Determinants of workplace safety towards SARS-Cov-2 and combating COVID-19 among non-healthcare workers in Hong Kong, Nanjing and Wuhan, China.

There has been no validated tool to assess workplace infection control towards SARS-Cov-2 in non-healthcare industries. In this first year survey during 07/2020-04/2021, 6684 workers were recruited from varied non-healthcare settings of Hong Kong, Nanjing and Wuhan of China and responded standard questionnaires containing information of prevention measures and policies implemented by companies and personal preventive behaviour towards infection control. All participants were randomly stratified into two sub-samples as training and validation sample. Workplace safety index towards SARS-Cov-2 (WSI-SC2) was developed and validated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We identified 14 manifest variables in WSI-SC2, with three sub-indices named "Workplace infection control measures and prevention", "Company occupational safety and health management and commitment" and "Worker's personal preventive behavior and awareness towards infectious control". WSI-SC2 obtained a good internal consistency reliability (Cronbach's alpha coefficients ranged: 0.76-0.91), good composite reliability (composite reliability ranged: 0.70-0.95) and satisfactory fit of the model (GFI = 0.95; SRMR = 0.05; RMSEA = 0.07). We further performed stratified analysis according to cities, and the index remained stable. Workers with higher scores of WSI-SC2 were more likely to uptake COVID-19 test. This multi-city large study developed a novel and validated tool that could horizontally measure the workplace safety towards SARS-Cov-2 in non-healthcare workers.

Association of current income and reduction in income during the COVID-19 pandemic with anxiety and depression among non-healthcare workers.

BACKGROUND: Many workers experienced income reduction during the coronavirus disease 2019 (COVID-19) pandemic, which may link to adverse mental health. AIMS: This study aimed to examine the association of current income and reduction in income during COVID-19 with anxiety and depression levels among non-healthcare workers. METHODS: This is a multi-city cross-sectional study. We used standardized questionnaires to collect information. We regrouped the current income and income reduction during COVID-19 according to the tertile and median value of each specific city. Depression, Anxiety and Stress Scales-21 item short version (DASS-21) was used to assess anxiety and depression levels. We performed multinomial logistic regression to examine the association of current and reduced income with anxiety and depression. Path models were developed to outline the potential modification/indirect effect of subsidies from government. RESULTS: Large income reduction and low current income were significantly associated with more anxiety/depression symptoms. Path analysis showed that government subsidies could not significantly alleviate the impact of reduced income on anxiety/depression. CONCLUSION: Our findings showed that large income reduction and low current income were independently associated with anxiety/depression, while these symptoms may not be ameliorated by one-off government funds. This study suggests the need for long-term policies (e.g. developing sustained economic growth policies) to mitigate negative impacts of the COVID-19.

Anxiety, Depression, and Satisfaction With Life Among College Students in China: Nine Months After Initiation of the Outbreak of COVID-19.

BACKGROUND/OBJECTIVE: Mental health problems are common among college students. This study sought to assess the prevalence and risk factors of depressive and anxiety symptoms and well-being among Chinese college students 9 months after initiation of the outbreak of COVID-19. METHOD: A cross-sectional study (N = 3,951, mean age = 19.58) was conducted from October to December 2020. An online survey was used to collect socio-demographic data, and the symptoms of depression and anxiety and satisfaction with life using Disorder 7-Item Scale (GAD-7), the Patient Health Questionnaire 9-Item Scale (PHQ-9), and the 5-items Satisfaction with Life Scale (SWLS). RESULTS: The prevalence of depressive and anxiety symptoms was 59.35 and 54.34%, respectively, and the score of satisfaction with life was 20.51 ± 6.42 among Chinese college students during the pandemic. After controlling for covariates, students in urban areas (AOR = 0.73, 95% CI = 0.61-0.87), with good family economic levels (AOR = 0.77, 95% CI = 0.66-0.91), and having psychological counseling (AOR = 0.55, 95% CI = 0.42-0.73) were positively associated with depression symptoms; meanwhile, higher anxiety symptoms were observed among medical students (AOR = 0.81, 95% CI = 0.69-0.95). Besides, healthy lifestyle such as regular physical activity and diet was associated with depression and anxiety symptoms. Multiple linear models revealed that medical students (ß = 0.479, P = 0.031), those with good family economic level by self-evaluation (ß = 1.283, P < 0.001 for good; ß = 3.013, P < 0.001 for general), good academic performance by self-evaluation (ß = 1.786, P < 0.001 for good; ß = 3.386, P < 0.001 for general), learning burden (ß = 1.607, P < 0.001 for general; ß = 2.117, P < 0.001 for light), regular physical activity (ß = 0.859, P < 0.001), daily routine (ß = 1.289, P < 0.001), diet (ß = 1.714, P < 0.001), and sufficient sleep (ß = 1.408, P < 0.001) had more score of SWLS (all ß > 0, P < 0.05), while senior students (ß = -1.053, P=0.009), students having psychological counseling (ß = -1.753, P < 0.001), and drinking (ß = -0.743, P = 0.012) had lower satisfaction with life. CONCLUSIONS: These findings suggest that more attention should be paid to psychological health among college students, especially during and after the COVID-19 outbreak. Policy makers and educators should help college students develop a healthy lifestyle with regular diet and exercise to promote the psychological health of college students.

Effect of public health interventions on COVID-19 cases: an observational study.

