As of August 5, 2020, there were 2683 valid, questionnaire entries which comprised 77.53% of the total participants who initiated the survey. The online survey method of nonprobability sampling was used to recruit participants via social media posts that targeted the general adult population (aged >18 years old).
This sample population was composed by anonymous denizens of 47 countries, with the highest number of participants from the United States, India, New Zealand and Australia (Fig 1A). The countries with less than 10 survey takers are listed in Table S1. Age-wise profiling of the survey takers show that 22.7% of the participants belonged to the age group between 56-65 years alone, followed by 26-35 years (20.6%) age group. Individuals under the age groups of 36-45 years and 46-55 years also formed a significant portion (36%) of the survey participants (Fig 1B). The rest were either adults younger than 25 years old (7.6%) or senior citizens above 65 years old (13.1%). The educational status for most of these participants ranged from an undergraduate to graduate degree as their highest qualification with 78% of the people having a bachelor’s degree or higher (Fig 1C). The survey takers had the following racial/ethnic identities: White, Asian, Hispanic or Latino, Black or African American and “others” such as Native Americans, Hawaiians, Pacific Highlanders, Alaskan Native etc. The majority of the participants were either White (60.4%) or Asian (23.6%), whereas 16% participants fell under the above mentioned “other” categories (Fig 1D).
To gain insights on the impact of the COVID-19 pandemic on professional lives, we asked the occupational background of the survey takers by listing a range of employment categories or occupational groups including art and entertainment, finance, research, first responders, healthcare, news and media, transportation, civil and military services and other relevant staff. The highest percentage of our survey takers belonged to the healthcare sector (31.2%). About 26% of the survey takers opted not to disclose their occupational category. The next three highest representations were from education (9.5%), science and technology (8.1%) and research sectors (6.4%) (Fig 2A). Furthermore, to analyze how their occupational lives were influenced by the unprecedented changes in the routine, we asked what best reflected the survey takers current professional status. Fig 2B is a heat map looking into the current employment status, taking into account potential overlaps between different professional statuses. The colored grids represent overlaps between any two given categories. For the non-overlapping population, represented along the diagonal, we have specified the exact number of participants in the figure. For the participants who have two professions, we represented the numbers using a color scale. The numerical values in the diagonal grids represent the total number of participants in individual categories. Even though there was a rapid shift to remote working options, most of the participants were employed full-time followed by a second highest group of retired personnel who took our survey. A smaller subset of the participants belonged to part-time or self-employment status followed by students, unemployed members and homemakers (Fig 2B). Thus, compared to other occupational groups, more than 50% of the survey takers belonged to full-time research and healthcare segments. Moreover, we found some overlap between the different categories. For instance, most of the full-time workers were students or self-employed individuals (Fig 2B). A critical separation of the workforce during the time of a pandemic generated crisis is classifying the essential and non-essential workers. Responses for this survey question revealed that there were 1659 essential workers present in our study cohort (61.8%) and 972 workers (36.2%) belonged to the non-essential workers category, with a few participants (n=52, 1.9%) who opted not to answer this question (Fig 2C). To understand whether this study group experienced unique challenges such as risk of financial stability during the COVID-19 crisis through loss of employment we asked the participants their current occupational status. Most of the candidates (91%) who took the survey were not affected by loss of employment except for a small subgroup (6.85%) who lost their jobs (Fig 2D). Thus, data from this section of the study suggests that there was a mixed distribution of candidates with regard to their occupational status and a major fraction of them did not lose employment.
We then assessed whether the study participants were tested for COVID-19 and found that a little more than one-fourth of the total participants, i.e, n= 777 or 29% took the COVID-19 detection test and the majority 1890 or 70.4% of total participants did not test for an infection until the time of filling the survey (Fig 3A). In order to estimate whether it was mandatory for this subset of COVID-19 test takers to be tested, we analyzed if they were essential or non-essential workers. The results showed that a large number of the tested individuals were essential workers (511 out of 777 i.e, 65.7%) and a few of them (244 out of 777 i.e., 31.4%) belonged to the non-essential workers category while 1.5% preferred not to answer (Fig 3B). This result suggests that along with the essential workers for whom COVID-19 testing was expected to be mandatory as a safety precaution, there was an alarming health concern among the general public /non-essential workers to obtain the COVID-19 test and thereby assure that they have not been exposed to an infection. Furthermore, a comparative analysis also informed what fraction of the total essential and non-essential workers in our study group took the COVID-19 test. A little more than half of the total essential workers, 511/972 i.e., 52.5 % took the test while working as frontline taskforce which accounts for 511/2683 or 19% of the total survey participants. As expected, this fraction was lower in the non-essential workers group where only 252/1659 i.e., 15.1% were tested (Fig S1). We then assessed whether the sub-population who opted for taking the COVID-19 detection test belonged to a few of the specific occupations or were evenly distributed among all categories. Upon analyzing which occupational categories these COVID-19 test takers belonged to, we found that the majority of them (67.3%) were healthcare workers followed by employees from the research and education sector (9.5%) (Fig 3C). To measure how people from different employment backgrounds were impacted by the unexpected and abrupt restrictions such as lower density of occupants in the office and business spaces we asked whether their jobs could be performed remotely. A vast majority of the tested individuals did not have the flexibility of working from home since most of our study cohort were employed by healthcare or research/education organizations. About 40.1% of the participants had to be onsite at their workplaces and 28% people reported that their work could only be partially done from home. Only 24.2% of the total participants could work entirely remotely with having any adverse effect on their work (Fig 3D). Overall, these studies show that regular monitoring through periodic testing for workers in healthcare and related sectors could help circumvent the spread of COVID-19 disease allowing smooth functioning of the healthcare delivery systems when working remotely is not an option.
