key: cord-0684378-ko4bidtr authors: Cervantes-Guevara, Gabino; Maciel-Saldierna, Manuel; Elizondo-Hernández, Emmanuel; Cervantes-Pérez, Lorena Alejandra; Cervantes-Cardona, Guillermo Alonso; García-Reyna, Bejanmín; Ibarrola-Peña, Juan Carlos; Almanza-Mena, Yolanda Lorelei; Barbosa-Camacho, Francisco José; Fuentes-Orozco, Clotilde; Chejfec-Ciociano, Jonathan Matias; Guzmán-Barba, José Aldo; Flores-Becerril, Paola; Reyes-Elizalde, Emilio Alberto; González-Ojeda, Alejandro title: Fear of COVID-19 in High School Personnel: a Survey Study in Western Mexico date: 2021-01-25 journal: Int J Ment Health Addict DOI: 10.1007/s11469-020-00473-z sha: e4b94d289b9cdb7e269c81edfef9067a27aa142a doc_id: 684378 cord_uid: ko4bidtr nan The participant must choose the options that best represent their perception about the statements presented. Total scores range from 7 (no fear) to 35 points (highest level of fear). The study was performed in a public high school in Guadalajara, Mexico, from June to August 2020. The study included a total of 1529 teachers and administrative personnel of a high school in the vicinity of the authors; the total population of personnel of the high school is 1800 persons, resulting in a response rate of 84.94%. The researchers asked the participants for their participation, and after consenting, a physical copy of the survey was provided, to be answered anonymously. Participants were encouraged to pass the invitation to other staff members to obtain a snowball sampling method. Once completed, the surveys were collected. The data were analyzed using SPSS software (version 23.0 for Windows; IBM SPSS, Armonk, NY, USA). The descriptive analyses included proportions, means, and standard deviations. The inferential analysis of categorical variables was performed using the chisquared test, Fisher's exact probability test, or analyses of variance (ANOVA) as appropriate. Student's t test was used to analyze continuous variables. Post hoc analysis was conducted with Tukey and Bonferroni tests. A probability level of p < 0.05 was considered significant. The internal reliability of the scale was good, with a Cronbach's alpha of 0.917. Participant demographics are described in Table 1 . The mean global FCV-19S score was 20.44 ± 6.92, and the results according to sex, age groups, and job are also described in Table 1 . An independent sample t test was conducted to compare the FCV-19S mean scores for female (21.07 ± 6.82) and male personnel (19.62 ± 6.96), finding statistically significant differences (t(1527) = 4.07, p < 0.001). There were no significant differences between the mean scores for teachers (20.49 ± 6.97) and administrative personnel (20.28 ± 6.77) (t(1527) = 0.51, p > 0.05). We divided the sample into two age groups: 18-45 years and 46-66+ years. There was no significant difference in mean FCV-19S score between the 18-45 years (20.74 ± 7.08) and 46-66+ years groups (20.05 ± 6.70) (t(1527) = 1.91, p > 0.05). An ANOVA test performed to compare the mean scores of all the age groups did not show any significant differences (F(9,1519 = 1.74, p > 0.05). We compared the emotional and physical responses to fear between male and female personnel using items 1, 2, and 4 to evaluate the emotional responses to fear and items 3, 5, 6, and 7 to evaluate physical responses to fear. An independent samples t test was conducted to compare the emotional response mean scores for female personnel (10.25 ± 3.0) and male personnel (9.73 ± 3.17), finding statistically significant differences (t(1527) = 3.30, p < 0.001). A comparison of the emotional response mean scores for teachers (10.03 ± 3.11) and administrative personnel (10.02 ± 3.04) did not show any significant differences (t(1527) = 0.06, p > 0.05). Comparison of the physical responses to fear between female (10.80 ± 4.22) and male personnel (9.88 ± 4.24) showed statistically significant differences (t(1527) = 4.19, p < 0.001). There were no significant differences between the physical response mean scores for teachers (10.45 ± 4.30) and for administrative personnel (10.25 ± 4.23) (t(1527) = 0.78, p > 0.05). When comparing the emotional responses mean scores for the 18-45 years group (10.15 ± 3.12) and the 46-66+ years group (9.86 ± 3.06), the difference was not statistically significant (t(1527) = 1.81, p > 0.05). Likewise, the differences between the physical responses mean scores for the 18-45 years group (10.57 ± 4.39) and the 46-66+ years group (10.18 ± 4.12) were not statistically significant (t(1527) = 1.77, p > 0.05). A detailed description of emotional and physical responses, compared between genders, age groups, and job categories, can be found in Table 