The COVID-19 Social Monitor longitudinal online panel: Real-time monitoring of social and public health consequences of the COVID-19 emergency in Switzerland.

BACKGROUND: The COVID-19 pandemic challenges societies in unknown ways, and individuals experience a substantial change in their daily lives and activities. Our study aims to describe these changes using population-based self-reported data about social and health behavior in a random sample of the Swiss population during the COVID-19 pandemic. The aim of the present article is two-fold: First, we want to describe the study methodology. Second, we want to report participant characteristics and study findings of the first survey wave to provide some baseline results for our study.
METHODS: Our study design is a longitudinal online panel of a random sample of the Swiss population. We measure outcome indicators covering general well-being, physical and mental health, social support, healthcare use and working state over multiple survey waves.
RESULTS: From 8,174 contacted individuals, 2,026 individuals participated in the first survey wave which corresponds to a response rate of 24.8%. Most survey participants reported a good to very good general life satisfaction (93.3%). 41.4% of the participants reported a worsened quality of life compared to before the COVID-19 emergency and 9.8% feelings of loneliness. DISCUSSION: The COVID-19 Social Monitor is a population-based online survey which informs the public, health authorities, and the scientific community about relevant aspects and potential changes in social and health behavior during the COVID-19 emergency and beyond. Future research will follow up on the described study population focusing on COVID-19 relevant topics such as subgroup differences in the impact of the pandemic on well-being and quality of life or different dynamics of perceived psychological distress.

Introduction

The acute respiratory infection caused by the virus SARS-CoV-2, with the clinical manifestations referred to as COVID-19, has spread within the first quarter of 2020 from the Chinese city of Wuhan to all over the world, becoming a pandemic with more than 38.9 million confirmed cases as of October 16, 2020 (https://coronavirus.jhu.edu). Most infected people have no, or only mild, symptoms, yet COVID-19 may be deadly for risk groups like the elderly or individuals suffering from a chronic illness [1]. The rapid and easy spread of the virus has challenged nations and societies as a whole, especially the healthcare systems.

Many countries have implemented public health measures to mitigate the spread of the novel Coronavirus [2]. Since the occurrence of the first COVID-19 case in Switzerland, the Swiss government has increasingly strengthened large-scale public health interventions like physical distancing (including a ban on large gatherings) and the isolation of symptomatic cases. On March 13, 2020, the government decided to close all schools and a few days later, on March 16th, a national lockdown was announced. This involved the closing of borders and a tight restriction on physical gatherings, including the closing of all restaurants and shops except for grocery stores and pharmacies. People were asked to stay at home and to avoid commuting to work, i.e. to work from home if possible. In a matter of just a few weeks, COVID-19 became part of everybody’s daily life.

The COVID-19 pandemic challenges society in unknown ways, and individuals experience a substantial change in their daily lives and activities. A cross-sectional study from the United Kingdom found that a majority of citizens adapted to public health measures but found differences across age and socioeconomic groups [3]. Currently, in Switzerland, it is unclear how the COVID-19 pandemic (and the implemented public health measures) impact people’s behavior, their health status and well-being. Neither the public nor health authorities are informed in a timely manner about important health and social consequences on a population level in terms of issues such as social isolation, fears related to health care and severe economic burdens.

Our study aims to close this important knowledge gap during the COVID-19 pandemic and beyond. By providing almost real-time evidence about relevant social and health behavior indicators, we want to inform the public and health authorities about the impact of the COVID-19 pandemic on relevant social and public health domains.

Overall study objectives and selected research hypotheses

Currently there is no population-based data on the effects on health and wellbeing in the Swiss population related to the ongoing COVID-19 pandemic. Therefore, we have defined the following objectives and research hypotheses.

Short-term: A weekly monitoring of timely and short-term relevant social and health indicators to inform the public, health authorities (on community, cantonal and federal levels), and the scientific community about positive and negative aspects of public health measures implemented during the COVID-19 pandemic.

Hypothesis: We expect a short-term change in social and health behavior towards increased social separation (e.g. within families, between age groups and generations) and a more sedentary and unhealthy lifestyle (e.g. decrease in physical activity, increase in unfavorable diet and/or problem drinking, increase in media consumption, decreasing use of healthcare services, reduction in social contacts) during the COVID-19 emergency.

Mid-term: A monthly report of the COVID-19 pandemic and the impact of public health measures on social and health consequences on a population level (for example, information about social isolation, limited access to care, or productivity and income losses).

Hypothesis: We expect an intensification of social and work-related problems (e.g. increase in social withdrawal, increase in relationship conflicts and work-family conflicts or interferences, increase in job stress despite home office, fear of unemployment) and a rise in social isolation and loneliness among the general population and particularly among the elderly over the course of the COVID-19 emergency.

Long-term: To assess the impact and acceptance of the implemented public health measures, for example, the adherence to the social distancing rules.

Hypothesis: We hypothesize a decrease in job, life and marital satisfaction, general well-being and particularly mental health as a result of the social isolation and the economic and/or job insecurity and a decreasing acceptance of and compliance with simple public health interventions and procedures like social distancing and handwashing during the COVID-19 emergency.

Besides the above-mentioned hypotheses on changes over time, significant differences in social and health behavior as well as health state between the sexes, different age groups and particularly the language regions can be expected and will be further explored.

The formulated objectives and hypotheses are part of future research using the COVID-19 Social Monitor online panel and will be investigated in separate research articles. The aim of the present manuscript is to describe the study methodology of the COVID-19 Social Monitor longitudinal online panel. Further we want to report participant characteristics and study outcomes of the first survey wave to provide a comprehensive baseline overview of our study population.

Methods

Study population

Our study population covers a random sample of a large cohort of the resident population in Switzerland with online access aged 18 years or older.

Study design

Our study design is a longitudinal online panel. Survey participants were selected by a stratified random sample from an existing participant pool. Stratification variables were age, gender and language region. Residents from the Italian-speaking region have been oversampled by about a factor of three to allow for more precise estimates for this region particularly hard (and early) hit by the COVID-19 pandemic. Regular follow-up survey waves every one to two weeks are planned according to a pre-defined scheme (see S1 Table).

Survey participants and recruiting

Survey participants are recruited by a renowned Swiss survey company (LINK Institute, Zurich, Switzerland). Survey participants were randomly selected from an existing online access panel of LINK during the first survey wave (period from March 30, 2020 to April 06, 2020) until an effective sample size of approximately 2,000 participants was reached. Panel members have been actively recruited using representative CATI surveys with landline and randomly generated mobile numbers.

Study outcomes

We measure numerous indicators from various domains of social and health behavior and states organized into 4 to 6 thematic modules (see S2 Table for items used in the first survey wave). The domains cover general well-being, physical health, mental health, social support, healthcare use and working state and conditions. The items used stem from validated and established questionnaires and population surveys, mainly the Swiss Health Survey (SHS https://www.bfs.admin.ch/bfs/de/home/statistiken/gesundheit/erhebungen/SHS.html), the Swiss Household Panel (SHP https://forscenter.ch/projekte/swiss-household-panel), and the Study on Health, Ageing and Retirement (SHARE http://www.share-project.org). The questions are partly adapted to fit the current context.

Sociodemographic characteristics

Sociodemographic characteristics include age, gender, highest achieved level of education (compulsory, secondary, tertiary), nationality, canton of residence, language region (German and Romansh, French, Italian), family situation (living with partner and/or children), and working status (employed, self-employed, unemployed, retired, not working).

Statistical methods

We report descriptive summaries by counts and percentages (%). We report estimates and 95% confidence intervals from multivariable generalized linear regression models. We use survey design calibration approaches such as post-stratification to account for sampling biases and non-response [4, 5]. Calibration and post-stratification information (population counts across age classes, gender, highest achieved education and living region) stem from official estimates of the Swiss Federal Statistical Office. We use hierarchical, multivariable, generalized linear regression models for spatial and longitudinal analyses [4, 6]. All analyses are performed in R version 3.6.3 [7].

Data protection and anonymization

Data collection and panel-administration (LINK) are organizationally completely separated. During data collection, an anonymous person ID generated by the LINK Institute is used to be able to match answers from the same participants in subsequent survey waves. However, after each wave of data collection, all identifiers that could theoretically be used for a later de-anonymization will be removed from the collected data. This includes the anonymous person ID provided by the LINK Institute. To allow for panel-analysis, a new Monitor-ID will be generated by the data collection center. A key list providing the link between the person ID generated by LINK and the Monitor-ID generated by us will be accessible only to the researcher responsible for the data collection. No one else has access to this list. After study termination, the key list will be deleted.

