Mandatory vaccination against COVID-19 would be supported by less than fifty per cent: A Twitter poll analysis on public health opinion. (Preprint)

BACKGROUND On January 30, 2020, the World Health Organization (WHO) Emergency Committee declared the rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) a global health emergency. By December 2020, the safety and efficacy of the first COVID-19 vaccines had been demonstrated. However, global vaccination coverage rates have remained below expectations. Mandatory vaccination is now being controversially discussed and has been enacted in some developed countries, while the vaccination rate is very low in many developing countries. We used the Twitter survey system as a viable method to quickly and comprehensively gather international public health insights on mandatory vaccination against COVID-19. OBJECTIVE The purpose of this study was to understand better the public's perception of mandatory COVID-19 vaccination in real-time utilizing Twitter polls. METHODS Two Twitter polls were developed to seek the public's opinion on the possibility of mandatory vaccination. The polls were pinned to the Digital Health and Patient Safety Platform's Twitter timeline for one week in mid-November 2021, three days after the official public announcement of mandatory COVID-19 vaccination in Austria. Twitter users were asked to participate and retweet the polls to reach the largest possible audience. RESULTS Our Twitter polls revealed two extremes on the topic of mandatory vaccination against COVID-19. Almost half of the respondents (49% [1,246/2,545]) favour mandatory vaccination, at least in certain areas. This attitude is in contrast to the 45.7% (1,162/2,545) who categorically reject mandatory vaccination. 26.3% (621/2,365) of participating Twitter users said they would never get vaccinated, which is reflected by the current vaccination coverage rate. Concatenating interpretation of these two polls needs to be done cautiously as participating populations might greatly differ. CONCLUSIONS Mandatory vaccination against COVID-19 (in at least certain areas) is favoured by less than 50%, whereas it is vehemently opposed by almost half of the surveyed Twitter users. Since (social) media strongly influences public perceptions and views through and social media discussions and surveys specifically susceptible to the "echo chamber effect", the results can be seen as a momentary snapshot. Therefore, the results of this study need to be complemented by long-term surveys to maintain their validity.

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People’s Willingness to Vaccinate Against COVID-19 Despite Their Safety Concerns: Twitter Poll Analysis (Preprint)

10.2196/preprints.28973 ◽

2021 ◽

Author(s):

Fabian Eibensteiner ◽

Valentin Ritschl ◽

Faisal A Nawaz ◽

Sajjad S Fazel ◽

Christos Tsagkaris ◽

...

Keyword(s):

Public Health ◽

Social Media ◽

Large Scale ◽

Digital Health ◽

Antibiotic Use ◽

World Health ◽

Vaccine Hesitancy ◽

Polling System ◽

Human Papillomavirus Vaccination ◽

Twitter Users

BACKGROUND On January 30, 2020, the World Health Organization’s Emergency Committee declared the rapid, worldwide spread of COVID-19 a global health emergency. Since then, tireless efforts have been made to mitigate the spread of the disease and its impact, and these efforts have mostly relied on nonpharmaceutical interventions. By December 2020, the safety and efficacy of the first COVID-19 vaccines were demonstrated. The large social media platform Twitter has been used by medical researchers for the analysis of important public health topics, such as the public’s perception on antibiotic use and misuse and human papillomavirus vaccination. The analysis of Twitter-generated data can be further facilitated by using Twitter’s built-in, anonymous polling tool to gain insight into public health issues and obtain rapid feedback on an international scale. During the fast-paced course of the COVID-19 pandemic, the Twitter polling system has provided a viable method for gaining rapid, large-scale, international public health insights on highly relevant and timely SARS-CoV-2–related topics. OBJECTIVE The purpose of this study was to understand the public’s perception on the safety and acceptance of COVID-19 vaccines in real time by using Twitter polls. METHODS We developed 2 Twitter polls to explore the public’s views on available COVID-19 vaccines. The surveys were pinned to the Digital Health and Patient Safety Platform Twitter timeline for 1 week in mid-February 2021, and Twitter users and influencers were asked to participate in and retweet the polls to reach the largest possible audience. RESULTS The adequacy of COVID-19 vaccine safety (ie, the safety of currently available vaccines; poll 1) was agreed upon by 1579 out of 3439 (45.9%) Twitter users. In contrast, almost as many Twitter users (1434/3439, 41.7%) were unsure about the safety of COVID-19 vaccines. Only 5.2% (179/3439) of Twitter users rated the available COVID-19 vaccines as generally unsafe. Poll 2, which addressed the question of whether users would undergo vaccination, was answered affirmatively by 82.8% (2862/3457) of Twitter users, and only 8% (277/3457) categorically rejected vaccination at the time of polling. CONCLUSIONS In contrast to the perceived high level of uncertainty about the safety of the available COVID-19 vaccines, we observed an elevated willingness to undergo vaccination among our study sample. Since people's perceptions and views are strongly influenced by social media, the snapshots provided by these media platforms represent a static image of a moving target. Thus, the results of this study need to be followed up by long-term surveys to maintain their validity. This is especially relevant due to the circumstances of the fast-paced pandemic and the need to not miss sudden rises in the incidence of vaccine hesitancy, which may have detrimental effects on the pandemic’s course.

