Background: The COVID-19 pandemic has impacted people’s lives at unprecedented speed and scale, including how they eat and work, what they are concerned about, how much they move, and how much they can earn. Traditional surveys in the area of public health can be expensive and time-consuming, and they can rapidly become outdated. The analysis of big data sets (such as electronic patient records and surveillance systems) is very complex. Google Trends is an alternative approach that has been used in the past to analyze health behaviors; however, most existing studies on COVID-19 using these data examine 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 United States. Objective: We aimed to use Google Trends to provide both insights into and potential indicators of important changes in information-seeking patterns during pandemics such as 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) Do search data correlate with—or precede—real-life events? Methods: We analyzed searches on 38 terms related to COVID-19, falling into six themes: social and travel; care seeking; government programs; health programs; news and influence; and outlook and concerns. We generated data sets at the national level (covering January 1, 2016, to April 15, 2020) and state level (covering January 1 to April 15, 2020). Methods used include trend analysis of US search data; geographic analyses of the differences in search popularity across US states from March 1 to April 15, 2020; and principal component analysis to extract search patterns across states. Results: The data showed high demand for information, corresponding with increasing searches for coronavirus linked to news sources regardless of the ideological leaning of the news source. Changes in information seeking often occurred 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 COVID-19 care was paralleled by a decrease in searches related to other health behaviors, such as urgent care, doctor’s appointments, health insurance, Medicare, and Medicaid. Finally, concerns varied 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 faced by the United States. 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 and recommend the development of a real-time dashboard as a decision-making tool.

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中文翻译：

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全美国COVID-19大流行期间的信息寻求模式：Google趋势数据的纵向分析

背景：COVID-19大流行以前所未有的速度和规模影响着人们的生活，包括他们的饮食和工作方式，他们所关注的事物，他们的移动量以及能赚多少钱。公共卫生领域的传统调查可能既昂贵又耗时，并且很快就会过时。大数据集（例如电子病历和监视系统）的分析非常复杂。Google趋势是过去用来分析健康行为的另一种方法；但是，使用这些数据进行的有关COVID-19的大多数现有研究都研究了单个问题或有限的地理区域。本文探讨了Google趋势，以了解人们在美国各地的实时想法，需求和计划。客观的：我们旨在利用Google趋势来洞察大流行期间（例如COVID-19）信息搜索模式的重要变化，并提供相关的潜在指标。我们提出了四个问题：（1）随着时间的推移，寻求信息有什么变化？（2）信息搜寻在地区和州之间如何变化？（3）国家在信息搜寻中是否有特定而独特的模式？（4）搜索数据是否与现实生活事件相关或在其之前发生？方法：我们分析了与COVID-19相关的38个词的搜索，分为六个主题：社交和旅行；寻求护理；政府计划；健康计划；新闻和影响力；以及前景和担忧。我们在国家一级（涵盖2016年1月1日至2020年4月15日）和州一级（涵盖2020年1月1日至2020年4月15日）生成了数据集。使用的方法包括对美国搜索数据进行趋势分析；2020年3月1日至4月15日全美各州搜索受欢迎程度差异的地理分析；和主成分分析以提取跨州的搜索模式。结果：数据显示出对信息的高需求，与搜索与新闻来源相关的冠状病毒的搜索量增加无关，而与新闻来源的意识形态倾向无关。寻求信息的变化通常发生在联邦政府采取行动之前。搜索失业救济金要求的流行预测了每周失业救济金的实际增长。与COVID-19护理相关的信息搜索量增加的同时，与其他健康行为有关的搜索量减少，例如紧急护理，医生的任命，健康保险，Medicare和Medicaid。最后，全国各地的关注点各不相同；有些搜索字词在某些地区比其他地区更受欢迎。结论：COVID-19不太可能是美国面临的最后一次大流行。在瞬息万变的形势下，我们的研究为州和联邦政府提供了重要的经验教训，需要把握公众情绪的脉动。我们建议决策者进行战略调整，以提高非药物干预措施的准确性和有效性，并建议开发实时仪表板作为决策工具。在瞬息万变的形势下，我们的研究为州和联邦政府提供了重要的经验教训，需要把握公众情绪的脉动。我们建议决策者进行战略调整，以提高非药物干预措施的准确性和有效性，并建议开发实时仪表板作为决策工具。在瞬息万变的形势下，我们的研究为州和联邦政府提供了重要的经验教训，需要把握公众情绪的脉动。我们建议决策者进行战略调整，以提高非药物干预措施的准确性和有效性，并建议开发实时仪表板作为决策工具。

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