One hundred years ago, when the 1918 influenza pandemic affected one-third of the world’s population, medical therapies and countermeasures were significantly limited, and information exchange that could facilitate any public health intervention primarily occurred by telephone, mail, or person-to-person interaction. 50 million people died.
Now, more than a century later, a novel coronavirus is the cause of a new global pandemic threatening millions of lives.
Today, many methods of sharing information have been subsumed by giant social media platforms that have incredible speed, reach, and penetration. More than 2.9 billion individuals use social media regularly, and many for long stretches of time.
A current understanding of how these platforms can be harnessed to optimally support emergency response, resilience, and preparedness is not well understood.
In this viewpoint, we outline a framework for integrating social media as a critical tool in managing the current evolving pandemic as well as transforming aspects of preparedness and response for the future.
Right now, the world is battling a coronavirus epidemic that started in December 2019, when a group of people from China’s northern Hubei province developed an unexplained pneumonia-like condition.
By the end of the month, the local scientific community managed to pinpoint the source of the disease and establish its link to the SARS virus that terrorized the world only 17 years ago.
As 2020 rolled around, the outbreak turned into an international pandemic. Each new country the virus spread to fueled panic and demand for information regarding the disease.
As a result, social media became both an indispensable source of vital information and a fertile ground for dangerous rumor-mongering, with claims of equal shock value but varying truth making big waves across the world.
The WHO Director-General even stated: “We’re not just fighting an epidemic; we’re fighting an infodemic.”
This situation is the testament to the raw power of social media and a sign of how much we achieved when it comes to curtailing the spread of dangerous lies online. Let’s talk about it.
Pandemics of The Social Media Age
The coronavirus outbreak wasn’t the first to arrive in the age of social media: at least three other international pandemics occurred in the ten years preceding it.
The H1N1 (swine flu), the Ebola epidemic, and the Zika outbreak all had prominent, and widely documented, influence on social media conversations.
Just ten years ago, NGOs weren’t necessarily well-equipped to communicate risk information online. The people used social media to look for directives, but unreliable and/or unofficial sources had the loudest voices.
By 2014, health organizations were much better prepared to launch their campaigns, and influencers helped them get exposure. But the social networks themselves had trouble identifying malicious actors and dealing with misinformation. These days we have made tremendous progress.
Social networks have matured in terms of their functionality, big organizations got better at communicating online, and, following the large-scale misinformation campaigns of 2016, people have gotten a bit better at telling truth from fiction. So, what role does social media play in this unfolding story?
Source of Facts
China was famously unprepared to take the stage during the 2009 H1N1 outbreak. It learned its lesson; being upfront and transparent about the coronavirus situation on social media.
In the days following the initial news, there was no shortage of verifiable information from official Chinese sources.
WHO and other public health organizations also use social media to inform the public about the outbreak and control the panic. Of course, it does not mean that misinformation is not being circulated among social media users.
For many people, conspiracy theories are a natural response to the senseless cruelty of this crisis. They offer clarity and an opportunity to blame someone for the havoc.
So it’s not unreasonable that a number of dangerous conspiracy theories ‘blew up’, offering interesting, albeit completely incorrect ways of viewing the situation.
Some claim that the virus is a biological weapon, created by either the US (to kill Chinese people) or China (to kill Americans). Some claim that the outbreak was orchestrated by big tech – to undermine China’s status as the world capital of high-tech manufacturing.
Social media websites are actively fighting this misinformation and fearmongering. Chinese tech giants, already well-versed in censorship, put their tools to good use to prevent the spread of such lies.
The creators of WeChat — China’s number one social media platform — are using a popular fact-checking platform to dispel harmful misconceptions. Western websites, such as Twitter, Facebook, and Instagram, are also actively working to ensure that only correct sources get amplified.
When people search for ‘coronavirus’ on these platforms, they are less likely to encounter any unsubstantiated claims than they would during the recent Zika crisis. Content from ‘reputable’ accounts is given priority, while amateur claims are being scrutinized and fact-checked.
Of course, no fake-news-filtering algorithm is perfect. As coronavirus became a trending topic, many people tried to profit off its popularity in ways that could not have been predicted.
