COVID-19 Outbreak In China Research Articles

Longitudinal wastewater surveillance of four key pathogens during an unprecedented large-scale COVID-19 outbreak in China facilitated a novel strategy for addressing public health priorities–A proof of concept study

Wastewater-based epidemiology (WBE) is a promising tool for monitoring the spread of SARS-CoV-2 and other pathogens, providing a novel public health strategy to combat disease. In this study, we first analysed nationwide reports of infectious diseases and selected Salmonella, norovirus, and influenza A virus (IAV) as prioritized targets apart from SARS-CoV-2 for wastewater surveillance. Next, the decay rates of Salmonella, norovirus, and IAV in wastewater at various temperatures were established to obtain corrected pathogen concentrations in sewage. We then monitored the concentrations of these pathogens in wastewater treatment plant (WWTP) influents in three cities, establishing a prediction model to estimate the number of infected individuals based on the mass balance between total viral load in sewage and individual viral shedding. From October 2022 to March 2023, we conducted multipathogen wastewater surveillance (MPWS) in a WWTP serving one million people in Xi'an City, monitoring the concentration dynamics of SARS-CoV-2, Salmonella, norovirus, and IAV in sewage. The infection peaks of each pathogen were different, with Salmonella cases and sewage concentration declining from October to December 2022 and only occasionally detected thereafter. The SARS-CoV-2 concentration rapidly increased from December 5th, peaked on December 26th, and then quickly decreased until the end of the study. Norovirus and IAV were detected in wastewater from January to March 2023, peaking in February and March, respectively. We used the prediction models to estimate the rate of SARS-CoV-2 infection in Xi'an city, with nearly 90 % of the population infected in urban regions. There was no significant difference between the predicted and actual number of hospital admissions for IAV. We also accurately predicted the number of norovirus cases relative to the reported cases. Our findings highlight the importance of wastewater surveillance in addressing public health priorities, underscoring the need for a novel workflow that links the prediction results of populations with public health interventions and allocation of medical resources at the community level. This approach would prevent medical resource panic squeezes, reduce the severity and mortality of patients, and enhance overall public health outcomes.

Mental health survey among front-line medical workers after 2 years of supporting COVID-19 efforts in Hubei Province.

During the outbreak of COVID-19 in China, many health care workers have been involved in the front-line fight against the epidemic and have experienced major psychological challenges. This study was aimed at assessing the mental health of front-line health workers after 2 years of COVID-19 efforts. We recruited front-line health workers from Liaoning province who supported Hubei, the epicenter of the COVID-19 outbreak. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder scale (GAD-7), and Insomnia Severity Index (ISI) were used to assess psychological status. A total of 1101 of 1354 contacted individuals completed the survey (participation rate of 81.31%): 963 (87.5%) were 20-45 years of age, 919 (83.47%) were women, 845 (76.7%) were nurses, and 245 (22.3%) were physicians. After 2 years, the mental health symptoms among survey respondents were as follows: 46.6% had depression, 35.5% had anxiety, and 38.1% had insomnia. Thus, 2 years after the COVID-19 pandemic, the front-line health workers who had assisted Hubei province during the COVID‑19 pandemic in China still had high levels of depression, anxiety, and insomnia. Our findings suggest that the pandemic has had significant long-term effects on the mental health of front-line health workers. Therefore, mental health policies should offer long-term rather than short-term services.

