Online Survey Reveals Patient Knowledge, Misperceptions About COVID-19

Pascal Geldseltzer, MD, MPH, PhD

Findings from an online survey could help guide information campaigns regarding appropriate coronavirus disease 2019 (COVID-19) measures and misperceptions, according to the findings of recent research.

Pascal Geldseltzer, MD, MPH, PhD, administered an online questionnaire to 6000 adults—3000 in the US and 3000 in the UK to determine knowledge and perception of COVID-19 among the general public in the 2 regions. Geldseltzer found that such surveys could be an important tool in tracking knowledge and misperceptions during rapidly moving infectious disease outbreaks. While patients had a general understanding of how the disease spreads, they still believed many misconceptions spread around the news and internet.

Geldseltzer, from the Department of Medicine at Stanford University, issued an online survey on Prolific Academic, an online platform that connects researchers with individuals around the world interested in participating in research studies online. Prolific Academic’s pool of participants consists of 80,000 participants—43% in the UK and 33% in the US.

Prolific Academic established strata by age group (18-27, 28-37, 38-47, 48-57, or ≥58 years), sex (male or female) and ethnicity (white, black or African American, Asian or Asian Indian, mixed, or “other”). The study was implemented in 2 rounds of 1500 participants in each country.

The questionnaire asked participants about the cause, current state, and future development of coronavirus; the risk of fatal disease course; knowledge of symptoms and recommended care-seeking behavior; measures to prevent an infection; and perception of the risk posed by those of East-Asian ethnicity in their community.

Participants were also asked if they believed false news listed on the World Health Organization’s “myth busters” website.

The survey asked whether receiving a letter or package from China posed a risk of infection and whether using hand dryers; rinsing your nose with saline; eating garlic; applying sesame oil to the skin; taking antibiotics; and vaccinating against pneumonia were effective in preventing the COVID-19 infection.

Of those who completed the survey, 64.4% of US participants and 51.5% of UK participants had a tertiary education. Nearly 70% of US respondents had a total household income between $20,000-$99,999 and 74.4% of UK respondents had a total income between $18,378-$91,891.

When asked if COVID-19 was a bioweapon developed by a government or terrorist organization, 23.9% (95% CI, 22.4-25.5) of US participants and 18.4% (95% CI, 17.1-19.9) of UK respondents chose “slightly likely,” “moderately likely,” or “extremely likely.” US and UK participants estimated that a median of 100 (IQR, 20-500) and 40 (IQR, 13-200) individuals in their country were currently infected with coronavirus, respectively. What’s more, a mean of 61% (95% CI, 59.3-62.8) of US and 71.7% (95% CI, 70.1-73.3) of UK respondents thought the number of fatalities from COVID-19 in their country would be <500 people by the end of 2020.

In the US, participants believed an estimate of 5% (IQR, 2-15) of individuals infected experienced a fatal disease course, while UK participants said 3% (IQR, 2-10).

Between children, young adults, or older adults, 96.3% (95% CI, 95.6-96.9) of participants in the US and 98.3% (95% CI, 97.7-98.7) of participants in the UK believed older adults were most likely to die from the illness caused by COVID-19. More than half (95% CI, 52.1-55.6) in the US and 39.1% (95% CI, 37.4-40.9) in the UK thought that children were at high risk of death when infected by the virus.

Most participants (96.3%; 95% CI, 95.6-97) in the US and 97.5% (95% CI, 96.9-98) in the UK said adults who had other health problems were more likely to experience a fatal disease course than those without.

Participants had fairly good knowledge of the main way the disease transmits and common symptoms, but others had misconceptions about preventing the infection and the recommended care-seeking behavior.

Nearly 40% (95% CI 36.1-39.6) of US participants and 29.7% (95% CI, 28.1-31.4) of UK respondents said wearing a common surgical mask was “highly effective” in protecting them from acquiring the virus. And 25.6% (95% CI 24.1%-27.2%) of US participants and 29.6% (95% CI, 28-31.3) of those in the UK thought it was best to refrain from eating at Chinese restaurants.

Overall, Geldseltzer believed that rapid online surveys could be promising in assessing and tracking knowledge and perceptions during a rapidly changing infectious disease outbreak. The findings from the surveys can lead to better ensuring that the general public is well informed and could reduce unnecessary anxiety and disease transmission.

The study, “Use of Rapid Online Surveys to Assess People’s Perceptions During Infectious Disease Outbreaks: A Cross-sectional Survey on COVID-19,” was published online in the Journal of Medical Internet Research.