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.

Background: Healthcare professionals (HCPs) are on the frontline of fighting the COVID-19 pandemic. Recent reports have indicated that, in addition to facing an increased risk of being infected by the virus, HCPs face an increased risk of suffering from emotional difficulties associated with the pandemic. Therefore, understanding HCPs’ experiences and emotional displays during emergencies is a critical aspect of increasing the surge capacity of communities and nations. Methods: In this study, we analyzed posts published by HCPs on Twitter to infer the content of discourse and emotions of the HCPs in the United States (US) and United Kingdom (UK), before and during the COVID-19 pandemic. The tweets of 25,207 users were analyzed using natural language processing (NLP). Results: Our results indicate that HCPs in the two countries experienced common health, social, and political issues related to the pandemic, reflected in their discussion topics, sentiments, and emotional display. However, the experiences of HCPs in the two countries are also subject to local socio-political trends, as well as cultural norms regarding emotional display. Conclusions: Our results support the potential of utilizing Twitter discourse to monitor and predict public health responses in emergencies.

BACKGROUND The COVID-19 pandemic has affected populations worldwide, with extreme health, economic, social, and political implications. Healthcare professionals (HCPs) are at the core of pandemic response and are one of the most crucial factors in maintaining coping capacities. Yet, they are also vulnerable to mental health effects, managing a long-lasting emergency under lack of resources and complicated personal concerns. Analysing online social networks is an accepted method to explore insights during routine and emergencies. However, there is a lack of longitudinal studies that investigate the HCP population. OBJECTIVE To analyse the state of mind of HCPs as expressed in online discussions published on Twitter in light of COVID-19, from the pandemic onset until the end of 2020. METHODS The population for this study was selected from followers of a few hundred Twitter accounts of healthcare 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 analysed the topics and emotions in their discourse during 2020. The topic distributions were obtained using the Latent Dirichlet Allocation (LDA) algorithm. We defined a measure of topic cohesion and described the most cohesive topics. The emotions expressed in tweets during 2020 were compared to 2019. Finally, the emotion intensities were cross-correlated with the pandemic waves to identify causal relationships. RESULTS We analysed timelines of 53,063 Twitter profiles 90% of which are maintained by individual HCPs. Professional topics account for 44.5% of tweets by HCPs from Jan. 1st to Dec. 6th, 2020. Events such as the pandemic waves, U.S. elections, or the George Floyd case affect the HCPs’ discourse. The levels of joy and sadness exceed their minimal and maximal values yesteryear respectively, 80% of the time, P = .001. Most interestingly, fear precedes the pandemic waves (in terms of the differences in daily death cases) by one week with a Pearson correlation coefficient of r(47)=.388, P=.001. CONCLUSIONS Analyses of longitudinal data over the 2020 year reveal that a large fraction of HCP discourse is related directly to professional content, including the increase in the volume of discussions following the pandemic waves. The changes in emotional patterns (decrease of joy, an increase of 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 in the post-pandemic period. The increase of fear one week in advance of pandemic waves indicates that many HCPs are in a position and with adequate qualification to anticipate the pandemic development.