COVID-19 Pandemisinin Kuzey Kıbrıs'ta Madde Bağımlılığı ve Aşırı Dozda Uyuşturucu Nedeniyle Acil Servis Başvurularına Etkisi

Introduction: Following the COVID-19 outbreak in China in December 2019, viral spread started to be seen in many countries. In March 2020, simultaneous with the pandemic declaration, the first case was observed in Northern Cyprus. During this time, the emergency department visit patterns showed differences worldwide. 
 Aim: Thus, this study aims to compare and contrast the differences between pre-pandemic and pandemic period emergency department visits resulting from any kind of drug and/or substance intoxication. To do so, a retrospective analysis was held using two private university hospitals’ electronic recording systems for the periods of 1st December 2017-9th March 2020 (before the pandemic) and 10th March 2020-30th June 2022 (during the COVID-19 pandemic). 
 Results: The demographic data were collected, and the study-specific data were grouped into 5 different intoxication categories. Data collected were compared in terms of pre- and post-pandemic timescales. The results showed that there is no significant difference between the demographic data of patients however, intoxication-related emergency department visits were significantly lower during the pandemic compared to the pre-pandemic period.
 Conclusion: This study will be a pioneer in contributing to many social problems, especially substance abuse, which was previously lacking in scientific data in Northern Cyprus.

Psychological resilience matters in the relationship between the decline in economic status and adults' depression half a year after the outbreak of the COVID-19 pandemic.

The outbreak of COVID-19 in China since 2019 has had a significant impact on the mental health of people in Hubei Province during the three-year pandemic period. Therefore, studying the prevalence of depression among the population of Hubei Province since the pandemic is of great significance. Based on opportunity and stress theory, we collected provincial-level data from Hubei (N = 3,285) to examine the impact of declining economic status on depressive symptoms and to investigate the moderating effect of psychological resilience during the period of economic adjustment. We used propensity score matching to estimate the treatment effect of economic status decline on depression severity and confirmed the moderating effect of psychological resilience. We found that the more that an individual's economic status declines, the more severe that his or her depressive symptoms become. Specifically, each unit decrease in economic status is associated with an increase of approximately 0.117 units in depression level. In addition, our results indicated that psychological resilience significantly moderated the relationship between economic decline and depression (-0.184*). Our study confirms the role of economic status in depressive symptoms. Compared with traditional research on the relationship between economic status and mental illness, this paper expands the research regarding the two in the context of a major public health emergency. Furthermore, we suggest ways to improve people's mental health following the pandemic.

The Psychological Network of Loneliness Symptoms Among Chinese Residents During the COVID-19 Outbreak.

Social distancing measures implemented during the COVID-19 pandemic have contributed to increased levels of loneliness, but the specific interactions between loneliness symptoms in the context of the pandemic remain unknown. This study characterized the psychological network of loneliness symptoms in residents during the initial wave of COVID-19 outbreak in China. The study recruited 8472 Chinese residents (61.5% women, aged 33.0±10.6 years) through online snowball sampling. The Six-item De Jong Gierveld Loneliness Scale (DJGLS) was used to measure loneliness symptoms. Central symptoms of and bridge symptoms between emotional and social loneliness subscales were identified based on centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedures. The nodes in the loneliness network were separated into two groups, corresponding to the social and emotional loneliness domains of the DJGLS. The strongest direction association was between "no reliable people" and "no trustworthy people" (edge weight=0.546). "No trustworthy people" has the highest node strength (1.047) in the loneliness network, followed by "emptiness sense" (0.767) and "no reliable people" (0.749). "Feeling of rejection" (1.672) and "no close people" (0.403) showed the first and second highest bridge strengths, respectively. Both the stability and accuracy tests supported robustness of the whole network. Interventions targeting central symptoms "no trustworthy people" and "emptiness sense" and central bridge symptom "feeling of rejection" may be effective for alleviating the overall level of loneliness in pandemic-affected Chinese residents.

Translational Structure Map of SARS-CoV-2: A Clinical Analysis of its Origin

Background: SARS-CoV-2 was declared a global health emergency by WHO Emergency Committee based on growing case notification rates at Chinese and international locations. In this paper, we present an approach to understand the probable clinical origin of SARS-CoV-2. Methods: A combination of citation network analysis, analysis of Medical Heading Subject (MeSH) terms, and quantitative content analysis of scientific literature, was employed to map the organization of the clinical origin of SARS-CoV-2 in this paper. Results: According to the results of the study, a genome of the first 2019-nCoV strain in Hangzhou was obtained, and phylogenetic analysis showed the genome to be closest to the genome of a bat SARS-like coronavirus strain, RaTG13, with an identity of 96.11%. Conclusion: The studies show that the dead Malayan pangolins found close to the outbreak of COVID-19 in China may have carried coronavirus closely related to SARS-CoV-2.

