Lockdown and psychological stress in Wuhan, China.

BACKGROUND: Wuhan was the epicenter of the Coronavirus Disease 2019 (COVID-19), outbreak in China. We aimed at surveying the general public in China to better understand their levels of psychological state and its influencing factors after the Wuhan shutdown on January 23. METHODS: The cross-sectional survey was conducted online and 4,701 respondents participated in this survey. Of them, 3,803 respondents were considered for final analysis. Data on subjective indicators of daily life changes were collected, and individual scores on changes in anxiety, depression, and stress were tested by 8-item, 11-item, and 6-item questionnaires, respectively. RESULTS: Multivariable regression analyses showed that living in the rural areas, living in the other regions except Hubei, and higher education were independent correlates of less negative emotions. Besides, the level of attention, self-assessed infection risk, impact on the daily life and mental health help-seeking tended to be positively associated with the scores of anxiety, depression, and stress. CONCLUSIONS: City of residence, education, marital status, monthly income, level of attention, self-assessed infection risk, impact on daily life and mental health help-seeking were important correlates of anxiety, depression, and stress scores.

Progression of Vision in Chinese School-Aged Children Before and After COVID-19.

Objectives: To investigate the changes of vision, including the prevalence of myopia, hyperopia, poor vision, and the spherical equivalent refraction (SER), in school-aged children before and after the pandemic of Coronavirus Disease 2019 (COVID-19). Methods: A school-based vision screening study was performed on children in 133 primary schools in Wuhan. This study was conducted in 4 consecutive years (2018-2021). Results: A total of 468,094 children (936,188 eyes) were recruited, 255,863 (54.7%) were boys. The SER decreased in 2020 compared to other years after the age of 10. A positive myopia shift was found in younger children aged 6 (0.1 D), 7 (0.05D), and 8 (0.03 D) in 2020 compared to 2019. The progression of vision has improved slightly in 2021. Among the students included in the study, 33.7% were myopia. Conclusion: The vision of older children decreased significantly during the COVID-19. After the pandemic, there is still a high risk for them. In the future, the focus on vision prevention and control should move forward to preschool children.

Association Between Social Support and Perceived Stress: A Cross-Sectional Study on Staffs of the Epidemic Prevention During the Covid-19 Epidemic in China.

Background: The Coronavirus Disease 2019 (COVID-19) lockdown considerably affects people's life in China, both physically and mentally. Staffs of the epidemic prevention and control in the community have played an irreplaceable role during community lockdown period in Wuhan. However, few studies have focused on their health status during epidemic prevention. This study aimed to appraise the available evidence of health conditions of them and explore the influencing factors. Method: Used a multistage sampling method, we conducted a survey in staffs of the epidemic prevention and control in the community (N = 503). Descriptive analysis was used to characterize the respondents. T-test and analysis of variance were for group differences analysis. Confirmatory factor analysis (CFA) was used to verify the scale validity, correlation analysis and pathway analysis and Structural equation model (SEM) was used to study the relationship between stress perception, social support, mental resilience and sleep quality. Statistical analysis was performed with SPSS 26.0, R version 4.1.3 and Mplus 8.3. Results: The mean Perceived Stress Scale (PSS) score of the respondents was 13.28 ± 7.31 and 51.1% had higher PSS score than the normal. In the absence of social support, people's sleeping quality and psychological resilience may decrease, their perceived stress may elevate and compromise mental health correspondingly. Social support could affect perceived stress directly, while Sleep quality and psychology resilience played significant partial mediating roles in social support affecting perceived stress. The mediating effects accounted for 50.8% of the total. Conclusion: Staffs of the epidemic prevention and control in the community suffered from poor sleep quality and high level of stress perception. Establishment of good social support may effectively reduce their stress and this effect is mediated by sleep quality and psychological resilience. Physical health status would affect the staffs' mental health and they more attention should be paid to those with poor physical health.

Factors associated with risk sexual behaviours of HIV/STDs infection among university students in Henan, China: a cross-sectional study.

