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Significance The US COVID-19 Trends and Impact Survey (CTIS) has operated continuously since April 6, 2020, collecting over 20 million responses. As the largest public health survey conducted in the United States to date, CTIS was designed to facilitate detailed demographic and geographic analyses, track trends over time, and accommodate rapid revision to address emerging priorities. Using examples of CTIS results illuminating trends in symptoms, risks, mitigating behaviors, testing, and vaccination in relation to evolving high-priority policy questions over 12 mo of the pandemic, we illustrate the value of online surveys for tracking patterns and trends in COVID outcomes as an adjunct to official reporting, and showcase unique insights that would not be visible through traditional public health reporting., The US COVID-19 Trends and Impact Survey (CTIS) is a large, cross-sectional, internet-based survey that has operated continuously since April 6, 2020. By inviting a random sample of Facebook active users each day, CTIS collects information about COVID-19 symptoms, risks, mitigating behaviors, mental health, testing, vaccination, and other key priorities. The large scale of the survey—over 20 million responses in its first year of operation—allows tracking of trends over short timescales and allows comparisons at fine demographic and geographic detail. The survey has been repeatedly revised to respond to emerging public health priorities. In this paper, we describe the survey methods and content and give examples of CTIS results that illuminate key patterns and trends and help answer high-priority policy questions relevant to the COVID-19 epidemic and response. These results demonstrate how large online surveys can provide continuous, real-time indicators of important outcomes that are not subject to public health reporting delays and backlogs. The CTIS offers high value as a supplement to official reporting data by supplying essential information about behaviors, attitudes toward policy and preventive measures, economic impacts, and other topics not reported in public health surveillance systems.

Significance The University of Maryland Global COVID Trends and Impact Survey (UMD-CTIS), launched April 2020, is the largest remote global health monitoring system. This study includes ∼30 million responses through December 2020 from all 114 countries/territories with survey weights to adjust for nonresponse and demographics. Using self-reported cross-sectional survey data sampled daily from Facebook users, we confirm consistent demographics and COVID-19 symptoms. Our global model predicts local COVID-19 case trends. Importantly, one survey item strongly correlates with reported cases, demonstrating potential utility in locales with scant UMD-CTIS sampling or government data. Despite limitations resulting from sampling, nonresponse, coverage, and measurement error, UMD-CTIS has the potential to support existing monitoring systems for COVID-19 as well as other new as-yet-undefined global health threats., Simultaneously tracking the global impact of COVID-19 is challenging because of regional variation in resources and reporting. Leveraging self-reported survey outcomes via an existing international social media network has the potential to provide standardized data streams to support monitoring and decision-making worldwide, in real time, and with limited local resources. The University of Maryland Global COVID-19 Trends and Impact Survey (UMD-CTIS), in partnership with Facebook, has invited daily cross-sectional samples from the social media platform's active users to participate in the survey since its launch on April 23, 2020. We analyzed UMD-CTIS survey data through December 20, 2020, from 31,142,582 responses representing 114 countries/territories weighted for nonresponse and adjusted to basic demographics. We show consistent respondent demographics over time for many countries/territories. Machine Learning models trained on national and pooled global data verified known symptom indicators. COVID-like illness (CLI) signals were correlated with government benchmark data. Importantly, the best benchmarked UMD-CTIS signal uses a single survey item whereby respondents report on CLI in their local community. In regions with strained health infrastructure but active social media users, we show it is possible to define COVID-19 impact trajectories using a remote platform independent of local government resources. This syndromic surveillance public health tool is the largest global health survey to date and, with brief participant engagement, can provide meaningful, timely insights into the global COVID-19 pandemic at a local scale.

Objectives: To examine the association of non-pharmaceutical interventions (NPIs) with anxiety and depressive symptoms among adults and determine if these associations varied by gender and age.Methods: We combined survey data from 16,177,184 adults from 43 countries who participated in the daily COVID-19 Trends and Impact Survey via Facebook with time-varying NPI data from the Oxford COVID-19 Government Response Tracker between 24 April 2020 and 20 December 2020. Using logistic regression models, we examined the association of [1] overall NPI stringency and [2] seven individual NPIs (school closures, workplace closures, cancellation of public events, restrictions on the size of gatherings, stay-at-home requirements, restrictions on internal movement, and international travel controls) with anxiety and depressive symptoms.Results: More stringent implementation of NPIs was associated with a higher odds of anxiety and depressive symptoms, albeit with very small effect sizes. Individual NPIs had heterogeneous associations with anxiety and depressive symptoms by gender and age.Conclusion: Governments worldwide should be prepared to address the possible mental health consequences of stringent NPI implementation with both universal and targeted interventions for vulnerable groups.

