Level of Anxiety and Community Behavior in Preventing the Covid-19 Pandemic in East Java

Corona virus-19 (COVID) has been declared a global pandemic. The increase in cases of covid-19 can be prevented by disease prevention behavior in accordance with the protocol that has been established by the government. However, there are still many people who heed the protocol. This condition has an impact on people’s anxiety, coupled with the presence of information that continues to be rolled out on social media and mass media about the development of covid-19. Anxiety is increasing with the stigma of the community about covid-19 patients. The purpose of this study was to analyze the level of anxiety and behavior of the community in preventing COVID-19 disease in East Java. The design of the study was descriptive survey. The sample in this study was people in East Java with the sampling techniques by accidental sampling techniques. The data collection used questionnaires using GAD-7. scale and behavior questionnaire according to DIRJEN control and prevention of covid-19 March 2020. The analysis of descriptive statistical test data that was percentile / percentage. The results showed that most people in East Java experience minimal anxiety and positive behavior. Minimal anxiety occured because most respondents are highly educated and already know about Covid-19, this will help solve psychological problems including anxiety. The efforts of health workers are also very much needed to always assist the community in adhering to health protocols by providing sustainable health education.


INTRODUCTION
Coronavirus-19 (COVID) has been declared a global pandemic by WHO (WHO,2020). Corona virus is a zoonotic or virus transmitted between animals and humans. The virus and disease are known to have originated in wuhan city, China since December 2019 (Bnpb, Adisasmito, Guru, Fkm, & Indonesia, 2020). The COVID-19 pandemic is incarnating terror for many people to the potential for mass paranoid. The increase in covid-19 can be prevented by disease prevention behavior. However, in the current condition there is still an increase in confirmed cases of covid-19. This incident indicates that the community is still not implementing disease prevention behaviors with health protocols, so the level of anxiety that occurs in the community is still high. Psychological and physiological conditions were disrupted due to bombardment with news of the outbreak (widya putri, 2020). The coronavirus pandemic did cause people anxiety. If left untreated, the anxiety could lead to mental and psychiatric disorders (Firmansyah, 2020).
In 2012, a new type of Coronavirus was rediscovered in the Middle East named MERS-CoV (group 2c -coronavirus). The extraordinary events in Wuhan are similar to the extraordinary events of SARS in Guangdong in 2002. Both occur in winter. When compared to SARS, PNEUMONI COVID-19 tends to be lower in terms of mortality. SARS death rate reaches 10% and MERS 37%. However, currently the infectivity rate of the COVID-19 pneumoni virus is known to be at least equivalent or higher than SARS-CoV. This is demonstrated by its R0, where recent study shows R0 of the SARSCoV-2 pneumoni virus is 4.08 (Indonesia, 2020). As of March 21, 2020, the number of cases of this disease reached 275,469 people spread across 166 countries, including Indonesia (Kemenkes RI, 2020). In a survey conducted by the American Psychiatric Association (APA) of more than 1,000 adults in America, it was found that 48 percent of respondents felt anxious they would contract the coronavirus. About 40 percent are worried that they will get seriously ill or die from Covid-19, and 62 percent are worried about their family or loved ones being infected. More than a third of respondents (36 percent) said the Covid-19 pandemic had a serious impact on their mental health, and 59 percent answered the effects are quite severe on daily life (Kompas, 2020). Based on data from the Ministry of Health, COVID-19 confirmed data nationally as many as 13,112 people and in Mojokerto Regency as many as 7 people (Dinas Komunikasi Dan Informatika, 2020). This makes people more anxious. Worried about contracting coronavirus because some positive patients are asymptomatic. The increase in confirmed cases of COVID-19 followed by disease prevention behavior that is still poorly applied by the community as an example: maintaining immunity only reached 76.3 percent, frequent hand washing 66.8 percent, work, study and worship at home reached 58.2 percent, avoiding greetings or physical contact, 55.3 percent, trying not to touch the face, 39.5 percent, buying masks, groceries and other goods, 1.5 percent (Pranita, 2020). The results of a preliminary study on May 9, 2020 in one of the villages that became a red zone in Mojokerto Regency with interview techniques for 10 people around the homes of people who were confirmed by COVID-19 with otg category (People Without Symptoms) 100% of people expressed anxiety and claimed to be wary when there were neighbors infected with coronavirus.
Psychosomatic disorder is a condition when psychological pressure affects physiological function (somatic) negatively to cause symptoms of pain. This can result in dysfunction or damage to physical organs due to the undue activity of the unconscious nervous system and the body's biochemical response. When anxious, the amygdala, the center of anxiety in the brain, responds by overactivating the autonomic nervous system. The body is made as if it is facing a threat so that it is always on standby. As a result psychosomatic symptoms appear, heart rate and blood pressure increase, creating pain in the chest (widya putri, 2020). We can distinguish psychosomatic symptoms with symptoms of disappearing, not constant, or moving around. Who recommends several measures to minimize anxiety that affects mental state in times of outbreak. First reduce exposure to news about COVID-19, as much as possible access reliable news sources, and increase access to positive news and still always apply disease prevention behaviors by always applying health proptocol. The purpose of this study was to analyze the level of anxiety and behavior of the community in the prevention of COVID-19 disease in East Java.

