Assessing the Impact of the COVID-19 Pandemic in Spain: Large-Scale, Online, Self-Reported Population Survey

Abstract

Background Spain has been one of the countries most impacted by the COVID-19 pandemic. Since the first confirmed case was reported on January 31, 2020, there have been over 405,000 cases and 28,000 deaths in Spain. The economic and social impact is without precedent. Thus, it is important to quickly assess the situation and perception of the population. Large-scale online surveys have been shown to be an effective tool for this purpose. Objective We aim to assess the situation and perception of the Spanish population in four key areas related to the COVID-19 pandemic: social contact behavior during confinement, personal economic impact, labor situation, and health status. Methods We obtained a large sample using an online survey with 24 questions related to COVID-19 in the week of March 28-April 2, 2020, during the peak of the first wave of COVID-19 in Spain. The self-selection online survey method of nonprobability sampling was used to recruit 156,614 participants via social media posts that targeted the general adult population (age >18 years). Given such a large sample, the 95% CI was ±0.843 for all reported proportions. Results Regarding social behavior during confinement, participants mainly left their homes to satisfy basic needs. We found several statistically significant differences in social behavior across genders and age groups. The population’s willingness to comply with the confinement measures is evident. From the survey answers, we identified a significant adverse economic impact of the pandemic on those working in small businesses and a negative correlation between economic damage and willingness to stay in confinement. The survey revealed that close contacts play an important role in the transmission of the disease, and 28% of the participants lacked the necessary resources to properly isolate themselves. We also identified a significant lack of testing, with only 1% of the population tested and 6% of respondents unable to be tested despite their doctor’s recommendation. We developed a generalized linear model to identify the variables that were correlated with a positive SARS-CoV-2 test result. Using this model, we estimated an average of 5% for SARS-CoV-2 prevalence in the Spanish population during the time of the study. A seroprevalence study carried out later by the Spanish Ministry of Health reported a similar level of disease prevalence (5%). Conclusions Large-scale online population surveys, distributed via social media and online messaging platforms, can be an effective, cheap, and fast tool to assess the impact and prevalence of an infectious disease in the context of a pandemic, particularly when there is a scarcity of official data and limited testing capacity.

Would the Use of Artificial Intelligence in COVID-19 Patient Management Add Value to the Healthcare System?

“…Oliver et al applied machine learning techniques and linear regression models to estimate the COVID-19 prevalence during a large-scale survey carried out in Spain during the March-April lockdown. The authors describe that results were similar to the antibody test study performed later by the government ( 36 ).…”

A Mixed Approach on Resilience of Spanish Dwellings and Households during COVID-19 Lockdown

“…This study is of an exploratory nature. This has been one of the most frequent consequences of the online surveys that have emerged on the issue of COVID-19 [58]. There are inherent biases in the way participants are recruited [59], as well as in the use of internet forms [60], and digital gaps, which could result in few respondents belonging to vulnerable areas.…”

COVID-19 anxiety scale (CAS): Development and psychometric properties

“…Hence, we focus on a specific type of anxiety caused by the pandemic scenario: COVID-19 anxiety. Although studies have already been conducted regarding the consequences for the general psychological well-being due to social distancing, resulting from the COVID-19 prevention (Wang et al, 2020b), to date few instruments have been builtor adaptedto assess the psychological demands regarding COVID-19 (Ahorsu et al, 2020;Oliver, Barber, Roomp, & Roomp, 2020;Taylor et al, 2020). More objectively, among those instruments already built, there is no one validated for the Brazilian context, that is able to evaluate the contextual COVID-19 anxiety.…”