Threat of mpox (monkeypox) outbreak after the COVID-19 pandemic: are healthcare professionals ready for new psychological wars?

Abstract

Aims: In this study, it was aimed to evaluate the psychological status of healthcare professionals regarding the COVID-19 pandemic, and to examine their perspectives and knowledge levels regarding the mpox epidemic. Methods: Having a cross-sectional design, the present study was carried out by using questions addressing sociodemographic characteristics of healthcare professionals, their experiences with the COVID-19 pandemic, and their knowledge and anxiety levels regarding mpox. Results: 202 healthcare professionals were involved in the present study. Of the participants, 55% were female and the mean age was 35.0±7.7 years. The majority (63.4%) of the participants were midwives/nurses/medical assistants. Of the participants, 68.8% were infected by COVID-19 during the pandemic. Considering the questions addressing their level of knowledge about mpox, 44.1% of participants stated that they had never heard of this disease before. Participants were found to have mainly moderate levels of depression and anxiety and low level of stress, whereas the ratios of very severe depression and anxiety were 5.0% and 7.4%, respectively. Conclusion: It was determined that almost half of the participants had no full knowledge of the disease before the increase in mpox cases. It was found that the participants varying levels of depression, anxiety, and stress about a new pandemic. We think that it is important to provide healthcare professionals with psychosocial support, make effort in order to determine and eliminate the sources of psychological negativities.

Keywords

• Anxiety
• COVID-19
• Depression
• Monkeypox
• Mpox

COVID-19 salgını sonrası mpox (maymun çiçeği) salgını tehdidi: Sağlık çalışanları yeni psikolojik savaşlara hazır mı?

Abstract

Amaç: Bu çalışmada, sağlık çalışanlarının COVID-19 pandemisine ilişkin psikolojik durumlarının değerlendirilmesi, mpox salgınına bakış açılarının ve bilgi düzeylerinin incelenmesi amaçlandı. Yöntemler: Kesitsel bir tasarıma sahip olan bu çalışma, sağlık çalışanlarının sosyodemografik özellikleri, COVID-19 pandemisi ile ilgili deneyimleri ve mpox'a ilişkin bilgi ve kaygı düzeylerini ele alan sorular kullanılarak gerçekleştirildi. Bulgular: Çalışmaya 202 sağlık çalışanı dahil edildi. Araştırma kapsamına alınanların %55’i kadındı ve yaş ortalaması 35.0±7.7 yıldı. Katılımcıların büyük çoğunluğu (%63.4) ebe/hemşire/sağlık memuruydu. Katılımcıların %68.8'i pandemi sırasında COVID-19 ile enfekte oldu. Mpox ile ilgili bilgi düzeylerine yönelik yöneltilen sorularda katılımcıların %44.1’i (n=89) bu hastalığı daha önce hiç duymadıklarını ifade etti. Katılımcıların ağırlıklı olarak orta düzeyde depresyon ve anksiyete ile düşük düzeyde strese sahip olduğu, çok şiddetli depresyon ve anksiyete oranlarının ise sırasıyla %5.0 ve %7.4 olduğu bulundu. Sonuç: Çalışmada katılımcıların neredeyse yarısının mpox vakalarındaki artıştan önce hastalık hakkında tam bilgiye sahip olmadığı belirlendi. Katılımcıların yeni bir pandemiye karşı farklı düzeylerde depresyon, kaygı ve stres yaşadıkları tespit edildi. Psikolojik olumsuzlukların kaynaklarının belirlenip ortadan kaldırılması için sağlık çalışanlarına psikososyal destek verilmesinin, çaba gösterilmesinin önemli olduğunu düşünüyoruz.

Keywords

• Anksiyete
• COVID-19
• Depresyon
• Maymun çiçeği
• Mpox

References

1. 1- World Health Organization [Internet]. Director-General’s opening remarks at the media briefing on COVID-19. 2020. [Cited 2020 Apr 9]. Available from: https://www. who. int/ dg/ speeches/ detail/ who- director- general's- opening remarks- at- the- media- briefing- on- covid- 19- 11- march- 2020
2. 2- World Health Organization [Internet]. Coronavirus (COVID-19) Dashboard. 2023. [Cited 31 May 2023].Available: https://covid19.who.int/
3. 3- Sommerstein R, Fux CA, Vuichard-Gysin D, et al. Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19. Antimicrob Resist Infect Control 2020; 9(1): 100. https://doi.org/10.1186/s13756-020-00763-0
4. 4- Yumru M. COVID-19 and burnout in health workers. J Clin Psy 2020; 23(1): 5-6. DOI: 10.5505/kpd.2020.18942
5. 5- Yang Z. Monkeypox: A potential global threat?. J Med Virol 2022; 94: 4034-4036. https://doi.org/10.1002/jmv.27884
6. 6- Rizk JG, Lippi G, Henry BM, Forthal DN, Rizk Y. Correction to: Prevention and Treatment of Monkeypox. Drugs 2022; 82(12): 1343. doi: 10.1007/s40265-022-01767-3
7. 7- Harapan H, Setiawan AM, Yufika A, et al. Knowledge of human monkeypox viral infection among general practitioners: a cross-sectional study in Indonesia. Pathog Glob Health 2020; 114(2): 68-75.DOI: 10.1080/20477724.2020.1743037
8. 8- World Health Organization [Internet]. Monkeypox. 2022. [Cited 3 Aug 2019]. Available from: https://www.who.int/newsroom/fact-sheets/detail/monkeypox

