Abstract
The current COVID-19 pandemic has been officially linked to the deaths of hundreds of thousands of people across the globe in just a few months. It is particularly lethal for the elderly in general, as well as for populations residing in long-term stay facilities. By this time, those working and caring for high-risk populations have been exposed to very intense and sudden levels of physical and psychological strain. The situation has taken a particularly tragic turn in residential nursing and care homes (NCH), which were hit hard by the pandemic. In residential NCH, neither residents nor workers tend to have immediate access to the same expertise, medication and equipment as in hospitals, which exacerbates an already tense situation. Among the mental health conditions related to exposure to potentially traumatic events, post-traumatic stress disorder and anxiety are the most prevalent and scientifically recognized. In this survey-based epidemiological study, we test the prevalence of anxiety and post-traumatic symptomatology in residential nursing and care home workers—a group of individuals that has been largely neglected but who nonetheless plays a very important and sensitive role in our society. We do this by focusing on the North of Italy, the most affected region during the first COVID-19 outbreak in Italy. Using a single-stage cluster design, our study returns an estimate for the prevalence of moderate-to-severe anxiety and/or post-traumatic symptomatology of 43% (s.e. = 3.09; 95% CI [37–49]), with an 18% (s.e. = 1.83; 95% CI [14–22]) prevalence of comorbidity among workers of Northern Italian NCH between 15 June and 25 July 2020 (i.e. 12–52 days after the end of national lockdown). Women and workers who had recently been in contact with COVID-19-positive patients/colleagues are more likely to report moderate-to-severe symptoms, with odds ratios of 2.2 and 1.7, respectively.
Highlights
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), otherwise known as the novel coronavirus (2019-nCoV), was first reported in December 2019 as a cluster of atypical viral pneumonia cases in the city of Wuhan, China [1]
We focused on symptoms of anxiety and posttraumatic stress disorder (PTSD) for all participants using an online version of validated measurement tools: the 7-item Generalized anxiety disorder (GAD) (GAD-7; range of total scores 0–21; [58,59]) and the 22-item impact of event scale-revised (IES-R; range of total scores 0–88; [60]) were used to test the presence and severity of symptoms of anxiety and PTSD respectively
In addition to the clinical attention, our results suggest that PTSD symptoms in particular are likely to represent a response to the COVID-19 emergency instead of a transient and generic reaction to stressors
Summary
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), otherwise known as the novel coronavirus (2019-nCoV), was first reported in December 2019 as a cluster of atypical viral pneumonia cases in the city of Wuhan, China [1]. In 2020, almost one-fourth of the total population in Italy was estimated to be aged 65 years and older, with elderly people in Italian society growing constantly [4,5]. According to official data released by the Italian Ministry of Health [6], the number of deaths for COVID-19 in Italy went from 10 to 32 007 between 25 February and 18 May 2020. This represents 13% of the individuals who tested positive for the presence of the virus (see figure 1 showing a breakdown of death rates by age group as of 15 May) [6]. Other potential factors involved in increasing the vulnerability of elderly individuals are the presence of concomitant physical illnesses associated with advanced age and the relatively confined space in which many of them live, such as residential nursing and care homes (NCH)2 [11]
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