A study on the emotional and attitudinal behaviors of social media users under the sudden reopening policy of the Chinese government.

Since the outbreak of the COVID-19 pandemic, the Chinese government has implemented a series of strict prevention and control policies to prevent the spread of the virus. Recently, the Chinese government suddenly changed its approach and lifted all prevention and control measures. This sudden change in policy is expected to lead to a widespread outbreak of COVID-19 in China, and the public and local governments are not adequately prepared for the unknown impact on society. The change in the "emergency" prevention and control policy provides a unique research perspective for this study. The purpose of this study is to analyze the public's attitudes and emotional responses to COVID-19 under the sudden opening policy, identify the key factors that contribute to these attitudes and emotions, and propose solutions. In response to this sudden situation, we conducted data mining on topics and discussions related to the opening of the epidemic on Sina Weibo, collecting 125,686 interactive comments. We used artificial intelligence technology to analyze the attitudes and emotions reflected in each data point, identify the key factors that contribute to these attitudes and emotions, explore the underlying reasons, and find corresponding solutions. The results of the study show that in the face of the sudden release of the epidemic, the public mostly exhibited negative emotions and behaviors, with many people experiencing anxiety and panic. However, the gradual resumption of daily life and work has also led some people to exhibit positive attitudes. The significance of this study is to help the government and institutions understand the impact of policy implementation on users, and to enable them to adjust policies in a timely manner to respond to potential social risks. The government, emergency departments, and the public can all prepare for similar situations based on the conclusions of this study.

The role of uncertainty, worry, and control in well-being: Evidence from the COVID-19 outbreak and pandemic in U.S. and China.

Uncertainty about the future often leads to worries about what the future will bring, which can have negative consequences for health and well-being. However, if worry can act as a motivator to promote efforts to prevent undesirable future outcomes, those negative consequences of worry may be mitigated. In this article, we apply a novel model of uncertainty, worry, and perceived control to predict psychological and physical well-being among four samples collected in China (Study 1; during the early COVID-19 outbreak in China) and the United States (Studies 2-4, during 4 weeks in May 2020, 4 weeks in November 2020, and cross-sectionally between April and November 2020). Grounded in the feeling-is-for-doing approach to emotions, we hypothesized (and found) that uncertainty about one's COVID-19 risk would predict greater worry about the virus and one's risk of contracting it, and that greater worry would in turn predict poorer well-being. We also hypothesized, and found somewhat mixed evidence, that perceptions of control over 1's COVID-19 risk moderated the relationship between worry and well-being such that worry was related to diminished well-being when people felt they lacked control over their risk for contracting the virus. This study is one of the first to demonstrate an indirect path from uncertainty to well-being via worry and to demonstrate the role of control in moderating whether uncertainty and worry manifest in poor well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Impacts of PM2.5 before and after COVID-19 outbreak on emergency mental disorders: A population-based quasi-experimental and case-crossover study