The U.S. COVID-19 Trends and Impact Survey (CTIS) is a large, cross-sectional, Internet-based survey that has operated continuously since April 6, 2020. By inviting a random sample of Facebook active users each day, CTIS collects information about COVID-19 symptoms, risks, mitigating behaviors, mental health, testing, vaccination, and other key priorities. The large scale of the survey – over 20 million responses in its first year of operation – allows tracking of trends over short timescales and allows comparisons at fine demographic and geographic detail. The survey has been repeatedly revised to respond to emerging public health priorities. In this paper, we describe the survey methods and content and give examples of CTIS results that illuminate key patterns and trends and help answer high-priority policy questions relevant to the COVID-19 epidemic and response. These results demonstrate how large online surveys can provide continuous, real-time indicators of important outcomes that are not subject to public health reporting delays and backlogs. The CTIS offers high value as a supplement to official reporting data by supplying essential information about behaviors, attitudes toward policy and preventive measures, economic impacts, and other topics not reported in public health surveillance systems.Significance statementThe U.S. COVID-19 Trends and Impact Survey (CTIS) has operated continuously since April 6, 2020, collecting over 20 million responses. The largest public health survey ever conducted in the United States, CTIS was designed to facilitate detailed demographic and geographic analyses, track trends over time, and accommodate rapid response to emerging priorities. Using examples of CTIS results illuminating trends in symptoms, risks, mitigating behaviors, testing and vaccination in relation to evolving high-priority policy questions over 12 months of the pandemic, we illustrate the value of online surveys for tracking patterns and trends in COVID outcomes as an adjunct to official reporting, and showcase unique insights that would not be visible through traditional public health reporting.

Simultaneously tracking the global COVID-19 impact across multiple populations is challenging due to regional variation in resources and reporting. Leveraging self-reported survey outcomes via an existing international social media network has the potential to provide reliable and standardized data streams to support monitoring and decision-making world-wide, in real time, and with limited local resources. The University of Maryland Global COVID Trends and Impact Survey (UMD-CTIS), in partnership with Facebook, invites daily cross-sectional samples from the social media platform’s active users to participate in the survey since launch April 23, 2020. COVID-19 indicators through December 20, 2020, from N=31,142,582 responses representing N=114 countries, weighted for nonresponse and adjusted to basic demographics, were benchmarked with government data. COVID-19-related signals showed similar concordance with reported benchmark case and test positivity. Bonferroni significance and minimal Spearman correlation strength thresholds were met in the majority. Light Gradient Boost machine learning trained on national and pooled global data verified known symptom indicators, and predicted COVID-19 trends similar to other signals. Risk mitigation behavior trends are correlated with, but sometimes lag, risk perception trends. In regions with strained health infrastructure, but active social media users, we show it is possible to define suitable COVID-19 impact trajectories. This syndromic surveillance public health tool is the largest global health survey to date, and, with brief participant engagement, can provide meaningful, timely insights into the COVID-19 pandemic and response in regions under-represented in epidemiological analyses.Significance StatementThe University of Maryland Global COVID Trends and Impact Survey (UMD-CTIS), launched April 23, 2020, is the largest remote global health monitoring system. This study includes about 30 million UMD-CTIS responses over 34 weeks (through December 2020) from N=114 countries with survey-weights to adjust for nonresponse and demographics. Using limited self-reported data, sampled daily from an international cohort of Facebook users, we demonstrate validity and utility for COVID-19 impacts trends, even in regions with scant or delayed government data. We predict COVID-19 cases in the absence of testing, and characterize perceived COVID-19 risk versus risk-lowering measures. The UMD-CTIS has the potential to support existing monitoring systems for the COVID-19 pandemic, as well as other new, as-yet-undefined global health threats.

Critical infrastructure systems must be both robust and resilient in order to ensure the functioning of society. To improve the performance of such systems, we often use risk and vulnerability analysis to find and address system weaknesses. A critical component of such analyses is the ability to accurately determine the negative consequences of various types of failures in the system. Numerous mathematical and simulation models exist which can be used to this end. However, there are relatively few studies comparing the implications of using different modeling approaches in the context of comprehensive risk analysis of critical infrastructures. Thus in this paper, we suggest a classification of these models, which span from simple topologically-oriented models to advanced physical flow-based models. Here, we focus on electric power systems and present a study aimed at understanding the tradeoffs between simplicity and fidelity in models used in the context of risk analysis. Specifically, the purpose of this paper is to compare performances measures achieved with a spectrum of approaches typically used for risk and vulnerability analysis of electric power systems and evaluate if more simplified topological measures can be combined using statistical methods to be used as a surrogate for physical flow models. The results of our work provide guidance as to appropriate models or combination of models to use when analyzing large-scale critical infrastructure systems, where simulation times quickly become insurmountable when using more advanced models, severely limiting the extent of analyses that can be performed.