Previous studies have shown that even under normal circumstances our overall well-being is influenced by the people we surround ourselves with . During the COVID-19 pandemic lockdown when everyone experienced either shorter or longer periods of home isolation, the people we live with is an important determinant of our social and mental wellbeing. Therefore, we designed our survey questionnaire to assess the immediate household cohabitants of the study participants and to explore how it impacted their daily routines. Our results show that the majority, ~65% (1730/2683) of the survey participants lived with their spouses while others had roommates, siblings or relatives as companions and a few lived by themselves. Single individuals formed the second highest category (14.7%). There was almost an equal distribution of individuals living either with their sibling(s), other relatives or roommates (~6%) while 1% of the entries preferred not to answer this question (Fig 4A). Based on further analysis of participants who lived with their spouse, we found that 45% among them (781/1730) had children in their household (Fig 4B). A comparison of the overlapping categories revealed that most of our study participants lived with one or more companions during this challenging time and only a small percentage lived by themselves (data not shown). In terms of how people felt about spending more time indoors with other household members during the pandemic, there were mixed reactions ranging from fluctuation in their opinion to feeling great or neutral (Fig 4C). The COVID-19 pandemic altered social interactions among people around the world. In particular, more than 2/3rd of the participants experienced a significant change in the extent of social interaction with people not living in their common household (Fig 4D). There was a pronounced increase (87.1%) in the level of social interaction during the isolation phase and only a few individuals (10.8%) responded to have no change in their interactions with other people.
The unprecedented COVID-19 disease outbreak, which led to serious health concerns, uncertainty and havoc in the global community, could be overwhelming and cause strong emotions in people of all ages. Although preventive measures adopted through public health actions such as social distancing are necessary to reduce the spread of the disease, these are associated with fear, loneliness and anxiety in the people. We wondered how people were adjusting to the changing environment with the sudden reduction in out-of-home activity and how it affected their mental health. Therefore, in our global survey, we chose to ask about people’s outlook towards the coronavirus crisis by creating different categories to gauge the extent of mental health changes ranging from none to moderately or extremely affected. There were mixed responses and opinions for how the participants felt under these changing circumstances. While around 30% of the participants stated that they were moderately affected, 13.5% people faced extreme and overwhelming mental health challenges (Fig 5A). On further analysis, we found that both the essential and non-essential workers groups had similar effects of social isolation on their mental health (data not shown). Our current findings and similar recent studies [19, 20] have shown that the unprecedented disease outbreak and the lockdown phase has induced higher chronic stress and psychological distress in the human community at large. We therefore aimed to assess the stress management strategies adopted by our study participants and how well they coped with their mental health burden. We focused on a few options that are considered as the prime coping strategies used by individuals facing stressful situations. These include pursuing hobbies, physical activity such as yoga, online therapies, religious practices and speaking to friends and family. As a way to cope with the accumulating stress and anxiety, there was a marked increase in the frequency of interactions with friends and family members (63.8%) as well as exercising or pursuing individual hobbies (58.5%). Moreover, we observed a correlation that the individuals who pursued hobbies were also engaged in social interactions more than others. There were a very few people, at least in this study cohort, who used online therapies (8%) or religious practices (13.9%) (Fig 5B). While being required to isolate themselves at home and prohibit physical social gatherings, we found that individuals actively discovered alternate socializing ways through virtual interactions. Thus, data from this section of the study suggest that an individual’s level of virtual interaction with family, friends and acquaintances increased while going through this phase of severe infectious disease prevalence. Overall, the majority of the survey takers were employed and living with one or more companions and yet chose social interaction, in part, as a coping mechanism to relieve their stress and anxiety during the COVID-19 pandemic.
Since the COVID-19 pandemic presents a major threat to public health, it is necessary for the human population to acquaint ourselves with some awareness of viral infections and the diseases associated with it. Viral infections can cause a series of disorders affecting multiple organs in the body including the lungs, liver, gut, brain, heart, pancreas and kidneys . In order to estimate as well as raise general awareness about viral infections or other manifestations associated with it we asked our study participants from different demographic and occupational backgrounds about their idea on the disorders that a viral infection might cause. The majority of the survey takers were aware of the impact of viral infection of seasonal flu. This information is particularly useful as we approach the annual flu season. Among our survey takers, the awareness was least that viral infections can cause Type 1 Diabetes. About 40-60% survey takers were familiar that viral infections can cause skin warts, Liver Cirrhosis, and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS; an unexplained, chronic disease that affects millions worldwide [22, 23]) (Fig 6A). Of note, there is an emerging body of evidence indicating that a section of the COVID-19 patients, especially the long haulers, will eventually develop ME/CFS [24, 25]. To find whether the survey takers had other underlying health conditions that might exacerbate the effects of COVID-19, we shortlisted a few disorders that are believed to have that effect. About 6.6%, 9.54%, 17.35%, 19.53%, 16.42%, 14.47%, 9.39%, 2.45% and 4.19% of our respondents suffered from diabetes, cardiovascular disorders, obesity, respiratory infections, other respiratory disorders, gastrointestinal disorders, autoimmune diseases, Chronic kidney disorders, and Myalgic Encephalomyelitis (ME/CFS), respectively. Overall, the majority of our respondents did not have the stated underlying conditions that could exacerbate their COVID-19 risk (Fig 6B).