•This was a cross-sectional survey in five cities without a culture of wearing masks.•Mask use decreased after the age of 50 years but this age effect was not seen in the US.•Risk perception and past ...experience affected mask use during the pandemic.•Mask use did not result in a net change in other risk-mitigation behaviours.•Pandemic fatigue was more common in young people and males in protracted outbreaks.
To determine patterns of mask wearing and other infection prevention behaviours, over two time periods of the COVID-19 pandemic, in cities where mask wearing was not a cultural norm.
A cross-sectional survey of masks and other preventive behaviours in adults aged ≥18 years was conducted in five cities: Sydney and Melbourne, Australia; London, UK; and Phoenix and New York, USA. Data were analysed according to the epidemiology of COVID-19, mask mandates and a range of predictors of mask wearing.
The most common measures used were avoiding public areas (80.4%), hand hygiene (76.4%), wearing masks (71.8%) and distancing (67.6%). Over 40% of people avoided medical facilities. These measures decreased from March–July 2020. Pandemic fatigue was associated with younger age, low perceived severity of COVID-19 and declining COVID-19 prevalence. Predictors of mask wearing were location (US, UK), mandates, age <50 years, education, having symptoms and knowing someone with COVID-19. Negative experiences with mask wearing and low perceived severity of COVID-19 reduced mask wearing. Most respondents (98%) believed that hand washing and distancing were necessary, and 80% reported no change or stricter adherence to these measures when wearing masks.
Pandemic mitigation measures were widely reported across all cities, but decreased between March and July 2020. Pandemic fatigue was more common in younger people. Cities with mandates had higher rates of mask wearing. Promotion of mask use for older people may be useful. Masks did not result in a reduction of other hygiene measures.
Aim
This study examined the influence of pandemic fatigue on clinical nurses’ mental health, sleep quality and job contentment, with resilience as a mediator.
Background
Pandemic fatigue is an ...emerging health concern among frontline clinical nurses as a consequence of the ongoing coronavirus pandemic and the various measures implemented to slow the spread of infection. As yet, no studies have investigated the link between pandemic fatigue and resilience, mental health, sleep quality and job contentment in frontline clinical nurses.
Methods
This was a descriptive, cross‐sectional study involving 255 frontline clinical nurses in the Philippines. The Pandemic Fatigue Questionnaire, Brief Resilience Scale, Job Contentment Scale and the Sleep Quality Scale were used to collect data through an online survey.
Results
The mean pandemic fatigue score was 3.086 (out of 5). Being vaccinated (β = 0.231, p < .001) and increased staffing levels (β = −0.488, p < .01) were associated with decreased pandemic fatigue in clinical nurses. Resilience partially mediated the relationships between (a) pandemic fatigue and mental health (β = −0.488, p < .001), (b) pandemic fatigue and sleep quality (β = −0.326, p < .001) and (c) pandemic fatigue and job contentment (β = −0.395, p < .001).
Conclusion
Clinical nurses who received a COVID‐19 vaccine and those who perceived sufficient staffing in their units reported lower levels of pandemic fatigue. Resilience reduces the effects of pandemic fatigue on clinical nurses’ mental health, sleep quality and job contentment.
Implications for Nursing Management
By providing frontline nurses with access to COVID‐19 vaccines and ensuring sufficient staffing levels, nurse managers could effectively reduce or prevent pandemic fatigue and improve their mental health. Implementing resilience‐promoting measures are essential to support nurses’ mental health, promote their sleep quality and foster job satisfaction.
The COVID-19 pandemic is a health issue leading older adults to an increased vulnerability to unfavorable outcomes. Indeed, the presence of physical frailty has recently led to higher mortality due ...to SARS-CoV-2 infection. However, no longitudinal studies have investigated the role of neuropsychogeriatric factors associated with lockdown fatigue in healthy cognitive aging. Eighty-one healthy older adults were evaluated for their neuropsychological characteristics, including physical frailty, before the pandemic (T0). Subsequently, 50 of them agreed to be interviewed and neuropsychologically re-assessed during the lockdown (T1) and immediately after it (T2). Moreover, during another home confinement, they performed a psychological screening (T3) to evaluate possible mood changes and fatigue. According to Fried's frailty criteria, at T0, 63% of the sample was robust, 34.5% pre-frail, and only 2.5% frail. Significantly, these subjects presented a decrease in handgrip strength and walking speed (29.6 and 6.1%, respectively). Results from Principal Component Analyses and multiple regression models highlighted the contribution of “cognitive” and “psychological” factors (i.e., attentive-executive performance and mood deflections) in explaining handgrip strength and gait speed. At T3, lockdown fatigue was explained by higher scores on the Beck Depression Inventory and lower scores on the Trail Making Test part A. Results from a moderated-mediation model showed that the effect of psychomotor speed on lockdown fatigue was mediated by depression, with a moderating effect of gait speed. Our findings highlight the complex interrelationship between cognitive, psychological, and physical factors in the emergence of pandemic fatigue in a carefully selected older population.
