Abstract

COVID-19 stress and fear of COVID-19 is an increasingly researched construct in the general population. However, its prevalence and association with sociodemographic factors and psychological process variables has not been explored in frontline workers under surveillance in a Bornean population. This study was a cross-sectional study using a sociodemographic questionnaire incorporating two specific epidemiological risk variables, namely specific questions about COVID-19 surveillance status (persons under investigation (PUI), persons under surveillance (PUS), and positive cases) and the nature of frontline worker status. Furthermore, five other instruments were used, with three measuring psychopathology (namely depression, anxiety and stress, fear of COVID-19, and stress due to COVID-19) and two psychological process variables (namely psychological flexibility and mindfulness). Kruskal–Wallis and Mann–Whitney tests were performed to assess if there were significant differences in psychopathology and psychological process variables between sociodemographic and epidemiological risk variables. Hierarchical multiple regression was further performed, with depression, anxiety, and stress as dependent variables. There were significant differences in the fear of COVID-19 between positive cases, PUI, and PUS. The fear of COVID-19 scores were higher in positive cases compared to in PUS and PUI groups. Upon hierarchical multiple regression, mindfulness and psychological flexibility were significant predictors of depression, anxiety, and stress after controlling for sociodemographic and epidemiological risk factors. This study demonstrates that exposure to COVID-19 as persons under investigation or surveillance significantly increases the fear of COVID-19, and brief psychological interventions that can positively influence mindfulness and psychological flexibility should be prioritized for these at-risk groups to prevent undue psychological morbidity in the long run.

Highlights

  • The inclusion criteria were individuals above 18 years of age who were persons under investigation, persons under surveillance, and positive cases that were picked up during surveillance of the COVID-19 Command Centre in Universiti Malaysia Sabah (UMS), and who were willing to participate in the study and were able to read and converse fluently in Malay

  • (53 individuals), followed by 52 participants who were not exposed to COVID-19 (28.7%)

  • For the fear of COVID-19 between groups, positive cases have much higher levels compared to persons under investigation (PUI) and persons under surveillance (PUS) groups

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Summary

Introduction

COVID-19 was first reported in China back in December 2019 [1] and was subsequently declared by the World Health Organization (WHO) as a pandemic on 11 March. Echoing efforts by many countries worldwide, Malaysia implemented a movement control order (MCO) back in 18 March 2020 in light of increasing cases [3,4]. Apart from movement and social restrictions, extensive contact tracing and large-scale quarantine for positive cases and at-risk groups were performed. These aggressive measures reduced the reproduction number, R-naught (Rt), to less than one in May 2020, signifying a lower infectivity rate [5].

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