|Year : 2020 | Volume
| Issue : 2 | Page : 70-75
Role of social media during the COVID-19 pandemic: Beneficial, destructive, or reconstructive?
Heena Sahni1, Hunny Sharma2
1 Department of Public Health Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
2 Department of Public Health Dentistry, Triveni Institute of Dental Sciences, Hospital and Research Centre, Bilaspur, Chhattisgarh, India
|Date of Submission||05-May-2020|
|Date of Acceptance||10-Jun-2020|
|Date of Web Publication||29-Jun-2020|
Dr. Heena Sahni
House No. 32, Arya Nagar, Opposite Bank of Baroda, Near Agrasen Chowk, Durg - 491 001, Chhattisgarh
Source of Support: None, Conflict of Interest: None
The world is facing the extensive spread of severe acute respiratory syndrome-coronavirus 2. This epidemic puts intensive pressure on healthcare, economic, and social structures. Commitment to implementing effective approaches for public health will take bold interventions by public health professionals and strong leadership by the nation's governing bodies. During this crisis, lack of awareness, knowledge, and preparedness would put people and health care staff at risk. The dilemma is how to pass the knowledge of current disease statistics and its prevention to the general population at a rate equivalent to or better than the spreading epidemic. At the same time, a huge amount of health-threatening misinformation is spreading at a faster rate than the disease itself. The major proportion of this false rumor is disseminated in the web-2 era through social media. Thus, delivering fast, accurate and reliable information addressing critical problems of infection control is, therefore, of key importance. This review outlines both the positive and negative impact of social media during coronavirus epidemic on health-care professionals and on the general population. However, if used wisely and prudently, social media serves as a powerful tool for changing people's behavior and to promote the well-being of individual and public health.
The following core competencies are addressed in this article: Medical knowledge, Interpersonal and communication skills, Practice-based learning.
Keywords: Communication, coronavirus, disease outbreaks, epidemics, fear, social media
|How to cite this article:|
Sahni H, Sharma H. Role of social media during the COVID-19 pandemic: Beneficial, destructive, or reconstructive?. Int J Acad Med 2020;6:70-5
|How to cite this URL:|
Sahni H, Sharma H. Role of social media during the COVID-19 pandemic: Beneficial, destructive, or reconstructive?. Int J Acad Med [serial online] 2020 [cited 2020 Oct 22];6:70-5. Available from: https://www.ijam-web.org/text.asp?2020/6/2/70/287959
| Introduction|| |
The 2019 novel coronavirus (2019-nCoV) or extreme severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as it is now known, is rapidly spreading in India and to the rest of the world from its origin in Wuhan City, China. This deadly and life-threatening virus infected 2,549,632 people and resulted in 175,825 deaths around the world. In India there are currently 17,610 positive corona infected cases (till 24 April 2020) as reported by the Ministry of Health and Family Welfare Department of India.
During sudden outbreaks, the public needs access to timely and reliable information about the disease symptoms and its prevention. Nowadays, social media are often seen as fast and effective platforms for searching, sharing, and distributing health information among the general population. Also, social media serves to provide an important informal source of data to identify health information that has not been reported to medical officers or health departments and to uncover or share perspectives on any life-threatening health-related issues. But this channel of disseminating knowledge sometimesmixed with scare tactics, discrimination, misleading reports and conspiracy theories related to the origin of the virus, its spread and mass buying of face masks, all closely connected to the modern 21st century “info media” social media networks. Despite the importance of rapid access to information in these critical situations, poor comprehension or inaccurate or false information in the format of rumors or unreliable news can lead to misunderstanding in the community, which makes the situation worse.
Dr. Tedros Adhanom, Director-General of the World Health Organization (WHO), calls this the battle against “trolls and conspiracy theories.” Misinformation creates confusion, and spreads fear, hampering the outbreak response. “Misinformation on the coronavirus might be the most contagious thing about it.” These circumstances can lead to an increase in the people's unnecessary expectations requiring diagnostic, medication, or referral services as for instance taken as shortage and black marketing of face masks and hand sanitizer in India. As for low- and middle-income countries with limited health services, this can make the situation worse because these nations don't have enough workforce and financial resources to cope up with this epidemic. Yet India is managing with its own level at its best, but it seems like the virus' potential path is uncertain. Hence, this review provides a bird's eye view of the impact of social media on the general population during this CoV epidemic. Government and health professionals must embrace and make plans for the use of social media, work together, establish limits and build guidelines for its usage, and above all, make them work for the general population.
| Social Media: Same Networks Same Information Everywhere|| |
The International Telecommunication Union's latest report revealed that 53.6% of the global population, or 4.1 billion people, uses the Internet till the end of 2019. With over 560 million Internet users, India became the world's second-largest online market globally, ranking next to China. Of all the social media available in India, the most popular social networking sites are YouTube and Facebook. Indeed, India has the largest Facebook user base in the world. WhatsApp, Instagram, and Facebook Messenger are recently a few of the other famous social networking sites used in India. People use mobile phones too much nowadays that it may cause medical implications. Likewise, a study reported by The Lancet described “WhatsAppitis” in which a young women had wrist pain because of sending too many messages from her phone, as almost every person is having Internet in their cell phones and laptop and everyone is capable of sending text messages and information, nowadays instead of “alert,” “panic” transmit faster when compare to CoV disease itself.
| Understanding Social Determinants of Health|| |
In the environment in which people are born, live, study, work, play, worship, and age are social determinants of health, which are the factors that influence a wide variety of health outcomes, risks, and overall quality of life. Based on these determinants' health-care organizations and public health professionals enormously used social media for health guidance and for any outbreak's prevention. Several hospitals, medical practitioners, and health agencies have opened YouTube, Facebook, and Twitter pages to get access to their patients. But these pages or sites should be used with precautions by doctors and other people as any misinformation creates havoc among the general population. To prevent this at some level, many health-care organizations have social media utilization standards for their doctors and other staff. For example, the social media advice issued by the UK Nursing and Midwifery Council, a supplement to professional guidelines that highlight the need for appropriate use of social media and social networking sites. At some places professional guidance is also supported and monitored by local organizational policies like, take the instance of Salisbury NHS Foundation Trust's social media policy and guidance as it stated that “Do not post, upload, forward or post a link to chain mail, junk mail, cartoons, jokes or gossip.” The use of social media for any public health crisis requires complete consideration and dedication.
| Use of the Internet and Other Social Media Applications to Seek Health-Related Information|| |
About 71% of the world's Internet users are youth aged 15–24. In India, there were 197 million active social media users (14% of the total population). According to the 2014 Digital Health Literacy Survey among European Citizens, 59% of Europeans used the Internet to check for health information. 55% requested general information, 54% requested information about a particular illness, 23% sought detailed information on a diagnosis, and 10% used the net to get a second opinion after consulting their physician. Approximately 82% and 87% of people looking for health-related information used search engines for their queries. The second source of information (47%–48% people) was relevant and dedicated websites such as health blogs and forums, while between 33% and 38% were looking for information from official health websites, such as the Ministry of Health or the WHO. Another study performed by Public Health Dentists of Bengaluru India in 2014 revealed that out of 572 study participants, 150 (26.2%) reported the use of the Internet for oral health-related information, overall more than 80% of the respondents preferred the use of Google as their search engine but when asked about any research article and journal website they could not picture anything.
| A Nonpharmaceutical Intervention to Combat Coronavirus|| |
At this time, when no other ways available to cure or manage CoV other than quarantine and social distancing. Social media become a strong platform for spreading public health awareness and advocacy regarding public health issues. Some nations do have Twitter and Facebook accounts for these purposes. The Ministry of Health and Family Welfare Department develops a tool to combat CoV to link critical health services with the citizens of India called “Aarogya Setu” application., The Center of Disease Control (CDC) maintains an active page on Twitter and Facebook as these platforms allows users to post large numbers of short messages in less period (known as Microblogs) also these organizations use to monitor “tweets” that may signify any outbreak and share information on events of this nature. Social networking sites also serve as a way for disaster management, outbreak prevention, and emergency response staff to easily communicate and access critical information collected by organizations like the WHO and the Center for Disease Control. A study showed that during the Ebola (2014) and Zika (2015) outbreak, social networks helped the CDC to establish active communications with the community and then applied it to improve in public health. Another evidence indicates that in 2016, when the WHO declared Zika virus as a danger to the world, social media monitoring and prevention awareness messages played as a lifesaving role in enhancing risk control and disease management.
| Coronavirus: How Panic Spreads Through Social Media|| |
With its capacity to bring people closer than ever before, social media has also set new and special challenges, including phenomena of Cyber-bullying, exploiting public opinion, and other forms of crime. The pandemic of CoV is affecting global health and now become a Public Health Emergency of International Concern (PHEIC) as declared by the WHO. In the International Health Regulations (IHR) 2005, the term Public Health Emergency of International Concern is defined as “an extraordinary event which is described, as given in these regulations:
- To constitute a public health risk to other States through the international spread of disease; and
- To potentially require a coordinated international response.” This definition implies a situation that: is serious, unusual or unexpected; carries implications for public health beyond the affected State's national border; and may require immediate international action.
While the Internet is seen as an effective source for obtaining health information, it can be used as a means of disseminating misinformation. As standard research methods include methodology and peer review, this analysis also includes a framework for inspections which balances to minimize the risk of inaccurate or inappropriate content dissemination; social media platforms will often encourage open membership, and in large part unrestricted exchange of ideas under 'protecting and allowing free' principles expression – sadly because of short legal consequences, there is little or no accountability for what is said or communicated.
In addition to resolving the urgent need to step up public health interventions for tackling the epidemic, the pandemic of social media hysteria must be combated. This spreading of panic and misinformation about CoV is termed as “Misinfodemics.” Sharing and spreading timely and transparent information, especially when the news is unfavorable and the predicting uncertainty is clearly an integral part of managing large-scale epidemics and other emergencies. All such interaction should be routine between government agencies and the public to develop trust that becomes critical during epidemics. In today's world, reaching the general population – especially in times of public health crisis – it takes more than common mass media like some of the channels which are behind paywalls. Subsequent public contact from China and other parts of the world and exchange of knowledge strengthened the response to the outbreak. Similarly, Singapore's approach to public risk communication, including Prime Minister Lee Hsien Loong's speech on February 8, 2020, which was lauded by experts in health care as they developed a model for reducing panic and rumors among their people. The last outbreak of Ebola in Western Africa is yet another clear example of the ability of social networks to influence the actions of people. This news of the epidemic created a fearful environment globally with rumors and misinformation, which rapidly spreads through social networks. Several studies had investigated the role that social networks have played in spreading misinformation about Ebola. A study published in the British medical journal analyzed tweets about the Ebola outbreak from African countries. The researchers revealed that most of the messages contained false information, and 'fake' tweets were more retweeted than those comprising “truthful” facts. Odlum andYoon also state that various senses of public anxiety, anger, and health information seeking global Ebola-related goals were identified during the Ebola epidemic though Twitter's 2014 to 2016 content review. Furthermore, social networks helped spread conspiracy theories, gibberish accusations, and some even gave them information about fake treatments; likewise, the SMS and WhatsApp messages also spread false news stories.
| Incentives and Motives behind Misleading News Generation|| |
According to the evidence published, the major reasons behind COVID-19 misinformation are cultural influences, continuous compulsion demands during disease prevalence, trouble-free dissemination of false news through online media, financial incentives, and lack of supervision., Marketing and financial benefits also triggered misinformation disseminated, as found in other studies.,
| Dangerous Consequences of Misinformation|| |
Vandalism of professional image
A major risk related to using social media is the posting and forwarding of unethical content which have adverse effects on health care professionals (HCPs), students, and health-care institutions. Social media conveyed information about the personality, beliefs, and interests of an individual; it also creates the initial impression which persists in the mind of people. Perceptions may be based on some of the details in a social media profile, such as photos, nicknames, links, and statements, posts, and comments that a person likes or shares, as well as friends, charities, organizations, games, and media that a person follows. Some health professional users strive to keep their personal and professional social accounts separate by having different social profiles. However, some of the social networking sites provide privacy settings that allow users to modify and manage both their profile content and select the people who can view their posts. HCPs must check their own names or other identifying details carefully to ensure that their social media activity projects a professional image of them.
