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To describe the economic, lifestyle and nutritional impact of the COVID-19 pandemic on parents, guardians and children in Malaysia, Indonesia, Thailand and Vietnam.
Design:
Data from the SEANUTS II cohort were used. Questionnaires, including a COVID-19 questionnaire, were used to study the impact of the pandemic on parents/guardians and their children with respect to work status, household expenditures and children’s dietary intake and lifestyle behaviours.
Setting:
Data were collected in Malaysia, Indonesia, Thailand and Vietnam between May 2019 and April 2021.
Participants:
In total, 9203 children, aged 0·5–12·9 years, including their parents/guardians.
Results:
Children and their families were significantly affected by the pandemic. Although the impact of lockdown measures on children’s food intake has been relatively mild in all countries, food security was negatively impacted, especially in Indonesia. Surprisingly, in Malaysia, lockdown resulted in overall healthier dietary patterns with more basic food groups and less discretionary foods. Consumption of milk/dairy products, however, decreased. In the other countries, intake of most food groups did not change much during lockdown for households based on self-reporting. Only in rural Thailand, some marginal decreases in food intakes during lockdown persisted after lockdown. Physical activity of children, monthly household income and job security of the parents/guardians were negatively affected in all countries due to the pandemic.
Conclusion:
The COVID-19 pandemic has significantly impacted societies in South-East Asia. To counteract negative effects, economic measures should be combined with strategies to promote physical activity and eating nutrient-adequate diets to increase resilience of the population.
This article explores the temporalities experienced by persons aged 70 years and over during the first months of the COVID-19 pandemic in Finland. Although the temporalities of the pandemic have been analysed from multiple perspectives, we contribute to this line of research in two ways. First, we show how deeply the pandemic affected older people's experiences of temporality. Second, we further develop the concept of forced present to highlight the consequences that the restriction measures had on older persons’ situations and perceptions of temporality. More specifically, we asked the following question: How did older people perceive time (past, present and future) during the pandemic? We used thematic analysis to examine a dataset consisting of written letters (N = 77) collected between April and June 2020. The findings showed that social isolation forced older people to live in the present without being able to plan their near future because they had no knowledge of when they would be ‘free’ again, which made some participants feel anxious and depressed. Furthermore, we found that the present became intertwined with the personal past as well as with the collective past, as evidenced by participants’ descriptions of war, previous pandemics and hardships. This article deepens our understanding of older people's everyday lives during the pandemic and highlights the problematic nature of social isolation of older people as a safety measure. Overall, this article reveals the particularity of older people's experiences in unequal pandemic times and the ageism inherent in the restriction measures.
The COVID-19 pandemic has had a globally devastating psychosocial impact. A detailed understanding of the mental health implications of this worldwide crisis is critical for successful mitigation of and preparation for future pandemics. Using a large international sample, we investigated in the present study the relationship between multiple COVID-19 parameters (both disease characteristics and government responses) and the incidence of the suicide crisis syndrome (SCS), an acute negative affect state associated with near-term suicidal behavior.
Methods:
Data were collected from 5528 adults across 10 different countries in an anonymous web-based survey between June 2020 and January 2021.
Results:
Individuals scoring above the SCS cut-off lived in countries with higher peak daily cases and deaths during the first wave of the pandemic. Additionally, the longer participants had been exposed to markers of pandemic severity (eg, lockdowns), the more likely they were to screen positive for the SCS. Findings reflected both country-to-country comparisons and individual variation within the pooled sample.
Conclusion:
Both the pandemic itself and the government interventions utilized to contain the spread appear to be associated with suicide risk. Public policy should include efforts to mitigate the mental health impact of current and future global disasters.
Intimate partner violence (IPV) is a global public health concern with negative effects on individuals and families. The present study investigated the prevalence, risk factors and gender disparities associated with IPV during the Shanghai 2022 Covid-19 lockdown – a public health emergency which may have exacerbated IPV.
