The effect of nationwide quarantine on anxiety levels during the COVID‐19 outbreak in China

  1. Jing Zhu
  2. Li Su
  3. Yi Zhou
  4. Juan Qiao
  5. Wei Hu

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Abstract

Background

In the recent outbreak of COVID‐19, many countries have enacted various kinds of quarantine measures to slow down the explosive spread of COVID‐19. Although these measures were proven to be successful in stopping the outbreak in China, the potential adverse effects of countrywide quarantine have not been thoroughly investigated.

Methods

In this study, we performed an online survey to evaluate the psychological effects of quarantine using the Zung Self‐rating Anxiety Scale in February 2020 when the outbreak had nearly peaked in China. Along with the anxiety scores, limited personal information, such as age, gender, region, education, occupation, and specifically, the type and duration of quarantine, was collected for analysis.

Results

From a total of 992 valid questionnaires from 23 provinces in China, clinically significant anxiety symptoms were observed in 9.58% of respondents according to clinical diagnostic standards in China. The specific groups of people showing higher levels of anxiety were (a) adolescents (<18 years); (b) respondents with education lower than junior high school; (c) people with chronic diseases; and (d) frontline medical personnel. Other characteristics, such as gender, marital status, region, and acquaintance with suspected or confirmed cases of COVID‐19, did not affect anxiety levels significantly. Respondents who experienced different forms of quarantine showed different anxiety levels. People undergoing centralized quarantine have higher levels of anxiety. Unexpectedly, longer durations of quarantine did not lead to a significant increase in anxiety level.

Conclusions

Our results suggest a rather mild psychological influence caused by the countrywide quarantine during the COVID‐19 outbreak in China and provide a reference for other countries and regions battling COVID‐19.

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  1. Version published to 10.1002/brb3.1938
  2. ScreenIT

    SciScore for 10.1101/2020.04.01.20041186: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: This study was conducted with informed consent of the respondent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical methods: Statistical analysis was performed using SPSS 22 (IBM, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The limitations of our study and implications are as follows. (1). Compared with super large-scale number of people affected by the countrywide quarantine, the sample size of our survey was very small. Thus, our results might not be able to fully reveal the true situation. (2). Although there is not much we can do, the form of online survey naturally ignored certain population, especially those aged adults who could be more vulnerable to COVID-19(Wu and McGoogan, 2020) but do not use smart phones. From our survey, only a very small portion of respondents (2.9%) are older than 65 years. (3). As we mentioned earlier, anxiety level could be a mixed result of many different factors. It is almost impossible to find out the pure contribution of quarantine to anxiety level. For example, worries about potential infection or financial problem could also elevate anxiety score(McAlonan et al., 2007, Zheng et al., 2005). Some respondents even leaved message to express their concerns about childcare and education due to school suspensions.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.04.01.20041186v1 on medRxiv