COVID-19 PANDEMIC: A STUDY OF QUALITY OF LIFE AND ANXIETY IN

AIZAWL CITY

Marcus Saihmingliana,

Johny Lalthafamkima,

Thurochami,

Saihlupuii Sailo,

Lalthanpuii Ralte

Department of Psychology

Mizoram University
 COVID-19 PANDEMIC: A STUDY OF QUALITY OF LIFE AND ANXIETY IN
AIZAWL CITY

By

Marcus Saihmingliana,

Johny Lalthafamkima,

Thurochami,

Saihlupuii Sailo,

Lalthanpuii Ralte

Department of Psychology

Mizoram University

Submitted in partial fulfillment of the requirement of the Pre Ph.D in Psychology of Mizoram
University, Aizawl
 ACKNOWLEDGEMENT

We express our heartfelt thanks and gratitude to our supervisor and mentor, Prof.
Zoengpari, without whom this research project would not have been possible. Thank you,
Madam for giving us this golden opportunity, your guidance, patience and motivation
throughout this project.
 TABLE OF CONTENTS

Page Numbers

LIST OF TABLES

LIST OF FIGURES

LIST OF APPENDICES

CHAPTER I – INTRODUCTION

CHAPTER II – STATEMENT OF THE PROBLEM

CHAPTER III – OBJECTIVES AND HYPOTHESIS

CHAPTER IV – METHODS AND PROCEDURE

CHAPTER V – RESULTS AND DISCUSSION

CHAPTER VI – SUMMARY AND CONCLUSION

REFERENCES

APPENDIX
LIST OF TABLES

Table-1 Descriptive Statistics.

Table-2 Lavene’s Test for Equality of Variances.

Table-3 Mean Scores.

Table-4 Correlations.

Table-5 Independent Samples Test.

Table-6 ANOVA.

Table-7 Multiple Comparisons.

LIST OF FIGURES

1. Means plot of the Coronavirus Anxiety scores.

 INTRODUCTION

Coronaviruses are a large family of viruses that are known to cause a wide range of
physical problems from common cold to more severe illnesses such as Middle East
Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). They are
often zoonotic and several known coronaviruses are circulating in animals that have not yet
infected humans. The novel coronavirus (COVID-19) is a new strain of coronavirus that has
not been identified in humans previously. The novel corona virus (COVID-19) outbreak,
which was first detected in Wuhan, China, in December 2019, has been evolving rapidly. On
30 January 2020, the WHO Director General (Dr Tedros Adhanom) declared that the current
outbreak constituted a public health emergency of international concern, and on 12th March
2020 the COVID-19 the outbreak was declared a pandemic.

At the time of conducting this research, as of 24th January 2021, we have a

worldwide reporting of over 107 million confirmed cases, about 59.5 million people have
recovered, and more than 2.33 million confirmed deaths were reported according to the
worldometer website which is run by an international team of developers and researchers, and
highly reliable. Currently India has over 10.8 million confirmed cases, with 10.5 million
recovered cases, and 155,000 deaths reported. The most affected top five states are:
Maharashtra, Karnataka, Andhra Pradesh, Tamil Nadu, and Kerela according to the Ministry
of Health India, together these states account for 50% of the cases reported in the country.
Mizoram reported its first confirmed case of novel coronavirus on 24th March, 2020.
Currently as of 24th January, 2021, Mizoram has 4351 confirmed cases, 4284 recoveries, and
9 deaths reported.

Currently, the citizens of Aizawl are under strict regulations, with severe punishment
and fines for those who do not follow Covid-19 prevention guidelines. An action plan called
"Covid-19 No Tolerance Forth-night" was implemented by the Government of Mizoram
designed to fight the spread of the coronavirus (COVID-19) pandemic. Specific to Mizoram,
the government established a task force to combat the spread of Covid-19 and to help
government officials such as the police force in implementing the law where each locality
and each village acquire or established a Local Council/ Village Task Force . The
Government also notified various Task Groups, each headed by a Secretary, to look into
various aspects and situations that arose and had to be dealt due to the Lockdown. These are -
(i)Task Group on Transportation and Commodities chaired by Commissioner & Secretary
Food Civil Supplies and Consumer Affairs (formed by merging Task Group on Transport and
Task Force on Essential Commodities).(ii)Task Group on Medicine & Medical Equipments
chaired by Secretary, Health & Family Welfare Department.(iii)Task Group on Migrant
Workers and Stranded Travellers chaired by Addl. Secretary, Home Department.(iv)Task
Group on Insurance chaired by Addl. Secretary, Finance Department.(v)Task Group on
Animal Husbandry & Veterinary Services and Fisheries chaired by Secretary, AH &Vety,
Department(vi)Task Group on Quarantine Facilities chaired by Commissioner & Secretary,
School Education Department.(vii)Task Group on Documentation chaired by Secretary,
Planning & Programme Implementation Department.(viii)Task Group on Media & Publicity
chaired by Secretary, I&PR Department. (ix)Task Group on Agricultural Input chaired by
Commissioner & Secretary, Agriculture Department.(x)Task Group on Direct Benefit
Transfer chaired by Secretary Finance.(xi)Task Group on International/State Boundaries
chaired by DGP, Mizoram.

The municipal wards in Aizawl is split into localities termed as Local Council areas.
The Local Council are the former village councils, which are the traditional community
governance structures still being followed till today. The Local Councils have a chairman of
4-6 members elected by the community belonging to the Local Council area. The Local
Council chairman and members look after the development of the Local Council area. Local
Councils are formally recognised decentralised traditional citizen consultative platforms that
are completely integrated with the city governance structures. These structures enabled the
setting up of task forces at the local council levels across the city during the crisis. These
Task Forces are strictly monitoring all home quarantine cases of people, even who are
otherwise healthy but have arrived from other countries and states in the last two weeks, for a
period of 14 days. They are also monitoring availability of essential items and prices of
goods. Announcements in this regard are being made by the Task Forces over public address
systems in localities.