Low standard quality of information
A lack of accuracy and reliability is the major drawback of health information found on social media or on other online sources. Medical or health-related information posted on social media sites are often anonymous in nature. Moreover, these kinds of health information are always incomplete, informal, and without references. Many users post false description videos on YouTube and Facebook just for getting views and followers. HCPs should guide people and their patients to seek information only on reputable peer-reviewed websites where quality assurance is the focus of the information. The WHO, therefore, addressed the Internet provider company for assigned names and numbers to create a new domain suffix that can be used only for validated information on health. So that if people search for any particular disease or health-related topic, then the search engines should give priority to only those domain addresses which provide reliable results and truthful facts. All HCPs, students, and other trainees must be educated and guided regarding the judicial use of social media platforms in the context of the Health Information Portability and Accountability Act.
Create fear-mongering environment
Social media have always been the key platforms for spreading misinformation, and the primary topics of misinformation include disease statistics, medications, methods of prevention, nutritional guidelines, and methods of transmitting the virus. A Brazilian study found that, during the outbreak of Zika in 2015 and the prevalence of yellow fever in 2016, misconceptions about the transferring of virus and its side effects were widely disseminated. Furthermore, Li et al., published a literature review study found that dissemination of misinformation about health can lead to unnecessary and undesirable outcomes such as fear, anxiety, misunderstanding of the disease, and problems in the patient-doctor relationship. To tackle this, WHO has initiated a dedicated WhatsApp and Facebook messaging services in Arabic, English, French, Hindi, Italian, Spanish and Portuguese languages to keep people safe and aware of the facts related to the coronavirus. This easy-to-use chat app has the ability to cover 2 billion people, and it also allows WHO to directly get in touch with those people who need it.
| Conclusion|| |
A significant amount of potentially dangerous misinformation has been generated about the COVID-19 pandemic, and much of it has been disseminated via social networks. This misleading news consists of different facets of the epidemic, which is capable of threatening public safety, which again aggravates crisis management. This false rumor about COVID-19 is disseminated faster than the virus, and it appears that HCPs are actively battling against two faces of the virus and the associated misinformation simultaneously. The key approach suggested in this review was also to correct misconceptions by health institutions experts. Although some studies stress that correct knowledge can be unsuccessful during any public health crisis but at the same time many researches demonstrated the efficacy of providing and transmitting truthful facts by health experts. We also suggest various methods for correcting misconceptions about health through social media, which involves timely expert advice, regular public health awareness, and correction program with periodic communication among general people and on media algorithms. We also want to draw attention to a correction program which will be successful if it is applied quickly and clearly, along with relevant document, at the same time evidence should also be provided and shown to the public. With all these above-mentioned ways one should always address the intellectual and emotional dimensions of the audiences during this phase of fear and anxiety. As the virus tends to be spread too quickly to interrupt but still too deadly to be ignored. There are many lessons learned during this corona epidemic, which will serve as a blueprint for coping with future pandemics, but the near future requires a sustainable new standard of management.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
Ethical conduct of research
This manuscript represents a literature review. Because this project involved no experimental design, the Institutional Review Board approval was not required. Applicable EQUATOR Network (http://www.equator-network.org) reporting guidelines were followed.
| References|| |
Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr 2020;87:281-6.
Coronavirus. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. [Last retrieved on 2020 Apr 24].
Ministry of Health and Family Welfare. (n.d.). Available from: https://www.mohfw.gov.in/dashboard/index.php. [Last retrieved on 2020 Apr 24].
