The emergence of COVID-19 over-concern immediately after the cancelation of the measures adopted by the dynamic zero-COVID policy in China

Fengyi Hao; Zhisong Zhang; Sam S S Lau; Soon-Kiat Chiang; Dewen Zhou; Wanqiu Tan; Xiangdong Tang; Roger Ho

doi:10.3389/fpubh.2023.1319906

The emergence of COVID-19 over-concern immediately after the cancelation of the measures adopted by the dynamic zero-COVID policy in China

Front Public Health. 2024 Jan 5:11:1319906. doi: 10.3389/fpubh.2023.1319906. eCollection 2023.

Authors

Fengyi Hao^{1

2}, Zhisong Zhang², Sam S S Lau^{3

4

5

6}, Soon-Kiat Chiang⁷, Dewen Zhou⁸, Wanqiu Tan⁹, Xiangdong Tang¹, Roger Ho^{7

10}

Affiliations

¹ Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.
² Faculty of Education, Huaibei Normal University, Huaibei, China.
³ Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China.
⁴ Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China.
⁵ College of International Education, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China.
⁶ Institute of Bioresource and Agriculture, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China.
⁷ Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁸ Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
⁹ National University of Singapore (Chongqing) Research Institute, Chongqing, China.
¹⁰ Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore.

Abstract

Background: This study aimed to report the prevalence of COVID-19 over-concern and its associated factors after the relaxation of the health-protective measures in China.

Methods: A team of seven experts in psychiatry and psychology specializing in COVID-19 mental health research from China, Hong Kong, and overseas reached a consensus on the diagnostic criteria for COVID-19 over-concern. Individuals had to meet at least five of the following criteria: (1) at least five physical symptoms; (2) stocking up at least five items related to protecting oneself during the COVID-19 pandemic; (3) obsessive-compulsive symptoms related to the COVID-19 pandemic; (4) illness anxiety related to the COVID-19 pandemic; (5) post-traumatic stress symptoms; (6) depression; (7) anxiety; (8) stress and (9) insomnia. An online survey using snowball sampling collected data on demographics, medical history, views on COVID-19 policies, and symptoms of COVID-19 over-concern. Multivariate linear regression was performed using significant variables from the previous regressions as independent variables against the presence of COVID-19 over-concern as the dependent variable. Breush-Pagan test was used to assess each regression model for heteroskedasticity of residuals.

Results: 1,332 respondents from 31 regions in China participated in the study for 2 weeks from December 25 to 27, 2022, after major changes in the zero-COVID policy. After canceling measures associated with the dynamic zero-COVID policy, 21.2% of respondents fulfilled the diagnostic criteria for COVID-19 over-concern. Factors significantly associated with COVID-19 over-concern were poor self-rated health status (β = 0.07, p < 0.001), concerns about family members getting COVID-19 (β = 0.06, p < 0.001), perceived usefulness of COVID-19 vaccine (β = 0.03, p = 0.012), impact on incomes, employment and studies (β = 0.045, p < 0.001) and impact on families (β = 0.03, p = 0.01).

Conclusion: After removing measures associated with the dynamic zero-COVID policy in China, approximately one-fifth of respondents met the diagnostic criteria for COVID-19 over-concern.

Keywords: COVID-19; China; anxiety; depression; dynamic zero-COVID; illness anxiety; overconcern; stress.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 Vaccines
COVID-19* / diagnosis
COVID-19* / epidemiology
China / epidemiology
Humans
Pandemics
Policy

Substances

COVID-19 Vaccines

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research/project is supported by the Ministry of Science and Technology of the People’s Republic of China (ST12030-MajorProjects 2021ZD0201900), the National Natural Science Foundation of China (82120108002, 82170099, 82170100), the National University of Singapore iHealthtech Other Operating Expenses (A-0001415-09-00), and the Research Grants Council of the Hong Kong Special Administrative Region, China (Project no. UGC/IDS(R) 23/20). The funders had no role in the study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.