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      A Comparative Study on the Psychological Health of Frontline Health Workers in Wuhan Under and After the Lockdown

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          Abstract

          Background: The coronavirus disease-2019 (COVID-19) outbreak and a 3-month lockdown of Wuhan may have had a long-term impact on the mental health of frontline healthcare workers (HWs). However, there is still a lack of comparative studies on the mental health of front-line HWs in the initial phase of the lockdown and 1 month after the lifting of the lockdown.

          Methods: We recruited 1717 HWs during the initial phase of the lockdown and 2214 HWs 1 month after the lifting of the lockdown, and their baseline characteristics and psychiatric health in these two phases were compared. Furthermore, Pearson's Chi-square test and multivariate logistic regression analysis were used to determine the possible risk factors associated with depressive symptoms in the front-line HWs.

          Results: Compared with the initial phase of the lockdown, the proportion of HWs with anxiety symptoms and stress decreased, while the proportion of HWs with depressive symptoms increased a month after the lifting of the lockdown. Male sex, exercise habit, comorbidities, and having family members or relatives with suspected or confirmed COVID-19 infection were significantly related to the increased incidence of depressive symptoms during the initial phase of the lockdown. Comorbidities, negative effect of media coverage, working >4 days a week, lower annual household income, and deteriorating relationships with family members were associated with depressive symptoms a month after the lifting of the lockdown.

          Conclusion: The increased proportion of HWs with depressive symptoms 1 month after the lifting of the lockdown suggested that mental health of front-line HWs should be a top-priority issue, not only during, but also after the pandemic.

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          Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

          Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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            Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

            Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                21 June 2021
                2021
                21 June 2021
                : 12
                : 701032
                Affiliations
                [1] 1Department of Neurology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology , Wuhan, China
                [2] 2Nursing Department, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology , Wuhan, China
                [3] 3Department of Medical Affair, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology , Wuhan, China
                [4] 4Department of Gastrointestinal Surgery, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology , Wuhan, China
                [5] 5Department of Chemistry, Emory University , Atlanta, GA, United States
                [6] 6Department of Neurology, Wuhan First Hospital , Wuhan, China
                Author notes

                Edited by: Roger C. Ho, National University of Singapore, Singapore

                Reviewed by: Fengyi Hao, First People's Hospital of Chongqing Liangjiang New District, China; Cyrus S. H. Ho, National University Health System, Singapore

                *Correspondence: Zhou Zhu zhouzhu@ 123456hust.edu.cn

                This article was submitted to Public Mental Health, a section of the journal Frontiers in Psychiatry

                †These authors have contributed equally to this work

                Article
                10.3389/fpsyt.2021.701032
                8255471
                34234703
                0641a456-272e-4142-8d63-ea0461adf3a4
                Copyright © 2021 Qiu, Lan, Miao, Wang, Wang, Wu, Li, Zhao, Cao, Mei, Sun, Zhu, Zhu and Wang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 03 May 2021
                : 26 May 2021
                Page count
                Figures: 2, Tables: 4, Equations: 0, References: 51, Pages: 11, Words: 7090
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                covid-19,front-line healthcare workers,depressive symptoms,anxiety symptoms,stress

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