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1.
Int J Public Health ; 67: 1604974, 2022.
Article in English | MEDLINE | ID: covidwho-2080314

ABSTRACT

Objectives: Real-time data analysis during a pandemic is crucial. This paper aims to introduce a novel interactive tool called Covid-Predictor-Tracker using several sources of COVID-19 data, which allows examining developments over time and across countries. Exemplified here by investigating relative effects of vaccination to non-pharmaceutical interventions on COVID-19 spread. Methods: We combine >100 indicators from the Global COVID-19 Trends and Impact Survey, Johns Hopkins University, Our World in Data, European Centre for Disease Prevention and Control, National Centers for Environmental Information, and Eurostat using random forests, hierarchical clustering, and rank correlation to predict COVID-19 cases. Results: Between 2/2020 and 1/2022, we found among the non-pharmaceutical interventions "mask usage" to have strong effects after the percentage of people vaccinated at least once, followed by country-specific measures such as lock-downs. Countries with similar characteristics share ranks of infection predictors. Gender and age distribution, healthcare expenditures and cultural participation interact with restriction measures. Conclusion: Including time-aware machine learning models in COVID-19 infection dashboards allows to disentangle and rank predictors of COVID-19 cases per country to support policy evaluation. Our open-source tool can be updated daily with continuous data streams, and expanded as the pandemic evolves.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , European Union , Communicable Disease Control , Pandemics/prevention & control
2.
Int J Public Health ; 67: 1604430, 2022.
Article in English | MEDLINE | ID: covidwho-1753425

ABSTRACT

Objectives: To examine the association of non-pharmaceutical interventions (NPIs) with anxiety and depressive symptoms among adults and determine if these associations varied by gender and age. Methods: We combined survey data from 16,177,184 adults from 43 countries who participated in the daily COVID-19 Trends and Impact Survey via Facebook with time-varying NPI data from the Oxford COVID-19 Government Response Tracker between 24 April 2020 and 20 December 2020. Using logistic regression models, we examined the association of [1] overall NPI stringency and [2] seven individual NPIs (school closures, workplace closures, cancellation of public events, restrictions on the size of gatherings, stay-at-home requirements, restrictions on internal movement, and international travel controls) with anxiety and depressive symptoms. Results: More stringent implementation of NPIs was associated with a higher odds of anxiety and depressive symptoms, albeit with very small effect sizes. Individual NPIs had heterogeneous associations with anxiety and depressive symptoms by gender and age. Conclusion: Governments worldwide should be prepared to address the possible mental health consequences of stringent NPI implementation with both universal and targeted interventions for vulnerable groups.


Subject(s)
COVID-19 , SARS-CoV-2 , Adult , Anxiety/epidemiology , Anxiety/prevention & control , Anxiety Disorders , COVID-19/epidemiology , COVID-19/prevention & control , Depression/epidemiology , Depression/prevention & control , Humans
3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-306102

ABSTRACT

Background: Guidelines and recommendations from public health authorities related to face masks have been essential in containing the COVID-19 pandemic. We assessed the prevalence and correlates of mask usage during the pandemic. Methods: We examined a total of 13,723,810 responses to a daily cross-sectional representative online survey in 38 countries who completed from April 23, 2020 to October 31, 2020 and reported having been in public at least once during the last seven days. The outcome was individual face mask usage in public settings, and the predictors were country fixed effects, country-level mask policy stringency, calendar time, individual sociodemographic factors, and health prevention behaviors. Associations were modelled using survey-weighted multivariable logistic regression. Findings: Mask-wearing varied over time and across the 38 countries. While some countries consistently showed high prevalence throughout, in other countries mask usage increased gradually, and a few other countries remained at low prevalence. Controlling for time and country fixed effects, sociodemographic factors (older age, female gender, education, urbanicity) and stricter mask-related policies were significantly associated with higher mask usage in public settings, while social behaviors considered risky in the context of the pandemic (going out to large events, restaurants, shopping centers, and socializing outside of the household) were associated with lower mask use. Interpretation: The decision to wear a face mask in public settings is significantly associated with sociodemographic factors, risky social behaviors, and mask policies. This has important implications for health prevention policies and messaging, including the potential need for more targeted policy and messaging design.

