On the frontlines in Shanghai: Stress, burnout and perceived benefit among COVID-19 testers and other personnel during the Omicron wave lockdown (preprint)

Background: COVID-19 control measure stringency including testing has been among the highest globally in China. Psychosocial impact on pandemic workers in Shanghai, and their pandemic-related attitudes were investigated. Methods: Participants in this cross-sectional study were healthcare providers (HCP) and other support workers. A Mandarin self-report survey was administered via Wenjuanxing between April-June 2022 during the omicron-wave lockdown. The Perceived Stress Scale (PSS) and Maslach Burnout Inventory were administered, as well as pandemic-specific questions. Results:887 workers participated, of which 691 (77.9%) were HCPs. They were working a mean of 6.25+/-1.24 days/week for 9.77+/-4.28 hours/day. Most participants were burnt-out, with 143(16.1%) moderately and 98(11.0%) seriously. Total PSS was 26.85+/-9.92/56, with 353(39.8%) participants having elevated stress. Workers perceived their families primarily as fully supportive (n=610, 68.8%), or also extremely concerned (n=203, 22.9%). Most wanted counseling and stress relief, but half(n=430) reported no time for it; indeed, 2/3rds wanted a few days off to rest (n=601). Many workers perceived benefits: that they fostered more cohesive relationships (n=581, 65.5%), they will be more resilient (n=693, 78.1%), and were honored to serve (n=747, 84.2%).Negative impacts were greater in HCPs, those with economic insecurity, and that did not perceive benefit (all p<.05).In adjusted analyses, those perceiving benefits showed significantly less burnout (OR=0.573, 95% CI=0.411 - 0.799), among other correlates. Conclusions: Pandemic work, including among non-HCP, is stressful, but some can derive benefits.

Impact of Omicron Wave and Associated Infection Prevention and Control Measures in Shanghai on Health Management and Psychosocial Well-Being of Patients with Chronic Conditions (preprint)

Background COVID-19 and associated controls may be particularly problematic in the context of chronic conditions. This study investigated health management, well-being, and pandemic-related perspectives in these patients in the context of stringent measures, and associated correlates. Methods A self-report survey was administered via Wenjuanxing in Simplified Chinese between March-June 2022 during the Omicron wave lockdown in Shanghai, China. Items from the Somatic Symptom Scale (SSS) and Symptom Checklist-90 (SCL-90) were administered, as well as pandemic-related items created by a working group of the Chinese Preventive Medical Association. Chronic disease patients in this cross-sectional study were recruited through an associated community family physician group. Results Overall, 1775 patients, mostly married females with hypertension, participated. Mean SSS scores were 36.1±10.5/80, with 41.5% scoring in the elevated range (i.e., above 36). In an adjusted model, female, diagnosis of coronary artery disease and arrhythmia, perceived impact of pandemic on life, duration can tolerate control measures, perception of future & control measures, impact of pandemic on health condition and change to exercise routine due to pandemic were significantly associated with greater distress. Approximately one-quarter (24.5%) perceived the pandemic had a permanent impact on their life, and 44.1% perceived at least a minor impact on their health. One-third (33.5%) discontinued exercise due to the pandemic. While 47.6% stocked up on their medications before the lockdown, their remaining supply was mostly only enough for a couple of weeks and 17.5% of participants discontinued use. Chief among their fears were inability to access healthcare (83.2%), and what they stated they most needed to manage their condition was medication access (65.6%). Conclusions Since 2020 when we assessed a similar cohort, distress and perceived impact of the pandemic has worsened. Greater access to cardiac rehabilitation in China could address these issues.