Apart from the chairman and members of local council, the task force also hold local
resident volunteers, health workers, church and Young Mizo Association (YMA)
representatives working in full tandem. These taskforces are authorised to manage the crisis
in its respective areas. The taskforces are supported by their respective ward councillors of
the Aizawl Municipal Corporation (AMC) and State Government officials for any form of
necessary administrative support, during the phase of the Covid-19 No tolerance Forth-Night
the Government of Mizoram established Task-Force different from Local Council Task Force
made up of Government Servants which roam the city of Aizawl to catch Covid-19 rule
breakers and to aid the Government in enforcing the Covid-19 restrictions. The Local Council
taskforce has been distributing food, enforcing social distancing norms and spreading
awareness through various means such as social media, local news channels etc.

Aizawl has a largely young population, the youth are engaged in a culture revolving
around the church and culturally active groups known as the YMA, the YMA which stands
for Young Mizo Association is a Non-Government Organisation that possesses huge
influence in the Mizo culture. The YMA conducts awareness and other local voluntary
activities, and this has been in practice for a long time. This has thus, led to active
participation of the youth across the city in various relief and support activities through
YMA, taskforce, college groups and the church. The church is the backbone to the city and of
the Mizo society. It has always played a major role in many of the activities that take place in
the city.

The Mizo Community is a very close knit society wherein everyone knows one
another, especially within the local council areas and local church groups. This also has in a
way helped in keeping a check on people who follow and break the Covid-19 rules/guidelines
and supporting families in need of help. The city is known for its discipline and it shows even
in normal times and for its obedience towards rules framed by their respective Local Councils
and YMA groups.

A broad body of research links social isolation and regulations to poor mental health;
and recent data on the Psychological impact of COVID-19 lockdowns in India, conducted by
Sandeep Grover et al, published in the Indian Journal of Psychiatry dated 27th July 2020
shows that significantly higher share of people who were quarantined or in lockdown
reported negative mental health effects resulting from worry or stress related to coronavirus
than among those not in lockdown or quarantined. The widespread outbreaks of infectious
diseases, such as COVID-19 are associated with psychological distress and symptoms of
mental illness worldwide.

Recent evidence suggests that people who are kept in isolation and quarantined
experience significant levels of anxiety, anger, stress with an overall lower quality of life
(Brooks et al 2020) Research has also shown that frequent media exposure may cause
distress/fear as well, leading to a lower quality of life [Neria Et al]. Studies conducted in
China, the first country that was affected by this recent Virus spread, show that people’s fear
of the unknown nature of the Virus can lead to psychological problems [Shigemura Et al].

A few recent studies have been conducted regarding the Covid19 pandemic within
Mizoram, but no studies have been reported so far on the effects of Covid-19 on the quality
of life and anxiety level within the population of Aizawl City, and as the city of Aizawl went
through several lockdowns and as firm and stringent regulations are still implemented, this
study therefore aims to show the effect of the coronavirus pandemic on the quality of life and
levels of anxiety within the population of Aizawl city within three age groups.

REVIEW OF LITERATURE

Zhang, Y., Ma, Z.F. (2020) aimed to investigate the immediate impact of the COVID-
19 pandemic on mental health and quality of life among local Chinese residents aged ≥18
years in Liaoning Province, mainland China. An online survey was distributed through a
social media platform between January and February 2020. Participants completed a
modified validated questionnaire that assessed the Impact of Event Scale (IES), indicators of
negative mental health impacts, social and family support, and mental health-related lifestyle
changes. A total of 263 participants (106 males and 157 females) completed the study. The
mean age of the participants was 37.7 ± 14.0 years, and 74.9% had a high level of education.
The mean IES score in the participants was 13.6 ± 7.7, reflecting a mild stressful impact.
Only 7.6% of participants had an IES score ≥26. The majority of participants (53.3%) did not
feel helpless due to the pandemic. On the other hand, 52.1% of participants felt horrified and
apprehensive due to the pandemic. Additionally, the majority of participants (57.8–77.9%)
received increased support from friends and family members, increased shared feeling and
caring with family members and others. In conclusion, the COVID-19 pandemic was
associated with mild stressful impact in our sample, even though the COVID-19 pandemic is
still ongoing.

Salari, N., Hosseinian-Far, A., Jalali, R. et al. (2020) analyzed existing research works
and findings in relation to the prevalence of stress, anxiety and depression in the general
population during the COVID-19 pandemic. In this systematic review and meta-analysis,
articles that have focused on stress and anxiety prevalence among the general population
during the COVID-19 pandemic were searched in the Science Direct, Embase, Scopus,
PubMed, Web of Science (ISI) and Google Scholar databases, without a lower time limit and
until May 2020. In order to perform a meta-analysis of the collected studies, the random
effects model was used, and the heterogeneity of studies was investigated using the I2 index.
Moreover. data analysis was conducted using the Comprehensive Meta-Analysis (CMA)
software. The prevalence of stress in 5 studies with a total sample size of 9074 is obtained as
29.6% (95% confidence limit: 24.3–35.4), the prevalence of anxiety in 17 studies with a
sample size of 63,439 as 31.9% (95% confidence interval: 27.5–36.7), and the prevalence of
depression in 14 studies with a sample size of 44,531 people as 33.7% (95% confidence
interval: 27.5–40.6). And they conclude the research by saying COVID-19 not only causes
physical health concerns but also results in a number of psychological disorders. The spread
of the new coronavirus can impact the mental health of people in different communities.
Thus, it is essential to preserve the mental health of individuals and to develop psychological
interventions that can improve the mental health of vulnerable groups during the COVID-19
pandemic.