Several teen bloggers pretended to be infected to elicit shock from their peers, pity from their online followers, and, most importantly, clicks.
Stunts like these cannot be controlled as well as the claims of international conspiracies, but they are still largely illegal – and the perpetrators are likely to face consequences for their acts of sowing panic on purpose.
Multiple cities in the Hubei province, where it all sprung from, were on lockdown to prevent the spread of the virus: more than 50 million individuals were prevented from leaving their cities.
Around the world, those suspected of harboring the disease are quarantined inside their homes or in medical institutions.
In these conditions, social media serves as the only reliable way for the victims of this virus to communicate with the outside world.
The demand for first-hand information about the outbreak fueled the popularity of coronavirus vlogs and blogs. People are eager to tell their stories and document their daily lives in the face of this deadly disease.
This particularly applies to people in highly isolated environments, such as that of the Diamond Princess cruise liner – a coronavirus-infected ship. It was on lockdown for most of February, with more than 3500 people on board, including 700 coronavirus patients.
The passengers were not allowed to mingle, and only a few were evacuated.
In the face of this horror, social media was the only way for passengers to stay in touch with their families and the world at large. They made vlogs, blogs, and appeared on live TV from the eerie comfort of their cabins.
Chinese citizens, particularly those who live in the North, avoid(ed) going outside and use(d) social media to curtail the risk of being infected. They can keep in touch with their friends, get the latest news, and order food, thanks to social media.
Social media has also been instrumental in helping improve the situation. Like other similar disasters, it gave birth to a fair share of online fundraisers. People are giving money to struggling hospitals, as well as individuals at risk of dying from the disease.
Big companies like Western Union and Tencent are also joining in, encouraging their clients and users to donate to the cause.
Scientists are using social media tools to collaborate. The coronavirus genome was openly published early on during the outbreak, allowing thousands of researchers to brainstorm possible solutions, cures, and explanations.
Regular people can simply use social media to provide moral support to those affected by the deadly virus. In a typically Chinese display of solidarity, WeChat users from across China published pictures of their local food in support of those in Wuhan.
Finally, social media provides a sort of collective grieving space. Events like these can be hard to process psychologically, and even harder to make sense of.
When one of the scientists to first discover the virus succumbed to the disease, his death sparked conversations about the selfless bravery of people fighting the outbreak. His memory was honored by thousands of netizens.
Getting to Trusted Sources
To date, social media platforms have been important for disseminating information during the outbreak of coronavirus 2019 (COVID-19).
The Centers for Disease Control and Prevention, the World Health Organization (WHO), numerous journals, and other health care organizations are regularly posting guidance across a host of platforms.
Teams employed by larger social media platforms have also been involved in the response as searches for information about coronavirus are escalating and, at times, dominating conversations online.
Facebook is using the news feed function to direct users to the WHO website and websites of local health authorities.
Google Scholar has highlighted leading medical journals and other sites.
Twitter and other social media sites are similarly pointing individuals who search for coronavirus-related content to reliable resources.
Health care organizations, clinicians, and social media influencers should also actively direct online traffic to trusted sources.
It may also be time for social media platforms to take on an active public health role and in parallel use banners, pop-ups, and other tools to directly message users about hand washing and social distancing.
This approach increases the likelihood of millions of people seeing the same messages whenever they access the platform, even if they forgo accessing the WHO website or other trusted sites.
Social media has also become a conduit for spreading both rumors and deliberate misinformation, and many perpetrators are deploying sites such as Facebook, Twitter, YouTube, and WhatsApp to create a sense of panic and confusion.
Unlike any prior event, WHO has identified that the “the 2019-nCoV outbreak and response has been accompanied by a massive ‘infodemic’-an over-abundance of information – some accurate and some not – that makes it hard for people to find trustworthy sources and reliable guidance.”
Research is needed to better understand the origins and spread of misinformation as well as coordinated efforts to disrupt its sources and identify, remove, and reduce its dissemination.
Diagnostic Tool and Referral System
Social media should be used to disseminate reliable information about when to get tested, what to do with the results, and where to receive care.