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Round table: Online anti-vaccination movements: the role of social media in public health communications

European Journal of Public Health ◽

10.1093/eurpub/ckz185.681 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

Keyword(s):

Public Health ◽

Social Networks ◽

Social Media ◽

Real Time ◽

Hpv Vaccine ◽

Digital Health ◽

World Health ◽

Swine Flu ◽

Potential Impact ◽

The Impact

Abstract Digital health has revolutionised healthcare, with implications for understanding public reaction to health emergencies and interventions. Social media provides a space where like-minded people can share interests and concerns in real-time, regardless of their location. This can be a force for good, as platforms like Twitter can spread correct information about outbreaks, for example in the 2009 swine flu pandemic. However, social media can also disseminate incorrect information or deliberately spread misinformation leading to adverse public health sentiment and outcomes. The current issues around trust in vaccines is the best-known example. Vaccine hesitancy, traditionally linked to issues of trust, misinformation and prior beliefs, has been increasingly fueled by influential groups on social media and the Internet. Ultimately, anti-vaccination movements have the potential to lead to outbreaks of vaccine-preventable diseases, especially if refusal is concentrated locally, creating vulnerable populations. For example, 2018-19 saw a large increase in incidence of measles in the US and Europe (where cases tripled from 2017), two regions where the disease was already or almost eliminated. In 2019, the World Health Organisation listed anti-vaccination movements as one of the top 10 threats to global public health. HPV vaccination is another example of the impact of anti-vaccination movements. As viral videos originating on YouTube spread across social networks, uptake has tumbled in a number of countries, with Japan, Denmark, Colombia and Ireland being badly hit. In Japan, the government came under sufficient pressure that they de-recommended HPV vaccine, seeing an 80% uptake rate fall below 1% in 2014. There have been reports of successful interventions by national governments. A recent campaign run by the HPV Alliance (a coalition of some 35 private companies, charities and public institutions) in Ireland has seen rates below 40% back up to a national average of 75%. A combination of hard-hitting personal testimonials, social media and traditional media promoted the HPV vaccine. Despite this, systematic engagement and supranational strategies are still in the early stages of being formulated. As misleading information spread through social media and digital networks has undesirable impact on attitudes to vaccination (and uptake rates), urgent actions are required. Analysis and visualisation techniques mining data streams from social media platforms, such as Twitter, Youtube enable real-time understanding of vaccine sentiments and information flows. Through identification of key influencers and flashpoints in articles about vaccination going viral, targeted public health responses could be developed. This roundtable discussion will showcase different ways in which media and social networks, accessible in real-time provide an opportunity for detecting a change in public confidence in vaccines, for identifying users and rumors and for assessing potential impact in order to know how to best respond. Key messages Social media has significantly enhanced our understanding of anti-vaccination movements and potential impact on public health attitudes and behaviors regarding vaccination. Innovative methods of analysing social media data, from digital health, data science and computer science, have an important role in developing health promotions to counter anti-vaccination movements.

