Iberoamerican Journal of Medicine
Iberoamerican Journal of Medicine

Physician Roles and Responsibilities in the Context of a Pandemic in Resource-Limited Areas: Impact of Social Media

Prévost Jantchou, Bamidele Johnson Alegbeleye, Valérie Nguyen

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Objective: This article aims to explore the role and responsibility of physicians in the era of social media; the authors take as an example of the current pandemic of Coronavirus disease 2019 (COVID-19). Also, we highlight how social media impact the way populations trust and follow the recommendations of the governments.
Methods: We identified relevant articles to date using a manual library search, journal publications on the subject, and critically reviewed them.
Results: We critically examined the fake news around COVID-19 disease: the disease origin, manifestations, symptoms, and treatments. The authors also explore the high expectation of people and changes in behaviors that led to risky manners, including self-medication after American President Donald Trump has claimed a major benefit of treatment with chloroquine in COVID-19. Surprisingly, the potential BCG vaccination trials in the COVID-19 pandemic were also greeted with much controversy and rejection, especially in Africa. This paper ends with some advice to various stakeholders, including leaders of global health national health organizations, and physicians on the measures to be taken in case of a similar situation in the future.
Conclusions: Social media offer significant benefits for individual and public health promotion, especially when used wisely and prudently. They equally provide opportunities for advancement and professional development. However, any careless use of such platforms poses a formidable danger to health care practitioners. Lately, there are existing guidelines issued by health care organizations and professional societies which provide sound and useful principles that health care practitioner should follow to avoid pitfalls. The authors also end by stressing the importance of culturally adapting prevention messages in the context of such a pandemic.


Coronavirus Disease; COVID-19; Health Professionals; Health Policy; Social Media; Twitter; WhatsApp; Facebook


1. Ventola CL. Social Media and Health Care Professionals: Benefits, Risks, and Best Practices. P T. 2014;39(7):491-520.
2. Grindrod K, Forgione A, Tsuyuki RT, Gavura S, Giustini D. Pharmacy 2.0: a scoping review of social media use in pharmacy. Res Social Adm Pharm. 2014;10(1):256-270. doi: 10.1016/j.sapharm.2013.05.004.
3. Peck JL. Social media in nursing education: responsible integration for meaningful use. J Nurs Educ. 2014;53(3):164-9. doi: 10.3928/01484834-20140219-03.
4. Chauhan B, George R, Coffin J. Social media and you: what every physician needs to know. J Med Pract Manage. 2012;28(3):206-9.
5. Von Muhlen M, Ohno-Machado L. Reviewing social media use by clinicians. J Am Med Inform Assoc. 2012;19(5):777-81. doi: 10.1136/amiajnl-2012-000990.
6. ASHP statement on use of social media by pharmacy professionals. Available from: www.ashp.org/DocLibrary/BestPractices/ AutoITStSocialMedia.aspx (accessed March 2020).
7. Dizon DS, Graham D, Thompson MA, Johnson LJ, Johnston C, Fisch MJ, et al. Practical guidance: The use of social media in oncology practice. J Oncol Pract. 2012;8(5):114-24. doi: 10.1200/JOP.2012.000610.
8. George DR, Rovniak LS, Kraschnewski JL. Dangers and opportunities for social media in medicine. Clin Obstet Gynecol. 2013;56(3):453-62. doi: 10.1097/GRF.0b013e318297dc38.
9. Househ M. The use of social media in healthcare: organizational, clinical, and patient perspectives. Stud Health Technol Inform. 2013;183:244-8.
10. Farnan JM, Snyder Sulmasy L, Worster BK, Chaudhry HJ, Rhyne JA, Arora VM, et al. Online medical professionalism: patient and public relationships: policy statement from the American College of Physicians and the Federation of State Medical Boards. Ann Intern Med. 2013;158(8):620-7. doi: 10.7326/0003-4819-158-8-201304160-00100.
11. Bernhardt M, Alber J, Gold RS. A social media primer for professionals: digital do’s and don’ts. Health Promot Pract. 2014;15(2):168-72. doi: 10.1177/1524839913517235.
12. MacMillan C. Social media revolution and blurring of professional boundaries. Imprint. 2013;60(3):44-6.
13. Pirraglia PA, Kravitz RL. Social media: new opportunities, new ethical concerns. J Gen Intern Med. 2012;28(2):165-6. doi: 10.1007/s11606-012-2288-x.