Kharshiing, K. D., Kashyap, D., Gupta, K., Khursheed, M., Shahnawaz, M. G., Khan,
N. H., Uniyal, R., & Rehman, U. (2020) studied quality of life in the COVID-19 pandemic
in India: exploring the role of individual and group variables. The data for the study was
collected from 305 male and female aged 18 to 78 years from Indian respondents using the
convenience sampling method to contact or reach the participant. Standardized measures
have been utilised to assess the constructs. Results revealed that QoL was significantly
influenced by individual variables (COVID-19 anxiety and personal identity) and group
variables (identification with family and nation). The effect of COVID-19 anxiety and
personal identity as individual variables is over and above that of demographic variables on
QoL. Group variables (family and national identification) significantly impacted QoL over
and above the individual variables.

Rogowska, A. M., Kuśnierz, C., & Bokszczanin, A. (2020) examined anxiety, life
satisfaction, general health, stress and coping styles during COVID-19 pandemic in Polish
sample of university students. A total of 914 university students, ranged in age between 18
and 40 years old (M = 23.04, SD = 2.60), participated in an online survey. The majority of
students (65%) showed mild to severe GAD and a high level of perceived stress (56%).
Those students who had the worst evaluated current GSRH, in comparison to the situation
before the COVID-19 outbreak, also demonstrated higher levels of anxiety, perceived stress,
and emotion-oriented coping styles. The study indicates that the variance of anxiety during
the COVID-19 outbreak may be explained for about 60% by such variables, like high stress,
low general self-rated health, female gender, and frequent use of both emotion-oriented and
task-oriented coping styles. University students experience extremely high stress and anxiety
during quarantine period and they need professional help to cope with COVID-19 pandemic.

Sharma P, Gupta S, Kushwaha P [Link] (2020), evaluated how mass media impact on
Quality of life during the COVID-19 pandemic among the Indian population. A total of 320
sample responses were received and data were analysed by using SPSS software. A
correlation has been used to find out the association between mass media and domains of
Quality of Life (Psychological, Physical, Environmental, and Social) during COVID-19.
They found a significant positive statistical correlation at 0.01 level between hours spent for
COVID-19 news on the view of mass media with anxiety and nervousness 0.54, with worry
0.41 and with Quality of life 0.48.

Pulvirenti, F., Cinetto, F., Milito, C., Bonanni, L., Pesce, A. M., Leodori, G., Garzi,
G., Miglionico, M., Tabolli, S., & Quinti, I. (2020) studied the quality of life in 158 patients
with PADs by the Common Variable Immune Deficiency Quality of Life questionnaire, a
disease-specific tool, and by the 12-item General Health Questionnaire, a generic tool to
assess the risk of anxiety/depression. The quality of life was worse in the group of patients
who were at risk of anxiety/depression at the study time. HRQOL was similar in patients
forced to shift from hospital-based to homebased. The risk of anxiety/ depression is
associated with pandemia caused by the severe acute respiratory syndrome coronavirus 2 and
with patients’ fragility, and not with related clinical conditions associated with common
variable immune deficiencies. Anxiety about running out of medications is a major new issue

Suryavanshi, N, Kadam, A, Dhumal, G, et al. (2020), using snowball sampling, has

conducted an online survey among 197 Health Care Professionals (HPC) in India. A large
proportion reported symptoms of depression (92, 47%), anxiety (98, 50%), and low QoL (89,
45%). Work environment stressors were associated with 46% increased risk of combined
depression and anxiety. Moderate to severe depression and anxiety were independently
associated with increased risk of low QoL [OR: 3.19 (95% CI: 1.30–7.84), OR: 2.84 (95%
CI: 1.29–6.29)]. Statistical analysis was done using STATA version 14.2. Demographic
characteristics were summarized across mental health diagnoses using frequencies and
percentages and compared using Fisher's exact test. Prevalence and 95% exact confidence
interval (CI) for moderate to severe depression and anxiety, stressors, and low QoL was
estimated for the overall group of HCPs and stratified by risk groups. Univariable and
multivariable logistic regression was used to estimate unadjusted and adjusted odds ratios
(OR) to assess independent risk factors associated with depression, anxiety, and QoL. The
effect of depression and anxiety on low QoL was assessed using Fisher's exact test and
logistic regression. Multivariable models were adjusted for variables significant in the
univariable analysis, as well as for age, gender, and whether or not the HCP was directly
involved in COVID‐19 care. Since stressors are highly correlated, a principal component
analysis was done to identify orthogonal components to assess association with moderate to
severe depression and anxiety. To assess the effect of stressors, principal components were
used as exposure variables in logistic regression analysis for mental health symptoms. Lastly,
qualitative data from open‐ended responses were analyzed to identify major themes with
exemplary quotations.

Zhu, J, Su, L, Zhou, Y, Qiao, J, Hu, W (2020) performed an online survey to evaluate
the psychological effects of quarantine using the Zung Self‐rating Anxiety Scale in February
2020 when the outbreak had nearly peaked in China. From a total of 992 valid questionnaires
from 23 provinces in China, clinically significant anxiety symptoms were observed in 9.58%
of respondents according to clinical diagnostic standards in China. The specific groups of
people showing higher levels of anxiety were (a) adolescents (<18 years); (b) respondents
with education lower than junior high school; (c) people with chronic diseases; and (d)
frontline medical personnel. Other characteristics, such as gender, marital status, region, and
acquaintance with suspected or confirmed cases of COVID‐19, did not affect anxiety levels
significantly. Respondents who experienced different forms of quarantine showed different
anxiety levels. People undergoing centralized quarantine have higher levels of anxiety.
Unexpectedly, longer durations of quarantine did not lead to a significant increase in anxiety
level.