4.
Addiction ; 117(2): 331-340, 2022 02.
Article in English | MEDLINE | ID: covidwho-1612824

ABSTRACT

AIMS: To examine changes in drinking behavior among United States (US) adults between March 10 and July 21, 2020, a critical period during the COVID-19 pandemic. DESIGN: Longitudinal, internet-based panel survey. SETTING: The Understanding America Study (UAS), a nationally representative panel of US adults age 18 or older. PARTICIPANTS: A total of 4298 US adults who reported alcohol use. MEASUREMENTS: Changes in number of reported drinking days from March 11, 2020 through July 21, 2020 in the overall sample and stratified by sex, age, race/ethnicity, household structure, poverty status, and census region. FINDINGS: Compared with March 11, the number of drinking days per week was significantly higher on April 1 by an average of 0.36 days (95% CI = 0.30, 0.43), on May 1 by an average of 0.55 days (95% CI = 0.47, 0.63), on June 1 by an average of 0.41 days (95% CI = 0.33, 0.49), and on July 1 by an average of 0.39 days (95% CI = 0.31, 0.48). Males, White participants, and older adults reported sustained increases in drinking days, whereas female participants and individuals living under the federal poverty line had attenuated drinking days in the latter part of the study period. CONCLUSIONS: Between March and mid-July 2020, adults in the United States reported increases in the number of drinking days, with sustained increases observed among males, White participants, and older adults.


Subject(s)
COVID-19 , Adolescent , Aged , Alcohol Drinking/epidemiology , Ethnicity , Female , Humans , Male , Pandemics , SARS-CoV-2 , United States/epidemiology
5.
Nature ; 600(7890): 614-615, 2021 12.
Article in English | MEDLINE | ID: covidwho-1605912
6.
Proc Natl Acad Sci U S A ; 118(51)2021 12 21.
Article in English | MEDLINE | ID: covidwho-1569348

ABSTRACT

Simultaneously tracking the global impact of COVID-19 is challenging because of regional variation in resources and reporting. Leveraging self-reported survey outcomes via an existing international social media network has the potential to provide standardized data streams to support monitoring and decision-making worldwide, in real time, and with limited local resources. The University of Maryland Global COVID-19 Trends and Impact Survey (UMD-CTIS), in partnership with Facebook, has invited daily cross-sectional samples from the social media platform's active users to participate in the survey since its launch on April 23, 2020. We analyzed UMD-CTIS survey data through December 20, 2020, from 31,142,582 responses representing 114 countries/territories weighted for nonresponse and adjusted to basic demographics. We show consistent respondent demographics over time for many countries/territories. Machine Learning models trained on national and pooled global data verified known symptom indicators. COVID-like illness (CLI) signals were correlated with government benchmark data. Importantly, the best benchmarked UMD-CTIS signal uses a single survey item whereby respondents report on CLI in their local community. In regions with strained health infrastructure but active social media users, we show it is possible to define COVID-19 impact trajectories using a remote platform independent of local government resources. This syndromic surveillance public health tool is the largest global health survey to date and, with brief participant engagement, can provide meaningful, timely insights into the global COVID-19 pandemic at a local scale.


Subject(s)
COVID-19/epidemiology , Public Health Surveillance/methods , Social Media , COVID-19/diagnosis , COVID-19 Testing , Cross-Sectional Studies , Epidemiologic Methods , Humans , Internationality , Machine Learning , Pandemics/statistics & numerical data
7.
Proc Natl Acad Sci U S A ; 118(51)2021 12 21.
Article in English | MEDLINE | ID: covidwho-1569347

