The Pace and Pulse of the Fight against Coronavirus across the US, A Google Trends Approach.

BACKGROUND The coronavirus pandemic has impacted our lives at unprecedented speed and scale - including how we eat and work, what we worry about, how much we move, and our ability to earn. Traditional surveys in the area of public health can be expensive, time-consuming, and rapidly go out of date. Analyzing big data sets (such as electronic patient records, surveillance systems) is very complex. Google Trends is an alternative approach which has been used before to analyze health behaviors, but most research on COVID-19 using this data, so far, looks at a single issue or a limited geographic area. This paper explores Google Trends as a proxy for what people are thinking, needing, and planning in real time across the US. OBJECTIVE We use Google Trends to provide both insights into, and potential indicators of, important changes in information-seeking patterns during pandemics like COVID-19. We asked four questions: (1) How has information seeking changed over time? (2) How does information seeking vary between regions and states? (3) Do states have particular and distinct patterns in information seeking? (4) Does search data correlate with - or precede - real-life events? METHODS We analyzed searches on 39 terms related to COVID-19, falling into six themes: Social & Travel; Care Seeking; Government Programs; Health Programs; News & Influence; Outlook & Concerns. We generated data sets at the national level (covering Jan 1, 2016 - April 15, 2020) and state level (covering Jan 1, 2020 - April 15, 2020). Methods used include trend analysis of US search data; geographic analyses of the differences in search popularity across US states during March 1st to April 15th, 2020; and Principal Component Analyses (PCA) to extract search patterns across states. RESULTS Data showed high demand for information corresponded with increasing searches for "coronavirus" linked to news sources regardless of the ideological leaning of the news source. Changes in information seeking often happened well in advance of action by the federal government. The popularity of searches for unemployment claims predicted the actual spike in weekly claims. The increase in searches for information on coronavirus care was paralleled by a decrease in searches related to other health behaviors, such as urgent care, doctor's appointment, health insurance/ Medicare/ Medicaid. Finally, concerns vary across the country - some search terms were more popular in some regions than in others. CONCLUSIONS COVID-19 is unlikely to be the last pandemic the US faces. Our research holds important lessons for both state and federal governments in a fast-evolving situation that requires a finger on the pulse of public sentiment. We suggest strategic shifts for policy makers to improve the precision and effectiveness of non-pharmaceutical interventions (NPIs) and recommend the development of a real-time dashboard as a decision-making tool. CLINICALTRIAL