BACKGROUND: This study aimed to identify factors associated with risk sexual behaviours and target high-risk groups at risk of HIV/STDs infection among university students. METHODS: The cross-sectional study was conducted from 1 November to 31 December 2020 in one university, located in Henan Province. A total of 1602 individuals who reported having ever had sex were analyzed as the subjects of this study. Descriptive analysis and multivariable logistic regression analysis were applied for this study to assess factors associated with risk sexual behaviours among university students. RESULTS: University students who reported having ever had sex accounted for about 9%, with an average age of 19.37 ± 1.03. Of them, having multiple sexual partners and inconsistent condom use during the last 6 months were 37.3% and 35%, respectively. Over 50% of participants had their sexual debut before the age of 18. Bisexual students (AOR = 0.27; 95% CI 0.16, 0.44) and those who lived on over 3000 Yuan per month (AOR = 0.50; 95% CI 0.28, 0.91) were consistently less likely to engage in condom use during the last 6 months. University students who were from high-grade (AOR = 1.56; 95% CI 1.12, 2.18 for sophomore; AOR = 1.84; 95% CI 1.28, 2.65 for junior; AOR = 2.07; 95% CI 1.38, 3.11 for senior), who lived on over 3,000 Yuan per month (AOR = 4.19; 95% CI 2.17, 8.11) or who reported being homosexual (AOR = 3.92; 95% CI 2.17, 7.06) and bisexual (AOR = 33.22; 95% CI 13.11, 84.15) were more likely to have multiple sexual relationships. University students who had sexual debut before the age of 18 were more likely to engage in risk sexual behaviours. CONCLUSIONS: The prevalence of sexual activity among Chinese university students is generally low, but risk sexual behaviours are of considerable concern. University students with higher living expenses, who are not heterosexual and who are younger at first sexual intercourse tend to engage in risk sexual behaviours. The scale-up of intervention is the need to prevent the expansion of the HIV epidemic among young students.

The HIV epidemic among university students is considerable, with the tendency of the high-risk population towards the general population. University students at risk of HIV/STDs infection tend to engage in risk sexual behaviours and were targeted for assessing factors corelated with their risk sexual behaviours in this study. Participants who reported having had sexual relations were selected. Information on the practice of risk sexual behaviours including multiple sexual partners and inconsistent condom use were collected and analyzed using a multivariable logistic regression model.Bisexual students were consistently less likely to use condoms within the last 6 months. University students from high-grade, who lived on over 3000 Yuan monthly, homosexual students and bisexual students were more likely to have multiple sexual relationships. University students who had sexual debut before the age of 18 were more likely to engage in risk sexual behaviours.In conclusion, University students with high cost of living per month, non-heterosexual, who are younger at first sexual intercourse tend to engage in risk sexual behaviours. Intensified intervention is the need to prevent the expansion of the HIV epidemic amongst young students.

Current status and influential factors for family health management during quarantine: A latent category analysis.

OBJECTIVE: We aimed to explore factors affecting family health management during home quarantine as well as the effects of variations in family health management (FHM) on individuals' health status. METHODS: Using stratified random sampling, 618 families in Wuhan as well as cities within its surrounding provinces were recruited and surveyed online. Latent class variables were extracted from four modules: disinfection, space layout, physical exercise, and food reserves. The analysis was conducted using the poLCA package in R software (v.4.1.0). Chi-squared tests, Fisher's exact tests, and non-parametric Kruskal-Wallis tests were used to compare groups as appropriate. RESULTS: We found an overall questionnaire reliability of 0.77 and a total omega of 0.92, indicating that the survey results were credible. The Bayesian information criterion and Akaike information criterion were used to identified four latent class variables, namely latent non-family health management (18.9%) and latent low, medium, and advanced FHM (30.93%, 29.49%, and 20.59%, respectively). Gender, household income level, body mass index, the presence of a nearby community hospital, and self-rated health status showed statistically significant differences with respect to latent FHM. Moreover, we found a statistically significant difference in emotional reactions when comparing latent advanced and low to mid-level latent FHM. Compared with latent non-family health managers, we detected statistically significant differences in individual energy levels between potential family health managers at latent low and medium levels. Additionally, we found statistically significant differences in individual energy levels between latent advanced and low level family health managers. CONCLUSIONS: We found that multiple factors, including gender, household income, and body mass index, were correlated with latent FHM during home quarantine. We conclude that FHM can meaningfully improve individuals' health. Thus, increasing social support for individuals can improve FHM as well as individuals' health during home quarantine.