9. 9- Focosi D, Novazzi F, Baj A, Maggi F. Monkeypox: an international epidemic. Rev Med Virol 2022; 32(6): e2392. https://doi.org/10.1002/rmv.2392
10. 10- Thornhill JP, Barkati S, Walmsley S, et al. Monkeypox virus infection in humans across 16 countries—April–June 2022. N Engl J Med 2022; 387(8): 679-691. DOI: 10.1056/NEJMoa2207323
11. 11- World Health Organization [Internet]. Monkeypox; 2022. [Cited 19 May 2022]. Available from: https://www.who.int/newsroom/fact-sheets/detail/monkeypox
12. 12- World Health Organization [Internet]. Second meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the multi-country outbreak of monkeypox. 2022. [Cited 23 July 2022]. https://www.who.int/ news/item/23-07-2022-second-meeting-of-theinternational-health-regulations-(2005)-(ihr)- emergency-committee-regarding-the-multicountry-outbreak-of-monkeypox.
13. 13- World Health Organization [Internet]. Monkeypox Outbreak: Global Trends. [Cited 6 June 2023]. Available from: https://worldhealthorg.shinyapps.io/mpx_global/
14. 14- World Health Organization [Internet]. WHO Informal Consultation on Monkeypox 2017. Geneva, Switzerland:World Health Organization; 2017. p.18.
15. 15- Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther 1995; 33: 335-342. https://doi.org/10.1016/0005-7967(94)00075-U
16. 16- Saricam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. JCBPR 2018; 7(1): 19-30. https://doi.org/10.5455/JCBPR.274847
17. 17- Polat ÖP, Coşkun F. COVID-19 Salgınında sağlık çalışanlarının kişisel koruyucu ekipman kullanımları ile depresyon, anksiyete, stres düzeyleri arasındaki ilişkinin belirlenmesi. Batı Karadeniz Tıp Dergisi 2020; 4(2): 51-58.
18. 18- Chan AOM, Huak CY. Psychological impact of the 2003 severe acute respiratory syndrome outbreak on health care workers in a medium size regional general hospital in Singapore. Occup Med (Lond) 2004; 54: 190-196. https://doi.org/10.1093/occmed/kqh027
19. 19- Restauri N, Sheridan AD. Burnout and Posttraumatic Stress Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and Interventions. J Am Coll Radiol 2020; 17: 921–926. https://doi.org/10.1016/j.jacr.2020.05.021
20. 20- Lee AM, Wong JG, McAlonan GM, et al. Stress and Psychological Distress among SARS Survivors 1 Year after the Outbreak. Can J Psychiatry 2007; 52(4): 233-240. doi:10.1177/070674370705200405
21. 21- Chew NW, Lee GK, Tan BY, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun 2020; 88: 559–565.
22. 22- Ghio L, Patti S, Piccinini G, et al. Anxiety, Depression and Risk of Post-Traumatic Stress Disorder in Health Workers: The Relationship with Burnout during COVID-19 Pandemic in Italy. Int J Environ Res Public Health 2021; 18: 9929. https://doi.org/10.3390/ijerph18189929
23. 23- Mahmud S, Hossain S, Muyeed A, Islam MM, Mohsin M. The global prevalence of depression, anxiety, stress, and, insomnia and its changes among health professionals during COVID-19 pandemic: A rapid systematic review and meta-analysis. Heliyon 2021; 7(7): e07393. https://doi.org/10.1016/j.heliyon.2021.e07393
24. 24- Li Y, Scherer N, Felix L, Kuper H. Prevalence of depression, anxiety and posttraumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS ONE 2021; 16(3): e0246454. https://doi.org/10.1371/journal.pone.0246454
25. 25- Giusti EM, Pedroli E, D'Aniello GE, et al. The psychological impact of the COVID-19 outbreak on health professionals: a cross-sectional study. Frontiers in psychology 2020; 11: 1684. doi: 10.3389/fpsyg.2020.01684
26. 26- Que J, Shi L, Deng J, et al. Psychological impact of the COVID-19 pandemic on healthcare workers: a cross-sectional study in China. Gen Psychiatr 2020; 33(3): e100259. doi:10.1136/gpsych-2020-100259.
27. 27- Sallam M, Al-Mahzoum K, Al-Tammemi AB, et al. Assessing HealthcareWorkers’ Knowledge and Their Confidence in the Diagnosis and Management of Human Monkeypox: A Cross-Sectional Study in a Middle Eastern Country. Healthcare 2022; 10: 1722. https://doi.org/10.3390/healthcare10091722
28. 28- Riccò M, Ferraro P, Camisa V, et al. When a Neglected Tropical Disease Goes Global: Knowledge, Attitudes and Practices of Italian Physicians towards Monkeypox, Preliminary Results. Trop Med Infect Dis 2022; 7:135. https://doi.org/10.3390/tropicalmed7070135
29. 29- Poland GA, Kennedy RB, Tosh PK. Prevention of monkeypox with vaccines: a rapid review. The Lancet Infectious Diseases 2022; 22(12): 349-358. https://doi.org/10.1016/S1473-3099(22)00574-6
30. 30- Temsah MH, Aljamaan F, Alenezi S, et al. Monkeypox caused less worry than COVID-19 among the general population during the first month of the WHO Monkeypox alert: Experience from Saudi Arabia. Travel Med Infect Dis 2022; 49: 102426. https://doi.org/10.1016/j.tmaid.2022.102426