Publication of results

The descriptive results from each wave are published on an online information platform (https://csm.netlify.app). Future research using this online panel will focus on the investigation of specific social and health-related domains and longitudinal analyses.

Ethics statement

Ethical approval: The Cantonal Ethics Commission of Zurich concluded that the current study does not fall within the scope of the Human Research Act (BASEC-Nr. Req-2020-00323).

Informed consent: Informed consent was obtained from all individual participants included in the study.

Results

From 8,174 contacted individuals, 2,026 individuals participated in the first survey wave (response rate: 24.8%). Table 1 shows the characteristics of the survey participants from the first survey wave. In total, 984 (48.6%) women and 1,042 (51.4%) men answered. The mean age of the survey participants was 46 years (standard deviation: 16 years; range: 18 years to 79 years). 304 (15.0%) individuals were aged 65 years or older. 147 (7.3%) of the survey participants had compulsory education, 966 (47.9%) a secondary education and 903 (44.8%) had a tertiary education. A majority of the survey participants are Swiss (90.7%), live with a partner (70.1%) and are employed (70.9%). 1,292 (63.8%) survey participants live in the German-speaking part, 437 (21.6%) in the French-speaking part and 297 (14.7%) in the Italian-speaking part of Switzerland. Fig 1 shows the survey participants’ distribution according to the seven main Swiss regions.

Table 1

Survey population characteristics of first survey wave (N = 2,026).

Characteristic		n (%) / mean (SD)
Age (years)		46 (16), range: 18–79
Age 65 years or older		304 (15.0%)
Gender	Women	984 (48.6%)
	Men	1,042 (51.4%)
Highest achieved education	Compulsory	147 (7.3%)
	Secondary	966 (47.9%)
	Tertiary	903 (44.8%)
	No answer	10 (0.4%)
Nationality	Swiss	1,834 (90.7%)
	Non-Swiss	192 (9.5%)
Living with partner		1,421 (70.1%)
Working situation	Employed	1,436 (70.9%)
	Unemployed	58 (2.9%)
	Retired	299 (14.8%)
	Other	233 (11.5%)
Language region	German/Romansh	1,292 (63.8%)
	French	437 (21.6%)
	Italian	297 (14.7%)

Fig 1

Number of survey participants from first survey wave (period March 30, 2020 to April 06, 2020) by main living regions.

Table 2 shows the unweighted results of selected study outcomes. Most survey participants reported a good to very good life satisfaction (93.3%, 95%CI [92.1%, 94.3%]). Four out of ten of the survey participants reported a worsened quality of life compared to before the COVID-19 emergency (41.4%, 95%CI [39.3%, 43.6%]) and approximately one tenth reported feelings of loneliness (9.8%, 95%CI [8.6%, 11.1%]). 3.6%, 95%CI (2.8%, 4.5%) of the survey participants never left the home during the previous seven days. Approximately every seventh (15.6%, 95%CI [14.1%, 17.3%]) survey participant used a health service during the previous 14 days. 1.3%, 95%CI (0.9%, 2.1%) of the survey participants reported that they became unemployed because of the COVID-19 emergency. Figs 2 and 3 show results from the survey domains of physical health (disease symptoms) and mental health. S3 Table shows post-stratification weighted study outcome results. We found only slight differences compared to the unweighted results, for example, the percentage of participants who used a health service during the previous 14 days changed to 16.8%, 95%CI (14.9%, 18.8%).

Table 2

Study outcome results of N = 2,026 survey participants.

Study outcome	n	Percentage	Lower 95% CI	Upper 95% CI
General health and well-being
General life satisfaction: Good to very good	2,025	93.3%	92.1%	94.3%
Current quality of life: Good to very good	2,026	85.8%	84.2%	87.3%
Quality of life compared to before COVID-19 emergency: Worsened	2,025	41.4%	39.3%	43.6%
General health status: Good to very good	2,025	88.1%	86.6%	89.4%
Social well-being
Feelings of loneliness: Often or very often	2,026	9.8%	8.6%	11.1%
Physical activity
No moderate physical activity during the last 7 days	2,025	18.5%	16.9%	20.3%
Never left home during the last 7 days	2,025	3.6%	2.8%	4.5%
Health service use
Medical treatment received (last 14 days)	2,025	15.6%	14.1%	17.3%
Non-use of medical treatment (last 14 days)	2,026	21.2%	19.5%	23.0%
Working situation
Unemployed due to Corona-Crisis	1,494*	1.3%	0.9%	2.1%
Already unemployed before Corona-Crisis	1,494*	2.5%	1.9%	3.5%
Fears of losing employment**	1,435*	10.5%	9.0%	12.1%
Home office during the last 7 days**	1,435*	54.3%	51.7%	56.8%
Home office before Corona-Crisis**	1,435*	25.9%	23.7%	28.2%

Abbreviations: CI Confidence interval.

