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Mental Health, Wellbeing and Preventive Behaviors in 10 Western Pacific Countries during COVID-19

Abstract Background COVID-19 has shown varying impacts on different populations. In the Western Pacific (WP) Region with a relatively low COVID-19 burden, the variabilities of its impact on mental health, wellbeing and preventive behaviors across countries are unclear. Methods We analyzed repeated national-representative, cross-sectional data of 87,787 adults collected via the Imperial College London YouGov COVID-19 behavior tracker in ten WP countries-Australia, China, Singapore, Japan, South Korea, Vietnam, Taiwan, the Philippines, Malaysia and Hong Kong during the pandemic (April-September 2020). Main outcomes were severe depression/anxiety (Patient Health Questionnaire-4 score≥9), wellbeing (Cantril Ladder Scale 0-10), worries of contracting COVID-19 and prevalence of preventive behaviors. Monthly temporal trends were examined. Results Percentages of severe depression/anxiety were higher in Australia (12.9%), Hong Kong (11.8%) and lowest in Vietnam (6.8%); increasing trends were noted in the Philippines (5.9% to 12.3%, p < 0.0001) and Malaysia (8.2% to 10.7%, p = 0.019). South Korea, China and Taiwan had the lowest levels of wellbeing (5.0-5.5) compared with their highest counterparts in the Philippines, Australia and Vietnam (6.2-6.5). Worries of COVID-19 remained high in Asia countries (Japan, South Korea, Malaysia, Vietnam and the Philippines: 79.2%-81.6%), compared to that in Australia (41%). 83.5%-97.2% of the Asian respondents persistently wore face masks outside home, while the mean percentages were low in Australia (32.2%) despite the increasing trend observed (24.1% to 48.6%, p < 0.000). Over half of the WP countries have significant decreasing trends (p < 0.000) for avoid going out; Taiwan showed the lowest prevalence (45.7%). Conclusions Psychological and behavioral responses to COVID-19 in the WP region varied widely. COVID-19-related negative impact on mental health and wellbeing was universal. A Global effort to tackle the aftermath of the pandemic is crucial. Key messages The psychological and behavioral responses to COVID-19 in Western Pacific countries varied widely. Severe depression/anxiety and low levels of wellbeing were prevalent in Western Pacific Region.


Background:
Intensive Care Units (ICU) faced a high pressure under the COVID-19 pandemic. It is recognized that patients admitted in these wards are more susceptible to Healthcare Associated Infections (HAIs). This study aims at comparing the incidence of HAIs in a COVID-19 ICU to a No-COVID ward. Methods: A retrospective cohort study including patients admitted to the ICU of the Teaching Hospital Policlinico Umberto I in Rome from April 2020 to March 2021 was performed. Data on age, gender, hospitalization, different types of devices (ventilation, central venous and urinary catheter), number and type of device-related HAI were collected. Statistical analyses were performed with Episheet and STATA 13. Results: Out of 347 patients admitted in the ICUs, 329 were included in the study (217 had COVID-19 and 112 had not). In the COVID-19 group, patients were mainly male (69.58%) with a mean age of 62.5AE13.5 years, whereas the other group was slightly older (63.2AE16.2 years) and more balanced between the two sexes (52.68% male). A total of 133 patients developed at least one HAI, 94 of which were SARS-CoV-2 positive. Globally, 246 HAIs were diagnosed: 163 occurred in the COVID group and 83 in the No-COVID one. The cumulative days of hospitalization were 3233 for the COVID group and 2134 for the No-COVID.

Background:
COVID-19 has shown varying impacts on different populations. In the Western Pacific (WP) Region with a relatively low COVID-19 burden, the variabilities of its impact on mental health, wellbeing and preventive behaviors across countries are unclear.

Methods:
We analyzed repeated national-representative, cross-sectional data of 87,787 adults collected via the Imperial College London YouGov COVID-19 behavior tracker in ten WP countries-Australia, China, Singapore, Japan, South Korea, Vietnam, Taiwan, the Philippines, Malaysia and Hong Kong during the pandemic (April-September 2020). Main outcomes were severe depression/anxiety (Patient Health Questionnaire-4 score!9), wellbeing (Cantril Ladder Scale 0-10), worries of contracting COVID-19 and prevalence of preventive behaviors. Monthly temporal trends were examined.