ABSTRACT

The US COVID-19 Trends and Impact Survey (CTIS) is a large, cross-sectional, internet-based survey that has operated continuously since April 6, 2020. By inviting a random sample of Facebook active users each day, CTIS collects information about COVID-19 symptoms, risks, mitigating behaviors, mental health, testing, vaccination, and other key priorities. The large scale of the survey-over 20 million responses in its first year of operation-allows tracking of trends over short timescales and allows comparisons at fine demographic and geographic detail. The survey has been repeatedly revised to respond to emerging public health priorities. In this paper, we describe the survey methods and content and give examples of CTIS results that illuminate key patterns and trends and help answer high-priority policy questions relevant to the COVID-19 epidemic and response. These results demonstrate how large online surveys can provide continuous, real-time indicators of important outcomes that are not subject to public health reporting delays and backlogs. The CTIS offers high value as a supplement to official reporting data by supplying essential information about behaviors, attitudes toward policy and preventive measures, economic impacts, and other topics not reported in public health surveillance systems.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/epidemiology , Health Status Indicators , Adult , Aged , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Vaccines , Cross-Sectional Studies , Epidemiologic Methods , Female , Humans , Male , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Social Media/statistics & numerical data , United States/epidemiology , Young Adult
8.
BMC Public Health ; 21(1): 2099, 2021 11 15.
Article in English | MEDLINE | ID: covidwho-1518268

ABSTRACT

BACKGROUND: Guidelines and recommendations from public health authorities related to face masks have been essential in containing the COVID-19 pandemic. We assessed the prevalence and correlates of mask usage during the pandemic. METHODS: We examined a total of 13,723,810 responses to a daily cross-sectional online survey in 38 countries of people who completed from April 23, 2020 to October 31, 2020 and reported having been in public at least once during the last 7 days. The outcome was individual face mask usage in public settings, and the predictors were country fixed effects, country-level mask policy stringency, calendar time, individual sociodemographic factors, and health prevention behaviors. Associations were modeled using survey-weighted multivariable logistic regression. RESULTS: Mask-wearing varied over time and across the 38 countries. While some countries consistently showed high prevalence throughout, in other countries mask usage increased gradually, and a few other countries remained at low prevalence. Controlling for time and country fixed effects, sociodemographic factors (older age, female gender, education, urbanicity) and stricter mask-related policies were significantly associated with higher mask usage in public settings. Crucially, social behaviors considered risky in the context of the pandemic (going out to large events, restaurants, shopping centers, and socializing outside of the household) were associated with lower mask use. CONCLUSION: The decision to wear a face mask in public settings is significantly associated with sociodemographic factors, risky social behaviors, and mask policies. This has important implications for health prevention policies and messaging, including the potential need for more targeted policy and messaging design.


Subject(s)
COVID-19 , Pandemics , Aged , Cross-Sectional Studies , Female , Humans , Masks , SARS-CoV-2
9.
Int J Environ Res Public Health ; 18(17)2021 08 31.
Article in English | MEDLINE | ID: covidwho-1390609

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is posing a global public health burden. These consequences have been shown to increase the risk of mental distress, but the underlying protective and risk factors for mental distress and trends over different waves of the pandemic are largely unknown. Furthermore, it is largely unknown how mental distress is associated with individual protective behavior. Three quota samples, weighted to represent the population forming the German COVID-19 Snapshot Monitoring study (24 March and 26 May 2020, and 9 March 2021 with >900 subjects each), were used to describe the course of mental distress and resilience, to identify risk and protective factors during the pandemic, and to investigate their associations with individual protective behaviors. Mental distress increased slightly during the pandemic. Usage of cognitive reappraisal strategies, maintenance of a daily structure, and usage of alternative social interactions decreased. Self-reported resilience, cognitive reappraisal strategies, and maintaining a daily structure were the most important protective factors in all three samples. Adherence to individual protective behaviors (e.g., physical distancing) was negatively associated with mental distress and positively associated with frequency of information intake, maintenance of a daily structure, and cognitive reappraisal. Maintaining a daily structure, training of cognitive reappraisal strategies, and information provision may be targets to prevent mental distress while assuring a high degree of individual protective behaviors during the COVID-19 pandemic. Effects of the respective interventions have to be confirmed in further studies.


