Abstract
The aim of the present study was to investigate the psychological effects of the COVID-19 outbreak and associated factors on hospital workers at the beginning of the outbreak with a large disease cluster on the Diamond Princess cruise ship. This cross-sectional, survey-based study collected demographic data, mental health measurements, and stress-related questionnaires from workers in 2 hospitals in Yokohama, Japan, from March 23, 2020, to April 6, 2020. The prevalence rates of general psychological distress and event-related distress were assessed using the 12-item General Health Questionnaire (GHQ-12) and the 22-item Impact of Event Scale-Revised (IES-R), respectively. Exploratory factor analysis was conducted on the 26-item stress-related questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes for workers both at high- and low-risk for infection of COVID-19. A questionnaire was distributed to 4133 hospital workers, and 2697 (65.3%) valid questionnaires were used for analyses. Overall, 536 (20.0%) were high-risk workers, 944 (35.0%) of all hospital workers showed general distress, and 189 (7.0%) demonstrated event-related distress. Multivariable logistic regression analyses revealed that ‘Feeling of being isolated and discriminated’ was associated with both the general and event-related distress for both the high- and low-risk workers. In this survey, not only high-risk workers but also low-risk workers in the hospitals admitting COVID-19 patients reported experiencing psychological distress at the beginning of the outbreak.
Highlights
On February 3, 2020, an outbreak of novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported on Cruise Ship Diamond Princess quarantined in the Yokohama Port in Japan [1]
Compared to the low-risk workers, the high-risk workers were more likely to report general distress and event-related distress. Those having actual direct contact with at least one COVID-19 patient showed significantly higher rates of general distress and event-related distress compared to those without direct contacts. Those showing the confidence in the standard precaution, were less likely to report general distress and event-related distress compared to those without confidence
We found that the ‘Feeling of being isolated and discriminated’ was an independent risk factor for worse mental health outcomes among the hospital workers, regardless of their working risks
Summary
On February 3, 2020, an outbreak of novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported on Cruise Ship Diamond Princess quarantined in the Yokohama Port in Japan [1]. The media reported the increasing number of patients who tested positive for SARS-CoV-2 on the cruise ship, labeled as a “second Wuhan,” where about one in five people aboard became infected [2]. Since the media continuously emphasized the effects of COVID-19 infection, the public plunged into anxiety and fear. Hospital workers in Yokohama likely experienced huge psychological stress, despite the fact that the COVID-19 infection had not exploded in Japan yet. Wards for COVID-19 and their staff had limited capacity in hospitals in Yokohama. No hospital closures or quarantine of staff was in place at that time
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