* Denominator: Employed population (N = 1,494).

Fig 2

Disease symptoms during the last 7 days.

Fig 3

Mental health problems during the last 7 days.

Discussion

The COVID-19 Social Monitor is a population-based online panel survey which aims to inform the public, authorities, and the scientific community and to produce evidence for research purposes about relevant aspects of population health and social behavior (and related positive and negative changes) during the COVID-19 pandemic and beyond. Our article describes the study methodology used and reports on participant characteristics and study outcomes of the first survey wave with 2,026 participants. These participants will be consecutively surveyed on a regular basis on various social, economic and health-related domains. By establishing an online information platform where we publish analyses of the data within days after collection, we can inform the public and health authorities about our study findings in a timely manner.

Two weeks after the nationwide lockdown most of the COVID-19 Social Monitor longitudinal online panel survey participants reported a good to very good general life satisfaction (93.3%) and a good to very good health status (88.1%). This number is comparable to estimates from the 2017 Swiss Health Survey–a representative survey of the Swiss population–with 84.7% of the population reporting good to very good health (https://www.bfs.admin.ch/bfs/de/home/statistiken/gesundheit/gesundheitszustand/allgemeiner.html). Despite the high percentage of good to very good life satisfaction and health status, 41.4% of the participants of the first wave reported a decreased quality of life compared to before the COVID-19 emergency and 9.8% reported feelings of loneliness. These numbers are in line with the first findings from a European Union (EU) wide e-survey with more than 85,000 participants (as of April 30, 2020) from the European Foundation for the Improvement of Living and Working Conditions (https://www.eurofound.europa.eu/publications/report/2020/living-working-and-covid-19-first-findings-april-2020). The authors report high levels of loneliness and a decrease in general well-being in survey participants across countries of the EU. Similar results for Switzerland and countries of the EU can be found for working-related indicators, such as higher reported fear of losing employment during the COVID-19 pandemic. Social isolation, loneliness and the loss of employment are known risk factors for mental health problems across different population subgroups such as older persons, chronically-ill persons or children [8-12]. New prevention strategies specifically addressing such subgroups are of great importance from a public health perspective [13-15].

One fifth of our survey participants reported a non-take-up of medical services due to the COVID-19 pandemic two weeks after the nationwide lockdown. This health care non-take-up (for example, GP visits, hospital stays, physiotherapy sessions) could be potentially harmful for particularly vulnerable groups, such as the elderly or chronically-ill, as these patients might have missed necessary treatments. Patients, health care providers and the government should be aware of a need for new treatment options (for example, telehealth [16]) to avoid future harm due to non-take-up of health care services.

In conclusion, the long-term consequences of the impact of the implemented mitigation measures in Switzerland requires future research. However, our study findings from the first survey wave allow us, for example, to identify, investigate and describe vulnerable subgroups during the lockdown period. Importantly, the study allows us to inform the public, the government and stakeholders about the positive and negative short-term impact of the implemented mitigation measures during the COVID-19 pandemic.

Strengths and limitations

Our population-based online panel with regular survey waves provides timely information about relevant social and health behavioral aspects of the Swiss population during the COVID-19 emergency. We are able to follow survey participants over the COVID-19 emergency period to monitor health and behavioral changes over time on an individual (not only aggregated) level and to make conclusions about the impact of public health measures on various domains. By establishing an online information platform, our study findings contribute to evidence-based decisions and policymaking and to a timely dialogue with health authorities and the public. Thus, public needs during the COVID-19 pandemic can be better addressed. To ensure and assess the generalizability and external validity of the findings, this study sample can be linked or at least compared with other nationally representative samples of the general population such as those used in the Swiss Health Survey or the Swiss Household Panel.