Methods
We estimated the total IPV prevalence and prevalence of physical, sexual and verbal IPV by using an adapted version of the Extended-Hurt, Insult, Threaten, Scream scale. This cross-sectional study was carried out using a population quota-based sampling of Shanghai residents across 16 districts during the 2022 Shanghai lockdown (N = 2026; 1058 men and 968 women).
Results
We found a distinct gendered dynamic, where women reported a significantly higher prevalence of experienced IPV (27.1%, 95% confidence interval [CI]: 23.1–31.4) compared to men (19.8%, 95% CI: 16.1–24.0). Notably, the prevalence estimate mirrored the national lifetime IPV prevalence for women but was over twice as high for men. In multivariable logistic regression analyses, economic stress (income loss: adjusted OR [aOR] = 2.42, 95% CI: 1.28–4.56; job loss: aOR = 1.73, 95% CI: 1.02–2.92; financial worry much more than usual: aOR = 1.89, 95% CI: 1.00–3.57) and household burden (one child at home: aOR = 1.81, 95% CI: 1.12–2.92; not enough food: aOR = 1.67, 95% CI: 1.04–2.70) were associated with increased odds of overall IPV victimization among women but not men. With regard to more serious forms of IPV, job loss (aOR = 2.27, 95% CI: 1.09–4.69) and household burden (two or more children at home: aOR = 2.95, 95% CI: 1.33–7.69) were associated with increased odds of physical IPV against men. For women, a lack of household supplies was associated with increased odds of physical IPV (water: aOR = 3.33, 95% CI: 1.79–6.25; daily supplies: aOR = 2.27, 95% CI: 1.18–4.35). Lack of daily supplies (aOR = 2.17, 95% CI: 1.03–4.55) and job loss (aOR = 2.66, 95% CI: 1.16–6.12) were also associated with increased odds of sexual IPV.
Conclusions
Although a larger proportion of women reported IPV, men experienced greater IPV during the lockdown than previously estimated before the pandemic. Economic stressors, including job loss, and household burden were critical risk factors for serious forms of IPV. Improving gender equality that my account for disparities in IPV in China is critically needed. Policies that mitigate the impact of economic losses during crises can potentially reduce IPV.
The objective of this study was to describe changes in emergency department volumes after statewide lockdown in a network of hospitals across the United States during the COVID-19 global pandemic.
Methods:
A retrospective study was performed utilizing data on daily volumes across multiple emergency departments from a centralized data warehouse from a private for-profit hospital system during the COVID-19 pandemic. The mean daily volumes of 148 emergency departments were evaluated across 16 states in relation to each state’s governmental statewide lockdown orders. Comparisons of the same period in the prior year were evaluated for percent changes in volumes. We also compared pre-lockdown to post-lockdown volumes. A separate analysis was made for the pediatric ED volumes.
Results:
The 2020 post-lockdown volumes compared to the same 2019 dates revealed a mean percent change of −43.09%. The overall post-lockdown volumes compared to the pre-lockdown volumes had a mean percent change of −45.00%. The pediatric data revealed a greater mean percentage change in volumes of −71.52% (post-lockdown compared to 2019) and −69.03% (post-lockdown compared to pre-lockdown).
Conclusions:
This study found an overall decrease in volumes among 148 emergency departments across 16 states when compared to the comparable period pre-global pandemic.
This chapter describes the initiative launched by YTL Foundation at the start of the COVID-19 pandemic to address remote learning during lockdown and school closure in Malaysia. It discusses the context of the Malaysian education system at the time and the challenges faced by teachers, parents, and students to ensure continuity in learning from home. Malaysia is a young nation and one that is seeking to establish itself as an example of a dynamic melting pot of Asian cultures that has grown out of its colonial past and embraced the global economy. As the wealth of the country has increased, there has been a growing awareness since the early 2010s that investment in a vibrant social sector is necessary to address the inequalities that often accompany rapid economic growth. This chapter showcases the solution developed for education that comprised providing smartphones, data, and learning resources that are delivered through partnerships to create a solution for low-income students. This solution was rolled out through partnership with the government, thereby demonstrating how such philanthropic interventions can be scaled up exponentially. The uniqueness of the solution in engaging parents is highlighted as an important feature. The chapter concludes by exploring some of the early measurable impact on the community and discusses the elements necessary for building resilience into the Malaysian education ecosystem in a future where hybrid education will be the norm.