14. Fogelson NS, Rubin ZA, Ault KA. Beyond likes and tweets: an in-depth look at the physician social media landscape. Clin Obstet Gynecol. 2013;56(3):495-508. doi: 10.1097/GRF.0b013e31829e7638.
15. Moorhead SA, Hazlett DE, Harrison L, Carroll JK, Irwin A, Hoving C, et al. A new dimension of health care: systemic review of the uses, benefits, and limitations of social media for health care professionals. J Med Internet Res. 2013;15(4):e85. doi: 10.2196/jmir.1933.
16. Grajales FJ 3rd, Sheps S, Ho K, Novak-Lauscher H, Eysenbach G. Social media: a review and tutorial of applications in medicine and health care. J Med Internet Res. 2014;16(2):e13. doi: 10.2196/jmir.2912.
17. O’Hara B, Fox BJ, Donahue B. Social media in pharmacy: heeding its call, leveraging its power. J Amer Pharm Assoc. 2013;53(6):561-4. doi: 10.1331/JAPhA.2013.13536.
18. Childs LM, Martin CY. Social media profiles: striking the right balance. Am J Health System Pharm Dec. 2012;69(23):2044-50. doi: 10.2146/ajhp120115.
19. Patela KS, Rathic JC, Raghuvanshi K, Dhimana N. Coronavirus (SARS-CoV-2): Preventions, keys to diagnosis and treatment of SARS-CoV-2. Iberoam J Med. 2020;2(2):87-99. doi: http://doi.org/10.5281/zenodo.3715266.
20. World Health Organization. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technicalguidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-thatcauses-it.
21. Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med. 2003;348(20):1986-94. doi: 10.1056/NEJMoa030685.
22. World Health Organization. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technicalguidance
23. Kavanagh MM. Authoritarianism, outbreaks, and information politics. Lancet 2020;5(3):e135-e136. doi: 10.1016/S2468-2667(20)30030-X.
24. WHO. WHO Director-General’s remarks at the media briefing on COVID-2019 outbreak on 14 February 2020. 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-covid-2019-outbreak-on-14-february-2020 (accessed Feb 2020)
25. WHO. WHO Director-General’s remarks at the media briefing on COVID-2019 outbreak on 1 April 2020. 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-covid-2019-outbreak-on-1-april-2020 (accessed April 2020)
26. Hyams J, Hyams J, Damaraju L, Blank M, Johanns J, Guzzo C, et al. Induction and maintenance therapy with infliximab for children with moderate to severe ulcerative colitis. Clin Gastroenterol Hepatol. 2012;10(4):391-9. doi: 10.1016/j.cgh.2011.11.026.
27. Mohajer Shojai T, Ghalyanchi Langeroudi A, Karimi V, Barin A, Sadri N. The effect of Allium sativum (Garlic) extract on infectious bronchitis virus in specific pathogen free embryonic egg. Avicenna J Phytomed. 2016;6(4):458-267.
28. Rabenau HF, Cinatl J, Morgenstern B, Bauer G, Preiser W, Doerr HW. Stability and inactivation of SARS coronavirus. Med Microbiol Immunol. 2005;194(1-2):1-6. doi: 10.1007/s00430-004-0219-0.
29. Organization WH. Coronavirus disease (COVID-19) advice for the public: Myth busters. Available from: https://wwwwhoint/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters (accessed April 2020)
30. Gaunt ER, Hardie A, Claas EC, Simmonds P, Templeton KE. Epidemiology and clinical presentations of the four human coronaviruses 229E, HKU1, NL63, and OC43 detected over 3 years using a novel multiplex real-time PCR method. J Clin Microbiol. 2010;48(8):2940-7. doi: 10.1128/JCM.00636-10.
31. Bannister-Tyrrell M, Meyer A, Faverjon C, Cameron A. Preliminary evidence that higher temperatures are associated with lower incidence of COVID-19, for cases reported globally up to 29th February 2020. medRxiv. 2020. doi: https://doi.org/10.1101/2020.03.18.20036731.
32. McIntosh K. Coronavirus disease 2019 (COVID-19): Epidemiology, virology, clinical features, diagnosis, and prevention. Available from: https://wwwuptodatecom/contents/coronavirus-disease-2019-covid-19-epidemiology-virology-clinical-features-diagnosis-and-prevention(accessed April 2020)
33. Eickmann M, Gravemann U, Handke W, Tolksdorf F, Reichenberg S, Müller TH, et al. Inactivation of Ebola virus and Middle East respiratory syndrome coronavirus in platelet concentrates and plasma by ultraviolet C light and methylene blue plus visible light, respectively. Transfusion. 2018;58(9):2202-7. doi: 10.1111/trf.14652.
34. Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nature Medicine. 2020;26(4):450-2. doi: 10.1038/s41591-020-0820-9.
35. Dominguez SR, O'Shea TJ, Oko LM, Holmes KV. Detection of group 1 coronaviruses in bats in North America. Emerg Infect Dis. 2007;13(9):1295-300. doi: 10.3201/eid1309.070491.
36. Price M. Can mosquitoes and ticks spread the coronavirus? Here’s the latest from experts. Available from: https://wwwmiamiheraldcom/news/coronavirus/article241520071html (accessed April 2020)
37. News B. Coronavirus: What misinformation has spread in Africa? Available from: https://wwwbbccom/news/world-africa-51710617 (accessed April 2020)
38. Boyce JM. Alcohols as Surface Disinfectants in Healthcare Settings. Infect Control Hosp Epidemiol. 2018;39(3):323-8. doi: 10.1017/ice.2017.301.
39. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020;104(3):246-51. doi: 10.1016/j.jhin.2020.01.022.
40. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-7. doi: 10.1056/NEJMc2004973.
41. Ohtani S, Ushiyama A, Maeda M, Ogasawara Y, Wang J, Kunugita N, et al. The effects of radio-frequency electromagnetic fields on T cell function during development. J Radiat Res. 2015;56(3):467-74. doi: 10.1093/jrr/rru126.
42. ARPANSA. 5G and other telecommunications do not affect the immune system. Available from: https://wwwarpansagovau/news/5g-and-other-telecommunications-do-not-affect-immune-system (accessed April 2020)
43. Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients. 2017;9(11). doi: 10.3390/nu9111211.
44. Kasprak A. Are People With Type-A Blood More Susceptible to COVID-19? Available from: https://wwwsnopescom/fact-check/blood-type-covid-19/?collection-id=242217 (accessed April 2020)
45. Lambert KM, Barry P, Stokes G. Risk management and legal issues with the use of social media in the healthcare setting. J Healthc Risk Manag. 2012;31(4):41-7. doi: 10.1002/jhrm.20103.
46. Chretien KC, Kind T. Social media and clinical care: ethical, professional, and social implications. Circulation. 2013;127(13):1413-21. doi: 10.1161/CIRCULATIONAHA.112.128017.
47. Petersena E, Hui D, Hamera DH, Blumberg L, Madoffa LC, Pollack M, et al. Li Wenliang, a face to the frontline healthcare worker. The first doctor to notify the emergence of the SARS-CoV-2, (COVID-19), outbreak. Int J Infect Dis. 2020;93:205-7. doi: 10.1016/j.ijid.2020.02.052.
48. South China Morning Post. Li Wenliang: an ‘ordinary hero’ at the center of the coronavirus storm. 15 February 2020. Available from: https:// http://www.scmp.com/news/china/society/article/3050733/li-wenliang-ordinary-hero-center-coronavirus-storm (accessed Feb 2020)
49. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak asscoated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3. doi: 10.1038/s41586-020-2012-7.
50. Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat Med. 2020;26(4):450-2. doi: 10.1038/s41591-020-0820-9.
51. Robertson A. Trump’s chloroquine hype is a misinformation problem bigger than social media: Social media sites are policing powerful voices. Available from: https://www.theverge.com/2020/4/9/21209797/trump-chloroquine-hydroxychloroquine-medication-social-media-misinformation (accessed April 2020)
52. FDA-USA News-Release: FDA warns consumers about the dangerous and potentially life threatening side effects of Miracle Mineral Solution. August 12, 2019. Available from: https://www.fda.gov/news-events/press-announcements/fda-warns-consumers-about-dangerous-and-potentially-life-threatening-side-effects-miracle-mineral.
53. Manson P, Cooke G, Zumla A, eds. Manson's tropical diseases. 22nd ed. Edinburgh: Saunders; 2009.
54. Bhattacharjee M. Chemistry of Antibiotics and Related Drugs. Springer; 2016.
55. World Health Organization. World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 2019. Available from: https://apps.who.int/iris/bitstream/handle/10665/325771/WHO-MVP-EMP-IAU-2019.06-eng.pdf?sequence=1&isAllowed=y.
