Journal of Preventive Medicine and Public Health

COVID-19: Original Articles

Associations Between General Perceptions of COVID-19 and Posttraumatic Stress Disorder in Korean Hospital Workers: Effect Modification by Previous Middle East Respiratory Syndrome Coronavirus Experience and Occupational Type: Youngrong Lee, Kwanghyun Kim, Sungjin Park, Sun Jae Jung; J Prev Med Public Health. 2021;54(2):86-95. Published online January 19, 2021; DOI: https://doi.org/10.3961/jpmph.20.540

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Abstract Summary PDF Supplementary Material

Objectives
This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience.
Methods
The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience.
Results
Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38).
Conclusions
During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.

Summary

Korean summary
본 연구는 COVID-19관련 인식과 COVID-19 안심 병원 근로자들의 외상 후 스트레스 장애 (PTSD) 유병률 사이의 연관성에서 직업 유형과 이전 중동 호흡기 증후군 (MERS-CoV) 방역 경험 여부로 인한 연관성의 크기 차이를 조사하였다. 비의료인이 의료인보다 PTSD유병에 더 강한 연관성을 보였고, 이전 메르스 방역 경험이 있는 근로자들이 COVID-19에 대한 "일반적 공포", "물품 부족 공포" 및 "특정 문제에 따른 공포"로 구분한 인식의 크기가 클 수록 방역 경험이 없는 근로자들보다 PTSD유병과의 관련성이 더 컸다. 결론적으로 COVID-19 대유행 기간 중 비의료 인력은 PTSD유병 확률이 더 높은 경향이 있었다. 이전 MERS-CoV 경험이 있는 근로자는 그러한 경험이 없는 근로자보다 더 취약했다.

Citations

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Association between social networks and symptoms of post-traumatic stress during the pandemic: Cohort study in South Korea
Ji Su Yang, Yu Jin Lee, Hyeon Chang Kim, Chul-Hyun Cho, Alexander C. Tsai, Sun Jae Jung
Comprehensive Psychiatry.2023; 127: 152432. CrossRef
Development and Validation of COVID-19 Stress Scale (CSS) in an Iranian Non-clinical Population
Roghieh Nooripour, Nikzad Ghanbari, Laurel E. Radwin, Simin Hosseinian, Peyman Hassani-Abharian, Mohsen Hosseinbor, Keyvan Kakabraee, Mojtaba Amiri Majd, Serge Brand, Esmaeil Soleimani, Hossein Ilanloo
Zahedan Journal of Research in Medical Sciences.2022;[Epub] CrossRef

The Effects of Border Shutdowns on the Spread of COVID-19: Nahae Kang, Beomsoo Kim; J Prev Med Public Health. 2020;53(5):293-301. Published online August 30, 2020; DOI: https://doi.org/10.3961/jpmph.20.332

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Abstract PDF Supplementary Material

Objectives
At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, some countries imposed entry bans against Chinese visitors. We sought to identify the effects of border shutdowns on the spread of the COVID-19 outbreak.
Methods
We used the synthetic control method to measure the effects of entry bans against Chinese visitors on the cumulative number of confirmed cases using World Health Organization situation reports as the data source. The synthetic control method constructs a synthetic country that did not shut down its borders, but is similar in all other aspects.
Results
Six countries that shut down their borders were evaluated. For Australia, the effects of the policy began to appear 4 days after implementation, and the number of COVID-19 cases dropped by 94.4%. The border shutdown policy took around 13.2 days to show positive effects and lowered COVID-19 cases by 91.7% on average by the end of February.
Conclusions
The border shutdowns in early February significantly reduced the spread of the virus. Our findings are informative for future planning of public health policies.

Summary

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Association of Comorbidities With Pneumonia and Death Among COVID-19 Patients in Mexico: A Nationwide Cross-sectional Study: Akram Hernández-Vásquez, Diego Azañedo, Rodrigo Vargas-Fernández, Guido Bendezu-Quispe; J Prev Med Public Health. 2020;53(4):211-219. Published online May 28, 2020; DOI: https://doi.org/10.3961/jpmph.20.186

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Abstract PDF

Objectives
The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death.
Methods
This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age.
Results
Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions.
Conclusions
Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.