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Trend of Social Media News: A Viewpoint of COVID-19 Tweets Using Natural Language Processing

10.31219/osf.io/zjkra ◽

2021 ◽

Author(s):

AISDL

Keyword(s):

Social Media ◽

Natural Language Processing ◽

Natural Language ◽

Language Processing ◽

Developed Countries ◽

World Health ◽

The World ◽

Twitter Users ◽

The Developed Countries ◽

Health Organization

The meteoric rise of social media news during the ongoing COVID-19 is worthy of advanced research. Freedom of speech in many parts of the world, especially the developed countries and liberty of socialization, calls for noteworthy information sharing during the panic pandemic. However, as a communication intervention during crises in the past, social media use is remarkable; the Tweets generated via Twitter during the ongoing COVID-19 is incomparable with the former records. This study examines social media news trends and compares the Tweets on COVID-19 as a corpus from Twitter. By deploying Natural Language Processing (NLP) methods on tweets, we were able to extract and quantify the similarities between some tweets over time, which means that some people say the same thing about the pandemic while other Twitter users view it differently. The tools we used are Spacy, Networkx, WordCloud, and Re. This study contributes to the social media literature by understanding the similarity and divergence of COVID-19 tweets of the public and health agencies such as the World Health Organization (WHO). The study also sheds more light on the COVID-19 sparse and densely text network and their implications for the policymakers. The study explained the limitations and proposed future studies.

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Misinformation, chiropractic, and the COVID-19 pandemic

Chiropractic & Manual Therapies ◽

10.1186/s12998-020-00353-2 ◽

2020 ◽

Vol 28 (1) ◽

Author(s):

Iben Axén ◽

Cecilia Bergström ◽

Marc Bronson ◽

Pierre Côté ◽

Casper Glissmann Nim ◽

...

Keyword(s):

Public Health ◽

Social Media ◽

Scientific Evidence ◽

Collective Responsibility ◽

Economic Consequences ◽

Best Interests ◽

World Health ◽

Chiropractic Treatment ◽

Health Organization ◽

The Impact

Abstract Background In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including ‘stay-at-home’ orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. Main text During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. Conclusions Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.

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Workshop: EUPHA and Europe-wide action on digital public health

European Journal of Public Health ◽

10.1093/eurpub/ckz185.767 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

Keyword(s):

Public Health ◽

Health Systems ◽

Digital Health ◽

Digital Technologies ◽

Digital Transformation ◽

Health System Strengthening ◽

World Health ◽

Collaborative Action ◽

European Public ◽

The World

Abstract The World Health Assembly Resolution on Digital Health unanimously approved by WHO Member States in May 2018 demonstrated a collective recognition of the value of digital technologies to contribute to advancing universal health coverage (UHC) and other health aims of the Sustainable Development Goals (SDGs). The World Health Organization has just released first ever guideline on digital interventions for health system strengthening. Et the European level, in June 2018 the WHO Regional Office for Europe launched the WHO/Europe initiative for Digitalization of Health Systems and in February 2019 organized the first Symposium on the Future of Digital Health Systems in the European Region. The European Commission in April 2018 published a Communication on Digital transformation of health and care in the digital single market and requested the Expert Panel on effective ways of investing in health (EXPH) to release an evidence-based opinion on how to assess the impact of digital transformation of health services. In such context, the European Public Health Association (EUPHA) has at an early stage acknowledged and understood the crucial importance of applying the potential offered by digitalization to public health. Not only its most prominent members work and research as WHO and EC experts on how to plan, implement and evaluate effective digital public health interventions, but EUPHA itself - as umbrella organization representing public health associations and institutes across Europe had: i) actively participated to the WHO Euro Symposium successfully co-organizing a session on the ‘beautiful marriage’ between digitalization and public health, ii) supported the publication of a EJPH supplement on digital health and iii) has planned to create a EUPHA Section on Digital Health. With the overall goal of positioning the proposed EUPHA Section on Digital Health in the enriching and constructive context of the European Public Health Conference the workshop specifically aims to: present a comprehensive conceptual framework for the application of digital technologies to public health in Europe;present and report on EUPHA collaborative action on digital health, aligned with European institutions;present the structure and content of the EJPH supplement on digital health;present the general aim, specific objectives, scope, mission and preliminary outputs of the proposed EUPHA Section on Digital Health, as well as its synergy with other EUPHA’s Section workPresent the results of two/three specific projects on digital public health to serve as concrete examples of the application of digital solutions to public healthEngage with the audience to promote the active participation of the broader EUPHA community to the activities of the Section, collect interests and best practices, and share ideas and projects worth scaling up at the Section-level. Key messages The ‘beautiful marriage’ between digitalization and public health has to be concretely planned, implemented and evaluated. EUPHA action on digital public health can be further strengthened through the collaborative action and work of its dedicated Section.