2 . Finally, we performed an ANOVA test to compare all the age groups' emotional responses mean scores; it did not show any significant differences. On the other hand, there was a significant effect of age on the physical responses mean scores (F(9,1519) = 2.237, p = 0.018). The emergence of COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide (Ahorsu et al. 2020) . Research has shown that emotions such as fear can affect their decision-making by undermining rationality; however, it can also motivate people, moderating their choices (Wagner et al. 2019) . Fear is a powerful emotion that can affect human behavior and job performance. One study on the psychological impact of quarantine in Chinese university students found that 24.9% of those interviewed experienced anxiety related to the COVID-19 outbreak (Baiano et al. 2020 ). In our sample, the average global score of FCV-19S was 20.44, which implies that most people suffered from a medium to high level of fear of COVID-19. It is interesting to note that the average score in our population is higher than that of others studies reported in general population of Latin America and Russia (Barrios et al. 2020; Huarcaya-Victoria et al. 2020; Reznik et al. 2020 ). This could be due to the Mexican environment of neglect, high incidence of COVID-19 cases and the unclear strategies of its government, which gave a complicated picture for its population. One way to make teachers feel secure could be to let them be part of the plan against COVID-19. A study conducted in the Philippines, which asked how the teachers dealt with the pandemic, found that the most commonly used preventive measure was social distancing (98.2%), almost 44% of teachers avoided crowded places, 20.2% observed proper hygiene, 16.5% used hand washing practices, 7.8% exercised, 6.4% wore face masks, 2.7% took vitamins, 1.4% stayed at home, and only 0.9% followed the government guidelines (Talidong and Toquero 2020) . In contrast, in a study performed in hospital personnel in the same region as this study, the level of fear is lower in healthcare professionals and overall hospital staff ( Barbosa-Camacho et al. 2020; García-Reyna et al. 2020 ). This could be due to a greater comprehension of the disease and easier access to protective measures than the general population. An analysis conducted in the general population of China to survey peritraumatic psychological distress during the epidemic found that scores were associated with participants' gender, age, education, occupation, and region. Female respondents showed significantly higher psychological distress than their male counterparts (mean (SD) = 24.87 (15.03) vs. 21.41 (15.97), p < 0.001) (Qiu et al. 2020) . Multiple studies have indicated the most vulnerable groups in this pandemic to be women, college students, and older adults (Huarcaya-Victoria 2020). In concord with this, a t test in our population to compare the emotional response mean scores for female personnel (10.25 ± 3.0) and male personnel (9.73 ± 3.17) found statistically significant differences (t(1527) = 3.30, p < 0.001). This result was expected, because even without a pandemic, women tend to have higher levels of social anxiety symptoms and are diagnosed with psychological illnesses more frequently than men (Allan et al. 2017 ). However, a comparison of the mean scores for the 18-45 and the 46-66+ age groups found no statistically significant effect for older adults. Additionally, an ANOVA test comparing mean scores of all the age groups did not show any significant differences. Although our study found older people had the same incidences as other age groups, international literature strongly maintains that they are a higher risk group for psychological illness caused by isolation and pandemic-related stress. It is not only the chronological age but also the presence of chronic disease and comorbidities that make individuals more vulnerable to COVID-19 and related diseases, including psychological illness. We also know that during emergency situations, older adults with cognitive or physical impairments are at even greater risk (Ayalon et al. 2020) . Elderly people are also the most likely group to suffer physical symptoms related to stress, anxiety, fear, and psychological illness. In our population, there was a significant effect of the age groups on the physical responses mean scores. The coronavirus pandemic affected the performance and ability of teachers to give or receive information. Mexico, like most countries in the world, had to improvise to continue with school courses at all educational levels. One of the most frequently used strategies was to go to an online website to teach classes, which may have contributed to increased stress and sadness in teachers. A Spanish study exploring the feelings of physical education teachers who had to improvise in this situation found that one of the main changes in emotional state was that teachers presented as happy and smiling when they taught physical education in person and were in direct contact with the students before confinement but were sad when they had to switch to online teaching (Varea and González-Calvo 2020) . It is important, therefore, to give faculty staff some flexibility, to allow them to develop their own ways to reach out to students and to assist them in this transition. With proper support and encouragement, they can all enjoy the benefits of taking the challenge created by such changes head on (Eachempati and Ramnarayan 2020) . In our sample of teachers, the average FCV-19S was 20.44 ± 6.92, which implies that most teachers suffered from a medium to high level of fear of COVID-19. Currently, there is limited information about the fear of COVID-19 in teachers and school administrative personnel. Talidong and Toquero (2020) conducted a study based on a 25-question survey of Filipino teachers' practices, perceptions, and experiences of the COVID-19 outbreak. They found that the greatest concern of teachers was the safety of their loved ones and that their lifestyles had been affected by fears related to the pandemic. The teachers had used various types of activities and measures, such as acquiring new hobbies, to deal with anxiety, while adhering to the preventive and educational policies of the Department of Education and the Commission on Higher Education. A higher incidence of fear of COVID-19 is expected in those professions on the front line, such as healthcare workers who are frequently exposed to COVID-19 patients. Nevertheless, it is important to pay special attention to those educating our future professionals, because their failure may translate into an educational weakness. Teachers must be able to deliver the academic program correctly and clearly from a distance, to ensure the least risk of contagion, to manage the difficulties raised by the pandemic, and to understand how stressful and complicated social isolation can be. The study have some limitations; one is that although we present a high number of participants, only one high school was studied; further studies should be performed including a higher diversity of educators and school personnel to better understand the impact of the pandemic in public high schools. This is the first study in Mexico to evaluate fear levels in this context and population. To date, studies have only been carried out in health personnel. It is interesting to observe that the prevalence of fear according to the FCV-19S is higher in teaching personnel than expected. Although we found higher scores, it is necessary to continue to evaluate the consequences in the teacher-student relationship, including the performance of both parties, and to evaluate other factors that could be involved. Additionally, it is important to emphasize that female personnel reported higher scores on the FCV-19S, which is consistent with the findings of other populations and that there was a similar prevalence in all age groups. Institutions must pay special attention to those who are educating our future professionals, because their failure may translate into an educational weakness. 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The Lancet Child & Adolescent Health Anxiety, fear, and political decision making Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations Authors' Contributions GCG and MMS conceived the presented idea. All authors contributed to the study conception and design. Material preparation was performed by EEH, LACP, GACP, and BGR. JAGB, PFB, and EARE assisted with the recruitment process and distribution of the surveys. Data management was performed by JCIP and YLAM. Data analysis was performed by FJBC, CFO, and AGO. All authors contributed to the writing and review of the manuscript. All authors read and approved the final manuscript. Conflict of Interest The authors declare that they have no conflict of interest.Informed Consent Informed consent was obtained from all participants to be included in the study. Their privacy, confidentiality, and anonymity were ensured. All procedures followed were in accordance with the ethical standards of the National Ethics Committee and the National Scientific Research Committee authorized the study protocol with the registration number r089-5-2020 and with the Declaration of Helsinki of 1975, as revised in 2013.