Precise Community-Based Public Health Management: Crucial Experience Responding to COVID-19 in Wuhan, China.

INTRODUCTION: Facing a grim public challenge caused by COVID-19, many countries decide to live with it for a long time, whereas China continues to enforce precise community-based public health management. This paper summarized China's approaches and aimed to provide illumination for health services decision-makers. METHODS: We systematically reviewed the construction of precise community-based public health management from three aspects: organizational structure, service content, and flexible adjustment, and summed up four essential elements for success. Then, we selected 9 typical countries to compare their non-pharmaceutical strategies and daily new cases. RESULTS: China's community-based public health management has a clear four-level organizational structure. It has worked on infection control, surveillance for new cases, management of contacts, health education, medicare service, outdoor environment disinfection, and living material supply in different stages, and the daily new confirmed cases in Wuhan sustainedly declined to zero. The outbreak was relatively well contained in China, Italy, and Germany as of June 2020, as they adopted stricter movement restrictions, social distance, and patient tracking. CONCLUSION: China's experience has proved the feasibility of non-pharmaceutical strategies responding to COVID-19. The precise community-based public health management strategy can be considered, as it's pretty much the same as public health and social measures (PHSMs) advocated by WHO.

Trends and Factors Associated With Risk Perception, Anxiety, and Behavior From the Early Outbreak Period to the Controlled Period of COVID-19 Epidemic: Four Cross-Sectional Online Surveys in China in 2020.

Background: The first wave of the COVID-19 epidemic in China was brought under with 3 months-from mid-January 2020 to the end of March 2020. Less studies examined dynamic psychological effect and behaviors during COVID-19 pandemic. This study aims to examine perceived risk, anxiety, and behavioral response of the general public related to the outbreak of COVID-19 in four cross-sectional surveys conducted throughout China. Methods: In 2020, four cross-sectional, population-based online survey were conducted from January 28 to February 3, from February 10 to 12, from February 20 to 22, and from March 1 to 10, respectively. Convenience sampling was used for easy recruiting survey participants under the long-term impact of the COVID-19 epidemic. The four independent online questionnaires were sent from the same approach (WeChat and MicroBlog), and anyone who receives the questionnaire on the Internet or mobile phone and meets the inclusion criteria could fill in it. The same questionnaires repeatedly used in the four surveys. Socio-demographic information and individual protective practice were collected and the state-trait anxiety inventory (STAI) was used for measuring anxiety. Propensity score matching was used to adjust for differences in baseline characteristics among the four surveys. Wilcoxon signed ranks test was used to compare people's perceived risk, anxiety and protective behaviors changes in four stages. General linear model was used to identify associations between some demographic factors and perceived risk, anxiety scores, and protective behaviors. Results: The proportion of high perceived risk has dropped from 24.7 to 4.7%. The proportion of severe anxiety has declined from 12.2 to 1.2%. The proportion of people wore masks when they went out has increased from 97.0 to 98.3%. Women were more likely to develop anxiety (OR = 1.5, 95%CI: 1.4-1.6) and more positively adopted recommended behaviors (OR = 2.1, 95%CI: 1.3-3.4) than men. People at age 30-39 years, with high-degree education, with married status, and accompanied with poor self-rated health status were prone to have higher risk perception and anxiety. Perceived risk was significantly associated with anxiety over the entire periods. Anxiety levels had stronger associations with adoption of protective behaviors (wearing mask and avoiding crowed place) in the early epidemic periods than in the late epidemic periods. Conclusions: The levels of perceived risk and anxiety showed a trend of rising first and then falling. Gradually upward trend on initiative preventive behaviors including wearing mask and avoiding visiting crowded places also was observed through scanning data at four stages. People at age 30-39 years, with high-degree education, and accompanied with poor self-rated health status were prone to have higher risk perception and anxiety. Our findings showed that people simultaneously presented both high-level risk perception and anxiety across the four wave surveys, leading to their positive self-prevention and protective behavior.