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Flu vaccination coverage in a large Italian teaching hospital: the example of the leaders

European Journal of Public Health ◽

10.1093/eurpub/ckz185.630 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M Di Pumpo ◽

A Barbara ◽

D I La Milia ◽

A Tamburrano ◽

D Vallone ◽

...

Keyword(s):

Teaching Hospital ◽

Vaccination Coverage ◽

Healthcare Workers ◽

Cross Sectional Study ◽

Vaccination Rate ◽

Coverage Rate ◽

Cross Sectional ◽

Vaccination Coverage Rate ◽

Flu Vaccination ◽

Frail Patients

Abstract Annual flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission especially to frail patients. In our teaching hospital, flu vaccination rate among HCWs has been growing during last 3 years. The aim of this study was therefore to describe the flu vaccination coverage across the past 3 years and to analyze which factors lead to such increase. We performed a cross-sectional study on all HCWs of Fondazione Policlinico Universitario “A. Gemelli” (FPG) hospital of Rome (Italy) to determine the flu vaccination coverage. Socio-demographic and occupational data were collected from hospital personnel records and included age, gender, previous flu vaccination, profession and workplace unit. On site vaccination plus academic detailing involving leaders have been the main strategies adopted in this last 3 years that have already proved to be effective in increasing vaccination coverage among HCWs. During the 2018-2019 season, we analyzed how the flu vaccination coverage among leaders (nurse coordinators and head physicians) could affect all HCWs coverage rate. Flu vaccination rate increased from 9.57% in the 2016-17 to 14.24% in the 2017-18 and to 22.38% in 2018-2019. A total of 4035 HCWs employed in the FPG were included in 2018-19. Concerning the role played by vaccination of leaders in increasing general vaccination coverage during the 2018-2019, the group of HCWs with a vaccinated leader showed a higher coverage rate (28.65%) than the group with a non-vaccinated leader (16.22%) (p < 0.0001). The results are preliminary. Flu vaccination coverage of HCWs in our hospital during the last 3 years has been increasingly higher. Vaccination of the leaders, in addition to previously implemented effective strategies, resulted to be a key factor in increasing flu vaccination coverage among all HCWs. Socio-demographic and occupational variables can significantly influence the coverage rate as well. Key messages Annual flu vaccination among healthcare workers (HCWs) is recommended to prevent influenza and to avoid its transmission especially to frail patients. This study shows the growing flu vaccination coverage rate in our teaching hospital and the effectiveness of the example given by the vaccinated leaders in increasing the coverage among all HCWs.

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3.E. Workshop: The Role of Digital Public Health in the European Climate Pact and Green deal

European Journal of Public Health ◽

10.1093/eurpub/ckab164.189 ◽

2021 ◽

Vol 31 (Supplement_3) ◽

Author(s):

◽

Keyword(s):

Public Health ◽

Climate Change ◽

Digital Health ◽

Digital Systems ◽

World Health ◽

Director General ◽

European Climate ◽

The World ◽

Climate Crisis ◽

The Impact

Abstract Europe is facing two major structural changes: the climate crisis, having a significant impact on public health, and digitalization of the economy, that could play a role in mitigating climate change and its impacts on public health. The COVID-19 pandemic has affected our lives in many ways including how we see public health, the climate change and has created the conditions for the almost exponential growth for telemedicine and digitalization in healthcare. Underlining that the world is facing an increasing innovation and integration of digital tools to address public health and environmental problems, as the UN Secretary-General and the Director-General of the World Health Organization both declared that we are currently fighting a climate “pandemic” in the same way as we are fighting COVID-19. Digital solutions have been implemented to address COVID-19 and impacted by reducing CO2 emissions and improving quality of life. Digital systems, including Artificial Intelligence, robots and drones, are now changing the paradigm of public health and environment management. Due to the complex nature of the information ecosystem our societies and communities live in, a digital public health approach can be managed to reduce harm to individual, community and population health, support social cohesion and trust in emergency response and interventions to deal with climate change. Digital health could, within 10 years establish a new paradigm in public and environmental health. Public health professionals need urgently to tackle digital health to bridge the gap with others areas of healthcare. During the COVID-19 crisis, national public health authorities have been challenged in the way they communicate with the public, engage with communities in collecting data to improve response, providing the scientific evidence, the day-to-day facts and figures. Likewise, The European Climate Pact provides a space for collectively develop and implement climate solutions. The Climate Pact is an open, inclusive and evolving initiative for climate action through an online platform and citizen dialogues and exchanges, it will foster the link between the digital and green transition. This workshop aims to share the experiences of digital public health interventions with significant impact on climate change mitigation during the pandemic. It will be organised as a round table, starting by setting the scene with an introduction to key digital health concepts and challenges. Each speaker will give a short pitch on how they have experienced the challenge of using digital systems in public health and how they approached its management during the crisis. This will be followed by a panel discussion. Participants will have ample time to ask questions to the panellists. The workshop will end with a summary of a selection of tools participants can use in their own environmental management activities and key take home messages from the panellist will be provided as a conclusion. Key messages Digital Public Health has been establishing evidence on interventions with significant effects on reducing the impact of climate crisis. A Partnership is needed across the health system and society to manage this crisis. European Green Deal and Climate Pact could be used as a roadmap in digital public health.

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Infodemic Signal Detection During the COVID-19 Pandemic: Development of a Methodology for Identifying Potential Information Voids in Online Conversations

JMIR Infodemiology ◽

10.2196/30971 ◽

2021 ◽

Vol 1 (1) ◽

pp. e30971

Author(s):

Tina D Purnat ◽

Paolo Vacca ◽

Christine Czerniak ◽

Sarah Ball ◽

Stefano Burzo ◽

...

Keyword(s):

Public Health ◽

Social Media ◽

World Health ◽

Aggregated Data ◽

Response Planning ◽

Online Conversations ◽

Social Media Platforms ◽

Health Organization ◽

Over Time ◽

Social Listening

Background The COVID-19 pandemic has been accompanied by an infodemic: excess information, including false or misleading information, in digital and physical environments during an acute public health event. This infodemic is leading to confusion and risk-taking behaviors that can be harmful to health, as well as to mistrust in health authorities and public health responses. The World Health Organization (WHO) is working to develop tools to provide an evidence-based response to the infodemic, enabling prioritization of health response activities. Objective In this work, we aimed to develop a practical, structured approach to identify narratives in public online conversations on social media platforms where concerns or confusion exist or where narratives are gaining traction, thus providing actionable data to help the WHO prioritize its response efforts to address the COVID-19 infodemic. Methods We developed a taxonomy to filter global public conversations in English and French related to COVID-19 on social media into 5 categories with 35 subcategories. The taxonomy and its implementation were validated for retrieval precision and recall, and they were reviewed and adapted as language about the pandemic in online conversations changed over time. The aggregated data for each subcategory were analyzed on a weekly basis by volume, velocity, and presence of questions to detect signals of information voids with potential for confusion or where mis- or disinformation may thrive. A human analyst reviewed and identified potential information voids and sources of confusion, and quantitative data were used to provide insights on emerging narratives, influencers, and public reactions to COVID-19–related topics. Results A COVID-19 public health social listening taxonomy was developed, validated, and applied to filter relevant content for more focused analysis. A weekly analysis of public online conversations since March 23, 2020, enabled quantification of shifting interests in public health–related topics concerning the pandemic, and the analysis demonstrated recurring voids of verified health information. This approach therefore focuses on the detection of infodemic signals to generate actionable insights to rapidly inform decision-making for a more targeted and adaptive response, including risk communication. Conclusions This approach has been successfully applied to identify and analyze infodemic signals, particularly information voids, to inform the COVID-19 pandemic response. More broadly, the results have demonstrated the importance of ongoing monitoring and analysis of public online conversations, as information voids frequently recur and narratives shift over time. The approach is being piloted in individual countries and WHO regions to generate localized insights and actions; meanwhile, a pilot of an artificial intelligence–based social listening platform is using this taxonomy to aggregate and compare online conversations across 20 countries. Beyond the COVID-19 pandemic, the taxonomy and methodology may be adapted for fast deployment in future public health events, and they could form the basis of a routine social listening program for health preparedness and response planning.

