The State of Mind of Health Care Professionals in Light of the COVID-19 Pandemic: Text Analysis Study of Twitter Discourses

Abstract

Background The COVID-19 pandemic has affected populations worldwide, with extreme health, economic, social, and political implications. Health care professionals (HCPs) are at the core of pandemic response and are among the most crucial factors in maintaining coping capacities. Yet, they are also vulnerable to mental health effects caused by managing a long-lasting emergency with a lack of resources and under complicated personal concerns. However, there are a lack of longitudinal studies that investigate the HCP population. Objective The aim of this study was to analyze the state of mind of HCPs as expressed in online discussions published on Twitter in light of the COVID-19 pandemic, from the onset of the pandemic until the end of 2020. Methods The population for this study was selected from followers of a few hundred Twitter accounts of health care organizations and common HCP points of interest. We used active learning, a process that iteratively uses machine learning and manual data labeling, to select the large-scale population of Twitter accounts maintained by English-speaking HCPs, focusing on individuals rather than official organizations. We analyzed the topics and emotions in their discourses during 2020. The topic distributions were obtained using the latent Dirichlet allocation algorithm. We defined a measure of topic cohesion and described the most cohesive topics. The emotions expressed in tweets during 2020 were compared to those in 2019. Finally, the emotion intensities were cross-correlated with the pandemic waves to explore possible associations between the pandemic development and emotional response. Results We analyzed the timelines of 53,063 Twitter profiles, 90% of which were maintained by individual HCPs. Professional topics accounted for 44.5% of tweets by HCPs from January 1, 2019, to December 6, 2020. Events such as the pandemic waves, US elections, or the George Floyd case affected the HCPs’ discourse. The levels of joy and sadness exceeded their minimal and maximal values from 2019, respectively, 80% of the time (P=.001). Most interestingly, fear preceded the pandemic waves, in terms of the differences in confirmed cases, by 2 weeks with a Spearman correlation coefficient of ρ(47 pairs)=0.340 (P=.03). Conclusions Analyses of longitudinal data over the year 2020 revealed that a large fraction of HCP discourse is directly related to professional content, including the increase in the volume of discussions following the pandemic waves. The changes in emotional patterns (ie, decrease in joy and increase in sadness, fear, and disgust) during the year 2020 may indicate the utmost importance in providing emotional support for HCPs to prevent fatigue, burnout, and mental health disorders during the postpandemic period. The increase in fear 2 weeks in advance of pandemic waves indicates that HCPs are in a position, and with adequate qualifications, to anticipate pandemic development, and could serve as a bottom-up pathway for expressing morbidity and clinical situations to health agencies.

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“…Sadness increased by the end of May 2020, when COVID‐19 deaths in the United States crossed 100,000. The increase in sadness and decrease in joy were also reported by Kaur et al (2020) and Elyashar et al (2021). This was noted even with a decrease in average deaths per 100k and the average number of cases per 100k remained stable.…”

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“… 40 Additional research employing content analysis to analyse online discussions published on Twitter during the pandemic found decreased joy and increased sadness, fear and disgust among healthcare workers. 41 While this research did not stratify by gender factors, conclusions were similar to our work and called for increased mental health support for healthcare workers.…”

Global and Local Trends Affecting the Experience of US and UK Healthcare Professionals during COVID-19: Twitter Text Analysis

“…Together, these results paint a detailed and dynamic portrait of HCPs’ state of mind in times of emergency [ 22 , 34 ]. Specifically, these findings suggest that HCPs around the globe are influenced by similar health, social, and political events but that these events elicit a similar profile of cognitive and emotional responses.…”

“…Then, we applied active machine learning to mark accounts of individual HCPs in this large bulk of followers. The detailed process is described in [ 22 ]. The current study used a semi-bounded data collection strategy that focuses on a defined set of Twitter users (i.e., HCPs), without restrictions on the topical content.…”

“…A recent analysis of more than 50,000 Twitter profiles of HCPs during the COVID-19 [ 22 ] showed how HCPs’ emotional displays and topics of interest resonated with local and global events. This study showed that, overall, during 2020 HCPs experienced more negative emotions and fewer positive emotions, compared with the year before.…”