The ongoing COVID-19 pandemic is a great challenge to mental health, but fine particulate matter (PM2.5), an increasingly reported risk factor for mental disorders, has been greatly alleviated during the pandemic in many countries. It remains unknown whether COVID-19 outbreak can affect the association between PM2.5 exposure and the risk of mental disorders. This study aimed to investigate the associations of total and cause-specific mental disorders with PM2.5 exposure before and after the COVID-19 outbreak in China. Data on daily emergency department visits (EDVs) and hospitalizations of mental disorders from 2016 to 2021 were obtained from Anhui Mental Health Center for Hefei city. An interrupted time series analysis was used to quantify the impact of COVID-19 outbreak on EDVs and hospitalizations of mental disorders. A time-stratified case-crossover analysis was employed to evaluate the association of mental disorders with PM2.5 exposure before and after the COVID-19 outbreak, especially in the three months following the COVID-19 outbreak. After COVID-19 outbreak, there was an immediate and significant decrease in total mental disorders, including a reduction of 15% (95% CI: 3%–26%) in EDVs and 44% (95% CI: 36%–51%) in hospitalizations. PM2.5 exposure was associated with increased risk of EDVs and hospitalizations for total and cause-specific mental disorders (schizophrenia, schizotypal and delusional disorders; neurotic, stress-related, and somatoform disorders) before COVID-19 outbreak, but this PM2.5-related risk elevation significantly decreased after COVID-19 outbreak, with greater risk reduction at the first month after the outbreak. However, young people (0–45 years) were still vulnerable to PM2.5 exposure after the COVID-19 outbreak. This study first reveals that the risk of PM2.5-related emergency mental disorders decreased after the COVID-19 outbreak in China. The low concentration of PM2.5 might benefit mental health and greater efforts are required to mitigate air pollution in the post-COVID-19 era.

Association of children’s behavioral changes and parent–child relationship with parental anxiety under confinement during COVID-19 pandemic: a cross-sectional study

ObjectiveCoronavirus Disease-19 (COVID-19) has become a global pandemic, and mental health of children and parents are affected by confinement in home. Since the outbreak of COVID-19 is still global pandemic currently, it is important to examine how the changes of children’s behaviors and parent–child relationship affect parental anxiety during this difficult time.MethodsA cross-sectional online investigation was conducted with snowball sampling to collect the information about the behavioral changes of children and the anxiety of parents from February 23 to March 3, 2020. 642 participants who had children aged 3–17 years included in this study. Information about behavioral change of children was reported by parents with a questionnaire, parental anxiety was assessed with Self-rating Anxiety Scale (SAS, Chinese Version).ResultsAmong children’s behaviors, decreased time of outdoor activity was associated with a lower odds of parental anxiety, with an adjusted odds ratios (ORs) of 0.31 (95% CI, 0.11–0.87). Parents’ satisfaction with children's behaviors was associated with a lower odds of parental anxiety (ORs, 0.13; 95% CI, 0.05–0.35). In addition, we observed a significant association of worse behavioral performance and worse family relationship with anxiety among parents with the adjusted ORs of 2.78 (95% CI, 1.35–5.73), and 2.67 (95% CI, 1.13–6.32), respectively.ConclusionUnder COVID-19 outbreak in China, changes in children’s behavioral and family relationship were associated with parental anxiety. Our finding suggested that family mental health support and promotion should consider the children’s behavioral regulation and parent–child relationship as essential components.

Supply chain disruption recovery in the evolving crisis—Evidence from the early COVID-19 outbreak in China

The speed of recovery from supply chain disruption has been identified as the predominant factor in building a resilient supply chain. However, COVID-19 as an example of an evolving crisis may challenge this assumption. Infection risk concerns may influence production resumption decision-making because any incidents of infection may lead to further shutdowns of production lines and undermine firms’ long-term cash flows. Sampling 244 production resumption announcements by Chinese manufacturers in the early COVID-19 crisis (February–March 2020), our analysis shows that, generally, investors react positively to production resumptions. However, investors perceived the earlier production resumptions were higher risk (indicated by declined stock price). Such concerns were exacerbated by more locally confirmed cases of COVID-19 but were less salient for manufacturers with high debts (liquidity pressure). This study calls for a reassessment of the current disruption management mindset in response to new evolving crises (e.g., COVID-19) and provides theoretical, practical, and policy implications for building resilient supply chains.

