Questionaire to collect data on covid +ves - especially clusters
1. Do you smoke? Yes/no
2. Do you drink ? Yes/no
3. What is the work that you do? Travelling and Meeting customers/ at office/service delivery/farming
In the past 3 days:
1. What type of food did you eat mainly? Veg/non-veg
2. Did you meet customers? Yes/no
3. Did you travel to any place outside the place where you live? If so, where?
4. How big is the place where you live? 1/2/3/4/5/more rooms/hostel
5.how many people stay with you?
6. Did you eat or drink any frozen items? Yes/no
7. Did anyone who stays with you have cold,cough or fever? Yes/no
8. Did you eat any outside food? Yes/no
9. Do you use filtered water for drinking? Yes/no
10. Do you share a common toilet and bathroom with your neighbours? Yes/no
11. Did you go out of your home ? Yes/no
12. Did you wear a mask when you went out? Yes/no
13. Are your living surroundings clean? Yes/no
14. Did you come in contact with any animal or insect? Yes/no
.....
More such questions can be added.
The questionnaire can be filled up by the person within 2 days of testing positive.
A clear written statement of why this is being collected should allay any fears of their misuse. more
Yes, masking, distancing, no crowding norms have to be necessary followed. more