METHODS
The design of this study was descriptive survey. The population of this study was the entire covid-19 pandemic community in East Java Province. The sampling technique used accidental sampling techniques. The variables in this study were the level of public criticism of the covid-19 pandemic and community behavior in preventing the covid-19 pandemic. The data collection used questionnaires by GAD-7.scale and behavior questionnaire according to DIRJEN control and prevention of covid-19 March 2020. The analysis of descriptive statistical test data was percentile/ percentage.

Characteristics of People in East Java in 2020
Based on Table 1 showed that the majority of respondents were students as many as 482 respondents (58.5%), based on gender data most of the respondents as many as 623 female genders (75.5%), based on the level of education mostly educated S1 as much as 327 (39.7%), and based on information data about covid-19 respondents stated that most had received information of 805 (97.7%) respondents and based on data on the occurrence of covid-19 in the residential environment of respondents showed there were 455 respondents (55.2%) incidents.

Diagram 1 Level of public anxiety impact of covid-19 pandemic in East Java in 2020
The results showed that the level of anxiety about the impact of the covid-19 pandemic in East Java in 2020 experienced the most anxiety at least 397 respondents (48 %).

Diagram 2 Community Behavior in Covid-19 Prevention in East Java in 2020
The results of the analysis showed that the behavior of the community in the prevention of covid-19 in East Java in 2020 was the most positive behavior of 53% (44 people).

The level of public anxiety about the impact of the covid-19 pandemic in East Java
Each individual has different levels or levels of anxiety in the face of stressors. The results found that the level of public anxiety during covid-19 pendemi experienced a minimum anxiety of 48%. Based on these results in respondents who experience minimal anxiety in the face of this pandemic, the government should be active in monitoring public opinions or opinions, because the public tends to worry much more quickly in this time. Governments in countries around the world have made various efforts to prevent the spread of the Covid-19 virus in order to break the chain of spread of the Covid-19 virus, called lockdown and social distancing. Health education strategies must be timely at various stages of epidemic development based on analysis of people's psychological changes and related key information should also be implemented on time.
COVID-19 not only causes physical health problems but also results in a number of psychological disorders. The spread of the new coronavirus can have an impact on the mental health of people in various communities (Salari, Hosseinian-far, Jalali, Vaisi-raygani, & Rasoulpoor, 2020). Therefore, it is important to maintain the mental health of individuals and develop psychological interventions that can improve the mental health of vulnerable groups during the Covid-19 pandemic.
Many factors can affect a person's anxiety level, including from work factors. The majority of respondents were 58.5% of students and 39.7% of undergraduates, one's education and knowledge could affect the anxiety that was reviewed from the lack of knowledge or information they had about covid-19 during this pandemic. The results of this study also showed that 97.7% of respondents said they had been informed about covid-19.
Based on the results of the study showed 75.6% of the female gender, this indicates that female respondents have a greater chance of experiencing anxiety compared to male respondents. A person who is female tends to have high anxiety compared to men because women have a more sensitive feeling than men. But that does not close the possibility of happening to men.