Exploring the Social Dynamics of Public Stigmatization in China of Wuhanese During the Initial Outbreak of COVID-19: A Moral Panic Analysis

ABSTRACT During the initial outbreak of COVID-19 in China in 2019 and 2020, the Wuhanese suffered tremendous public stigmatization. Why and how did the general public in China develop such strong feelings against the Wuhanese? To address these questions and understand the social forces underlying this phenomenon, a moral panic analysis was conducted. Using a mixed-method design, this research examined the scale and mechanisms of the public stigmatization of the Wuhanese as ‘the folk devil’ of a moral panic and identified the social factors (social media, the collective memory of SARS, and the influence of close relations) which produced and facilitated the initial panic and subsequent public stigmatization. Through its presentation and analysis of quantitative and qualitative data, this article explains how public stigmatization has served as an effective social control instrument in China during the COVID-19 outbreak, used to contain the disease, garner strong public support for the government authorities, legitimize extreme methods used to implement containment policies, and monitor and restrict the population.

Evaluating the Impact of COVID-19 on Hospital Profit Compensation Activities: A Difference-in-Differences Event Study Analysis in China.

The impact of the 2019 coronavirus disease (COVID-19) pandemic is still being revealed, and little is known about the effect of COVID-19-induced outpatient and inpatient losses on hospital operations in many counties. Hence, we aimed to explore whether hospitals adopted profit compensation activities after the 2020 first-wave outbreak of COVID-19 in China. A total of 2,616,589 hospitalization records from 2018, 2019, and 2020 were extracted from 36 tertiary hospitals in a western province in China; we applied a difference-in-differences event study design to estimate the dynamic effect of COVID-19 on hospitalized patients' total expenses before and after the last confirmed case. We found that average total expenses for each patient increased by 8.7% to 16.7% in the first 25 weeks after the city reopened and hospital admissions returned to normal. Our findings emphasize that the increase in total inpatient expenses was mainly covered by claiming expenses from health insurance and was largely driven by an increase in the expenses for laboratory tests and medical consumables. Our study documents that there were profit compensation activities in hospitals after the 2020 first-wave outbreak of COVID-19 in China, which was driven by the loss of hospitalization admissions during this wave outbreak.

Risk Perception, Perceived Government Coping Validity, and Individual Sleep Problems in the Early Stage of the COVID-19 Pandemic in China: Mediation Analysis Based on Negative Emotions

This study aimed to investigate the relationship among risk perception, negative emotions, perceived government coping validity, and the sleep problem of the public, through regression analysis and mediation analysis of data from the early stages of the COVID-19 outbreak in China (three months after the outbreak). It found that people's perception of the risk of the pandemic, negative emotions, and perceived government coping validity significantly affected people's sleep quality and nightmares. Further analysis found that individuals' perception of risk not only affected their sleep but also intensified their negative emotions, ultimately impairing the quality of their sleep and leading to nightmares. However, having a high level of coping validity can mitigate negative emotions and consequently decrease the occurrence of nightmares, thereby enhancing the quality of sleep. Specifically, perceived government coping validity could not only directly reduce nightmares, but also indirectly reduce nightmares by lowering negative emotions. However, it could only indirectly improve sleep by reducing negative emotions. It implicated that improving and resolving sleep problems required not only medical intervention but also psychological intervention. Simultaneously, improving the government's response effectiveness could strengthen people's trust in the government, stabilize their mental states, and significantly improve their quality of life by reducing negative emotions and improving sleep.

COVID-19 symptoms and compliance: The mediating role of fundamental social motives.