Results:
Percentages of severe depression/anxiety were higher in Australia (12.9%), Hong Kong (11.8%) and lowest in Vietnam (6.8%); increasing trends were noted in the Philippines (5.9% to 12.3%, p < 0.0001) and Malaysia (8.2% to 10.7%, p = 0.019). South Korea, China and Taiwan had the lowest levels of wellbeing (5.0-5.5) compared with their highest counterparts in the Philippines, Australia and Vietnam (6.2-6.5 urbanity of residence (OR = 4.5;p<0.01) and direct contact with positive COVID-19 patients (OR = 1.9;p=0.007). Compared to paramedical staff, doctors were more willing to be vaccinated (OR = 4;p<0.01). Belief in the efficacy of the vaccine as effective with few adverse effects (OR = 2.04;p<0.01), as protective against the virus (OR = 4.5;p<0.01) as well as the only solution to stop the pandemic (OR = 2.6;p<0.01) and to decrease serious complications of the disease (OR = 28;p<0.01) were statistically associated with vaccination acceptance.

Conclusions:
This original study revealed a relatively reasonable acceptance rate for vaccination against covid-19. Socio-demographic, cultural and professional factors predisposing to the willingness to be vaccinated were highlighted. Thus, planning vaccination campaigns to raise awareness of the efficacy and the safety of vaccine is strongly recommended to promote vaccination in the general population.

Key messages:
This original study revealed a relatively reasonable acceptance rate for vaccination against covid-19. Socio-demographic, cultural and professional factors predisposing to the willingness to be vaccinated were highlighted.
Public health recovery -building back healthier and more resilient societies

Anja Koornstra
A Koornstra 1 , K Boode 1 1 GGD GHOR Nederland, Utrecht, Netherlands Contact: akoornstra@ggdghor.nl During the Covid-pandemic it became clear that some groups were suffering more from the regulations against the spread of the virus than from the virus itself. To ensure social support for the regulations and to avoid increasing social economic health differences, the Dutch Association of Municipal Health Services (GGD GHOR Nederland) started a program. It was based on a plan form a group of doctors working in these health services and who worried about the health impact and wanted to strengthen the resistance against the virus and the resilience to cope with the lockdown. The aim was to build back better health on the level of society. individual Covidpatients received recovery care to gather strength -and so should public health build back a stronger and healthier society. The program consists of three parts: extensive monitoring of the impact of Covid-19, mitigating effects of the lockdown on lifestyle and mental/social wellbeing and seizing the political moment to strengthen prevention in public policy and in care. We will present examples of actions taken and their results. Key messages: Societies need public health to recover from the impact of Covid-19, both the disease and the regulations taken to prevent spreading the virus. It is crucial to seize the moment to build back better health, both professionally to improve our services and politically to strengthen public health.

Background:
Incident reporting (IR) is a system of spontaneous and voluntary reporting of events, important for assessing safety risks and for improving safety and quality of care. Since Covid-19 pandemic led to a change on the hospital organization, related to an overload of work and an increase of pressure in the wards, this study aims to evaluate the impact of Covid-19 on IR and on safety culture.

Methods:
This retrospective study analyzed the data of IR in 2019 and 2020 in the academic hospital of Udine. Number of IR, severity of the events (near miss, events with no harm and events with harm) and IR'S topic were compared. Inappropriate IR were excluded from severity analysis. The chi-square test was used for statistical significance. Results: IR in 2020 showed a reduction of 17.7% compared to 2019 (1097 vs 1334, p < 0,05). Furthermore, we observed a reduction in near misses (276 vs 390, -4,81%, p < 0,05) and an increase in events with harm (226 vs. 219, + 4,52%, p < 0,05). Events with no harm showed no significant increase. The analysis of topics revealed an increase in 2020 of problems concerning assessment of patient (+ 4.47%), especially swab's results delays, organizational aspects (+ 4.88%), due to staff reassignment and ward reorganization, and infection prevention and control (+ 4.65%). This increase is significantly associated with Covid-related IR (p < 0,05).

Conclusions:
In 2020 were collected fewer IR than 2019 and with an higher level of severity. This change may be associated to the increased 14th European Public Health Conference 2021