COVID-19 and social media: doctors' opinion

INTRODUCTION

Social media has emerged as a popular medium for people to express their opinions, perceptions and attitudes and it has transformed how the world interacts with information.¹ Social networking sites such as Facebook, Twitter, and Instagram allow users to post and share information with others on that platform. The massive volume of data makes it impossible to institute any semblance of real-time fact-checking or verification.² The same social media has an unprecedented ability to connect with others across the globe, and the information, misinformation, and disinformation spread all too easily.² Numerous research and literature are available on social media’s impacts on health care since 2010 and increasing exponentially.^2,3 But, only during this COVID-19 pandemic it has been possible to communicate so fast due to social media and it plays an essential function in disseminating information.^2-4 Government bodies, public organizations, and businesses use this medium to share information with the public. Some multiple advantages and disadvantages must be considered and responsible use of these tools can help quickly disseminate critical information globally, removing geographic boundaries.⁴ Numerous studies have been done in this field to gauge the public’s opinion on the relevance of social media during this pandemic. However, only a few have exclusively captured the perception of healthcare professionals, whose opinion matters the most during this pandemic. The current study attempts to capture the view of the health professional, exclusively doctors, regarding social media and its impact during the COVID-19 pandemic.

METHODS

This Cross-Sectional Descriptive study is carried out with doctors all over India who worked in COVID units. After an extensive literature search, a questionnaire has been developed catering to the various objectives of this study using google forms. There are three main aspects of the questionnaire, positive, negative and interventional aspects of social media (Table 1). A pilot study with a sample size of 30 was tested among the doctors at the study center in October-December 2021 and necessary changes were made. The pre-tested questionnaire is circulated among doctors using social media like WhatsApp, Facebook, etc. The data was collected from January 2022 to November 2022 and analyzed using appropriate statistics. A total of 400 responses has been received. After discarding 11 answers due to incomplete information, 389 responses were considered. Sample 389 is considered statistically significant based on Cochran’s formula with an unknown population and a population proportion of 50%. There are six questions on the positive aspect of social media and corresponding responses by the doctors (Table 1), (Figure 1) and three questions on the negative element of social media and the related opinion of the respondent’s doctors (Table 1), (Figure 1). Rest four questions are for the interventional aspect of social media and the respective views of the doctors (Figure 1).

RESULTS

All over India, 389 responses were found through the questionnaire. The responses were received from all over India, mostly from Odisha (17%), followed by Gujrat (15%), Telangana (14%) and others (Figure 2). 69% are Male, and 28% are female (3% do not prefer to say). Notably, among the respondents, the majority are specialists (39%), followed by others (31%), 16% super specialists, and 15% general practitioners. Most of the responded doctors are in the active age group, 36% between 30-39 years, 22% between 40-49 years, 21% between 20-29 years of age, and only 1% more than 70 years. More than 50 % of the population of doctors have zero to ten years of experience, the highest being 0-5 years of experience (25.4%), followed by 5-9 years (14.9%) and 10-14 years (14.9%) and lowest is 30-45 years of (4.5%) experiences. The responses from the said respondent doctors regarding the various questionnaire are summarized in a five-point Likert scale from strongly disagree to strongly agree (Table 1).

The positive aspect of social media and the corresponding responses like an excellent tool, preferred media and dependable, helpful, reliable and responsible tool. The doctors agreed on positive aspects by 48.6% (strongly agreed by 15.4%) and disagreed by 27.5% (strongly disagreed by 12.1%) and neutral responded 23.9% (Table 1), (Figure 1). The Negative aspects of social media and related opinions, like, damaging the image, motive of business, and spreading more stigma. The doctors agreed about the negative aspects by 70.9% (strongly agreed by 22.4%), disagreed 14.7 % (strongly disagreed by 3.1%), and 14.4% were neutral (Table 1), (Figure 1). Opinions regarding the interventional aspect of social media, like mechanism to check, code conduct etc., the doctors agreed 72.9% (strongly agree by 34.2%), disagreed 19.6 % (strongly agree by 9.8%), only 7.5% opined neutral (Figure 1).