BACKGROUND: As the epidemic of COVID-19 is gradually controlled in China, a summary of epidemiological characteristics and interventions may help control its global spread. METHODS: Data for COVID-19 cases in Hubei Province (capital, Wuhan) was extracted until 7 March 2020. The spatiotemporal distribution of the epidemic in four periods (before 10 January, 10-22 January, 23 January-6 February and 7 February-7 March) was evaluated, and the impacts of interventions were observed. RESULTS: Among 67 706 COVID-19 cases, 52 111 (76.97%) were aged 30-69 years old, and 34 680 (51.22%) were women. The average daily attack rates (95% CI) were 0.5 (0.3 to 0.7), 14.2 (13.2 to 15.1), 45.7 (44.0 to 47.5) and 8.6 (7.8 to 9.3) cases per 106 people in four periods, and the harmonic means (95% CI) of doubling times were 4.28 (4.01 to 4.55), 3.87 (3.78 to 3.98), 5.40 (4.83 to 6.05) and 45.56 (39.70 to 52.80) days. Compared with the first period, daily attack rates rose rapidly in the second period. In the third period, 14 days after 23 January, the daily average attack rate in and outside Wuhan declined by 33.8% and 48.0%; the doubling times increased by 95.0% and 133.2%. In the four periods, 14 days after 7 February, the daily average attack rate in and outside Wuhan decreased by 79.1% and 95.2%; the doubling times increased by 79.2% and 152.0%. CONCLUSIONS: The public health interventions were associated with a reduction in COVID-19 cases in Hubei Province, especially in districts outside of Wuhan.

Spatiotemporal analysis of COVID-19 outbreaks in Wuhan, China.

Few study has revealed spatial transmission characteristics of COVID-19 in Wuhan, China. We aimed to analyze the spatiotemporal spread of COVID-19 in Wuhan and its influence factors. Information of 32,682 COVID-19 cases reported through March 18 were extracted from the national infectious disease surveillance system. Geographic information system methods were applied to analysis transmission of COVID-19 and its influence factors in different periods. We found decrease in effective reproduction number (Rt) and COVID-19 related indicators through taking a series of effective public health measures including restricting traffic, centralized quarantine and strict stay-at home policy. The distribution of COVID-19 cases number in Wuhan showed obvious global aggregation and local aggregation. In addition, the analysis at streets-level suggested population density and the number of hospitals were associated with COVID-19 cases number. The epidemic situation showed obvious global and local spatial aggregations. High population density with larger number of hospitals may account for the aggregations. The epidemic in Wuhan was under control in a short time after strong quarantine measures and restrictions on movement of residents were implanted.

Epidemiological characteristics and transmission dynamics of paediatric cases with coronavirus disease 2019 in Hubei province, China.

AIM: This study aimed to identify the epidemiological characteristics and transmission dynamics of paediatric cases. METHODS: Information on 1369 paediatric cases with COVID-19 from 8 December 2019 to 7 March 2020 in Hubei province was extracted from the National Infectious Disease Surveillance System. The analysis included epidemic curves, temporal-spatial distribution, clinical classification and interval times between onset and diagnosis. RESULTS: Among 1369 paediatric cases, the median age was 9 years and 58.2% of them were males. The proportion of severe and critical cases in children was lower than that in adults and the proportion of asymptomatic cases in children was five times greater than for adult cases. The first paediatric case was reported on 2 January 2020, and the daily number of new paediatric cases remained high from 1 February through to 22 February. The epidemiological curve of paediatric cases lagged behind that of adults by 19 days, and the first spike of the epidemic curve in senior high school students occurred 1 week earlier than in other paediatric groups. The proportion of clustered cases among children was about twice that for adults. The median of the interval in paediatric cases between onset and diagnosis, isolation and notification were 3, 0 and 3 days, respectively, and all of those were significantly shorter than in adults. CONCLUSIONS: The epidemic curve of child cases lagged behind that of adult cases by 19 days, and the major form of transmission observed was in clusters.

Epidemiological characteristics and the entire evolution of coronavirus disease 2019 in Wuhan, China.

BACKGROUND: Coronavirus Disease 2019 (COVID-19) spread rapidly around the world. We aimed to describe the epidemiological characteristics and the entire evolution of COVID-19 in Wuhan, and to evaluate the effect of non-pharmaceutical intervention by the government. METHODS: The information of COVID-19 cases until Mar 18, 2020 in Wuhan were collected from the national infectious disease surveillance system in Hubei province. RESULTS: A total of 49,973 confirmed cases were reported until Mar 18, 2020 in Wuhan. Among whom, 2496 cases died and the overall mortality was 5.0%. Most confirmed cases (25,619, 51.3%) occurred during Jan 23 to Feb 4, with a spike on Feb 1 (new cases, 3374). The number of daily new cases started to decrease steadily on Feb 19 (new cases, 301) and decreased greatly on Mar 1 (new cases, 57). However, the mortality and the proportion of severe and critical cases has been decreasing over time, with the lowest of 2.0 and 10.1% during Feb 16 to Mar 18, 2020, respectively. The percentage of severe and critical cases among all cases was 19.6%, and the percentage of critical and dead cases aged over 60 was 70.1 and 82.0%, respectively. CONCLUSION: The number of new cases has dropped significantly after the government taking the isolation of four types of personnel and the community containment for 14 days. Our results indicate that the mortality and proportion of severe and critical cases gradually decreased over time, and critical and dead cases are more incline to be older individuals.