Bastani P, Bahrami MA. COVID-19 Related Misinformation on Social Media: A Qualitative Study from Iran [published online ahead of print, 2020 Apr 05]. J Med Internet Res 2020;10.2196/18932.
Zhao Y, Zhang J. Consumer health information seeking in social media: A literature review. Health Info Libr J 2017;34:268-83.
Charles-Smith LE, Reynolds TL, Cameron MA, Conway M, Lau EH, Olsen JM, et al
. Using social media for actionable disease surveillance and outbreak management: A systematic literature review. PLoS One 2015;10:e0139701.
Larson HJ. The biggest pandemic risk? Viral misinformation. Nature 2018;562:309.
van der Meer TG, Jin Y. Seeking formula for misinformation treatment in public health crises: The effects of corrective information type and source. Health Commun 2020;35:560-75.
Atlani-Duault L, Ward JK, Roy M, Morin C, Wilson A. Tracking online heroisation and blame in epidemics. Lancet Public Health 2020;5:e137-e138.
International Telecommunication Union. Measuring the Information Society Report 2019. Geneva: International Telecommunication Union; 2019. Available from: https://www.itu.int/en/ITU-D/Statistics/Pages/default.aspx. [Last retrieved on 2020 Apr 19].
Internet Usage in India. Available from: https://www.statista.com/topics/2157/internet-usage-in-india/. [Last retrieved on 2020 Apr 19].
Fernandez-Guerrero IM. “WhatsAppitis”. Lancet 2014;383:1040.
World Health Organization, Commission on Social Determinants of Health. Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Available from: http://www.who.int/social_determinants/en. [Last retrieved on 2020 Apr 19].
Bender JL, Yue RY, To MJ, Deacken L, Jadad AR. A lot of action, but not in the right direction: Systematic review and content analysis of smartphone applications for the prevention, detection, and management of cancer. J Med Internet Res 2013;15:e287.
Nursing and Midwifery Council. Social Media Guidance; 2015. Available from: https://www.nmc.org.uk/standards/guidance/social-media-guidance. [Last retrieved on 2020 Apr 19].
Salisbury NHS Foundation Trust. Guidance on the Use of Mobile Phones and other Devices; 2015. Available from: https://www.salisbury.nhs.uk/InformationForPatients/Pages/Guidanceontheuseofmobilephonesandotherdevices.aspx. [Last retrieved on 2020 Apr 19].
European Citizens' Digital Health Literacy. (n.d.). Available from: http://ec.europa.eu/commfrontoffice/publicopinion/flash/fl_404_sum_en.pdf. [Last retrieved on 2020 Apr 19].
Naganandini S, Rao R, Kulkarni SB. Survey on the use of the Internet as a source of oral health information among dental patients in Bangalore City, India. Oral Health Prev Dent 2014;12:141-7.
Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: Pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med 2020;27:taaa020.
Farnan JM, Snyder Sulmasy L, Worster BK, Chaudhry HJ, Rhyne JA, Arora VM, et al
. Online medical professionalism: Patient and public relationships: Policy statement from the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med 2013;158:620-7.
Househ M. The use of social media in healthcare: Organizational, clinical, and patient perspectives. Stud Health Technol Inform 2013;183:244-8.
Aarogya Setu Coronavirus Tracker App for India: How to Download, Setup and Use for COVID-19 Tracing; April 14, 2020. Available from: https://indianexpress.com/article/technology/social/aarogya-setu-covid19-coronavirus-tracking-app-india-how-to-setup-download-use-6347537/. [Last retrieved on 2020 Apr 19].
Ministry of Health #StayHome #StaySafeVerified Account. Ministry of Health #StayHome #StaySafe (@MoHFW_INDIA); 2 April, 2020. Available from: https://twitter.com/MoHFW_INDIA. [Last retrieved on 2020 Apr 19].
Account, C. D. C. V. (2020, April 15). CDC (@CDCgov). Available from: https://twitter.com/cdcgov. [Last retrieved on 2020 Apr 19].