If a vaccine becomes available, the same platforms could be used to encourage uptake and address challenges associated with vaccine hesitancy. These targeted efforts can occur in response to what people search for or in a more personalized approach based on an individual’s online profile, posts, and underlying risk. Health systems may become overwhelmed as testing becomes more available and as more mildly ill yet concerned individuals seek care; yet, social media platforms are well poised to enable users to remotely assess symptoms and determine their most appropriate course of action.
The Facebook Preventive Health tool provides individuals with vetted guidelines about preventive health recommendations (e.g., heart disease, cancer screening) and then directs users to geotargeted locations (e.g., federally qualified health centers, retail clinics) where these services are available.
Users also have the option to share the tool and their scheduled testing with their network. This could be modified to direct individuals (when relevant) to resources for COVID-19 testing.
For those whose test results are positive for COVID-19, the platform could enable users to inform their contacts about the potential exposure and how to follow up for testing.
Enabling Connectivity and Psychological First Aid
As individuals start to self-quarantine and telecommute, new forms of social isolation are occurring. In some places in the US, funerals, weddings, religious services, in-restaurant dining, and other places of traditional socialization have already been severely limited or completely restricted.
The long-term effects of social distancing and isolation will likely affect populations differently, necessitating comprehensive strategies for addressing the downstream sequelae.
Navigating social isolation will be particularly challenging for already disadvantaged populations, such as older individuals, individuals with low socioeconomic status or housing insecurity, individuals managing chronic illnesses or disabilities, and individuals who are undocumented.
Social media should be used to raise awareness about the needs of these groups in disasters and for the development of new methods for communities to mobilize resources and support in the absence of physical contact.
The “crisis response,” “safety check,” and related functions available on some social media platforms could enable more frequent status updates and sharing.
Psychological first aid could be delivered through chatbots that use artificial intelligence to learn from the millions of interactions that are occurring in response to the pandemic and better understand critical needs.
While social media cannot replace in-person contact, there may be ways to better use it to support recovery and resilience.
Advancing Remote Learning
New approaches to enhance the education of health care professionals is needed. Social distancing will affect clinical training (e.g., emergency department rotation) and didactic education (e.g., anatomy laboratory).
Stand-alone video conferencing services may be overwhelmed as many institutions move entirely online.
Social media can be a useful tool for facilitating contact among students and supporting active learning.
Front-line health care clinicians and other health care workers who provide care for critically ill patients with COVID-19 would also benefit from being able to share their experiences broadly in a de-identified way to advance education and teaching in an evolving crisis.
Social media data about symptoms, interactions, photos at events, travel routes, and other digital footprints about human behavior should be analyzed in real-time to understand and model the transmission and trajectory of COVID-19.
At present, Facebook is providing aggregated and anonymized data to researchers about how people move from location to location and associated population density maps to better inform how the virus is spreading.
Merged social media data and electronic medical record data from consenting patients could also provide insights about individual-level risk.
Basic and translational science can also be advanced through social media channels. Foundations have funded researchers to sequence the complete genome of COVID-19 in a short period of time.
The output of these efforts included a research tool to further analyze the genome and a cell atlas that can be used to study how COVID-19 affects different organ functions.
This infrastructure can be strengthened to facilitate communication among scientists working to address critical priorities related to animal and environmental research and candidate therapeutics and vaccines.
Enabling a Culture of Preparedness
More than 100 years ago, a global pandemic affected more than 500 million people worldwide.
Today, in the midst of another public health emergency, some lessons from history demonstrate the importance of understanding how information spreads and individuals interact.
Integrating social media as an essential tool in preparedness, response, and recovery can influence the response to COVID-19 and future public health threats.
Whereas the coverage of earlier pandemics’ social media influence was largely focused misinformation, it wouldn’t really be fair to do the same here.
Social networks are doing their part by creating new tools to tackle fake news and conspiracy theories. At this point, they’re doing more good than bad to help people affected by the virus.
They fuel scientific collaboration, create fundraising opportunities, and – perhaps, most importantly – helps the quarantined people overcome their isolation.
Social media can be an unstoppable force, especially in times of crisis.