There is an emerging literature on the mental and physical exhaustion due to the COVID-19 related restrictions. Some individuals seem to exercise fewer precautions recently in comparison to the onset ...of the pandemic in preventing the spread of the COVID-19. This phenomenon is described as pandemic fatigue. Though acknowledged in conceptual articles and news reports, there is a lack of empirical evidence pertaining to pandemic fatigue. We collected data from 516 adult participants to investigate pandemic fatigue and its relations to fear of coronavirus, intolerance of uncertainty, apathy, and self-care. 34.40% of the participants reported that the level of COVID-19-related precautions they take have decreased in comparison to measures they took at the onset of the pandemic. Additionally, our model examining the role of fear of coronavirus, intolerance of uncertainty, and apathy as mediated by self-care predicting pandemic fatigue demonstrated acceptable to excellent goodness-of-fit indices. The fact that one in every three individuals is taking fewer precautions is not only a threat to the individuals’ own health but also to the public. Given that individuals are experiencing pandemic fatigue, governments should consider paying more attention to the biopsychosocial nature of humans in ordering restrictions and planning necessary precautions.
This study aims to provide evidence of hesitancy in receiving the COVID-19 booster vaccine and associated factors in the vaccinated population that have completed a primary vaccination series. An ...anonymous web-based survey was disseminated to Malaysian adults aged ≥18 years via social media platforms. A total of 1010 responses were collected, of which 43.0% (95%CI 39.9-46.0) declared a definite willingness to receive a COVID-19 vaccine booster, 38.2% (95%CI 35.2-44.3) reported being somewhat willing and only 5.7% (95%CI 4.5-7.4) reported being definitely unwilling. Demographically younger participants, those of higher income, Chinese ethnicity and those from the central region reported significantly higher odds of a definite willingness to receive the COVID-19 vaccine booster compared to the reference group (somewhat willing/undecided/somewhat unwilling/definitely unwilling). Having no side effects with past COVID-19 vaccination was associated with a significantly higher odds of definite willingness (OR = 2.82, 95% CI 1.33-5.99). A lower (range 6-22) pandemic fatigue score (OR = 2.34, 95% CI 1.75-3.22) and higher (range 24-30) preventive practices score (OR = 2.45, 95% CI 1.80-3.34) were also associated with higher odds of definite willingness. Regarding attitudes toward COVID-19 booster vaccine, having fewer concerns about the side effects of booster vaccination and the uncertain long-term safety of multiple COVID-19 vaccinations were found to create greater odds of a definite willingness to receive the COVID-19 vaccine booster. Findings from this study provided insights into demographic characteristics and important behavioral and attitudinal factors associated with COVID-19 vaccine booster hesitancy.
Abstract
Background
Governmental restrictions of daily life are key elements in reducing the transmission of COVID-19, but they have also put a strain on people’s mental health. Preventive policies ...differ all over the world as well as over different periods of time, and depend mostly on current infection rates. In Germany, there were two periods of restraint of varying severity, during which the government used different combinations of containment and mitigation measures to protect risk groups and to lower the number of hospitalizations.
Methods
In two online studies, we aimed to determine differences and similarities in COVID-19-related fear, generalized anxiety, depression and distress levels, as well as in the adherence to safety behaviour between the first lockdown in March and April and the second lockdown in November.
Results
This study showed continued high psychological burden and even increased levels of depression symptoms, as well as less safety behaviour in the second phase of restrictions.
Conclusions
The results hint at a prolonged negative impact on people’s mental health and their safety behaviour despite lesser restrictions in the second lockdown, which may be interpreted as pandemic fatigue and hence strengthens the argument for a low-threshold access to psychological care.
The COVID-19 pandemic introduced the use of color-coded COVID-19 guidance maps to communicate varying levels of transmission based on local public health data and infrastructure capacity. This study ...explores the application of an extended Theory of Planned Behavior (TPB) to understand how color-coded COVID-19 guidance, pandemic fatigue, and risk perception influence intentions to seek COVID-19 risk information and engage in preventative behaviors. Through two separate studies comprising nationally representative samples in the U.S. (N = 169 and N = 148), conducted at different points during the pandemic, we examine the effect of these factors on intentions to seek COVID-19 risk information and intentions to engage in preventative behaviors. Study 1, conducted in November 2020, focused on these behavioral intentions before vaccine availability, while Study 2, conducted in March 2022, examined these behavioral intentions as the pandemic evolved and vaccines were widely accessible. Path analysis using OLS regression was used to evaluate the models proposed in each study. Our findings highlight that while color-coded risk maps significantly influenced preventive behavior intentions, their impact on information-seeking intentions was less consistent. Results surrounding the influence of pandemic fatigue are mixed, with pandemic fatigue leading to increased risk information seeking in Study 1 and greater preventative behavioral intentions in Study 2. This study offers implications and recommendations for public health officials responsible for communicating complex, prolonged, and location-specific health information.
•Pandemic fatigue in social distance continuously worsened over time.•A sharp increase of pandemic fatigue occurred after the vaccination program began.•Greenspace and urbanicity levels moderated ...pandemic fatigue.•Areas with more greenness experienced lower pandemic fatigue.•Areas with higher urbanicity levels experienced lower pandemic fatigue.
Non-pharmaceutical interventions (NPIs) remain some of the most effective measures for coping with the ever-changing coronavirus disease 2019 (COVID-19) pandemic. Pandemic fatigue, which manifests as the declined willingness to follow the recommended protective behaviors (e.g., keeping social distance policies, wearing masks), has commanded increasing attention from researchers and policymakers after the prolonged NPIs and COVID-19 worldwide. However, long-term changes in pandemic fatigue are not well understood, especially amidst the ever-changing pandemic landscape. Built environment factors have been shown to positively affect mental and physical health, but it is still unclear whether built environments can moderate pandemic fatigue. In this study, we used Google mobility data to investigate longitudinal trends of pandemic fatigue in social distance since the onset of NPIs enforcement in the United States. The results indicated that pandemic fatigue continuously worsened over nearly two years of NPIs implementation, and a sharp increase occurred after the vaccination program began. Additionally, we detected a significant moderation effect of greenspace and urbanicity levels on pandemic fatigue. People living in areas with high levels of greenness or urbanicity experienced lower levels of pandemic fatigue. These findings not only shed new light on the effects of greenness and urbanicity on COVID-19 pandemic fatigue, but also provide evidence for developing more tailored and effective strategies to cope with pandemic fatigue.
Hong Kong has implemented stringent public health and social measures (PHSMs) to curb each of the four COVID-19 epidemic waves since January 2020. The third wave between July and September 2020 was ...brought under control within 2 m, while the fourth wave starting from the end of October 2020 has taken longer to bring under control and lasted at least 5 mo. Here, we report the pandemic fatigue as one of the potential reasons for the reduced impact of PHSMs on transmission in the fourth wave. We contacted either 500 or 1,000 local residents through weekly random-digit dialing of landlines and mobile telephones from May 2020 to February 2021. We analyze the epidemiological impact of pandemic fatigue by using the large and detailed cross-sectional telephone surveys to quantify risk perception and self-reported protective behaviors and mathematical models to incorporate population protective behaviors. Our retrospective prediction suggests that an increase of 100 daily new reported cases would lead to 6.60% (95% CI: 4.03, 9.17) more people worrying about being infected, increase 3.77% (95% CI: 2.46, 5.09) more people to avoid social gatherings, and reduce the weekly mean reproduction number by 0.32 (95% CI: 0.20, 0.44). Accordingly, the fourth wave would have been 14% (95% CI%: -53%, 81%) smaller if not for pandemic fatigue. This indicates the important role of mitigating pandemic fatigue in maintaining population protective behaviors for controlling COVID-19.
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