Impact of the coronavirus disease 2019 lockdown on Schistosoma host Oncomelania hupensis density in Wuhan.

BACKGROUND: Snails that host the parasitic worm Schistosoma were once controlled or eliminated in Wuhan, China. However, safety measures associated with the outbreak of novel coronavirus disease 2019 (COVID-19) halted snail detection and extermination efforts. The impact of the COVID-19 pandemic on urban schistosomiasis transmission remains unclear. This study aimed to investigate snail density and the associated risk of a schistosomiasis outbreak in Wuhan. METHODS: The density and infection status of snails were monitored by global positioning system satellites, and outbreak risk was calculated by adjusting the Kaiser model. SigmaPlot was used to create a three-dimensional risk matrix. RESULTS: The living snail frame occurrence rate was 1.48%, and the average living snail density was 0.054/0.11 m2 in 2020, indicating an increase relative to the respective 2019 values (0.019/0.11 m2). No infectious snails were observed in the survey area. The possibility, harmfulness, and uncontrollability indicator values were 0.842, 0.870, and 0.866, respectively. The areas at greatest risk were the northern bank of Tianxingzhou and the Tianxingzhou and Hongshan districts overall. The existing snail sites in the northern bank of Tianxingzhou exhibited the highest risk scores, followed by those in Pak Sha Chau, with the highest risk score found in Yangsiji Village. The events likely to occur in Hongshan District were also likely to have high severity. CONCLUSIONS: During the COVID-19 outbreak, the risk of schistosomiasis increased due to snail colonies returning to their sites of origin in Wuhan, suggesting a need for strengthened infection control and prevention measures.

Hand hygiene, mask-wearing behaviors and its associated factors during the COVID-19 epidemic: a cross-sectional study among primary school students in Wuhan, China

Although the emphasis on behaviors of hand-washing and mask-wearing was repeated during the pandemic of Coronavirus Disease 2019 (COVID-19), not everyone paid enough attention to this. A descriptive statistic was used to make sense of the status of hand hygiene and mask-wearing among primary school students in Wuhan, China. A binary logistic regression analysis was conducted to identify the risk factors affecting the behaviors of hand-washing and mask-wearing. p < 0.05 (two-sides) was considered as significant at statistics. 42.05% of the primary school students showed a good behavior of hand-washing, while 51.60% had a good behavior of mask-wearing. Gender, grade, out-going history, father's occupation, mother's educational background, and the time filling out the survey were significantly associated with hand hygiene, whereas grade, mother's educational background, and residence were associated with mask-wearing. The behaviors of hand-washing and mask-wearing among primary school students were influenced by gender, grade, and other factors, therefore, parents should make efforts of behavior guidance whereas governments should enlarge medium publicity.

Sleep quality and associated factors during the COVID-19 epidemic among community non-medical anti-epidemic Workers of Wuhan, China.

BACKGROUND: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in December 2019, community non-medical anti-epidemic workers have played an important role in the prevention of COVID-19 in China. The present study aimed to assess sleep quality and its associated factors among community non-medical anti-epidemic workers. METHOD: A survey was conducted using anonymous online questionnaire to collect information from 16 March 2020 to 24 March 2020. A total of 474 participants were included, with a 94.23% completion rate. The questionnaire contained demographic data, physical symptoms, and contact history with COVID-19. The researchers assessed perceived social support by the Multidimensional Scale of Perceived Social Support (MSPSS), assessed perceived stress by the Perceived Stress Scale (PSS), and measured sleep quality by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. RESULTS: Among the participants, 46.20% reported poor sleep quality. A binary logistic regression revealed that having educational background of junior college or above, being a member of the police force, having contacted individuals with confirmed or suspected COVID-19 infection, having chronic disease(s), having illness within 2 weeks, and having high or moderate perceived stress were significant factors associated with an increased risk of poor sleep quality. CONCLUSION: Demographic factors, physical symptoms, history of contact with COVID-19, and perceived stress are significantly associated with poor sleep quality of community non-medical anti-epidemic workers. Thus, targeting these factors might be helpful in enhancing sleep quality of community workers.