Chauhan B, George R, Coffin J. Social media and you: What every physician needs to know. J Med Pract Manage 2012;28:206-9.
Gesser-Edelsburg A, Diamant A, Hijazi R, Mesch GS. Correcting misinformation by health organizations during measles outbreaks: A controlled experiment. PLoS One 2018;13:e0209505.
Carey JM, Chi V, Flynn DJ, Nyhan B, Zeitzoff T. The effects of corrective information about disease epidemics and outbreaks: Evidence from Zika and yellow fever in Brazil. Sci Adv 2020;6:eaaw7449.
Stawicki SP, Firstenberg MS, Papadimos TJ. The Growing Role of Social Media in International Health Security: The Good, the Bad, and the Ugly. Global Health Security Recognizing Vulnerabilities, Creating Opportunities. Switzerland AG: Springer Nature; 2020.
World Health Organization. Communicating Risk in Public Health Emergencies. WHO Guideline for Emergency Risk Communication (ERC) Policy and Practice. Available from: https://apps.who.int/iris/bitstream/handle/10665/259807/9789241550208eng.pdf; jsessionid=D6796FA0ECAD7D6A4E4C5456A762BDB2?sequence=2. [Last retrieved on 2020 Apr 22].
Hsu LY, Chia PY, Vasoo S. A midpoint perspective on the COVID-19 pandemic [published online ahead of print, 2020 Mar 25]. Singapore Med J 2020;10.11622/smedj.2020036.
Fernández-Luque L, Bau T. Health and social media: Perfect storm of information. Healthc Inform Res 2015;21:67-73.
Oyeyemi SO, Gabarron E, Wynn R. Ebola, Twitter, and misinformation: A dangerous combination? BMJ 2014;349:g6178.
Odlum M, Yoon S. Health information needs and health seeking behavior during the 2014-2016 ebola outbreak: A twitter content analysis. PLoS Curr 2018;10:ecurrents.outbreaks.fa814fb2bec36e29b718ab6af66124fa.
Kelion L. Ebola Text-Message System Set to Expand. London: BBC News; 2014. Available from: http://www.bbc.com/news/technology-29610865. [Last retrieved on 2020 Apr 22].
Bahrami MA, Nasiriani K, Dehghani A, Zarezade M, Kiani P. Counteracting online health misinformation: A qualitative study. Manage Strat Health Syst 2019;4:230-9.
Li YJ, Cheung CM, Shen XL, Lee MK. Health Misinformation on Social Media: A Literature Review. Twenty-Third Pacific Asia Conference on Information Systems, China 2019. Available from: http://pacis2019.org/wd/Submissions/PACIS2019_paper_263.pdf. [Last retrieved on 2020 Apr 22].
Peck JL. Social media in nursing education: Responsible integration for meaningful use. J Nurs Educ 2014;53:164-9.
Bernhardt M, Alber J, Gold RS. A social media primer for professionals: Digital do's and don'ts. Health Promot Pract 2014;15:168-72.
Moorhead SA, Hazlet DE, Harrison L, Carroll JK, Irwin A, Hoving C, et al
. A new dimension of health care: Systemic review of the uses, benefits, and limitations of social media for health care professionals. J Med Internet Res 2013;15:E85.
Grajales FJ 3rd
, Sheps S, Ho K, Novak-Lauscher H, Eysenbach G. Social media: A review and tutorial of applications in medicine and health care. J Med Internet Res 2014;16:e13.
Stawicki TT, Peck GL, Galwankar SC, Bahner DP, Papadimos JS, Stawicki SP, et al
. From “pearls” to “tweets:” How social media and web-based applications are revolutionizing medical education. Int J Acad Med 2018;4:93-7. [Full text]
WHO Health Alert Brings COVID-19 Facts to Billions via WhatsApp. Available from: https://www.who.int/news-room/feature-stories/detail/who-health-alert-brings-covid-19-facts-to-billions-via-whatsapp. [Last retrieved on 2020 Apr 22].