Harvard PGP: COVID-19 Demographics Survey
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Responses submitted 3/23/2020 19:41:17.
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Timestamp |
3/23/2020 19:41:17 |
What is the zip code of your primary residence? |
53227 |
Do have another residence where you spend more than 30 days a year? |
No |
What is your gender? |
Female |
Select all the following that apply to your current living arrangements. |
Live with partner/spouse |
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 been diagnosed with any of the following? [Asthma (Adult)] |
No |
Have you ever been diagnosed with any of the following? [Asthma (Childhood)] |
No |
Have you ever been diagnosed with any of the following? [Chronic obstructive pulmonary disease (COPD)] |
No |
Have you ever been diagnosed with any of the following? [Emphysema] |
No |
Have you ever been diagnosed with any of the following? [Chronic bronchitis] |
No |
Have you ever been diagnosed with any of the following? [Pneumonia] |
No |
Have you ever been diagnosed with any of the following? [Type 1 Diabetes] |
No |
Have you ever been diagnosed with any of the following? [Type 2 Diabetes] |
No |
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? |
Employed: Working 1-39 hrs per week |
Select the category that best describes your occupation. |
Healthcare Support |
What is the zip code of your primary workplace/worksite? |
53208 |
Do you have a secondary workplace/worksite where you work more than 30 days a year? |
No |
If a vaccine against coronovirus (COVID-19) would reach the stage where it must be tested for safety and efficacy in humans, would you - assuming that you are eligible - be interested in taking part in that trial? |
No |
Harvard PGP: COVID-19 Health Assessment for Week of 29 March- 4 April 2020
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Responses submitted 3/30/2020 11:23:30.
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Timestamp |
3/30/2020 11:23:30 |
Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
No |
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? [Running nose] |
Yes |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Sore throat] |
Yes |
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? [Shortness of breath] |
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 |
Harvard PGP: COVID-19 Health Assessment for Week of 5 April - 11 April 2020
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Responses submitted 4/6/2020 14:53:29.
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Timestamp |
4/6/2020 14:53:29 |
Since Jan 1, 2020, have you been 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 |
Since Jan 1, 2020, to the best of your recollection,have you experienced ANY of the above list of symptoms? |
Yes |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Headache] |
Yes |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Running nose] |
Yes |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Sore throat] |
Yes |
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 |
Harvard PGP COVID-19 Health Assessment Week 4: 12 April - 18 April 2020
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Responses submitted 4/13/2020 20:51:31.
Show responses
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Timestamp |
4/13/2020 20:51:31 |
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? |
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 |
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 |