Associations between Indoor Environmental Quality and Infectious Diseases Knowledge, Beliefs and Practices of Hotel Workers in Wuhan, China.

Knowledge, beliefs, and practices regarding infectious diseases are key elements that ensure practitioners' health and safety. It is important to carry out such a survey in hotels. This study aims to determine the levels of knowledge, beliefs, and practices regarding infectious diseases among practitioners and their associations with the environmental quality of hotels in Wuhan, China. We surveyed infectious disease knowledge, beliefs, and practices of practitioners in 18 hotels and detected these hotels' environment, including physical factors of temperature, humidity, noise, and the indoor air quality of benzene, toluene, xylene, formaldehyde, CO, CO2, the total count of fungi, aerobic plate count, PM10, and PM2.5. 128 practitioners were included, and 28.9% were male. The questionnaire included knowledge, beliefs, and practices regarding infectious diseases. Our study found moderate levels of knowledge and beliefs, and good health practices. People's beliefs toward COVID-19 were correlated significantly with their knowledge (p < 0.05). Beliefs and health practices were correlated significantly with environmental quality (p < 0.05). However, the environmental quality was correlated negatively with the classification of hotels. Conclusively, despite the good health practices of practitioners, the knowledge and beliefs toward infectious diseases need to strengthen. Hotels should emphasize health education in practitioners and the improvement of environmental hygiene. Integrating all three components into a comprehensive environmental promotion program is warranted.

Study on Factors of People's Wearing Masks Based on Two Online Surveys: Cross-Sectional Evidence from China.

(1) Background: To analyze factors of people's wearing masks based on two online surveys, and to explore whether living area factor or quarantine status could have an impact on mask-wearing. (2) Methods: Chi-square test and logistic regression analysis were used to explore the influence of different factors on people's behavior of mask-wearing in the present study. R3.6.2 was used for data cleaning, SPSS 26.0 was used to conduct corresponding statistical analysis, and a two-sided p-value less than 0.05 was considered to be statistically significant. (3) Results: According to our study, the proportion of participants who wore face masks was higher than 90.0% in both surveys. Single factor analysis showed that the proportion of people wearing face masks raised with the increase of people's education, age, and monthly income (Yuan) in both surveys. People who lived in rural areas were less likely to wear masks. Mask-wearing rate was lower in the isolated individuals than in the non-isolated ones. (4) Conclusions: Masks-wearing is one of the effective measures for COVID-19 pandemic prevention and control. After the Chinese government made wearing face masks mandatory in public places, most residents in China had developed the habit of wearing masks, contributing to the high rate of masks-wearing in China. However, people in rural areas need to raise their awareness of wearing masks. Meanwhile, the mask-wearing of the isolated individuals needs to be enhanced.

Risk Factors of Healthcare Workers With Coronavirus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China.

Coronavirus Disease 2019 (COVID-19), which originated in Wuhan, China, has caused many healthcare workers (HCWs) to be infected. Seventy-two HCWs manifested with acute respiratory illness were retrospectively enrolled to analyze the risk factors. The high-risk department, longer duty hours, and suboptimal hand hygiene after contacting with patients were linked to COVID-19.

Changes in Anxiety, Depression, and Stress in 1 Week and 1 Month Later After the Wuhan Shutdown Against the COVID-19 Epidemic.