Subject(s)
COVID-19 , Pandemics , Germany/epidemiology , Humans , Pandemics/prevention & control , Risk Factors , SARS-CoV-2
10.
Ann Behav Med ; 55(2): 93-102, 2021 03 16.
Article in English | MEDLINE | ID: covidwho-1069209

ABSTRACT

BACKGROUND: Cross-sectional studies have found that the coronavirus disease 2019 (COVID-19) pandemic has negatively affected population-level mental health. Longitudinal studies are necessary to examine trajectories of change in mental health over time and identify sociodemographic groups at risk for persistent distress. PURPOSE: To examine the trajectories of mental distress between March 10 and August 4, 2020, a key period during the COVID-19 pandemic. METHODS: Participants included 6,901 adults from the nationally representative Understanding America Study, surveyed at baseline between March 10 and 31, 2020, with nine follow-up assessments between April 1 and August 4, 2020. Mixed-effects logistic regression was used to examine the association between date and self-reported mental distress (measured with the four-item Patient Health Questionnaire) among U.S. adults overall and among sociodemographic subgroups defined by sex, age, race/ethnicity, household structure, federal poverty line, and census region. RESULTS: Compared to March 11, the odds of mental distress among U.S. adults overall were 1.84 (95% confidence interval [CI] = 1.65-2.07) times higher on April 1 and 1.92 (95% CI = 1.62-2.28) times higher on May 1; by August 1, the odds of mental distress had returned to levels comparable to March 11 (odds ratio [OR] = 0.80, 95% CI = 0.66-0.96). Females experienced a sharper increase in mental distress between March and May compared to males (females: OR = 2.29, 95% CI = 1.85-2.82; males: OR = 1.53, 95% CI = 1.15-2.02). CONCLUSIONS: These findings highlight the trajectory of mental health symptoms during an unprecedented pandemic, including the identification of populations at risk for sustained mental distress.


Subject(s)
COVID-19/psychology , Mental Health/trends , Psychological Distress , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Patient Health Questionnaire , Self Report , Socioeconomic Factors , United States , Young Adult
11.
Am J Public Health ; 110(11): 1628-1634, 2020 11.
Article in English | MEDLINE | ID: covidwho-982652

ABSTRACT

Objectives. To assess the impact of the COVID-19 pandemic on mental distress in US adults.Methods. Participants were 5065 adults from the Understanding America Study, a probability-based Internet panel representative of the US adult population. The main exposure was survey completion date (March 10-16, 2020). The outcome was mental distress measured via the 4-item version of the Patient Health Questionnaire.Results. Among states with 50 or more COVID-19 cases as of March 10, each additional day was significantly associated with an 11% increase in the odds of moving up a category of distress (odds ratio = 1.11; 95% confidence interval = 1.01, 1.21; P = .02). Perceptions about the likelihood of getting infected, death from the virus, and steps taken to avoid infecting others were associated with increased mental distress in the model that included all states. Individuals with higher consumption of alcohol or cannabis or with history of depressive symptoms were at significantly higher risk for mental distress.Conclusions. These data suggest that as the COVID-19 pandemic continues, mental distress may continue to increase and should be regularly monitored. Specific populations are at high risk for mental distress, particularly those with preexisting depressive symptoms.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Stress, Psychological/epidemiology , Adolescent , Adult , Alcohol Drinking/epidemiology , Betacoronavirus , COVID-19 , Coronavirus Infections/ethnology , Depression/epidemiology , Female , Humans , Insurance, Health , Male , Marijuana Smoking/epidemiology , Medically Uninsured , Middle Aged , Pneumonia, Viral/ethnology , SARS-CoV-2 , Socioeconomic Factors , United States/epidemiology , Young Adult
12.
Dtsch Arztebl Int ; 117(38): 625-630, 2020 09 18.
Article in English | MEDLINE | ID: covidwho-931014