Our study has several limitations. First, due to the nature of the data collection (online survey using an access-panel) there is likely some selectivity regarding, for example, online-affinity and education that must be considered and addressed using statistical adjustment methods as far as possible. Second, our survey design uses a simple random sampling approach which might lead to informative sampling, because study outcome variables are jointly associated with (cantonal) public health interventions and individual and cultural characteristics, but also to an under-representation of specific subpopulations (like individuals with chronic diseases). Bias from informative sampling might distort our estimates, but we try to correct for this bias by including relevant individual characteristics in the survey design analysis. Third, our online panel questionnaire is based on self-reported outcomes which are prone to misdiagnosis of health conditions.

Impact for research and society

Academic institutions and other public health institutions in Switzerland have implemented several population-based monitoring systems. A long-established population-based monitoring system is the Swiss Household Panel, which started in 1999 and provides detailed information about social dynamics in Switzerland [17]. Another example is the regular monitoring of population-level health indicators for individuals with non-communicable diseases and addictive behavior, performed by the Swiss Health Observatory (https://www.obsan.admin.ch/de/MonAM). This monitoring is part of the nationwide public health strategy “Health 2020” initiated by the Federal Office of Public Health. Under the current COVID-19 emergency, our study can be integrated into (and extends) already implemented population-based monitoring systems by providing important evidence with a much higher frequency for a better understanding of short- and midterm changes in social and health behavior during the COVID-19 emergency. We believe that this will provide societally relevant knowledge for the public and health authorities. Additionally, it serves as an important basis for future research studies, public health decision making, as well as for future public health emergencies.

Conclusion

The COVID-19 Social Monitor is a population-based online survey which informs the public and health authorities about relevant aspects and possible changes in social and health behavior during the COVID-19 emergency and beyond. Future research using this online panel will focus on specific social and health-related domains and longitudinal analyses.

Scheme for follow-up survey waves (planned, depending on pandemic/public health measures dynamic and financing).

(DOCX)

Click here for additional data file.

Table of items used for the first survey wave questionnaire*.

(DOCX)

Click here for additional data file.

Post-stratification weighted study outcome results of N = 2,026 survey participants.

(DOCX)

Click here for additional data file.

(PDF)

Click here for additional data file.

(CSV)

Click here for additional data file.

4 Sep 2020

PONE-D-20-15990

The COVID-19 social monitor longitudinal online panel: Real-time monitoring of social and public health consequences of the COVID-19 emergency in Switzerland

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Reviewer #1: Yes

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #2: Yes

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Reviewer #1: The authors present an important study highlighting real time social and public health monitoring of the consequences of the COVID-19 emergency in Switzerland. The significance of such a study at this time where the world faces a global pandemic in commendable. The authors employ a longitudinal approach to sample from an existing sampling frame, provided descriptive analysis of sample and study variables accompanied by multi-variable analysis. The results and discussion are properly well presented. I have no specific concerns nor issues regarding the current state of the manuscript and will recommend publishing as is.

Reviewer #2: This paper describes a new survey that aims to investigate the impact of COVID 19 on the daily lives of Swiss residents. This is a timely topic, and the routinely collected data can produce a continuous update on a variety of social and health indicators, which are not just important for evaluating the impact of the pandemic but also for ongoing surveillance of the health and well-being of the nation. The dataset has so much potential for future research. This paper also describes various social and health indicators for the first wave of data collection.

However, the aim of the paper is rather unclear and unfocused and makes for confusing reading – is it to describe the potential of the survey or is it to report the results of the first wave of data collection? The results section in the abstract for instance indicates the latter, but the discussion suggests the former.

Additionally, the aim outlined in 79-82 is somewhat unclear – this sounds like the aim of the survey itself, rather than this specific paper. There are then a number of specific research hypotheses, some of which relate to the aim of the survey overall eg. Weekly, monthly, long-term monitoring of behaviour. While what is presented in the results section looks at the first wave only, rather than changes over time). Additionally, a number of different indicators are described under the objectives, with specific hypotheses, but there is nothing in the introduction that informs the reader why the hypotheses are logical.

Generally I think the aims of this paper are supposed to be two-fold – to describe the potential of this survey overtime, and to present the findings from the first wave. Until the aims and objectives are rectified I find it hard to give informed comments on the rest of the content of this paper. I have made more specific comments below, but they may or may not be relevant, depending on the aims of the paper.

More specific comments include:

Abstract:

Authors should indicate something about data from wave one being presented.