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COVID-19: Perspective

The Pandemic League of COVID-19: Korea Versus the United States, With Lessons for the Entire World: Alwin Issac, Shine Stephen, Jaison Jacob, Vijay VR, Rakesh Vadakkethil Radhakrishnan, Nadiya Krishnan, Manju Dhandapani; J Prev Med Public Health. 2020;53(4):228-232. Published online May 25, 2020; DOI: https://doi.org/10.3961/jpmph.20.166

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Abstract PDF

Coronavirus disease 2019 (COVID-19) is inflicting a brutal blow on humankind, and no corner of the world has been exempted from its wrath. This study analyzes the chief control measures and the distinctive features of the responses implemented by Korea and the United States to contain COVID-19 with the goal of extracting lessons that can be applied globally. Even though both nations reported their index cases on the same day, Korea succeeded in flattening the curve, with 10 752 cases as of April 28, 2020, whereas the outbreak skyrocketed in the United States, which had more than 1 million cases at the same time. The prudent and timely execution of control strategies enabled Korea to tame the spread of the virus, whereas the United States paid a major price for its delay, although it is too early to render a conclusive verdict. Information pertaining to the number of people infected with the virus and measures instituted by the government to control the spread of COVID-19 was retrieved from the United States Centers for Disease Control and Prevention and the Korea Centers for Disease Control and Prevention websites and press releases. Drawing lessons from both nations, it is evident that the resolution to the COVID-19 pandemic lies in the prudent usage of available resources, proactive strategic planning, public participation, transparency in information sharing, abiding by the regulations that are put into place, and how well the plan of action is implemented.

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COVID-19: Brief Report

The Delay in Confirming COVID-19 Cases Linked to a Religious Group in Korea: Hyung-Ju Kim, Hyun-Seong Hwang, Yong-Hyuk Choi, Hye-Yeon Song, Ji-Seong Park, Chae-Young Yun, Sukhyun Ryu; J Prev Med Public Health. 2020;53(3):164-167. Published online April 8, 2020; DOI: https://doi.org/10.3961/jpmph.20.088

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Abstract PDF

Objectives
As of March 3, 2020, the Shincheonji religious group accounted for the majority of Korean cases of coronavirus disease 2019 (COVID-19). Nonetheless, the most likely cause of the broad spread of COVID-19 among members of the Shincheonji religious group remains largely unknown.
Methods
We obtained data of laboratory-confirmed cases related to the Shincheonji religious group from press releases by Korean public health authorities and news reports. We measured the period from the date of illness onset to the date of COVID-19 confirmation.
Results
We analysed data from 59 cases (median age, 30 years). The estimated median period between the date of symptom onset and the date of COVID-19 confirmation was 4 days (95% confidence interval, 1-12).
Conclusions
There was a delay in COVID-19 confirmation from the date of illness onset among the cases linked to the Shincheonji religious group. This delay likely contributed to the occurrence of many cases of COVID-19 in the group.

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COVID-19: Perspective

A Chinese Case of Coronavirus Disease 2019 (COVID-19) Did Not Show Infectivity During the Incubation Period: Based on an Epidemiological Survey: Jong-Myon Bae; J Prev Med Public Health. 2020;53(2):67-69. Published online March 2, 2020; DOI: https://doi.org/10.3961/jpmph.20.048

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Abstract Summary PDF

Controversy remains over whether the coronavirus disease 2019 (COVID-19) virus may have infectivity during the incubation period before the onset of symptoms. The author had the opportunity to examine the infectivity of COVID-19 during the incubation period by conducting an epidemiological survey on a confirmed patient who had visited Jeju Island during the incubation period. The epidemiological findings support the claim that the COVID-19 virus does not have infectivity during the incubation period.

Summary

Korean summary
잠복기 동안 제주도를 방문했던 중국인 COVID-19 확진자에 대한 역학조사를 수행하였다. 환자와 직접 접촉한 11명을 14일간 격리조치 하였는데, 이들 모두 격리해제까지 COVID-19 감염증상을 보이지 않았다. 이상의 역학조사 결과는 잠복기때는 감염력이 없다는 주장을 뒷받침한다.

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Special Articles

Ethical Perspectives on the Middle East Respiratory Syndrome Coronavirus Epidemic in Korea: Ock-Joo Kim; J Prev Med Public Health. 2016;49(1):18-22. Published online January 29, 2016; DOI: https://doi.org/10.3961/jpmph.16.013

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Abstract PDF

Ethical considerations are essential in planning for and responding to outbreaks of infectious diseases. During the outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea in 2015, serious challenges emerged regarding important ethical issues, such as transparency and the protection of privacy. The development of bioethics in Korea has been influenced by individualistic perspectives applied in clinical contexts, leading to a paucity of ethical perspectives relevant to population-level phenomena such as outbreaks. Alternative theories of public health ethics include the perspectives of relational autonomy and the patient as victim and vector. Public health actions need to incorporate clear and systematic procedures founded upon ethical principles. The MERS-CoV epidemic in Korea created significant public support for more aggressive early interventions in future outbreaks. This trend makes it all the more imperative for ethical principles and procedures to be implemented in future planning and responses to outbreaks in order to promote perceptions of legitimacy and civic participation.

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Structural Factors of the Middle East Respiratory Syndrome Coronavirus Outbreak as a Public Health Crisis in Korea and Future Response Strategies: Dong-Hyun Kim; J Prev Med Public Health. 2015;48(6):265-270. Published online November 30, 2015; DOI: https://doi.org/10.3961/jpmph.15.066

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Abstract PDF

The recent Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system’s weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of “control tower” in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.

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