Measuring the Outreach Efforts of Public Health Authorities and the Public Response on Facebook during the COVID-19 Pandemic in Early 2020: A Cross-Country Comparison

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic presents one of the most challenging global crises at the dawn of a new decade. Public health authorities (PHAs) are increasingly adopting the use of social media such as Facebook to rapidly communicate and disseminate pandemic response measures to the public. Understanding of communication strategies across different PHAs and examining the public response on the social media landscapes can help in improving practices for disseminating information to the public. OBJECTIVE: This study examines COVID-19 related outreach efforts of PHAs in Singapore, the United States (US) and England and the corresponding public response to these outreach efforts on Facebook. METHODS: Posts and comments from the Facebook pages of the Ministry of Health (MOH) in Singapore, Centers for Disease Control and Prevention (CDC) in the US and Public Health England (PHE) in England, were extracted from 01 Jan 2019 to 18 Mar 2020. Posts published before 01 Jan 2020 were categorized as pre-COVID-19 while the remaining posts were categorized as peri-COVID-19 posts. COVID-19 related posts were identified and classified into themes. Metrics used for measuring outreach and engagement were frequency, mean posts per day (PPD), mean reactions per post (RPP), mean shares per post (SPP) and mean comments per post (CPP). Responses to the COVID-19 posts were measured using frequency, mean sentiment polarity (SP), positive to negative sentiments ratio (PNSR) and positive to negative emotions ratio (PNER). Toxicity in comments were identified and analyzed using frequency, mean likes per toxic comment (LPTC) and mean replies per toxic comment (RPTC). Trend analysis was performed to examine how the metrics varied with key events such as when COVID-19 was declared a pandemic. RESULTS: MOH published more COVID-19 posts (n=271, PPD=5.0) compared to CDC (n=94, PPD=2.2) and PHE (n=45, PPD=1.4). The mean number of comments per COVID-19 post was highest for CDC (CPP=255.3) compared to MOH (CPP=15.6) and PHE (CPP=12.5). Six major themes were identified, with posts about preventive/safety measures and situation updates being prevalent across the three PHAs. The themes of MOH's posts were diverse while CDC and PHE posts focused on a few themes. The number of comments spiked alongside key events. Response sentiments for MOH's COVID-19 posts were largely negative initially but improved over time. Overall, response sentiments for MOH posts (PNSR=0.94) were more favorable compared to response sentiments for CDC (PNSR=0.57) and PHE (PNSR=0.55) posts. Toxic comments were rare (0.01%) across all PHAs. CONCLUSIONS: PHAs' extent of Facebook usage for outreach purposes during the COVID-19 pandemic varied among the three PHAs, highlighting the strategies and approaches that other PHAs can potentially adopt. Our study showed that social media analysis is capable of providing insights about the communication strategies of PHAs during disease outbreaks. CLINICALTRIAL: