Yong, Ming Lee

While there are many online data dashboards on COVID-19, there are few analytics available to the public and non-epidemiologists to help them gain a deeper insight into the COVID-19 pandemic and evaluate the effectiveness of social intervention measures. To address the issue, this study describes the methods underlying the development of a real-time, data-driven online Epidemic Calculator for tracking COVID-19 growth parameters. From publicly available infection case and death data, the calculator is used to estimate the effective reproduction number, final epidemic size, and death toll. As a case study, we analyzed the results for Singapore during the "Circuit Breaker” period from April 7, 2020 to the end of May 2020. The calculator shows that the stringent measures imposed have an immediate effect of rapidly slowing down the spread of the coronavirus. After about two weeks, the effective reproduction number reduced to about 1.0. Since then, the number has been fluctuating around 1.0 for more than a month. The COVID-19 Epidemic Calculator is available in the form of an online Google Sheet and the results are presented as Tableau Public dashboards at www.cv19.one. By making the calculator readily accessible online, the public can have a tool to assess the effectiveness of measures to control the pandemic meaningfully.

Aims: This study investigates multi-dimensional Covid-19 related stressors and the extent to which these stressors are related to young adult’s smoking and heavy alcohol use among university students in Singapore during the Covid-19 pandemic.

Design/Setting/Participants: A total of 2,339 undergraduate students (862 male, 1309 female) in Singapore participated in an online survey.

Measures: The Covid-19 Stressors Questionnaire (C19SQ) is a developmentally influenced, Covid-19 related stress scale, used alongside mental health measures (GAD & PHQ) and substance use. Structural equation modeling was used to model the association between four types of Covid-19 related stressors and past month smoking and heavy drinking while accounting for student mental health, family socio-economic status, gender and race/ethnicity.

Findings: Stress related to Covid-19 social restrictions was associated with increased likelihood of heavy drinking and smoking behavior, whereas stress related to health concerns was associated with decreased likelihood of smoking and heavy drinking. Covid-19 related stressors related to resource constraints and future uncertainties were not associated with young adult substance use.

Conclusions: Our finding that Covid-19 stressors related to Social Restrictions and Health Concerns were particularly salient for university student’s substance use, but in opposite directions, extend prior work by demonstrating that young adult substance use behavior is differentially impacted by specific types of Covid-19 stress and point to areas where public health and clinical intervention efforts can focus in the wake of the Covid-19 pandemic for this vulnerable population.

The use of a screening tool for school-wide screening of internalizing symptoms is an important strategy for early identification and prevention of more serious and impairing emotional and behavioral health problems in adolescents. However, threshold cut-off scores determined for screening tools may not be suitable for all populations. Using a sample of 237 Singaporean secondary school students, this study validated the Youth Internalizing Problems Screener (YIPS) for local use. Results of confirmatory factor analyses supported a one-factor solution for the construct. A threshold cut-off score of 27 was found to show good classification accuracy based on receiver operating characteristics (ROC) analyses. Correlational and path analyses provided evidence of convergent and predictive validity for using YIPS to indicate at-risk status. The YIPS status was uniquely associated with girls’ sense of school well-being over and above the nature of their interpersonal relationships and their sense of inadequacy. Overall, YIPS demonstrated comparable sensitivity and specificity rates even though a different cut-off score was used for this study sample. The use of YIPS as a screening tool in a multitier system of support and directions for future development were discussed.