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Harvard PGP: COVID-19 Demographics Survey
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Responses submitted 3/23/2020 19:22:29.
Show responses
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| Timestamp |
3/23/2020 19:22:29 |
| What is the zip code of your primary residence? |
53223 |
| Do have another residence where you spend more than 30 days a year? |
No |
| What is your age (in years)? |
69 |
| What is your gender? |
Male |
| Select all the following that apply to your current living arrangements. |
Live alone |
| What is your race? Pick all that apply. |
White |
| What is your ethnicity? |
Not Hispanic or Latino or Spanish Origin |
| Select which one of the following applies to you and your birth status. |
None of the above |
| Have you ever smoked tobacco products? |
Yes |
| Do you currently smoke tobacco products? |
No |
| What is the average number of cigarettes (# of cigarettes not packs) you smoke per day? |
Don't currently smoke |
| Have you ever used e-cigarettes (e.g. JUUL, Vuse, MarkTen)? |
No |
| Which one of the following best describes your employment status for the past 3 months? |
Retired |
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Harvard PGP: COVID-19 Health Assessment for Week of 29 March- 4 April 2020
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Responses submitted 3/30/2020 10:41:47.
Show responses
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| Timestamp |
3/30/2020 10:41:47 |
| Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
Yes |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Feeling cold, chills or shivers] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Headache] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Aches all over the body] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Cough] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Rapid breathing] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Shortness of breath] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Wheezing or chest tightness] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Bluish lips or face] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Dizziness] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Confusion or inability to arouse] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Running nose] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Sore throat] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Nausea] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Vomiting] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Abdominal pain] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Diarrhea] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of smell] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of taste] |
No |
| Are you currently experiencing any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
| Are you currently experiencing any of the following symptoms? [Feeling cold, chills or shivers] |
No |
| Are you currently experiencing any of the following symptoms? [Headache] |
No |
| Are you currently experiencing any of the following symptoms? [Aches all over the body] |
No |
| Are you currently experiencing any of the following symptoms? [Cough] |
No |
| Are you currently experiencing any of the following symptoms? [Rapid breathing] |
No |
| Are you currently experiencing any of the following symptoms? [Wheezing or chest tightness] |
No |
| Are you currently experiencing any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
| Are you currently experiencing any of the following symptoms? [Bluish lips or face] |
No |
| Are you currently experiencing any of the following symptoms? [Dizziness] |
No |
| Are you currently experiencing any of the following symptoms? [Confusion or inability to arouse] |
No |
| Are you currently experiencing any of the following symptoms? [Running nose] |
No |
| Are you currently experiencing any of the following symptoms? [Sore throat] |
No |
| Are you currently experiencing any of the following symptoms? [Nausea] |
No |
| Are you currently experiencing any of the following symptoms? [Vomiting] |
No |
| Are you currently experiencing any of the following symptoms? [Abdominal Pain] |
No |
| Are you currently experiencing any of the following symptoms? [Diarrhea] |
No |
| Are you currently experiencing any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
| Are you currently experiencing any of the following symptoms? [Loss of sense of smell] |
No |
| Are you currently experiencing any of the following symptoms? [Loss of sense of taste] |
No |
| Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
| In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
| In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
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Harvard PGP: COVID-19 Health Assessment for Week of 5 April - 11 April 2020
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Responses submitted 4/6/2020 17:15:11.
Show responses
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| Timestamp |
4/6/2020 17:15:11 |
| Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
Yes |
| Currently are you experiencing ANY of the above list of symptoms? |
No |
| In the past two weeks, have you experienced ANY of the above list of symptoms? |
No |
| Since Jan 1, 2020, to the best of your recollection,have you experienced ANY of the above list of symptoms? |
No |
| Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
| In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
| In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
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Harvard PGP COVID-19 Health Assessment Week 4: 12 April - 18 April 2020
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Responses submitted 4/13/2020 18:27:21.
Show responses
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| Timestamp |
4/13/2020 18:27:21 |
| Are you currently ill with a cold or flu-like illness? |
No |
| Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
Yes |
| Currently are you experiencing ANY of the above list of symptoms? |
No |
| In the past two weeks, have you experienced ANY of the above list of symptoms? |
No |
| Since Jan 1, 2020, to the best of your recollection,have you experienced ANY of the above list of symptoms? |
No |
| Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
| In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
| In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
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Harvard PGP COVID-19 Health Assessment [Ongoing]
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Responses submitted 5/27/2020 18:02:26.
Show responses
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| Timestamp |
5/27/2020 18:02:26 |
| Are you currently ill with a cold or flu-like illness? |
No |
| Currently are you experiencing ANY of the above list of symptoms? |
No |
| In the past two weeks, have you experienced ANY of the above list of symptoms? |
No |
| Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
| In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
| In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
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Harvard PGP COVID-19 Health Assessment [Ongoing]
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Responses submitted 6/12/2020 12:30:41.
Show responses
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| Timestamp |
6/12/2020 12:30:41 |
| Are you currently ill with a cold or flu-like illness? |
No |
| Currently are you experiencing ANY of the above list of symptoms? |
No |
| In the past two weeks, have you experienced ANY of the above list of symptoms? |
No |
| Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
| In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
| In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |