The impact of COVID-19 on Italy web users: a quantitative analysis of regional hygiene interest and emotional response

Background: Between the end of February and the beginning of June 2020, Italy was certainly one of the most affected countries in the world by the COVID-19 pandemic. In this period, the web interest in the novel coronavirus has undergone a drastic surge. Objective: The aim of this study is to analyze quantitatively the impact of COVID-19 on web searches related to hygiene-preventive measures and emotional-psychological aspects, as well as to estimate the effectiveness and limits of online information during an epidemic. We looked for significant correlations between COVID-19 relative search volumes and cases per region to understand the interest of the average Italian web user in the international, national, and regional COVID-19 situation. By doing so, from the analysis of web searches, it will be possible to deduce the mental and physical health of the population. Methods: To conduct this research we used the "Google Trends" tool, which returns normalized values, called "relative search volume" (RSV), ranging from 0 to 100 according to the web popularity of a group of queries. By comparing the RSVs in periods before and after the outbreak of the novel coronavirus in Italy, we derived the impact of COVID-19 on the activity of Italian netizens towards novel coronavirus itself, hygiene, prevention, and psychological well-being. Furthermore, we calculated Pearson's correlations {rho} ; between all these queries and COVID-19 cases for each region. We chose a p-value (p) threshold =. 1. Results: After the two initial spikes that occurred on February 23 and March 9, 2020, the general web interest in COVID-19 in Italy has waned, as has the correlation with the official number of cases per region (p< .1 only until March 14, 2020). Anyway, web interest was similarly distributed across the regions (ASV=92,SD=6). We also found that all trends depend significantly on the number of COVID-19 cases at national but not international nor regional level. Between 20 February and 10 June, 2020, web interest relating to hygiene and prevention increased by 116 and 901% respectively compared to those from 1 January to 19 February, 2020 (95% CIs: [115.3,116.3],[850.3,952,2]). Significant correlations between regional cumulative web searches and COVID-19 cases were found only between February 26 and March 7, 2020 ({rho}-best= .43, 95% CI:[.42.44],p= .07). During the COVID-19 pandemic until 10 June, 2020, national web searches of the generic terms "fear" and "anxiety" grew by 8 and 21% respectively (95% CIs: [8.0,8.2],[20.4,20.6]) compared to those of the period 1 January, 2018 - 29 December, 2019. We found cyclically significant correlations between negative emotions related to the novel coronavirus and COVID-19 official data. Conclusions: The Italian netizens showed a marked interest in the COVID-19 pandemic only when this became a direct national problem. In general, web searches have rarely been correlated with the number of cases per region; we conclude that the danger, once it arrived in the country, was perceived similarly in all regions. We can state that the period of maximum effectiveness of the online information, in relation to this type of situation, is limited to 3-4 days from a specific key event. If such a scenario were to occur again, we suggest that all government agencies focus their web disclosure efforts over that time. Despite this, we have found cyclical correlations with research related to negative feelings such as anxiety, depression, fear, and stress. Therefore, to identify mental and physical health problems among the population, it suffices to observe slight variations in the trend of related web queries. Keywords: COVID-19, Google Trends, web interests, Italy, novel coronavirus.