Emergency Physician Twitter Use in the COVID-19 Pandemic as a Potential Predictor of Impending Surge: Retrospective Observational Study

Abstract

Background The early conversations on social media by emergency physicians offer a window into the ongoing response to the COVID-19 pandemic. Objective This 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. Methods Followers 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. Results A 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. Conclusions COVID-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.

Examining the Utility of Social Media in COVID-19 Vaccination: Unsupervised Learning of 672,133 Twitter Posts

“…To further enrich the main findings, we conducted an exploratory analysis to identify the underlying emotions of each tweet using the VADER (Valence Aware Dictionary and Sentiment Reasoner) package [36] in R. VADER is an established sentiment analysis tool that has been widely employed in recent studies of free-text data on Twitter [37][38][39][40] and online news [41]. For each tweet, VADER used a rule-based machine learning model to identify three key emotions (ie, positive, negative, and neutral), which were then combined into a composite sentiment score ranging from -1 (most negative sentiment) to +1 (most positive sentiment).…”

“#LongCOVID affects children too”: A Twitter analysis of healthcare workers’ sentiment and discourse about Long COVID in children and young people in the UK

“…10 People used Twitter during the COVID-19 pandemic for different purposes: world leaders communicated with citizens, 11,12 organisations monitored movement, 13 scientists studied public discourse around the pandemic, 14,15 performed sentiment analysis, [16][17][18] and more. In the case of physicians and healthcare workers (HCW), Twitter has been used to share and evaluate scientific evidence, guidelines, technical advice, [19][20][21] and track the course and burden of disease, 22 among others.…”

The Unclear Role of the Physician on Social Media During the COVID-19 Pandemic. Comment on “Emergency Physician Twitter Use in the COVID-19 Pandemic as a Potential Predictor of Impending Surge: Retrospective Observational Study”

“…We congratulate Margus and colleagues on their interesting study documenting emergency medicine physicians’ use of Twitter preceding surges in COVID-19 cases [ 1 ]. The correlations discovered between tweet count and hospital case numbers represent a unique instrument to assess epidemiologic trends related to the COVID-19 pandemic [ 1 ].…”

“…We congratulate Margus and colleagues on their interesting study documenting emergency medicine physicians’ use of Twitter preceding surges in COVID-19 cases [ 1 ]. The correlations discovered between tweet count and hospital case numbers represent a unique instrument to assess epidemiologic trends related to the COVID-19 pandemic [ 1 ]. An additional subanalysis by geographic region may provide enhanced insight into the efficacy of social media utilization as a predictive tool for emergency medical resource allocation.…”

“…As time moves forward, the use of social media in medicine will continue to expand beyond prediction as will its potential pitfalls. Margus and colleagues’ article [ 1 ] brings up a positive prospect of social media in medicine, and it is important that physicians understand the current limitations of these innovative platforms. We believe that physicians need medicine-based verification for social media in addition to clearly established roles for physicians from national governing bodies.…”