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic has caused mental stress in a number of ways: overstrain of the health care system, lockdown of the economy, restricted opportunities for interpersonal contact and excursions outside the home and workplace, and quarantine measures where necessary. In this article, we provide an overview of psychological distress in the current pandemic, identifying protective factors and risk factors. METHODS: The PubMed, PsycINFO, and Web of Science databases were systematically searched for relevant publications (1 January 2019 - 16 April 2020). This study was registered in OSF Registries (osf.io/34j8g). Data on mental stress and resilience in Germany were obtained from three surveys carried out on more than 1000 participants each in the framework of the COSMO study (24 March, 31 March, and 21 April 2020). RESULTS: 18 studies from China and India, with a total of 79 664 participants, revealed increased stress in the general population, with manifestations of depression and anxiety, post-traumatic stress, and sleep disturbances. Stress was more marked among persons working in the health care sector. Risk factors for stress included patient contact, female sex, impaired health status, worry about family members and significant others, and poor sleep quality. Protective factors included being informed about the increasing number of persons who have recovered from COVID, social support, and a lower perceived infectious risk. The COSMO study, though based on an insufficiently representative population sample because of a low questionnaire return rate (<20%), revealed increased rates of despondency, loneliness, and hopelessness in the German population as compared to norm data, with no change in estimated resilience. CONCLUSION: Stress factors associated with the current pandemic probably increase stress by causing anxiety and depression. Once the protective factors and risk factors have been identified, these can be used to develop psychosocial interventions. The informativeness of the results reported here is limited by the wide variety of instruments used to acquire data and by the insufficiently representative nature of the population samples.


Subject(s)
Coronavirus Infections/psychology , Mental Disorders/epidemiology , Pandemics , Pneumonia, Viral/psychology , Resilience, Psychological , COVID-19 , Coronavirus Infections/epidemiology , Germany/epidemiology , Humans , Pneumonia, Viral/epidemiology , Protective Factors , Risk Factors
13.
JMIR Mhealth Uhealth ; 8(8): e19857, 2020 08 28.
Article in English | MEDLINE | ID: covidwho-769046

ABSTRACT

BACKGROUND: The COVID-19 pandemic is the greatest public health crisis of the last 100 years. Countries have responded with various levels of lockdown to save lives and stop health systems from being overwhelmed. At the same time, lockdowns entail large socioeconomic costs. One exit strategy under consideration is a mobile phone app that traces the close contacts of those infected with COVID-19. Recent research has demonstrated the theoretical effectiveness of this solution in different disease settings. However, concerns have been raised about such apps because of the potential privacy implications. This could limit the acceptability of app-based contact tracing in the general population. As the effectiveness of this approach increases strongly with app uptake, it is crucial to understand public support for this intervention. OBJECTIVE: The objective of this study is to investigate the user acceptability of a contact-tracing app in five countries hit by the pandemic. METHODS: We conducted a largescale, multicountry study (N=5995) to measure public support for the digital contact tracing of COVID-19 infections. We ran anonymous online surveys in France, Germany, Italy, the United Kingdom, and the United States. We measured intentions to use a contact-tracing app across different installation regimes (voluntary installation vs automatic installation by mobile phone providers) and studied how these intentions vary across individuals and countries. RESULTS: We found strong support for the app under both regimes, in all countries, across all subgroups of the population, and irrespective of regional-level COVID-19 mortality rates. We investigated the main factors that may hinder or facilitate uptake and found that concerns about cybersecurity and privacy, together with a lack of trust in the government, are the main barriers to adoption. CONCLUSIONS: Epidemiological evidence shows that app-based contact tracing can suppress the spread of COVID-19 if a high enough proportion of the population uses the app and that it can still reduce the number of infections if uptake is moderate. Our findings show that the willingness to install the app is very high. The available evidence suggests that app-based contact tracing may be a viable approach to control the diffusion of COVID-19.


Subject(s)
Contact Tracing/methods , Coronavirus Infections/prevention & control , Intention , Mobile Applications , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adolescent , Adult , Aged , COVID-19 , Coronavirus Infections/epidemiology , Cross-Cultural Comparison , Female , France/epidemiology , Germany/epidemiology , Humans , Italy/epidemiology , Male , Middle Aged , Pneumonia, Viral/epidemiology , Surveys and Questionnaires , United Kingdom/epidemiology , United States/epidemiology , Young Adult
14.
Prev Med ; 139: 106231, 2020 10.
Article in English | MEDLINE | ID: covidwho-692091