This introductory chapter sets out the need for a handbook of university mental health. It considers the health of staff alongside that of students, and that does not presume American systems of education and healthcare. Far more of the UK population expects to attend university, with a consequent expansion in the size and numbers of institutions. Financial constraints mean that universities can no longer run as elite communities of self-governing scholars, but are now governed according to business models, with implications for the wellbeing of all involved. In the context of population-wide increases in mental disorder and demand for treatment, more students than ever now disclose a psychiatric diagnosis. The recent COVID pandemic and lockdown disproportionately threatened the well-being of students and may have changed for good some of the ways in which education and healthcare are delivered. The author summarises her own personal and professional of UK university life and describes the motivation for embarking on the production of a single author handbook on this topic. A wide readership is welcomed to the book, which will provide a series of interlinked but standalone chapters to be consulted piecemeal as well as read as a whole.
Edited by
Richard Williams, University of South Wales,Verity Kemp, Independent Health Emergency Planning Consultant,Keith Porter, University of Birmingham,Tim Healing, Worshipful Society of Apothecaries of London,John Drury, University of Sussex
This chapter considers the potential psychological impact of the quarantines, lockdowns, and isolation that have affected almost every country in the world as a result of the SARS-CoV-2 (COVID-19) outbreak. It describes the published literature on the short-term and long-term psychological impact of other (pre-2020) pandemic-related quarantines, identifies factors associated with this psychological impact pre-quarantine, during quarantine, and in the long term, discusses how this applies to the COVID-19 pandemic, and suggests how the psychological impact of quarantine and isolation might be reduced.
In this chapter, the effects of the COVID-19 pandemic on new motherhood amongst the contemporary sample are examined through ‘diary’ entries (shared by email, WhatsApp messages or voice notes) shared by participants between April 2020 and May 2021. The pandemic resulted in daily living for many being concertinaed into available rooms in homes, as spaces and time were redefined. Taken-for-granted and minutiae aspects of daily living were suddenly apparent to those not normally involved in these tasks and family, caring and work dynamics shifted. The ‘diary’ entries focus on responses to the first and subsequent lockdowns and restrictions experienced between lockdowns when restrictions continued across the UK (e.g., face coverings, limits on numbers allowed to convene and where, access restricted to some places, childcare and schools being periodically closed). The unique situation and real-time, unfolding responses illuminate several things, including how aspects of perceived good mothering are hard to escape and continue to be invoked to frame individual experiences, including examples of what they perceive to be ‘poor’ mothering (‘too much screen time’) as well as resilience and coming through the trials of lockdown. The hard work of an unremitting sense of maternal responsibility is crystalised through this exceptional year.
The COVID-19 pandemic foregrounded a numerical conception of age. Many of the targets of proposals to introduce age-specific restrictions are members of the ‘baby boomer’ generation, a generation that is widely recognised as having a youthful approach to ageing. Attending to arguments that baby boomers are a ‘bridging’ generation – i.e. they share cultural orientations with both preceding and succeeding generations – we argue that ‘bridging’ is a dynamic practice. Drawing on repeat interviews with 45 ‘war baby’ and baby boomer women conducted prior to the pandemic and shortly after the first national lockdown, the paper demonstrates how lockdown restrictions brought to light older women's relationships to, and investments in, spatial mobilities. We focus on how they experienced and understood (im)mobilities in three realms: home life, going places and social connection. Pre-pandemic, mobilities in each of these realms had been important to how the women established youthfulness and resisted being seen as ‘old’; mobilities helped older women ‘bridge’ with younger adult generations. This bridging was undermined practically, symbolically and discursively by their experiences of the lockdown, with profound consequences for perceptions of their ageing. Restrictions on spatial mobilities created conditions for older women to reassess and narrate the social world in generational terms. Their narratives provide an illuminating case study of the complex ways that generational cohort shapes experiences and self-understandings. We argue that the capacity of baby boomers to ‘bridge’ dynamically is a legacy of their youth.