OBJECTIVE: The aim of this study was to investigate the changes in Chinese residents' psychological state and its influencing factors after the Wuhan shutdown on January 23, 2020. METHODS: Two surveys were conducted on February 1-5 and February 20-24, separately, using an online self-administrated questionnaire among 3145 and 3814 participants, respectively. Subjective indicators of daily-life changes include level of attention, risk of infection, impact of daily life, self-perceived health status, and mental health help-seeking. Individual scores on changes in anxiety, depression, and stress were generated by 6-item, 4-item, and 3-item questions. A multivariate regression model was fitted in each survey, separately and combined. RESULTS: A total of 6959 residents participated in the study, with 32.78% male and 67.22% female, people living in Wuhan and other cities in Hubei Province accounted for 25.22% and 18.85%, respectively. One week after the Wuhan shutdown, their anxiety, depression, and stress had all increased. Compared with the first survey, the changes in the scores of anxiety, depression, and stress in the second survey were decreased (ß = -1.220, -0.798, and -0.623, all P < 0.001). The level of attention, risk of infection, and self-perceived health status tended to be positively associated with the changes in the scores of anxiety, depression, and stress. CONCLUSIONS: The study showed that the lives and psychological conditions of residents had undergone negative changes after the Wuhan shutdown, but the measures taken during this period were effective. These results may provide guidance for public health policies in other countries and regions.

Contactless Food Supply and Delivery System in the COVID-19 Pandemic: Experience from Raytheon Mountain Hospital, China.

The contactless food supply and delivery system of Raytheon Mountain Hospital is an innovative action to solve the dining problem and balance nutrition for medical staff and patients. The system was established according to five approval criteria, including localization, experience in hospital meal service, sufficient raw materials and supporting facilities, food safety, and high execution in dispatching. From the preparation phase to service optimization and improvement, the service model of the full collection of food and beverage information, point-to-point distribution, contactless food delivery, one-stop ordering, and full coverage of separately eating is established to safeguard the contactless food supply and delivery system operating smoothly. As of April 15, 2020 Raytheon Mountain Hospital had been operating safely for 68 days with no occurrence of food safety accident.

Risk perception of coronavirus disease 2019 (COVID-19) and its related factors among college students in China during quarantine.

OBJECTIVE: At the end of 2019, the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan was a serious threat to public health. This study aimed to evaluate the risk perception of COVID-19 among college students in China during the quarantine, explore its related factors, and provide reference for future study. METHODS: This study invited college students from various provinces of China to participate in the survey through the Internet, and a total of 1,461 college students were included. T-test and analysis of variance were used to explore the relationship between demographic characteristics, social pressure, knowledge and risk perception. Multiple linear regression was used to identify factors associated with risk perception. RESULTS: This study shows that college students in China have high risk perception of COVID-19. Female college students (p<0.01), non-medical students (p<0.01), college students whose schools are located in Hubei (p = 0.01) and college students with higher knowledge level (p<0.01) have higher risk perception. CONCLUSION: Due to the strong infectivity and occult nature of COVID-19, it is necessary to improve the risk perception of college students through health education in various ways, and attention should be paid to some college students with low risk perception.

A specialized clinical laboratory center for the coronavirus disease 2019 (COVID-19) in Wuhan Leishenshan Hospital during the COVID-19 outbreak

Responding to the extreme scarcity of medical resources during the early outbreak of the coronavirus disease 2019 (COVID-19) in Wuhan, China, an emergency specialist hospital of Leishenshan started to construct on January 26, 2020 and accommodate patients on February 6, 2020. The clinical laboratory center of Leishenshan Hospital (CLCLH) was constructed at the same time within 11 days to support the treatment of inpatients in Leishenshan Hospital and the testing of suspected patients from different fever clinics in Wuhan. The CLCLH could perform a total of 320 clinic, 299 biochemistry, 31 microorganism and 47 infection and immunity examinations per day. It could also complete an average of 239 nucleic acid tests and 118 SARS-CoV-2 antibody examinations per day. No suspected cases were documented amongst the health care workers during the operation of the CLCLH. The construction and operation experiences of the CLCLH is provided in this study and might be used by other countries as reference. The content of this study is divided into four parts: (1) the establishment of the CLCLH, including its layout and medical resource allocation;(2) the major testing items;(3) the specific procedure of COVID-19 indicator examination;(4) the standardized personal protection measures.