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The relationship of urbanization with the formation and implementation of public health policy in Ukraine

Public administration aspects ◽

10.15421/151965 ◽

2020 ◽

Vol 7 (12) ◽

pp. 59-69

Author(s):

О. І. Деміхов

Keyword(s):

Public Health ◽

Health Policy ◽

Public Health Policy ◽

Healthy Lifestyle ◽

Developed Countries ◽

World Health ◽

Motor Vehicles ◽

Industrial Emissions ◽

The World ◽

The Impact

The purpose of the research is to study and find out the modern foreign technologies of public health policy in the context of the impact of urbanization processes, to explore the possibilities of implementation of best practices in Ukraine.Materials. Peculiarities of public health policy implementation in developed countries in the context of population density increase and agglomeration expansion are described in the article. The study is based on the analysis of statistics, publications in the media and scientific articles. The comparative statistical analysis of the countries of the world on the incidence of the incidence of different species and the correlation of these processes with the urbanization dynamics is made in the article. Expert assessments of UN and World Health Organization experts on processes of concentration of population around the world, deterioration of living conditions, quality of health, morbidity and appropriate prevention, promotion of healthy lifestyle and quality control of goods, works and services for the population are given in the article. Particular emphasis is placed on the environmental problems of densely populated areas, including through the proliferation of motor vehicles, substandard housing and uncontrolled industrial emissions. The connection of the dynamics of urbanization with the increase of the sedentary lifestyle of the citizens is also described. The urban way of life is assessed as requiring immediate influence by public health policy makers. The current experience of foreign public administration and public policy entities on a proactive approach to shaping the concept of public health in the context of urban transformation in society can be used in Ukraine. Practical results of the work of state institutions in developed countries should be implemented in Ukraine. Conclusions. On the example of the positive experience of the capitalist countries of the world, the further directions of the development of public health policy in Ukraine in the conditions of deepening urbanization processes are clearly defined.

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Temporal and Location Variations, and Link Categories for the Dissemination of COVID-19–Related Information on Twitter During the SARS-CoV-2 Outbreak in Europe: Infoveillance Study (Preprint)

10.2196/preprints.19629 ◽

2020 ◽

Author(s):

Monika Pobiruchin ◽

Richard Zowalla ◽

Martin Wiesner

Keyword(s):

Public Health ◽

Social Media ◽

Media Coverage ◽

Relative Proportion ◽

World Health ◽

Shared Resources ◽

Public Health Response ◽

External Resources ◽

Geographical Variations ◽

Social Media Platforms

BACKGROUND The spread of the 2019 novel coronavirus disease, COVID-19, across Asia and Europe sparked a significant increase in public interest and media coverage, including on social media platforms such as Twitter. In this context, the origin of information plays a central role in the dissemination of evidence-based information about the SARS-CoV-2 virus and COVID-19. On February 2, 2020, the World Health Organization (WHO) constituted a “massive infodemic” and argued that this situation “makes it hard for people to find trustworthy sources and reliable guidance when they need it.” OBJECTIVE This <i>infoveillance</i> study, conducted during the early phase of the COVID-19 pandemic, focuses on the social media platform Twitter. It allows monitoring of the dynamic pandemic situation on a global scale for different aspects and topics, languages, as well as regions and even whole countries. Of particular interest are temporal and geographical variations of COVID-19–related tweets, the situation in Europe, and the categories and origin of shared external resources. METHODS Twitter’s Streaming application programming interface was used to filter tweets based on 16 prevalent hashtags related to the COVID-19 outbreak. Each tweet’s text and corresponding metadata as well as the user’s profile information were extracted and stored into a database. Metadata included links to external resources. A link categorization scheme—introduced in a study by Chew and Eysenbach in 2009—was applied onto the top 250 shared resources to analyze the relative proportion for each category. Moreover, temporal variations of global tweet volumes were analyzed and a specific analysis was conducted for the European region. RESULTS Between February 9 and April 11, 2020, a total of 21,755,802 distinct tweets were collected, posted by 4,809,842 distinct Twitter accounts. The volume of #covid19-related tweets increased after the WHO announced the name of the new disease on February 11, 2020, and stabilized at the end of March at a high level. For the regional analysis, a higher tweet volume was observed in the vicinity of major European capitals or in densely populated areas. The most frequently shared resources originated from various social media platforms (ranks 1-7). The most prevalent category in the top 50 was “Mainstream or Local News.” For the category “Government or Public Health,” only two information sources were found in the top 50: US Centers for Disease Control and Prevention at rank 25 and the WHO at rank 27. The first occurrence of a prevalent scientific source was Nature (rank 116). CONCLUSIONS The naming of the disease by the WHO was a major signal to address the public audience with public health response via social media platforms such as Twitter. Future studies should focus on the origin and trustworthiness of shared resources, as monitoring the spread of fake news during a pandemic situation is of particular importance. In addition, it would be beneficial to analyze and uncover bot networks spreading COVID-19–related misinformation.

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