Dehkordi A.H., Gholamzad S., Myrfendereski S. & Dehkordi A.H (2020)

investigated the effect of Covid-19 on anxiety, quality of work life and fatigue of health
center staff in southwestern Iran. It was a descriptive comparative study and the statistical
population of the study included the staff of health centers of Shahrekord University of
Medical Sciences. Using random sampling method, 181 people who had direct involvement
with patients with Covid-19 were selected and compared with 261 staff in other wards who
had no direct contact with patients with Covid-19. For data collection, demographic
information (demographic characteristics questionnaire), Covid-19 Anxiety Questionnaire,
quality of work life and Rhoten fatigue questionnaires were used. The results showed that the
quality of life in both groups decreased and fatigue and anxiety caused by Covid-19
increased, but there was no statistically significant difference between anxiety derived
fatigues of personnel involved with Covid-19 with personnel of other wards which were no
directly faced Covid-19 patients. Regarding the quality of work life, no significant difference
was observed in other components except in the component of human resource development.
The results also showed that there was a statistically significant relationship between the level
of anxiety caused by Covid-19 with quality of work life and fatigue. According to the results
of the present study, Covid-19 had a negative effect on physical, mental and various aspects
of quality of life of health care staff and led to increased fatigue and burnout, resulting in
absence from work and its consequences.

Korkmaz S., Kazgan A., Çekiç S., Tartar A.S., Balcı H.N & Atmaca M (2020)
investigated the level of anxiety experienced by healthcare workers employed in COVID-19
services, the effects of anxiety on sleep quality and quality of life and, the relationship
between these variables and problem-solving skills of the healthcare workers. The study was
conducted in two healthcare facilities which serve as pandemic hospitals. 140 healthcare
workers, who were employed in the COVID-19 outpatient clinics or emergency departments,
participated in the present study. All participants were submitted to the Pittsburgh Sleep
Quality Index (PSQI), Problem Solving Inventory (PSI), World Health Organization Quality
of Life-BREF (WHOQOL-BREF), Beck Anxiety Inventory (BAI). The number of
participants without anxiety was 41(29%), with mild anxiety was 53(38%). Clinically
significant anxiety findings were found in only 33% of the participants. A positive correlation
was found between the participants’ BAI scores and PSQI, PSI scores, and a negative
correlation with the WHOQOL-BREF scores. PSQI and PSI scores of nurses were
statistically higher when compared to those of physicians and staff. WHOQOL-BREF scores
were found to be lower. Healthcare workers might develop psychiatric symptoms such as
anxiety and sleep disturbance. Such symptoms could adversely affect the problem-solving
skills of healthcare workers and cause a deterioration in their quality of life.

Sharma, K., Saji, J., Kumar, R., & Raju, A. (2020) assessed the level of
psychological, anxiety/depression in quarantine people during covid19 outbreak. Self-
designed digital questionnaire has been used to assess the psychological and
anxiety/depression level. The questionnaire contains questions about demographic, socio-
assessment, anxiety/depression and psychological assessment. The questionnaire was
circulated via digital medium. Total 181 quarantined people were participated in our study,
most of our population ages between of 21-30. General health of our participants is
moderately good, Socio-status of our participants is fairly effected may be due to restrict
movement and conservative way of living during quarantine period. 60.8% of participants
become nervous some of the time, about 50% of participants shows the anxiety/depression
symptoms, about 30% of our participants are somewhat affected by their sleeping patterns
and about 35% participants are sometimes unsatisfied or slightly satisfied during quarantine
period. Apart from this out of 181 participants 15 people are having travel history of
International or national destinations. The overall mean is 2.2 and SD is 0.6. Negative
emotions (anxiety/depression, Socio status) were found in people during quarantine which
may show low quality of life or low satisfactory life.

Karim, S.K., Taha, P.H., Amin, N.M.M. et al. (2020) aimed to address the paucity of
the unknown data on psychological consequences as an appraisal of the mental health burden
represented by anxiety disorder related to the global COVID-19 era. Among the 1591 Iraqi
respondents, 788 (49.5%) accounted for having health anxiety over the current home
restriction situation. Younger ages experienced more COVID-19-related health anxiety
compared to older ages. Females reported higher health anxiety compared to males (57.7% vs
42.3%). The health care professionals reported 20.9% health anxiety. The Iraqi southern
population displayed more health anxiety compared to the northern and middle portions. This
work showed that about half of the respondents were spending over 60 min focusing on news
of COVID-19. They found that 80 to 90% carrying out preventive efforts and home
quarantine against COVID-19 infection. Interestingly, participants experienced fear from the
risk of COVID-19 infection, whether more or equal to a level of war scare, in 70.1% of the
sample. In Iraq, during the COVID-19 pandemic, nearly half of the respondents have health
anxiety. Southern Iraqi cities displayed higher rates of anxiety. Also, being female, younger
ages, holding an academic degree, or being a college student are associated with more
prominent degrees of anxiety. Furtherly, it is important to adopt strategies for public health
education and prevention and alerting future governmental responses focusing on
psychological state impact among the general population.