This article examines Antonin Artaud’s ‘Theatre and the Plague’ in the light of the Covid-19 pandemic and through the Ancient Greek term stasis, which describes a civil war between domestic and public spaces. Once initiated, it was believed that this conflict would spread from household to household like a contagion; city states thus implemented draconian measures in the name of preventing stasis. Giorgio Agamben argues that such measures were embedded in subsequent theories of the state, fuelling ever more oppressive policies throughout history. Artaud’s ‘Theatre of Cruelty’ energizes a force comparable to this stasis, both in terms of its latency and its contagiousness, activating dormant conflicts in the individual that are expressed through networks of infection and create frontiers of shared resistance to institutional authority. ‘Theatre and the Plague’, read through the lens of stasis, can thus offer valuable contributions to current debates around biopolitics, particularly those seeking collective forms of agency during and beyond the current pandemic.
Symptoms of obsessive-compulsive disorder (OCD) have been reported to increase during the COVID-19 lockdowns because of the hygiene requirements related to the pandemic. Patients with adjustment disorder (AD) may, in turn, represent a vulnerable population for identifiable stressors. In this study, we aimed at assessing potential symptoms changes in OCD patients during the lockdown in comparison with AD patients as well as versus healthy controls (HC).
Methods
During the COVID-related lockdown, we enrolled 65 patients and 29 HC. Participants were tested with four clinical rating scales (Yale–Brown obsessive-compulsive scale and Brown Assessment of Beliefs Scale for OCD patients; Beck Depression Inventory-II and State–Trait Anxiety Inventory-Y for each group) that had been also administered just before the Italian lockdown.
Results
Our results showed that during the lockdown: (i) the symptoms of depression and anxiety increased in all groups, but this increase was most pronounced in HC (p < 0.001); (ii) OCD symptoms severity did not increase, but the insight worsened (p = 0.028); (iii) the proportion of OCD patients showing hygiene-related symptoms increased (p = 0.031 for obsessions of contamination), whereas that of patients with checking-related symptoms decreased.
Conclusions
The lockdown-induced psychological distress apparently changed the characteristics and the pattern of OCD symptoms expression but not their overall severity. This evidence confirms the heterogeneity and changing nature of OCD symptoms, strongly depending on the environmental circumstances.
The potential impact of the COVID-19 pandemic on suicidal behavior has generated predictions anticipating an increase in suicidal tendencies. The aim of this research is to study its influence on the incidence of hospital-treated suicide attempts throughout the year 2020 in Oviedo, Spain.
Methods
Data were collected on all patients admitted to the emergency department of Central University Hospital of Asturias in Oviedo for attempted suicide during 2020. Incidence rates were calculated for three lockdown periods. Suicide attempt trends in 2020 were compared with a non-COVID-19 year (2009) to avoid seasonal variations bias. Chi-square and Fisher’s exact tests were performed. The influence of COVID-19 incidence in Oviedo was analyzed using Spearman’s correlation coefficient.
Results
The cumulative incidence rate of attempted suicide per 100,000 person-years was 136.33 (pre-lockdown), 115.15 (lockdown), and 90.25 (post-lockdown) in adults (over 19 years old), and 43.63 (pre-lockdown), 32.72 (lockdown), and 72.72 (post-lockdown) in adolescents (10–19 years old). No association was found with COVID-19 incidence rates (Spearman’s rho −0.222; p = 0.113). Comparing the years 2020 and 2009, statistically significant differences were observed in adolescents (Fisher’s exact test; p = 0.024), but no differences were observed in adults (chi-square test = 3.0401; p = 0.218).
Conclusions
Hospital-treated suicide rates attempted during the COVID-19 outbreak in Oviedo, Spain showed a similar trend compared with a non-COVID-19 year. In contrast, the number of adolescents hospital-treated for attempted suicide increased during lockdown, suggesting more vulnerability to COVID-19 restrictions after the initial lockdown period in this age group.
