WU Candid Conversation COVID-19 Survey

This information will be used to guide the Candid Conversations: COVID-19- An honest conversation about COVID-19, the virus, and the vaccine in our community on February 11th at 6 pm.

As you will see, there is no way to identify you. The information you share is totally anonymous but would be helpful for us to address the responses you provide during the conversation.
1. What is your race?

Black White, non-Hispanic Asian, non-Hispanic Other/Mixed race, non-Hispanic Hispanic
2. Do you feel that worry or stress related to coronavirus has had a negative impact on your mental health, or not?

Yes -Major Impact Yes- Minor Impact No I don’t have worry or stress related to Coronavirus Don’t Know
3. Starting today, how much longer do you think you can follow social distancing in order to limit the spread of coronavirus in your community?

Not do it at all Less than a month/1-3 months Less than a month Between 1 and 3 months 4-6 months/More than 6 months Between 4 and 6 months More than 6 months or until there is a vaccine widely available Can follow longer, but won’t because need freedom Don’t know
4. Which of the following best describes your feelings about the coronavirus outbreak in the United States?

The worst is behind us The worst is yet to come The coronavirus is or will not be a major problem in the U.S. Don’t know
5. Thinking about what is said in the news, in your view is the seriousness of coronavirus

Generally exaggerated Generally correct Generally underestimated Don’t know
6. How worried, if at all, are you that you or someone in your family will get sick from the coronavirus?

Very Worried Somewhat worried Not too worried Not worried at all Not applicable Don’t know

7. In its efforts to slow the spread of coronavirus, do you think your state currently has the right amount of restrictions on the following?

Too many

Not Enough

About the right time

Don’t Know

Businesses

Individuals

8. How often, if at all, do you wear a protective mask when you leave your house and might be in contact with other people?

Some of the time At least most of the time Every time Most of the time Some of the time/Never Some of the time Never
9. Which comes closer to your view: wearing a mask to prevent the spread of COVID-19?

Wearing a mask is a personal choice Wearing a mask is part of everyone’s responsibility to protect the health of others Both Neither Don’t know

10. As far as you know

Yes

I Don't Know

A. Does wearing a face mask help to limit the spread of coronavirus?

B. Is wearing a face mask harmful to your health

C. Does wearing a face mask help protect you from coronavirus

21. Are you currently..
21. Are you registered to vote at your present address?
23. What’s best describes your current employment status?
24. Have you been deemed an essential worker, meaning you are still required to work outside your home during the coronavirus outbreak?
25. Do you or anyone in your household work in a health care delivery setting, such as a doctor’s office, clinic, hospital, nursing home, or dentist’s office?
25a. Answer this if you answered yes above. Does you/your family member’s/you or your family member’s work involve direct contact with patients or their bodily fluids?
26. Are you, yourself, now covered by any form of health insurance or health plan or do you not have health insurance at this time?
27. Do you normally get a flu vaccine each year?
28. Do you personally know anyone who has tested positive for Coronavirus?
29. Do you personally know anyone who has been hospitalized due to Coronavirus?
30. Do you personally know anyone who has died from complications related to Coronavirus?