Nair, D. R., Rajmohan, V., & Raghuram TM. (2020) assessed the influence of
lockdown on lifestyle, psychosocial stresses and experienced quality of life (QOL). The study
also assessed the association of the socio-demographic variables with lifestyle, psychosocial
stress and QOL. Methodology: An online survey on the lifestyle changes, psychosocial stress
and QOL were conducted using a validated questionnaire via the Google forms platform. The
data collected were analysed using parametric and nonparametric tests. Results: The study
included 263 respondents. The fear of developing COVID-19 was reported by 67.7%, 31.2%
experienced weight gain, internet use was increased in 66.9%, and alcoholism and smoking
decreased by 83.3% and 58.8% respectively. Lockdown upset 48.3% moderately, and 36.1%
experienced anxiety, 23.4% feared job loss and 51.3% had financial worries. 91.1% of the
study population reported fair to good QOL. Females showed significantly more religiosity,
(?2= 7.81; p= 0.02) did lesser exercise, (?2= 10.9; p= 0.023) and had poor mood. (t=2.68;
p=0.009) Older people were less afraid of COVID-19 infection and were less upset by the
lockdown. The urban population were more fearful of COVID-19 and were more upset by the
lockdown. Conclusion: Lockdown had a major effect on lifestyle and increased psychosocial
stress, but people still experienced a fair QOL during this period.

STATEMENT OF THE PROBLEM:

Only a hnadful of research have been conducted regarding the Covid-19 pandemic within the
state of Mizoram, and no research have been reported so far that studied the effects of Covid-19 on
the quality of life and anxiety level within the population of Aizawl City, as the city of Aizawl went
through several lockdowns due to the Covid-19 Pandemic, causing havoc in every aspect of life and
as firm and stringent regulations are still implemented. This study therefore aims to show the effect of
the coronavirus pandemic on the quality of life and levels of anxiety within the population of Aizawl
city in specific to three age groups, providing us vital insight and information which can be used to
minimize the negative effects of the Covid-19 pandemic.

Objectives:-

1. To examine reliability and construct validity of the scale.

2. To examine the quality of life and anxiety during the COVID-19 pandemic.
3. To elucidate the relationship between quality of life and anxiety.
4. To highlight the gender differences in quality of life.
5. To highlight the gender differences in anxiety.

Hypothesis:-

1. There will be differences in Quality of life by age

2. There will be gender differences in Quality of life
3. There will be differences in Anxiety by age
4. There will be gender differences in Anxiety
5. There will be positive correlation between Quality of life and Anxiety
 METHODOLOGY

Sampling:

Using the method of Proportionate Stratified Random Sampling technique, a total of 300
Samples were drawn from three different age groups, with equal number of sexes from the
population of Aizawl City.

Sample
300

Age 19-29 (Young Age 40-64 (Middle

Age 30-39 (Thirties)
Adulthood) Adulthood)
50 Males 50 Males
50 Males
50 Females 50 Females
50 Females

Brief Description of the Scales:

1. Coronavirus Anxiety Scale:

The coronavirus anxiety scale (CAS) is a self-report mental health screener of dysfunctional
anxiety associated with the coronavirus crisis. Because a significant number of people
experience clinically significant fear and anxiety during an infectious disease outbreak, the
CAS was developed to help clinicians and researchers efficiently identify cases of individuals
functionally impaired by coronavirus-related anxiety.

Psychometric properties- Independent studies of adults residing across the United

State have demonstrated that the CAS is a reliable instrument (αs > .90), with solid factorial
(single-factor; invariant across socio-demographics) and construct (correlated with anxiety,
depression, suicidal ideation, and drug/alcohol coping) validity. The diagnostic properties of
the CAS (90% sensitivity and 85% specificity) are comparable to related screening
instruments, such as the Generalized Anxiety Disorder-7.
 Scoring and interpretation- Each item of the CAS is rated on a 5-point scale, from 0
(not at all) to 4 (nearly every day), based on experiences over the past two weeks. This
scaling format is consistent with the DSM-5’s cross-cutting symptom measure. A CAS total
score ≥ 9 indicates probable dysfunctional coronavirus-related anxiety. Elevated scores on a
particular item or a high total scale score (≥ 9) may indicate problematic symptoms for the
individual that might warrant further assessment and/or treatment. Clinical judgement should
guide the interpretation of the CAS results.

2. Covid-19 Impact on Quality of Life Scale:

The scale was made in order to serve as a tool for controlling the impact of the situation with
the COVID- 19 pandemic in general on findings of various research on mental health. The
scale has been validated on a non-clinical and clinical sample.

Scoring Procedure-

1. The higher score, the greater impact on quality of life and related domains
subjectively perceived by the participants.
2. Scores could be displayed and analysed for each item separately.
3. We recommend the following way of calculating the total score for each participant:
summing the scores on all of the items and dividing that result by the number of items
(i.e. 6). Hence, the total score will be the average of all the items. Then, average
scores could be compared with the theoretical one for a five-point scale (which equals
to 3).

Research Design:

Exploratory Descriptive design will be employed to explore and provide insights along with
obtaining complete and accurate information about the impact of coronavirus on quality of
life and anxiety among the selected samples. Mean comparisons and Correlational analysis
will be employed as follows-

 Analysis on Gender (male and female) differences on Quality of Life and Anxiety
Scales using t-test.
 Pandemic
Covid-19

Quality of
Anxiety
Life

Male Female Male Female

 Analysis on Age Group (three age group) differences on Quality of Life and Anxiety
Scales using Analysis of Variance (ANOVA).

Pandemic
Covid-19

Quality
Anxiety
of Life

Age 19- Age 30- Age 40- Age 19- Age 30- Age 40-
29 39 64 29 39 64
  Correlational analysis on Quality of Life and Anxiety Scales using Pearson Product
Moment Correlation.

