Changes in suicide and resilience-related Google searches during the early stages of the COVID-19 pandemic

Introduction
Pandemics such as the 2019 coronavirus (COVID-19) outbreak have the potential to negatively impact mental health,1 which may, in turn, influence suicide rates.2 Due to the substantial lag before mortality data become available, it will be some time before that can be investigated. More readily available proxy indicators, such as Google search trends,3 may be of value both for early characterization of the impact of COVID-19 on suicide and in formulating an early public health response. However, this has never been tested in the context of a pandemic. We aimed to characterize changes in suicide-related searches worldwide and in the United States (the country with the most reported COVID-19 cases to date) to identify potential early indications of impact on suicide which can later be compared to mortality data.