Background Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. Methods Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). Conclusions Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.

Background: Public health workers at China CDCs and primary health care institutes (PHI) constitute one of the main workforces for implementing prevention and control measures to contain the COVID-19 epidemic, but their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of frontline public health workers in China during the epidemic. Methods: Between February 18 to March 1, 2020, we conducted a cross-sectional survey among 2,313 CDC workers and 4,004 PHI workers in ve provinces across China experiencing different scales of COVID-19 epidemic. We interviewed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health by self-constructed questionnaire and standardized measurements. To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results: The prevalence of depression, anxiety, and poor self-rated health was 21.3%, 19.0%, and 9.8%, respectively, among public health workers (27.1%, 20.6% and 15.0% among CDC workers; and 17.5%, 17.9% and 6.8% among PHI workers). The majority (71.6%) participated in both eld and non-eld work and gave immense efforts. Nearly 20.0% have worked all night for more than 3 days and 45.3% had worked during the whole period of Chinese New Year. Three risk factors and two protective factors were found independently associated with all three health outcomes in our nal multivariate models, including working all night for >3 days (ORm=1.67~1.75, p<0.001), concerns about being infected at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), starting COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and capability to persist for more than 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). Conclusion: Chinese public health workers gave immense efforts and personal sacri ces to curb the COVID-19 epidemic and were exposed to risk of mental health problems. Efforts should be taken to improve the working condition and health status of public health workers to maintain the morale and effectiveness of public health workers in the ght against the epidemic. health workers involved in the epidemic containment efforts, (2) the roles and job functions they played, (3) the challenges associated with their work, and (4) factors that were associated with their mental and physical health. Methods Study design This cross-sectional study was conducted from February 18 to March 1, 2020. Data was collected from ve provinces (Hubei, Guangdong, Sichuan, Jiangsu and Gansu) which were purposely selected to cover different levels of epidemic severity de ned by numbers of reported cases (by March 5, 2020, 67466, 1351, 539, 631, and 102 COVID-19 cases were reported in the selected ve provinces), and to cover different regions of the country (center, southern, western, eastern, and northern). In each province, 3-5 cities were...

Background: Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic.Methods: Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results: The prevalence of depression, anxiety, and poor self-rated health was 21.3%, 19.0%, and 9.8%, respectively, among public health workers (27.1%, 20.6%, and 15.0% among CDC workers and 17.5%, 17.9%, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001).Conclusions: Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.

Background: Public health workers at China CDCs and primary health care institutes (PHI) constitute one of the main workforces for implementing prevention and control measures to contain the COVID-19 epidemic, but their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of frontline public health workers in China during the epidemic. Methods: Between February 18 to March 1, 2020, we conducted a cross-sectional survey among 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We interviewed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health by self-constructed questionnaire and standardized measurements. To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results: The prevalence of depression, anxiety, and poor self-rated health was 21.3%, 19.0%, and 9.8%, respectively, among public health workers (27.1%, 20.6% and 15.0% among CDC workers; and 17.5%, 17.9% and 6.8% among PHI workers). The majority (71.6%) participated in both field and non-field work and gave immense efforts. Nearly 20.0% have worked all night for more than 3 days and 45.3% had worked during the whole period of Chinese New Year. Three risk factors and two protective factors were found independently associated with all three health outcomes in our final multivariate models, including working all night for >3 days (ORm=1.67~1.75, p<0.001), concerns about being infected at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), starting COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and capability to persist for more than 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). Conclusion: Chinese public health workers gave immense efforts and personal sacrifices to curb the COVID-19 epidemic and were exposed to risk of mental health problems. Efforts should be taken to improve the working condition and health status of public health workers to maintain the morale and effectiveness of public health workers in the fight against the epidemic.

Background: Public health workers at Chinese Center for Disease Control and Prevention (China CDC) and primary health care institutes (PHI) constitute one of the main workforces for implementing prevention and control measures to contain the COVID-19 epidemic, but their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of frontline public health workers in China during the epidemic.Methods: Between February 18 to March 1, 2020, we conducted a cross-sectional survey among 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We interviewed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardized measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results: The prevalence of depression, anxiety, and poor self-rated health was 21.3%, 19.0%, and 9.8%, respectively, among public health workers (27.1%, 20.6% and 15.0% among CDC workers; and 17.5%, 17.9% and 6.8% among PHI workers). The majority (71.6%) participated in both field and non-field work and gave immense efforts. Nearly 20.0% have worked all night for more than 3 days and 45.3% had worked during the whole period of Chinese New Year. Three risk factors and two protective factors were found independently associated with all three health outcomes in our final multivariate models, including working all night for >3 days (ORm=1.67~1.75, p<0.001), concerns about being infected at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), starting COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and capability to persist for more than 1 month at the current work intensity (ORm=0.44~0.55, p<0.001).Conclusions: Chinese public health workers gave immense efforts and personal sacrifices to curb the COVID-19 epidemic and were exposed to risk of mental health problems. Efforts should be taken to improve the working condition and health status of public health workers to maintain the morale and effectiveness of public health workers in the fight against the epidemic.