Covid- Anxiety
19 Scale
Quality
of Life
Scale

Procedure:

Due to the prevailing pandemic and the Standard Operating Procedures needed to be
followed, data collection was done using Google Forms, utilizing the technological
advancement of the modern world.

RESULTS

Subject scores were first evaluated to determine the normality of sample distribution
and homogeneity of variances. Results revealed acceptable values of normality in terms of
skewness and kurtosis for Quality of life Scale but substantial unacceptable positive skewness
on total scores of Coronavirus Anxiety Scale. So, transformation was done using Log
Transformation (Log10) to enable further analysis. The transformed results revealed
acceptable values for normality in terms of skewness for the CAS scores, Levene's test of
homogeneity of variances also showed non-violation of test assumptions for the use of
parametric tests in our analyse as shown on table 1 and 2.
Table 1. Descriptive Statistics
N Minimu Maximu Mean Std. Skewness Kurtosis
m m Deviation
Statistic Statistic Statistic Statistic Statistic Statistic Std. Statistic Std. Error
Error
Quality of Life
300 6.00 30.00 14.7500 6.03176 .485 .141 -.574 .281
Scale
Coronavirus
300 .00 1.32 .2539 .31793 1.085 .141 .372 .281
Anxiety Scale
Valid N
300
(listwise)

Table [Link]'s Test for Equality of Variances

Levene's Test for Equality of
Variances

F Sig.
Quality of Equal variances assumed 1.882 .171
life Scale Equal variances not
assumed
Coronavir Equal variances assumed 2.207 .138
us Anxiety Equal variances not
Scale assumed

In the Coronavirus Anxiety Scale, the scale possesses a maximum score of 1.32, descriptive
statistics revealed that the sample mean score is only 0.25, showing that the Covid-19 impact
on Anxiety level is very low. In the Quality of Life scale, descriptive statistics shows that the
average total score is 14.75 out of an available maximum score of 30, as the average scores
are recommended to be calculated along the five-point scale, the average total score is
divided by the number of items which is 6, resulting in an average score of 2.46 to a
maximum available score of 5, indicating a moderate impact of Covid-19 on Quality of Life,
as shown on Table No.3
Table No.3 Mean Scores

N Minimu Maximu Mean Std.

m m Deviation
Quality of Life
300 6.00 30.00 14.7500 6.03176
Scale
Coronavirus
300 .00 1.32 .2539 .31793
Scale
Valid N
300
(listwise)

Pearson's Correlation revealed a positive correlation (r=.384, p<.01) between the

scales, indicating participants having a high score on Quality of Life Scale will also likely
have a high score on the Coronavirus Anxiety Scale and vice versa, accepting of hypothesis
5, as shown on Table No.4

Table No.4 Correlations

QolTota CasTotal
l
Pearson
Quality 1 .384**
Correlation
of Life
Sig. (2-tailed) .000
Scale
N 300 300
Corona Pearson
.384** 1
virus Correlation
Anxiety Sig. (2-tailed) .000
Scale N 300 300
**. Correlation is significant at the 0.01 level (2-
tailed).
 Independent Samples t-test was employed to evaluate gender differences in Quality of
Life Scale. The result showed a non-significant mean difference for Quality of Life Scale on
gender (Male & Female) because the t-score of .247 is higher than the acceptable significant
level of .05, resulting in rejection of Hypothesis 2. On the other hand, independent samples t-
test for the Coronavirus Anxiety Scales revealed gender (Male&Female) differences on the
scale because the score of .000 is lower than the acceptable significant level of .01, resulting
in the acceptance of Hypothesis 4. Group statistics shows females scoring a bit higher in the
Coronavirus Anxiety Scale. Table No.5 shows the Independent Samples T test and Group
statistics

Table No.5

Group Statistics
Gender N Mean Std. Deviation Std. Error Mean
QolTotal 1.00 150 14.3467 5.72407 .46737
2.00 150 15.1533 6.31791 .51585
CasLog 1.00 150 .1867 .29190 .02383
2.00 150 .3211 .32946 .02690

Analysis of Variance (One-Way ANOVA) showed that there was no significant age
difference among the three age groups (Young Adult, Thirties and Middle Adult) in the
Quality of Life scale, with a scores of .466, which is higher than the significance level of .05,
resulting in the rejection of Hypothesis 1. Whatsoever, Coronavirus Anxiety Scale revealed a
significant difference on the three age groups with a score of .049, which is significant at .05
level, resulting in the acceptance of Hypothesis No.3. The results of the analysis of variance
(One-Way ANOVA) is shown in Table No.6

Table 6. ANOVA
Sum of
Squares df Mean Square F Sig.
Corona Between Groups .608 2 .304 3.051 .049
virus Within Groups 29.615 297 .100
Anxiety Total
30.223 299
Scale
Quality of Between Groups 55.860 2 27.930 .766 .466
life Scale Within Groups 10822.390 297 36.439
Total 10878.250 299

Post hoc analysis was further employed to highlight the group that differs. Fisher's Least
Significant Difference (LSD) Post hoc Test revealed significant levels in the age groups of
thirties on the Coronavirus Anxiety Scale, as shown on table 7.

