Monitoring COVID-19 related public Interest and population Health Literacy in South Asia: An Internet Search-Interest Based Model

BackgroundInformation epidemiology based on internet search data can be used to model COVID-19 pandemic progressions and monitor population health literacy. However, the applicability of internet searches to monitor COVID-19 infections and public health awareness in South Asian countries are unclear. ObjectivesTo assess the association of public interest and health literacy in COVID-19 with the actual number of infected cases for countries in South Asia. MethodsGoogle Trends data from January to March 2020 were used to correlate public interest and health literacy with official data on COVID-19 cases using the relative search volume (RSV) index. Public interest in COVID-19 was retrieved in RSV indices with the search term "Coronavirus (Virus)". Similarly, an OR combination of search terms "hand wash", "face mask", "hand sanitizer", "face shield" and "gloves" were used to retrieve RSV indices as a surrogate of population health literacy in COVID-19. Daily confirmed COVID-19 cases were obtained from the COVID-19 data repository managed by the Johns Hopkins University. Country-level time-lag correlation analyses were performed for a time lag between 30 and +30 days. ResultsCOVID-19-related worldwide public interest reached a peak on March 16, 2020, right after the WHO announcement of coronavirus outbreak as a pandemic. COVID-19 related public interest reached the highest peak in South Asian countries a few days after each county reported 100th confirmed cases. There were significant positive correlations between COVID-19 related public interest and daily laboratory confirmed cases in countries expect Nepal, Bhutan, and Sri Lanka. The highest public interest in South Asian Countries was on average 12 days before the local maximum of new confirmed cases. Similarly, web searches related to personal hygiene and COVID-19 preventive measures in south Asia correlated to the number of confirmed cases as well as national restriction measures. ConclusionPublic interest indicated by RSV indices can help to monitor the progression of an outbreak such as the current COVID-19 pandemic particularly in countries with a lack of diagnostic and surveillance capacity, and thereby distribute appropriate health information to the general public.