DISCUSSION

The responses are male dominant (69%), and the distribution of type of medical professionals depicts mainly specialists (36%) and others means administrative health professionals. It depicts the story of the pandemic being served by specialists and in hospital setups mainly. However, the role of super specialists and general practitioners is always there; rather, it depends on the nature of the role and work. The sample age distribution shows that more than 70% of doctors are aged between 20 and 50 years, the active age group. It is also found that the respondent group mostly zero to ten years of experience, which corroborates with the pandemic. More than half of the doctors (~48%) agreed that social media is a wonderful tool, preferred media for spreading awareness among the public, and an excellent instrument to eliminate geographical limitations during the pandemic. In this study, doctors opined that social media has more negative aspects (~70%) compared to positive elements (48.6%), and there is a need for a control mechanism (72.9%). There are several studies describing both positive and negative aspects of social media from several groups of people (Table 2). A study offers a perspective for the practicing clinician regarding how social media interactions influence patients for proactively discussing medical decision-making with patients and suggests that the best practices need to be established to assist medical professionals in developing an online presence to combat misinformation or address individual patients. 2 another study’s says multiple advantages and disadvantages summarize the most relevant information on the influence, benefits, and drawbacks of using social networks during the COVID-19 pandemic.^4,14 In a systematic review of 28 articles pertinent to three socially sensitive domains; disaster, health, and politics; discuss the inter-relationships of concepts and the strategies to control the spread of misinformation on social media.⁵ A scoping review to identify the sources and impact of COVID-19 misinformation on social media and examine potential strategies for limiting the spread of misinformation, using 20 articles on the three themes, suggested that the said practice may exacerbate the severity of the pandemic, create mistrust in public health experts and impact physical and mental health and efforts to limit and prevent misinformation require interdisciplinary, multilevel approaches involving government and public health agencies, social media corporations and social influencers.^6,15,16 In a narrative review on chronic tic disorders, functional tics, and mass functional illness with a particular focus on the key distinguishing features, social media’s role and COVID-19 noted that social media are implicated in the rise and spread of tic-like behaviors; which may represent a modern-day form of mass functional illness.⁷ A narrative review based on three points of view, namely, the volume of use of social media, the evolution of scientific production and emerging issues, suggests other areas of in-depth research to combat high-level infodemic produced by scientific publications that are not yet official (preprint) or that have undergone peer review with bias/distortion and focusing on the impact of the infodemic considering its spread in different languages.^8,15-18 Another review article with 45 articles aimed at misinformation about COVID-19 vaccines spread on social media platforms and its effects identified three main themes of misinformation: medical misinformation, vaccine development and conspiracies, and concluded that to prevent these misconceptions, health authorities should openly address and discuss these false claims with both cultural and religious awareness in mind.⁹ In a scoping review, 81 studies identified five overarching public health themes concerning the role of online social media platforms and COVID-19. These themes focused on: surveying public attitudes, identifying infodemic, assessing mental health, detecting or predicting COVID-19 cases, analyzing government responses to the pandemic, and evaluating the quality of health information in prevention education videos and emphasizes the paucity of studies on the application of machine learning on data from COVID-19-related social media and a scarcity of studies documenting real-time surveillance that was developed with data from social media on COVID-19.^10,18,19 In a scoping review investigating nurses’ use of social media about COVID-19 using eleven cross-sectional studies, three themes were identified: ‘Social media as a knowledge node,’ ‘Social media functioned as profession-promoting channels,’ and ‘Social media as a disciplinary tool’ and concluded for further multi-methodological and in-depth qualitative research, including theoretically framed studies, with a specific focus on the uses of social media among nurses during the pandemic.^11,15,16,20 Another narrative review uses 91 studies to discuss the usage of social media in the healthcare industry from the perspective of patients and describe the main issues surrounding its use about ethical and legal considerations in the use of social media and suggests that due diligence must be practiced to assess the credibility of the information obtained and its source and the limitations and shortcomings of patients’ and risk associated with the use of social media should be understood.^12,16 Overall, the positive aspects are enormous, but precautions for negative aspects could lead social media a step ahead in communication.

In the current study, the opinion of healthcare professionals, exclusively doctors who worked in the COVID units all over India, is that social media have more negative (~70%) impacts than positive (~48%) ones. However, this current study shows a more neutral response in favour of positive aspects (28.9%) than negative aspects (14.4%) of social media (Table 1 and figure 2). Most (72.9%) of them agree about the need for regulation or ethical consideration. A similar type of study with 536 Romanian healthcare professionals was undertaken and aimed to analyses, from the perspective of medical staff, the way medical and non-medical information about the virus was communicated during the pandemic to encourage the development of future research or interventions to raise awareness about the way misinformation affected medical staff. The findings revealed that most respondents stated that the credibility of health professionals and, to a greater extent, trust in doctors were affected.¹³

People are now connected in a borderless web-based world. The modern public, especially the younger generation, relies heavily on the internet as the primary source of health-related information. In health care, patients can use social media for more tailored uses such as telemedicine, finding a provider, and peer support; Healthcare professionals had to face numerous challenges during the pandemic, their professional activity being influenced not only by the virus but also by the spread of medical misinformation. There are a growing understanding and recognition of how social media impacts health care. Healthcare professionals from all backgrounds need to increase their understanding of these complex interactions to assist patients with their medical decision-making best. Knowledge of these impacts is essential to mitigate downstream health effects and poor outcomes. The infodemic is an integral component of the cyber risk regarding the poor and uncontrolled dissemination of information related to the COVID-19 pandemic.

CONCLUSION

The study concluded that Healthcare professionals, especially doctors in India, acknowledged the positive role of social media but simultaneously cautioned about the negative aspects, especially in spreading medical misinformation. They also agreed that social media could be used to share official information with caution or regulation and control. Judicious use of social media in ethical and moral ways can make social media a boon, not a bane.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee (T/IM-NF/Hos.Admin/ 21/116)

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