In the BJPsych Open Wong et al examined the influence of lockdown stringency during early stages of the COVID-19 pandemic on psychiatric emergency presentations among children and adolescents from ten countries. Data from March and April 2019 were compared with the same time frame in 2020, with particular focus on self-harm admissions. In this editorial, the publication is summarised and potential implications for the field and future studies are discussed.
This study investigates the impacts of the COVID-19 lockdown on municipal solid waste (MSW). Based on a unique data set of daily discarding records of 252 communities in Beijing, China, we conduct a difference-in-differences estimation and find that the total daily MSW decreased by 134.16 kg in a community, which is equivalent to at least 0.22 kg per household per day, and the average weight of MSW per package decreased by 56.8 per cent after the COVID-19 lockdown. We consider a series of potential mechanisms, such as MSW hoarding, shifts in discarding time, and fear of going out, and find the most support for consumption pattern shifts with reduced consumption. We then discuss the effect of the lockdown on the reduction of MSW generation because of the strict restriction of consumption. We also conduct various heterogeneity analyses. Our results present clear implications for municipal waste management by highlighting the effect of the lockdown on the generation of MSW and the underlying consumption mechanism.
Measures to reduce the spread of the SARS-CoV-2 virus have an impact on the mental health of the general population. Drug prescription rates can be used as a surrogate marker to estimate help seeking and health parameters of a population. The aim of this study was to compare psychopharmacologic drug prescriptions in Austria from the start of the pandemic in 2020 over time and with the previous year and to investigate the impact of the COVID-19 lockdowns in 2020.
Methods
Data from the three largest public health insurances in Austria, covering over 98% of the general population, were analyzed. A total of 1,365,294 patients with a prescription of a psychopharmacologic drug in the months March to December in 2019 and 2020 were selected.
Results
There was no significant change in prescribed defined daily doses (DDDs) during the lockdowns. However, there was a stockpiling effect before and at the beginning of lockdown 1. The number of new patients initiating psychopharmacologic treatment was significantly reduced during lockdown 1 but not during lockdown 2.
Conclusions
The first COVID-19 lockdown in 2020 functioned as a barrier for new psychiatric patients seeking help, whereas the patients with ongoing treatments did not have significant problems. These results have to be taken into account for future planning, but follow-up studies are needed, as our results could be indicative of a change in the effect of the protective measures on the utilization of the healthcare system over time.
Taiwan’s record of preventing infections and deaths from COVID-19 outshines that of almost every other nation, far outstripping the performance of the US, all European countries, and almost all Asian countries. Yet Taiwan is the nation closest to Wuhan, font of the pandemic. Equally importantly, Taiwan’s public health achievement has occurred without the government dictates such as business and residential lockdowns that have aroused controversy and caused economic and psychological distress around the globe. This essay relates the story of Taiwan’s actions during the crucial early months of 2020 and explores the factors—historical, geographical, legal, institutional, strategic, and cultural—accounting for Taiwan’s remarkable success. Prominent among those factors are the legal and institutional infrastructure of preparedness that Taiwan constructed following its unhappy experience with the 2003 SARS outbreak, and the prompt and decisive measures taken upon discovery of the Wuhan outbreak on 31 December 2019. A dialogue between the judiciary and the legislative and executive branches of government following the SARS episode enabled the infrastructure of preparedness to be created through a process consonant with democratic government, respecting principles of individual liberty and fairness. Risk communication techniques were skilfully employed to build public trust in expert advice about measures for infection prevention. Persuasion, not compulsion, was the norm. Cultural factors including customary acceptance of mask-wearing and authoritative advice, and perhaps a high level of risk-aversity, also played an important part. Taiwan’s pandemic control policies have drawn criticism of government overreach. Some recommendations, such as for outdoor masking, bear little rational relation to infection prevention and are best characterized as mere “hygiene theatre.” Nevertheless, early-2020 government measures received a high level of public approval. Taiwan’s successful response to the pandemic illustrates the nation’s nature: a disciplined democracy.