Table 7. Multiple Comparisons

LSD
Dependent (I) Age (J) Age Mean Std. Sig. 95% Confidence Interval
Variable Group Group Difference Error Lower Upper Bound
(I-J) Bound
Thirties .03000 .85369 .972 -1.6500 1.7100
Young
Middle
Adult -.90000 .85369 .293 -2.5800 .7800
Adult
Young
-.03000 .85369 .972 -1.7100 1.6500
Quality of Life Adult
Thirties
Scale Middle
-.93000 .85369 .277 -2.6100 .7500
Adult
Young
Middle .90000 .85369 .293 -.7800 2.5800
Adult
Adult
Thirties .93000 .85369 .277 -.7500 2.6100
Corona virus Young Thirties -.09679* .04466 .031 -.1847 -.0089
Anxiety Scale Adult Middle
-.00258 .04466 .954 -.0905 .0853
Adult
Young
.09679* .04466 .031 .0089 .1847
Adult
Thirties
Middle
.09421* .04466 .036 .0063 .1821
Adult
Young
Middle .00258 .04466 .954 -.0853 .0905
Adult
Adult
Thirties -.09421* .04466 .036 -.1821 -.0063
*. The mean difference is significant at the 0.05 level.

Means plot of the Coronavirus Anxiety Scale scores confirmed higher score by the thirties
age group.

DISCUSSION AND CONCLUSION

The main objective of the study was to explore the gender and age group differences of
young adults, thirties and middle aged adults on the effect of Covid-19 on the quality of life
and anxiety among the population of Aizawl City. It was hypothesized that there will be
significant differences in the effect of Covid-19 on the Quality of Life and Anxiety among
the three age groups and gender, with a positive correlation between Quality of Life and
Anxiety. Results from ANOVA proved that there was no significant age differences in the
Quality of Life, resulting in the rejection of Hypothesis 1, whereas significant difference was
detected in Coronavirus Anxiety Scale between the three age groups, resulting in the
acceptance of Hypothesis 3. (LSD) Post hoc Test revealed significant higher levels of Anxiety
in the age groups of thirties on the Coronavirus Anxiety Scale. Independent Samples t-test
revealed non significance differences between males and females in both the Coronavirus
Anxiety Scale and the Quality of Life Scale, resulting in rejection of Hypothesis 2 and 4,
Pearson Correlation also revealed a low positive correlation between the Quality of Life
Scale and Coronavirus Anxiety Scale. Results showed Covid-19 impact on Quality of Life
and Anxiety levels to be low.

Community can mean anything from the people in the backyard to the ecosystem
around us. For many, this sense of connection is what makes them thrive physically,
mentally, and/or emotionally. It provides role models, offers belonging, and creates an
avenue to explore ideas in a safe environment. Regardless of where you find your
community, becoming a part of one is a major factor in being happy and balanced as noted by
Martin Seligman - a leading psychologist and founder of “Positive Psychology.” Seligman
outlines five key elements that craft wellbeing in his novel Flourish. These five elements are:
positive emotion, engagement, relationships, meaning, and accomplishments (coined as
PERMA). Communities help foster exactly these characteristics to produce healthy and
happy members of society.

Suryavanshi, N, Kadam, A, Dhumal, G, et al. (2020) research in the Indian state of

Maharashtra showed a large proportion of the population reporting symptoms of depression ,
high anxiety level , and low Quality of Life due to the Covid-19 pandemic, Salari, N.,
Hosseinian-Far, A., Jalali, R. et al. (2020) systematic review and meta-analysis on articles
that focused on stress, anxiety prevalence due to the Covid-19 pandemic among the general
population of India showed prevalence of stress in 5 studies, the prevalence of anxiety in 17
studies and the prevalence of depression in 14 studies caused by the Covid-19 pandemic.
Whatsoever, our study contradicts the aforementioned researches, whereas Danny Horesh and
his colleagues, in their study, aimed to examine risk factors for mental health problems
among Israeli adults during this crisis, wherein a total of 204 participants took part. They
completed self-report questionnaires assessing perceived stress, anxiety, quality of life, and
various questions related to quarantine, pre-existing health issues, and worries related to the
virus. Danny Horesh et al study revealed that majority of participants reported relatively high
levels of perceived stress and corona-related worries, but low levels of anxiety. Not only that,
being female, younger in age, corona-related loneliness that could have stem from isolation
and self-distancing, and pre-existing chronic illness were all related to higher levels of
psychological distress and lower levels of quality of life. Autumn Kujawa and his colleagues
developed the Pandemic Stress Questionnaire (PSQ) and tested its psychometric properties,
characterized experiences in emerging adults, and examined associations with internalizing
symptoms. Their study provided scientific evidence that emerging adults are at high risk for
depression and anxiety related to the psychosocial effects of the COVID‐19 pandemic. Xia
Zhou and Benxian Yao examined the impact that social support has on Acute Stress
Symptoms (ASSs) among primary and secondary school teachers from a sample of 751 who
answer self-reported questionnaires regarding ASSs, social support, psychological needs, and
the sense of control. Their findings revealed that social support can play a relieving role in
ASSs when the support satisfies individuals’ psychological needs and improves their sense of
control. To alleviate ASSs among primary and secondary school teachers, more attention
should be paid to satisfying their specific psychological needs and improving their sense of
control.