Community behavior in the prevention of covid-19 pandemic in East Java
Based on the results showed that most respondents had 53% positive behavior. The results are different from previous study that the prevalence of depression in 14 studies with a sample size of 44,531 people as many as 33.7% experienced (Salari et al., 2020). Psychiatric consequences of SARS-CoV-2 infection can be caused either by the immune response to the virus itself, or by psychological stress such as social isolation, the psychological impact of a severe and potentially fatal new disease, concerns about infecting others, and stigma . The immune response to the corona virus induces the production of cytokines, chemokin, and other local and systematic inflammatory mediators (Huang & Zhao, 2020). The emergence of COVID-19, with its rapid spread, has exacerbated anxiety in the population globally, leading to mental health disorders in individuals. This even raises cases of stereotypes and discrimination (Zhong, Gelaye, Zaslavsky, Fann, & Rondon, 2015). Therefore, it is necessary to examine and recognize the mental state of people in this challenging, destructive and unprecedented time. Evidence suggests that individuals may experience symptoms of psychosis, anxiety, trauma, suicidal thoughts, and panic attacks. Recent studies have also shown that COVID-19 affects mental health outcomes such as anxiety, depression, and post-traumatic stress (Lee & Lee, 2020). COVID-19 is new and unexplored, and its rapid transmission, high mortality rate and concerns about the future can be a cause for anxiety. Anxiety, when above normal, weakens the immune system and consequently increases the risk of contracting the virus (Van Bogaert et al., 2016). A person will not experience anxiety if they have good behavior.
Good behavior can be an effort to prevent the transmission of covid19. Health behaviors are influenced by many factors, including knowledge, perception, emotions, motivation, and environment. Exploration of public health behavior can be seen from various components, including perceptions of disease susceptibility, perception of obstacles in prevention efforts, perceptions of benefits, the existence of encouragement, and individual perceptions about the ability to conduct prevention efforts (Purnamasari & Raharyani, 2020). In this study, showed that as many as 53% of east Java people have positi behavior. Forms of behavior shown include compliance in using masks when outdoors, washing hands with soap or hand sanitizer frequently, avoiding crowds and maintaining social or physical distancing. Hand washing is one of the effective ways to kill germs, known covid-19 virus can stick to parts of the body, especially hands that touch objects that have been infected by droplets. It was conveyed by the Ministry of Health that 75% of covid virus transmission is through saliva splashes (Kemenkes RI, 2020).
According to the theory of knowledge-attitudebehavior models, knowledge is an essential factor that can influence behavior changes, and individuals can acquire knowledge and skills through the learning process (Liu et al, 2016). Thus, public knowledge that still needs to be straightened out and negative community behavior can be pursued with learning activities through education by the authorities. In the community, village health forums or the like can take a role in the implementation of activities.

CONCLUSION
The level of anxiety of people affected by the covid-19 pandemic in East Java was mostly minimal anxiety. This was because most respondents were highly educated and had been informed about covid-19. One's knowledge and experience could help solve psychic problems including anxiety. Community Behavior in Preventing Covid-19 Pandemic in East Java mostly showed positive behavior. Positive behavior occured because respondents had been informed about covid-19 so as to increase knowledge. This knowledge could change a person's behavior.

SUGGESTION
Based on the results of this study, shows that the level of anxiety and behavior of the community in the prevention of pandemic covid 19 in East Java is in the category of minimal anxiety and the behavior of the community mostly shows positive behavior. This condition becomes a good potential and strength for the government of East Java in this Covid-19 handling program. However, prevention and monitoring efforts against the termination of the spread of covid 19 must still be carried out by various parties so that there is no increase in the number of serious cases