The COVID-19 pandemic and associated preventive measures have an impact on the persons’ mental health, including increasing risk of symptoms of anxiety and depression in particular. Individual experiencing mental health difficulties in the past could be especially vulnerable during lockdown, however, few studies have tested this empirically considering preexisting mental health difficulties using longitudinal data.
Objectives
The objective of this study is to examine the longitudinal association between preexisting symptoms of anxiety/depression and symptoms of anxiety/depression during lockdown due to the COVID-19 pandemic in a community sample.
Methods
Seven waves of data collection were implemented from March-May 2020. Generalized estimation equations models were used to estimate the association between preexisting symptoms of anxiety/depression and symptoms of anxiety/depression during lockdown among 662 mid-aged individuals from the French TEMPO cohort.
Results
We found an elevated odds ratio of symptoms of anxiety/depression (OR=6.73 95% [CI=4.45–10.17]) among individuals experiencing such symptoms prior lockdown. Furthermore, the odds of symptoms of anxiety/depression during lockdown was elevated among women (OR=2.07 [95% CI=1.32–3.25]), subjects with low household income (OR=2.28 [1.29–4.01]) and persons who reported loneliness (OR=3.94 [2.47–6.28]).
Conclusions
This study demonstrates a strong relationship between preexisting symptoms of anxiety/depression and anxiety/depression during the COVID-19 outbreak among mid-aged French adults. The findings underline the role of preexisting symptoms of anxiety/depression as a vulnerability factor of anxiety/depression during lockdown. Furthermore, the study shows that loneliness is independently associated with symptoms of anxious/depression, when controlling for prior anxiety/depression symptoms.
COVID19 lockdown is having a significant impact on mental health, patients with eating disorders (ED) are particularly vulnerable.
Objectives
1) To explore changes in eating and other psychological features due to confinement in patients with ED from various European and Asian countries; and 2) to assess differences related to diagnostic subtypes, age and geography.
Methods
The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID19 Isolation Scale (CIES).
Results
On one hand, patients with Binge Eating Disorder experienced the highest impact on weight and ED symptoms due to confinement. Together with subjects diagnosed with Other Specified Feeding and Eating Disorders (OFSED), they also experienced a deterioration in general psychological state. On the other hand, there was less symptomatic impact on people with Bulimia Nervosa or Anorexia Nervosa and asian and younger individuals appeared to be more resilient in this situation.
Conclusions
The impact of COVID varied by cultural context and individual variation in age and form of illness. Services may need to target preventive measures and adapting therapeutic approaches for the most vulnerable patients.
Increase in affective and somatic complaints during pandemic is considered as related to experienced stress (Wang et al., 2020, Roy et al., 2020, Robillard et al., 2020). Expression or suppression of emotions related to pandemic could affect the vulnerability of people to stressful situations (Gross, Thompson, 2007, Roberts et al., 2008).
Objectives
The aim was to reveal a role of suppression / expression emotions regarding pandemic in the changes in somatic and affective complaints in people without coronavirus during lockdown.
Methods
In May 2020 110 people 18-65 years old (61.2% females) without coronavirus appraised their strategy of dealing with different emotions regarding pandemic on the 1-5 scale from emotional expression to hiding and suppression (Cronbach’s alphas) and 26 somatic and emotional symptoms including sleep-related symptoms, daytime functioning, affective symptoms, general physical condition (Cronbach’s alphas .81-.90). In December 2020 they reappraised 26 complaints.
Results
There were no statistically significant changes in somatic and affective complaints during May-December 2020 (p>.20). Increase in sleep-related complaints (β=.23, p<.05, ΔR2=5.0%) and complaints regarding general physical condition (β=.32, p<.05, ΔR2=10.0%) were more pronounced in those reporting higher expression of emotions related to COVID.
Conclusions
People with higher emotional reactivity to pandemic situation tend to report increase in sleep-related problems and general worsening of their physical condition during lockdown. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799.
Disclosure
Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00799