Our findings revealed low levels of Coronavirus Anxiety and a low effects on the
Quality of Life within the population of Aizawl City. This might be due to the collectivistic
culture of the Mizo society. Collectivist cultures emphasize the needs and goals of the group
as a whole over the needs and desires of each individual, in such cultures, relationships with
other members of the group and the interconnectedness between people play a central role in
each person's identity (Kendra Cherry 2020), Shuguang Jiang et al(2020) also reported that
collectivistic cultures fared better in comparison to individualistic cultures when it comes to
the Covid-19 pandemic. The Mizo community in Aizawl City identifies itself with a
collectivistic altruistic mindset and is customary for the community to help those who are in
need and provide them with resources (food, shelter, etc). In Aizawl City, the Local Level
Task Force (LLTF) took responsibility and mobilise its citizen to give care and support to one
another. Special vegetables supply chain were created to meet the needs of every families.
Not only that, financial and basic daily necessities were given for free to many households to
ease tensions and stress since many families cannot earn money due to the lockdown caused
by the pandemic. Not only that, Mizoram is a religious state where spirituality and good
deeds are highly valued. Many engaged in family worship services, programs were made
through social networking and television to keep the hopes and well-being of citizens intact.
 Positive Correlation between Coronavirus Anxiety and Covid-19 impact on Quality of
Life was detected, which was an expected outcome and further reinstated by many
researchers or researchers. Gretchen [Link] et al(2007), Mauro V. Mendlowicz, and
Murray B. Stein et al(2000) and many other researches revealed relationships between levels
of anxiety to quality of life. In terms of gender differences, no significant differences was
found. This too could be attributed to the cultural aspect of the Mizo , wherein an upstanding
gender equality present within the community. McKinsey Global Institute’s (2015) research
on gender parity across every state of India, showed that Mizoram and Meghalaya to have the
best gender parity across all the states, further supporting our notion. Post Hoc analysis shows
that thirties age group significantly scores the highest among the three age groups, this might
well be due to the fact that thirties age group are thought to be more anxious in a general
sense. A study conducted by the National Institute of Mental Health in America (2017) also
showed adults in there thirties to be the most anxious among the different age groups and also
shows females to be more anxious than males further supporting and validating our study.
Still, even though there exist significant difference for the thirties age group, the scores
remains well within the low levels.

The present study is crucial to look into and explore the effects of the
pandemic Covid-19 and its implications on the general population. The research findings can
be useful in showing where psychological aid and economic aid is needed the most in terms
of gender and age groups as per the requirements. It also shows the cultural and social
difference, how the collectivistic and disciplined nature of the Mizo community fared
positively against a pandemic, and how such behaviour act as a resilience factor. The Mizo
community strategies could indeed be used as a model and an archetype for other
communities or states to confront the pandemic Covid-19.

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APPENDIX

APPENDIX A

COVID-19 – Impact on Quality of Life (COV19-QoL)

Instruction for participants:

Please, choose the number that best represents the degree of your agreement with the
statements provided below. Please keep in mind that your estimates reflect your feelings and
thoughts during the past 7 days.

Please use ratings as below:-

1 - Completely disagree

2 - Disagree

3 - Neither agree nor disagree

4 - Agree

5 - Completely agree

Due to the spread of the coronavirus,

1. ...I think my quality of life is lower than before

2. ...I think my mental health has deteriorated

3. ...I think my physical health may deteriorate

4. ...I feel more tense than before

5. ...I feel more depressed than before

6. ...I feel that my personal safety is at risk

APPENDIX B

How often have you experienced the following activities over the last 2 weeks?

Nearly
Rare, less every day
Several More than
Not at all than a day over the
days 7 days
or two last 2
weeks
1. I felt dizzy, lightheaded, or
faint, when I read or listened to [ ] 0 []1 []2 []3 []4
news about the coronavirus
2. I had trouble falling or
staying asleep because I was [ ] 0 []1 []2 []3 []4
thinking about the coronavirus.
3. I felt paralyzed or frozen
when I thought about or was
[]0 []1 []2 []3 []4
exposed to information about
the coronavirus.
4. I lost interest in eating when
I thought about or was exposed
[]0 []1 []2 []3 []4
to information about the
coronavirus.
5. I felt nauseous or had
stomach problems when I
thought about or was exposed [ ] 0 []1 []2 []3 [
to information about the
coronavirus.
APPENDIX C

Scales translated to Mizo language

Cov19-QoL

Chhangtute hriat tur:

Heng thute hi nangmaha a dik dan chen nia i hriat angin a chhanna te hi thlang rawh. I
chhanna te hi tunhnai ni sarih chhunga i awmdan ang tak tilangtu tur an ni tih hre reng la.

Coronavirus hri a len hnu hian,…

1. Ka nitin khawsak dan leh ka nun hman dan a nawmna a tlakhniam phahin ka hria.
2. Ka rilru hriselna a tlakhniam phahin ka hria.
3. Ka taksa hriselna in a tawrh phah thei dawnin ka hria.
4. A hma aiin ka rilru a tawt zawk.
5. A hma aiin ka nun a hlim lo zawk.
6. Ka mimal nun himna a derthawngin ka hria.

1 – Ka ni lo hrim hrim

2 – Ka ni chiah lo

3 – Ka inhrethiam lo

4 – Ka ni in ka hria

5 – Ka nihna chiah

Coronavirus Anxiety Scale

Hengte hi tun kar hnih chhungin eng anga zingin nge i tawn?

1. Chanchinthar a hrileng chungchang ka hriatin ka tlu a nih loh pawhin luhai emaw
nghet lo deuhin emaw ka awm thin.
2. Hrileng leh a nghawng chungchang ka ngaihtuahnaah a awm avangin muthilh emaw
mut ngheh ka harsat thin.
3. Hrileng leh a nghawng chungchang thu ka ngaihtuah emaw ka hriatin che thei lovin
ka awm emaw ka khawng thin.
4. Hrileng leh a nghawng chungchang thu ka ngaihtuah emaw ka hriatin ka thil ei
chakna a bo thin.
 5. Hrileng leh a nghawng chungchang thu ka ngaihtuah emaw ka hriatin luak chhuak
emaw pum dik lo ka neih phah thin.

0 – Ka nei lo hrim hrim

1 – A khat, ni khat emaw ni hnih vel bak a ni lo.

2 – A awm zeuh zeuh, ni engemaw zat.

3 - Ni sarih aiin a tam

4 - Nitin deuh thaw ka nei.