As mentioned above, discussion in the abstract doesn’t discuss findings that are mentioned under results in the abstract – making the aim of this paper confusing

Introduction:

In the introduction, the authors highlight that it is unclear how the COVID 19 pandemic impact people’s behaviour, health status and well-being (72-74). It might be good to have a little more background information about why we might expect changes in health/well-being and also why this information is useful for the public / health authorities (75-77).

Line 51: has spread – should be ‘spread’ not has spread

53: in the revision round, aothors can update number of confirmed cases

Line 69: residents – strange term to use when its not referring to residents of a certain place? Perhaps ‘people all over the world’ or if focusing on swiss residents …’The COVID-19 pandemic challenges the Swiss society in unknown ways, and residents…’

Line 71 – adopted should be adapted? Or ‘ a majority of citizens adopted recommended public health measures’ ?

Objectives – I think the authors should separate the aims/objectives /hypotheses of the ongoing survey compared to specific aims that relate to the results presented in this paper.

The authors also state that they will explore differences in health state between sexes, different age groups and language regions – is this a future aim? Because the analyses don’t seem to do this here. Perhaps in the online version, but this is not available in a language for an international readership.

Results:

Line 232 – every fourth out of ten – should be ‘four out of ten’

Study population lines 212-222 – most of this text is repetition of what is in table 1

Discussion:

The discussion only talks about the potential for the survey itself and not the results that are presented. What do the findings indicate? Which ones are important? What health / well-being factors should the authorities be aware of? Since many of the questions are based on previous Swiss surveys, it might be possible to discuss how general health /wellbeing etc compare to what is usually reported in surveys.

The paper should also be reviewed by an native English speaker as there are many errors throughout, a few of which I’ve mentioned above.

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Reviewer #1: No

Reviewer #2: Yes: Melanie L. Straiton

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16 Oct 2020

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: No

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

5. Review Comments to the Author

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Reviewer #1: The authors present an important study highlighting real time social and public health monitoring of the consequences of the COVID-19 emergency in Switzerland. The significance of such a study at this time where the world faces a global pandemic in commendable. The authors employ a longitudinal approach to sample from an existing sampling frame, provided descriptive analysis of sample and study variables accompanied by multi-variable analysis. The results and discussion are properly well presented. I have no specific concerns nor issues regarding the current state of the manuscript and will recommend publishing as is.

Thank you. We highly appreciate the reviewer’s effort in careful reading of our manuscript and the feedback. We believe that our study is of high importance for the readership of PLOS One.

Reviewer #2: This paper describes a new survey that aims to investigate the impact of COVID 19 on the daily lives of Swiss residents. This is a timely topic, and the routinely collected data can produce a continuous update on a variety of social and health indicators, which are not just important for evaluating the impact of the pandemic but also for ongoing surveillance of the health and well-being of the nation. The dataset has so much potential for future research. This paper also describes various social and health indicators for the first wave of data collection.

However, the aim of the paper is rather unclear and unfocused and makes for confusing reading – is it to describe the potential of the survey or is it to report the results of the first wave of data collection? The results section in the abstract for instance indicates the latter, but the discussion suggests the former.

Additionally, the aim outlined in 79-82 is somewhat unclear – this sounds like the aim of the survey itself, rather than this specific paper. There are then a number of specific research hypotheses, some of which relate to the aim of the survey overall eg. Weekly, monthly, long-term monitoring of behaviour. While what is presented in the results section looks at the first wave only, rather than changes over time). Additionally, a number of different indicators are described under the objectives, with specific hypotheses, but there is nothing in the introduction that informs the reader why the hypotheses are logical.

Generally I think the aims of this paper are supposed to be two-fold – to describe the potential of this survey overtime, and to present the findings from the first wave. Until the aims and objectives are rectified I find it hard to give informed comments on the rest of the content of this paper. I have made more specific comments below, but they may or may not be relevant, depending on the aims of the paper.

We thank the reviewer for her time efforts in reviewing our manuscript and for the very detailed and helpful feedback. The reviewer is right that our aim is two-fold. First, we want to describe the study methodology (i.e. study population, study design, analysis). Second, we want to report characteristics and study outcomes of the participants of the first study wave to give the reader a comprehensive overview of our study population. Both together should build a fundament for future research using the COVID-19 Social Monitor Online Panel to investigate COVID-19 related topics.

