents was 17.65%. Increased risk of sleep disturbances was found to be associated with older age, female gender, and poor self-reported health status. Moreover, the odds ratios (ORs) were 1.42 (95% CI: 1.1-2.64), 1.35 (95% CI: 1.16-1.59), 5.59 (95% CI: 4.32-7.23), respectively. Those residents who believed COVID-19 had caused a high number of deaths or who thought COVID-19 was not easy to cure were more likely to experience sleep disorders, and the ORs were 1.73 (95% CI: 1.43-2.09), 1.57 (95% CI: 1.29-1.91), respectively. Regular exercise was a protective factor for sleep disturbances, OR = 0.77 (95% CI: 0.63-0.93). CONCLUSIONS: During the outbreak of COVID-19, nearly one-fifth of participants had sleep disorders. It is necessary to pay more attention to people at high risk for sleep disturbances during the outbreak, adopt effective risk communication methods, enhance residents' rational understanding of COVID-19, and develop practical indoor exercise programs for general public to improve sleep quality.

Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China.

BACKGROUND: The emergency department is considered to be a high-risk area, as it is often the first stop for febrile patients who are subsequently diagnosed with coronavirus disease 2019. This study, which employed a cross-sectional design, aimed to assess the mental health of emergency department medical staff during the epidemic in China. METHODS: Demographic data and mental health measurements were collected by electronic questionnaires from February 28, 2020 to March 18, 2020. OUTCOMES: A total of 14,825 doctors and nurses in 31 provinces of mainland China completed the survey. The prevalence rates of depressive symptoms and post-traumatic stress disorder (PTSD) were 25.2% and 9.1%, respectively. Men were more likely to have depressive symptoms and PTSD than women. Those who were middle aged, worked for fewer years, had longer daily work time, and had lower levels of social support were at a higher risk of developing depressive symptoms and PTSD. Working in the Hubei province was associated with a higher risk of depressive symptoms, while those working in the Hubei province but residing in another province had a lower risk of depressive symptoms and PTSD. Being a nurse was associated with a higher risk of PTSD. INTERPRETATION: The findings suggest that targeted psychological interventions to promote the mental health of medical staff with psychological problems need to be immediately implemented. Special attention should be paid to local medical staff in Hubei.