Count data are pervasive in many areas of risk analysis; deaths, adverse health outcomes, infrastructure system failures, and traffic accidents are all recorded as count events, for example. Risk analysts often wish to estimate the probability distribution for the number of discrete events as part of doing a risk assessment. Traditional count data regression models of the type often used in risk assessment for this problem suffer from limitations due to the assumed variance structure. A more flexible model based on the Conway-Maxwell Poisson (COM-Poisson) distribution was recently proposed, a model that has the potential to overcome the limitations of the traditional model. However, the statistical performance of this new model has not yet been fully characterized. This article assesses the performance of a maximum likelihood estimation method for fitting the COM-Poisson generalized linear model (GLM). The objectives of this article are to (1) characterize the parameter estimation accuracy of the MLE implementation of the COM-Poisson GLM, and (2) estimate the prediction accuracy of the COM-Poisson GLM using simulated data sets. The results of the study indicate that the COM-Poisson GLM is flexible enough to model under-, equi-, and overdispersed data sets with different sample mean values. The results also show that the COM-Poisson GLM yields accurate parameter estimates. The COM-Poisson GLM provides a promising and flexible approach for performing count data regression.

Critical infrastructure systems must be both robust and resilient in order to ensure the functioning of society. To improve the performance of such systems, we often use risk and vulnerability analysis to find and address system weaknesses. A critical component of such analyses is the ability to accurately determine the negative consequences of various types of failures in the system. Numerous mathematical and simulation models exist that can be used to this end. However, there are relatively few studies comparing the implications of using different modeling approaches in the context of comprehensive risk analysis of critical infrastructures. In this article, we suggest a classification of these models, which span from simple topologically-oriented models to advanced physical-flow-based models. Here, we focus on electric power systems and present a study aimed at understanding the tradeoffs between simplicity and fidelity in models used in the context of risk analysis. Specifically, the purpose of this article is to compare performance estimates achieved with a spectrum of approaches typically used for risk and vulnerability analysis of electric power systems and evaluate if more simplified topological measures can be combined using statistical methods to be used as a surrogate for physical flow models. The results of our work provide guidance as to appropriate models or combinations of models to use when analyzing large-scale critical infrastructure systems, where simulation times quickly become insurmountable when using more advanced models, severely limiting the extent of analyses that can be performed.

The Carbon Cycle module provides a tool for interdisciplinary, team-based assessment of the causes and solutions to changes in carbon dioxide in the atmosphere, for use in high-school or introductory undergraduate courses in earth systems science or environmental science. A reduced-scale model (i.e. a model whose complexity is well below that of full scientific models, and yet reproduces the behavior of those more complex models) has been developed that allows students to systematically explore the relationship between a variety of biogeochemical processes, and their interactions with social processes, as these relate to the accumulation of carbon in the atmosphere. The module walks the students through the construction of the model, through exercises in which simulations are performed of changes in either environmental processes or society's use of energy, and through use of the model to identify effective policies for reduction of atmospheric carbon dioxide. Through use of such a module, students can un...

Count data are pervasive in many areas of risk analysis; deaths, adverse health outcomes, infrastructure system failures, and traffic accidents are all recorded as count events, for example. Risk analysts often wish to estimate the probability distribution for the number of discrete events as part of doing a risk assessment. Traditional count data regression models of the type often used in risk assessment for this problem suffer from limitations due to the assumed variance structure. A more flexible model based on the Conway-Maxwell Poisson (COM-Poisson) distribution was recently proposed, a model that has the potential to overcome the limitations of the traditional model. However, the statistical performance of this new model has not yet been fully characterized. This article assesses the performance of a maximum likelihood estimation method for fitting the COM-Poisson generalized linear model (GLM). The objectives of this article are to (1) characterize the parameter estimation accuracy of the MLE implementation of the COM-Poisson GLM, and (2) estimate the prediction accuracy of the COM-Poisson GLM using simulated data sets. The results of the study indicate that the COM-Poisson GLM is flexible enough to model under-, equi-, and overdispersed data sets with different sample mean values. The results also show that the COM-Poisson GLM yields accurate parameter estimates. The COM-Poisson GLM provides a promising and flexible approach for performing count data regression.