Difficulties of Prevention and Control Staff in COVID-19 Outbreak: A Cross-sectional Study Based on Five Provinces

Abstract Objectives: The aim of this study is to address the difficulties encountered by epidemic control staff in the early and middle stages of their efforts to combat COVID-19, compare the gaps among different types of institutions, and identify shortcomings in epidemic control. Methods: Using multi-stage sampling, a survey of primary (“primary-urban” and “primary-rural”) and non-primary (“CDC”) public health workers involved in the prevention and control of COVID-19 in five provinces, including Hubei, Guangdong, Sichuan, Jiangsu and Gansu, was conducted from 18 February to 1 March 2020 through a self-administered questionnaire.Results: A total of 9475 outbreak prevention and control workers were surveyed, of which 40.0% were from the primary-rural, 27.0% were from the primary-urban and 33.0% were CDC. Resources shortage was reported at 27.9%, with the primary-rural being the worst affected (OR=1.201, 95%CI: 1.073-1.345). Difficulties in data processing were reported at 31.5%, with no significant differences among institutions. Communication and coordination difficulties were reported at 29.8%, with the CDC being the most serious (the rural primary: OR=0.520, 95%CI: 0.446-0.606; the primary-urban: OR=0.533, 95%CI: 0.454-0.625). Work object difficulties were reported at 20.2%, with the primary-urban being the worst (OR=1.368, 95%CI: 1.199-1.560). Psychological distress was reported at 48.8%, with no significant differences among institutions.Conclusions: Psychological distress is the most serious problem in the prevention and control of COVID-19, and the resources shortage in primary-rural, communication and coordination difficulties in CDC, and difficulties in working with the target population in the primary-urban deserve attention. This study will provide a scientific basis for improving the national public health emergency management system, especially for reducing the urban-rural differences in emergency response capacity.