The psychological impact of reopening after COVID-19 lockdowns in China: Threat perception, affect and moral conflict

COVID-19 reopening of China in the context of the highly transmissible Omicron variant has resulted in an unprecedented wave of infections, placing significant strain on healthcare systems and giving rise to a range of psychological responses, including perceptions of the pandemic's threat, emotional reactions, and prosocial intentions amid moral conflicts over medical resource scarcity and evolving public health responses. This study employed a comprehensive approach integrating surveys, behavioral experiments, and agent-based modeling (ABM) to examine these psychological impacts of COVID-19 reopening. A total of 1,675 participants from 34 Chinese provinces completed the surveys, with 587 also undertaking the reversal-learning task. The measures employed were primarily designed to assess perceptions of COVID-19 infection risk and medical resources, negative affect, and prosocial intentions in moral conflicts. Results found that the perception of infection risk and associated negative affects remained elevated until the pandemic decline. However, prosocial intentions initially increased, but subsequently decreased. Moreover, the influence of perceived public medical resources and negative affect on prosocial intentions is mediated by distinct pathways. ABM suggested that anxiety might accelerate the pandemic but increase overall fatalities through prosocial actions, while public medical resources perceptions might shape the pandemic by influencing healthcare-seeking behaviors. These findings underscore the crucial role of psychological factors in pandemic management, alongside physical aspects, providing a scientific foundation for future responses.