ABSTRACT

Most individuals in the United States have no history of a mental health condition yet are at risk for psychological distress due to the COVID-19 pandemic. The objective of this study was to assess the frequency and risk and protective factors of psychological distress, during the beginning of the COVID-19 pandemic, in this group. Data comes from the Pew Research Center's American Trends Panel (ATP), a probability-based online survey panel representative of the US adult population. The analytic sample consisted of 9687 individuals with no prior history of a mental health condition who completed the survey between March 19-24, 2020. Explanatory variables included sociodemographic factors and items related to behavior, perceptions, and experiences surrounding the pandemic. The outcome was psychological distress, measured by five items on symptoms of anxiety, depression, loneliness, sleep difficulties, and hyperarousal. A multivariable linear regression model was used to identify risk and protective factors for psychological distress. Fifteen percent of the sample experienced 2 psychological distress symptoms for at least 3 days over the past week; 13% had three or more symptoms. Risk factors for higher distress included searching online or using social media to post about coronavirus, reporting that the outbreak caused major changes to personal life, and perception that the virus was a threat to the US economy, the individual's personal health or finances. This has important implications for mental health service delivery.


Subject(s)
Betacoronavirus , Coronavirus Infections/psychology , Pneumonia, Viral/psychology , Stress, Psychological/epidemiology , Adolescent , Adult , Aged , COVID-19 , Coronavirus Infections/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Risk Factors , SARS-CoV-2 , Socioeconomic Factors , Surveys and Questionnaires , United States , Young Adult
15.
Am J Prev Med ; 59(5): 630-638, 2020 11.
Article in English | MEDLINE | ID: covidwho-641666

ABSTRACT

INTRODUCTION: Exposure to disaster-related media may be a risk factor for mental distress, but this has not been examined in the context of the COVID-19 pandemic. This study assesses whether exposure to social and traditional media during the rise of the COVID-19 pandemic was associated with mental distress among U.S. adults. METHODS: Data came from the Understanding America Study, conducted with a cross-sectional, nationally representative sample of adults who completed surveys online. Participants included 6,329 adults surveyed between March 10 and March 31, 2020. Regression analyses examined the associations of (1) self-reported average time spent on social media in a day (hours) and (2) number of traditional media sources (radio, TV, and newspaper) consulted to learn about COVID-19 with self-reported mental distress (4-item Patient Health Questionnaire). Data were analyzed in April 2020. RESULTS: Participants responding at later survey dates reported more time spent on social media (ß=0.02, 95% CI=0.01, 0.03), a greater number of traditional media sources consulted to learn about COVID-19 (ß=0.01, 95% CI=0.01, 0.02), and greater mental distress (ß=0.07, 95% CI=0.04, 0.09). Increased time spent on social media and consulting a greater number of traditional media sources to learn about COVID-19 were independently associated with increased mental distress, even after adjusting for potential confounders (social media: ß=0.14, 95% CI=0.05, 0.23; traditional media: ß=0.14, 95% CI=0.08, 0.20). CONCLUSIONS: Exposure to a greater number of traditional media sources and more hours on social media was modestly associated with mental distress during the rise of the COVID-19 pandemic in the U.S.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Psychological Distress , Social Environment , Social Media/statistics & numerical data , Adult , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Correlation of Data , Cross-Sectional Studies , Female , Humans , Information Dissemination/methods , Male , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Psychology , Risk Factors , SARS-CoV-2 , Self Report/statistics & numerical data , United States/epidemiology
16.
Surv. Res. Methods ; 2(14): 159-163, 2020.
Article in English | WHO COVID, ELSEVIER | ID: covidwho-613617

ABSTRACT

This paper describes a partnership between Facebook and academic institutions to create a global COVID-19 symptom survey. The survey is available in 56 languages. A representative sample of Facebook users is invited on a daily basis to report on symptoms, social distancing behavior, mental health issues, and financial constraints. Facebook provides weights to re-duce nonresponse and coverage bias. Privacy protection and disclosure avoidance mechanisms are implemented by both partners to meet global policy and industry requirements. Country and region-level statistics are published daily via dashboards, and microdata are available for researchers via data use agreements. Over 1 million responses are collected weekly.

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