Abstract
BackgroundThe early conversations on social media by emergency physicians offer a window into the ongoing response to the COVID-19 pandemic.ObjectiveThis retrospective observational study of emergency physician Twitter use details how the health care crisis has influenced emergency physician discourse online and how this discourse may have use as a harbinger of ensuing surge.MethodsFollowers of the three main emergency physician professional organizations were identified using Twitter’s application programming interface. They and their followers were included in the study if they identified explicitly as US-based emergency physicians. Statuses, or tweets, were obtained between January 4, 2020, when the new disease was first reported, and December 14, 2020, when vaccination first began. Original tweets underwent sentiment analysis using the previously validated Valence Aware Dictionary and Sentiment Reasoner (VADER) tool as well as topic modeling using latent Dirichlet allocation unsupervised machine learning. Sentiment and topic trends were then correlated with daily change in new COVID-19 cases and inpatient bed utilization.ResultsA total of 3463 emergency physicians produced 334,747 unique English-language tweets during the study period. Out of 3463 participants, 910 (26.3%) stated that they were in training, and 466 of 902 (51.7%) participants who provided their gender identified as men. Overall tweet volume went from a pre-March 2020 mean of 481.9 (SD 72.7) daily tweets to a mean of 1065.5 (SD 257.3) daily tweets thereafter. Parameter and topic number tuning led to 20 tweet topics, with a topic coherence of 0.49. Except for a week in June and 4 days in November, discourse was dominated by the health care system (45,570/334,747, 13.6%). Discussion of pandemic response, epidemiology, and clinical care were jointly found to moderately correlate with COVID-19 hospital bed utilization (Pearson r=0.41), as was the occurrence of “covid,” “coronavirus,” or “pandemic” in tweet texts (r=0.47). Momentum in COVID-19 tweets, as demonstrated by a sustained crossing of 7- and 28-day moving averages, was found to have occurred on an average of 45.0 (SD 12.7) days before peak COVID-19 hospital bed utilization across the country and in the four most contributory states.ConclusionsCOVID-19 Twitter discussion among emergency physicians correlates with and may precede the rising of hospital burden. This study, therefore, begins to depict the extent to which the ongoing pandemic has affected the field of emergency medicine discourse online and suggests a potential avenue for understanding predictors of surge.
Highlights
The contagiousness, fatality rate, and long-term sequelae far attributed to COVID-19, the disease caused by SARS-CoV-2, have led to significant strains on the health care system
COVID-19 Twitter discussion among emergency physicians correlates with and may precede the rising of hospital burden
Python 3.8.5 and the Tweepy library (Python Software Foundation) [16] made it possible to acquire all unique followers of the three major physician professional societies in emergency medicine: the American College of Emergency Physicians (ACEP; @ACEPNow), the Society for Academic Emergency Medicine (SAEM; @SAEMonline), and the American Academy of Emergency Medicine (AAEM; @aaeminfo) [17,18,19,20,21]
Summary
The contagiousness, fatality rate, and long-term sequelae far attributed to COVID-19, the disease caused by SARS-CoV-2, have led to significant strains on the health care system. Since the World Health Organization (WHO) first reported “a cluster of pneumonia cases” in Wuhan, China, on January 4, 2020 [1], the social media platform Twitter has become a source of both official health information and unofficial medical discourse regarding the ongoing pandemic. In its Twitter message, or tweet, about the decision, the FDA (@US_FDA) reiterated its aim to “assure the public and medical community that it has conducted a thorough evaluation of the available safety, effectiveness, and manufacturing quality information” [4]. Addressing Twitter’s medical community in this way was intentional: throughout the COVID-19 pandemic, many physicians turned to social media rather than traditional medical information channels to discuss the merits and demerits of possible treatments, prior to the availability of formal clinical guidance. The early conversations on social media by emergency physicians offer a window into the ongoing response to the COVID-19 pandemic
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