Understanding the compliance of infected individuals and the psychological process underlying compliance during pandemics is important for preventing and controlling the spread of pathogens. Our study investigated whether fundamental social motives mediate the relationship between having infectious disease and compliance. An online survey was conducted in March 2020, during the severe phase of the COVID-19 outbreak in China to collect data from 15,758 participants. The survey comprised self-report questionnaires with items pertaining to current symptoms (COVID-19 symptoms, other symptoms or no symptoms), the Fundamental Social Motive Inventory, and measures of compliance. Correlation analysis, linear regression analysis, and structural equation model were used for data analysis. The participants with COVID-19 symptoms had lower levels of compliance than those without symptoms, and their lower compliance was caused by a decrease in disease avoidance (indirect effect = -0.058, 95% CI = [-0.061, -0.056]) and familial motives (indirect effect = -0.113, 95% CI = [-0.116, -0.062]). Whereas exclusion concern (indirect effect = 0.014, 95% CI = [0.011, 0.017]) suppressed the effects of COVID-19 symptoms on compliance, the effect disappeared in the multiple mediation model, while those of disease avoidance and familial motives remained. Our findings emphasize the critical role of disease avoidance and familial motives in promoting compliance with public health norms during pandemics and suggest that enhancing these motives may serve as an effective intervention strategy to mitigate noncompliance among potentially infected individuals.

Through a Keynesian Theory to Analyze the Economic Impact under the Outbreak of COVID-19 in China

With the outbreak of COVID-19 pandemic, Chinese economy was hit severely and this disease brought a significant challenge for China. This was particularly the case for unemployment, the variation of GDP and the shrinking of small and medium-sized enterprises. The objective of this research is to investigate the impacts of COVID-19 in China, evaluating economic approaches being applied for different countries and point out the suitable method to boost the recovery of the Chinese economy from economic depression. The study used the fundamental concept of Keynesian theory to conclude the most effective approaches and showed that according to Keynesian theory, the Chinese government should implement expansionary policies to sustain economic growth by raising effective demand and solving unemployment problems. Therefore, the Chinese government can encourage the whole economy through fiscal and monetary policy.

The impact of coping styles on the mental health of healthcare workers one year after the initial COVID-19 outbreak in China

IntroductionA 2020 study in Wuhan residents reported 70.2% of participants faced the COVID-19 pandemic using active coping strategies, and we wanted to explore its comparability in Chinese Health Care Workers (HCWs) across 7 regions in China 1 year after the initial outbreak.ObjectivesThe study analyzed coping strategies utilized by different Chinese HCWs under a stressful period like the COVID-19 pandemic and three psychological scales were used to assess its effect on five psychological outcomes such as depression, anxiety, stress, post-traumatic stress disorder and suicidal ideation.MethodsA cross-sectional self-administered online questionnaire was conducted during the period of November 2020 and March 2021 and included sociodemographic information, work environment before and during the pandemic, experiences, fears and concerns about COVID-19 and three psychological scales including Depression, Anxiety and Stress Scale-21(DASS-21), Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and Simplified Coping Style Questionnaire (SCSQ-20). Chi-square analysis was used to explore categorical association.ResultsThe findings demonstrated that 633 (52.5%) of the participants used passive coping strategies, while 600 (47.5%) used active coping strategies. Passive coping strategies with at least one mental health problem were positively correlated with participants having a previous chronic disease diagnosis, working days in a week during the outbreak, PPE availability, days in isolation for being suspected or a confirmed case of COVID-19, worries about infecting relatives and the pandemic affecting family’s financial situation.ConclusionsDeveloping and creating intervention programs to strengthen active coping strategies will improve mental health outcomes in Chinese HCWs during the COVID pandemic.Disclosure of InterestNone Declared

Changes in Mobile Health Apps Usage Before and After the COVID-19 Outbreak in China: Semilongitudinal Survey.