We agree with the reviewer that the current manuscript likely leads to a misunderstanding of our formulated study aims together with a description of methodology and results from the first study wave. Thus, we changed the manuscript and integrated key sentences which sharpens the message of our manuscript and ensures a better understanding of our manuscript.

More specific comments include:

Abstract:

Authors should indicate something about data from wave one being presented.

As mentioned above, discussion in the abstract doesn’t discuss findings that are mentioned under results in the abstract – making the aim of this paper confusing

Thank you. We added a sentence to the Abstract which explicitly states the aims of the current article (i.e. description of study methodology and reporting of characteristics and study outcomes of the first wave). We believe that - together with the formulated overall study aims – the reader has now a better understanding of the manuscript and study aims.

Introduction:

In the introduction, the authors highlight that it is unclear how the COVID 19 pandemic impact people’s behaviour, health status and well-being (72-74). It might be good to have a little more background information about why we might expect changes in health/well-being and also why this information is useful for the public / health authorities (75-77).

Line 51: has spread – should be ‘spread’ not has spread

Thank you. We changed the wording accordingly.

53: in the revision round, aothors can update number of confirmed cases

Thank you. We updated the number of confirmed as of September 24, 2020.

Line 69: residents – strange term to use when its not referring to residents of a certain place? Perhaps ‘people all over the world’ or if focusing on swiss residents …’The COVID-19 pandemic challenges the Swiss society in unknown ways, and residents…’

Thank you. We changed the wording accordingly.

Line 71 – adopted should be adapted? Or ‘ a majority of citizens adopted recommended public health measures’ ?

Thank you. We changed the wording accordingly.

Objectives – I think the authors should separate the aims/objectives /hypotheses of the ongoing survey compared to specific aims that relate to the results presented in this paper. The authors also state that they will explore differences in health state between sexes, different age groups and language regions – is this a future aim? Because the analyses don’t seem to do this here. Perhaps in the online version, but this is not available in a language for an international readership.

Thank you. We changed the subsection title to “Overall study objectives and hypotheses” to emphasis the focus on general study aims. Additionally, we added a sentence “The formulated objectives and hypotheses are part of future research using the COVID-19 social monitor longitudinal online panel and will be investigated in separate research articles. The aim of the present manuscript is to describe the study population and the study design of the COVID-19 social monitor longitudinal online panel. Further we want to report characteristics and study outcomes of participants of the first survey wave to provide a comprehensive baseline overview of our study population.” to make a better distinction between overall study objectives and the aim of the current manuscript.

Results:

Line 232 – every fourth out of ten – should be ‘four out of ten’

Thank you. We changed the wording accordingly.

Study population lines 212-222 – most of this text is repetition of what is in table 1

Thank you. Yes, this is a summary of table 1, but a brief description of the study population in own words is required in the results section.

Discussion:

The discussion only talks about the potential for the survey itself and not the results that are presented. What do the findings indicate? Which ones are important? What health / well-being factors should the authorities be aware of? Since many of the questions are based on previous Swiss surveys, it might be possible to discuss how general health /wellbeing etc compare to what is usually reported in surveys.

Thank you. We added a paragraph to the discussion which highlights our findings and compare them to national and international results. We further added important consequences for new prevention strategies or opportunities (i.e. telehealth).

The paper should also be reviewed by an native English speaker as there are many errors throughout, a few of which I’ve mentioned above.

Thank you. The manuscript was edited by a native speaking English Editor (Paul Kelly) mentioned in the Acknowledgments. We sent the revised manuscript back to him for editing.

6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #2: Yes: Melanie L. Straiton

Submitted filename: Responses to reviewers PLOS One.pdf

Click here for additional data file.

28 Oct 2020

The COVID-19 Social Monitor longitudinal online panel: Real-time monitoring of social and public health consequences of the COVID-19 emergency in Switzerland

PONE-D-20-15990R1

Dear Dr. Moser,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Tam Truong Donnelly, Ph.D

Academic Editor

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Additional Editor Comments (optional):

Thank you for this very important timely article. Best wishes!

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

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Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

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The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The two fold aim is much clearer now and the discussion is relevant to the results section. I am satisfied with the changes.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

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Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: Yes: Melanie Straiton

3 Nov 2020

PONE-D-20-15990R1

The COVID-19 Social Monitor longitudinal online panel:Real-time monitoring of social and public health consequences of the COVID-19 emergency in Switzerland

Dear Dr. Moser:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

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