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.

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中文翻译：

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评估西班牙 COVID-19 大流行的影响：大规模、在线、自我报告的人口调查。

背景：西班牙是受 COVID-19 大流行影响最严重的国家之一。自2020年1月31日报告第一例确诊病例以来，西班牙已有超过405,000例病例，28,000人死亡。其经济和社会影响是史无前例的。因此，快速评估民众的情况和看法非常重要。大规模在线调查已被证明是实现这一目的的有效工具。目标：我们旨在评估西班牙民众在与 COVID-19 大流行相关的四个关键领域的情况和看法：隔离期间的社会接触行为、个人经济影响、劳动状况和健康状况。方法：我们在 2020 年 3 月 28 日至 4 月 2 日这一周（西班牙第一波 COVID-19 高峰期间）通过在线调查获得了大样本，其中包含 24 个与 COVID-19 相关的问题。采用非概率抽样的自选在线调查方法，通过针对一般成年人口（年龄>18岁）的社交媒体帖子招募了156,614名参与者。考虑到如此大的样本，所有报告比例的 95% CI 均为 ±0.843。结果：就隔离期间的社会行为而言，参与者主要是为了满足基本需求而离开家。我们发现不同性别和年龄组的社会行为存在一些统计上显着的差异。民众遵守限制措施的意愿是显而易见的。从调查的答案中，我们发现这一流行病对小企业工作人员产生了重大的不利经济影响，并且经济损失与留在隔离场所的意愿之间呈负相关。调查显示，密切接触者在疾病传播中发挥着重要作用，28%的参与者缺乏适当隔离自己的必要资源。我们还发现检测工作严重不足，只有 1% 的人口接受了检测，6% 的受访者尽管有医生的建议，但仍无法接受检测。我们开发了一个广义线性模型来识别与 SARS-CoV-2 阳性检测结果相关的变量。使用该模型，我们估计研究期间西班牙人群中 SARS-CoV-2 的平均患病率为 5%。西班牙卫生部后来进行的一项血清流行率研究报告了类似的疾病流行水平（5%）。结论：通过社交媒体和在线消息平台分发的大规模在线人口调查可以成为一种有效、廉价且快速的工具，用于评估大流行背景下传染病的影响和流行率，特别是当存在大流行时官方数据匮乏，测试能力有限。

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