Mobile health (mHealth) apps are rapidly emerging technologies in China due to strictly controlled medical needs during the COVID-19 pandemic while continuing essential services for chronic diseases. However, there have been no large-scale, systematic efforts to evaluate relevant apps. We aim to provide a landscape of mHealth apps in China by describing and comparing digital health concerns before and after the COVID-19 outbreak, including mHealth app data flow and user experience, and analyze the impact of COVID-19 on mHealth apps. We conducted a semilongitudinal survey of 1593 mHealth apps to study the app data flow and clarify usage changes and influencing factors. We selected mHealth apps in app markets, web pages from the Baidu search engine, the 2018 top 100 hospitals with internet hospitals, and online shopping sites with apps that connect to smart devices. For userexperience, we recruited residents from a community in southeastern China from October 2019 to November 2019 (before the outbreak) and from June 2020 to August 2020 (after the outbreak) comparing the attention of the population to apps. We also examined associations between app characteristics, functions, and outcomes at specific quantiles of distribution in download changes using quantile regression models. Rehabilitation medical support was the top-ranked functionality, with a median 1.44 million downloads per app prepandemic and a median 2.74 million downloads per app postpandemic. Among the top 10 functions postpandemic, 4 were related to maternal and child health: pregnancy preparation (ranked second; fold change 4.13), women's health (ranked fifth; fold change 5.16), pregnancy (ranked sixth; fold change 5.78), and parenting (ranked tenth; fold change 4.03). Quantile regression models showedthatrehabilitation (P75, P90), pregnancy preparation (P90), bodybuilding (P50, P90), and vaccination (P75) were positively associated with an increase in downloads after the outbreak. In the user experience survey, the attention given to health information (prepandemic: 249/375, 66.4%; postpandemic: 146/178, 82.0%; P=.006) steadily increased after the outbreak. mHealth apps are an effective health care approach gaining in popularity among the Chinese population following the COVID-19 outbreak. This research provides direction for subsequent mHealth app development and promotion in the postepidemic era, supporting medical model reformation in China as a reference, which may provide new avenues for designing and evaluating indirect public health interventions such as health education and health promotion.

Prevalence and factors associated with anxiety and depression among community-dwelling older adults in Hunan, China: a cross-sectional study

BackgroundOlder adults’ psychological health is a public health issue that cannot be ignored, especially when these psychological health problems and related factors change across different social backgrounds because of rapid changes in traditions and family structures and the epidemic responses after the outbreak of COVID-19 in China. The aim of our study is to determine the prevalence of anxiety and depression and their associated factors among community-dwelling older adults in China.MethodsA cross-sectional study was conducted from March to May 2021 with 1173 participants aged 65 years or above from three communities in Hunan Province, China who were selected using convenience sampling. A structured questionnaire including sociodemographic characteristics, clinical characteristics, the Social Support Rating Scale (SSRS), the 7-Item Generalized Anxiety Disorder scale (GAD-7), and the Patient Health Questionnaire-9 Item (PHQ-9) was used to collect relevant demographic and clinical data and to measure social support status, anxiety symptoms, and depressive symptoms, respectively. Bivariate analyses were conducted to explore the difference in anxiety and depression based on samples’ different characteristics. The multivariable logistic regression analysis was performed to test for significant predictors of anxiety and depression.ResultsThe prevalence of anxiety and depression were 32.74% and 37.34%, respectively. Multivariable logistic regression analysis revealed that being female, being unemployed before retirement age, lacking physical activity, having physical pain, and having three or more comorbidities were significant predictors for anxiety. Subjective social support and support utilization were significant protective factors. Regarding depression, religion, lacking physical activity, having physical pain, having three or more comorbidities were found to be significant predictors. Support utilization was a significant protective factor.ConclusionsThe study group showed a high prevalence of anxiety and depression. Gender, employment status, physical activity, physical pain, comorbidities, and social support were associated with psychological health problems of older adults. These findings suggest that governments should focus on the psychological health problems of older adults by raising community awareness of issues related to older adults’ psychological health. They should also screen for anxiety and depression among high-risk groups and encourage individuals to seek supportive counseling.

The COVID-19 Pandemic and Chinese Trade Relations

This paper presents an analysis of the effects of non-pharmaceutical interventions on countries’ bilateral trade with China. Our panel regression results suggest a reduction in monthly Chinese exports to countries that introduced more stringent lockdown measures. We extend our analysis by decomposing observed trade flows into gravity and residual trade components. More stringent lockdowns are associated with less residual trade. Moreover, an event study approach reveals a negative effect of the Covid-19 outbreak in China but this effect vanishes after only 2 months.