Capturing COVID-19-Like Symptoms at Scale Using Banner Ads on an Online News Platform: Pilot Survey Study

Abstract

Background: Identifying new COVID-19 cases is challenging. Not every suspected case undergoes testing, because testing kits and other equipment are limited in many parts of the world. Yet populations increasingly use the internet to manage both home and work life during the pandemic, giving researchers mediated connections to millions of people sheltering in place.

Objective: The goal of this study was to assess the feasibility of using an online news platform to recruit volunteers willing to report COVID-19-like symptoms and behaviors.

Methods: An online epidemiologic survey captured COVID-19-related symptoms and behaviors from individuals recruited through banner ads offered through Microsoft News. Respondents indicated whether they were experiencing symptoms, whether they received COVID-19 testing, and whether they traveled outside of their local area.

Results: A total of 87,322 respondents completed the survey across a 3-week span at the end of April 2020, with 54.3% of the responses from the United States and 32.0% from Japan. Of the total respondents, 19,631 (22.3%) reported at least one symptom associated with COVID-19. Nearly two-fifths of these respondents (39.1%) reported more than one COVID-19-like symptom. Individuals who reported being tested for COVID-19 were significantly more likely to report symptoms (47.7% vs 21.5%; P<.001). Symptom reporting rates positively correlated with per capita COVID-19 testing rates (R²=0.26; P<.001). Respondents were geographically diverse, with all states and most ZIP Codes represented. More than half of the respondents from both countries were older than 50 years of age.

Conclusions: News platforms can be used to quickly recruit study participants, enabling collection of infectious disease symptoms at scale and with populations that are older than those found through social media platforms. Such platforms could enable epidemiologists and researchers to quickly assess trends in emerging infections potentially before at-risk populations present to clinics and hospitals for testing and/or treatment.

Keywords: COVID-19; coronavirus; epidemiology; research subject recruitment; signs and symptoms.

Figure 1

Screenshot of the Microsoft News platform showing the banner ad placed at the top of the screen that recruited participants to take a survey about COVID-19 symptoms and behaviors.

Figure 2

Overview of data collection and analysis processes. ETL: extract, transform, load; REDCap: Research Electronic Data Capture.

Figure 3

Total responses by US state normalized by population. Lighter colors indicate low counts, whereas darker colors indicate a higher number of responses.

Figure 4

Cumulative responses over time, stratified by location of respondent, to a survey on COVID-19 symptoms. The survey was offered in Japan 16 days after it was introduced in the United States.

Figure 5

COVID-19 epidemic curves for the United States and Japan through May 1, 2020 [26]. The plot shows cumulative confirmed COVID-19 cases. The number of confirmed cases is lower than the number of actual cases; the main reason for that is limited testing. The source of this data is the European Centre for Disease Prevention and Control, Situation Update Worldwide, last updated August 31, 2020, 10:34 AM (London time). Official data were collated by Our World in Data [28].