56. Aralen Phosphate. The American Society of Health-System Pharmacists. Available from: https://www.pharmacompass.com/chemistry-chemical-name/aralen-diphosphate.
57. Drugs & Medications. Available from: www.webmd.com (accessed March 2020)
58. Chloroquine Side Effects: Common, Severe, Long Term. Available from: https://www.drugs.com/sfx/chloroquine-side-effects.html (accessed March 2020)
59. Chloroquine: MedlinePlus Drug Information. Available from: https://medlineplus.gov/druginfo/meds/a682318.html (accessed March 2020)
60. Ajayi AA. Mechanisms of chloroquine-induced pruritus. Clin Pharmacol Ther.2 000;68(3):336.
61. Vaziri A, Warburton B. Slow release of chloroquine phosphate from multiple taste-masked W/O/W multiple emulsions. J Microencapsul. 1994;11(6):641-8. doi: 10.3109/02652049409051114.
62. Tönnesmann E, Kandolf R, Lewalter T. Chloroquine cardiomyopathy - a review of the literature. Immunopharmacol Immunotoxicol. 2013;35(3):434-42. doi: 10.3109/08923973.2013.780078.
63. Aralen Chloroquine Phosphate, USP. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/006002s043lbl.pdf.
64. A Cost Increase of Chloroquine After Media Assumption. Available from: https://theintercept.com/2020/03/24/trump-hyped-chloroquine-cure-covid-19-man-arizona-took-died/
65. Hassan I. The other COVID-19 pandemic- Fake news. The African Arguments, Available from: https://africanarguments.org/2020/03/26/the-other-covid-19-pandemic-fake-news/
66. Goodman C, Brieger W, Unwin A, Mills A, Meek S, Greer G. Medicine sellers and malaria treatment in sub-Saharan Africa: what do they do and how can their practice be improved? Am J Trop Med Hyg. 2007;77(6 Suppl): 203-18.
67. Snow RW, Peshu N, Forster D, Mwenesi H, Marsh K. The role of shops in the treatment and prevention of childhood malaria on the coast of Kenya. Trans R Soc of Trop Med Hyg. 1992; 86(3):237-9. doi: 10.1016/0035-9203(92)90290-s.
68. van der Geest S. Self-care and the informal sale of drugs in south Cameroon. Soc Sci Med. 1987;25(3):293-305. doi: 10.1016/0277-9536(87)90232-2.
69. Adome RO, Whyte SR, Hardon A. Popular Pills: Community Drug Use in Uganda. Amsterdam: Het Spinhuis; 1996.
70. Molyneux CS, Mung’Ala Odera V, Harpham T, Snow RW. Maternal responses to childhood fevers: a comparison of rural and urban residents in coastal Kenya. Trop Med Int Health. 1999; 4(12):836-45. doi: 10.1046/j.1365-3156.1999.00489.x.
71. Goodman CA. An economic analysis of the retail market for fever and malaria treatment in rural Tanzania. PhD thesis, London School of Hygiene & Tropical Medicine. 2005. doi: https://doi.org/10.17037/PUBS.00682327.
72. Williams HA, Jones CO. A critical review of behavioral issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made? Soc Sci Med. 2004;59(3):501-23. doi: 10.1016/j.socscimed.2003.11.010.
73. Amin AA, Marsh V, Noor AM, Ochola SA, Snow RW. The use of formal and informal curative services in the management of paediatric fevers in four districts in Kenya. Trop Med Int Health. 2003;8:1143-52. doi: 10.1046/j.1360-2276.2003.01140.x.
74. Brieger WR, Sesay HR, Adesina H, Mosanya ME, Ogunlade PB, Ayodele JO, et al. Urban malaria treatment behavior in the context of low levels of malaria transmission in Lagos, Nigeria. Afr J Med Med Sci. 2001;30(Suppl):7-15.
75. Iweze EA. The patent medicine store: hospital for the urban poor. In: Makinwa PK, Ozo A, editors. The Urban Poor in Nigeria. Lagos: Evans Brothers Ltd.; 1987:317-22.
76. Abiola A, Alhassan M, Famuyide A, Nwaorgu O, Olujohungbe A, Uche F, et al. A Qualitative Assessment of Medicine Sellers in Igbo-Ora. University of Ibadan; 1983. A project submitted to the Department of Preventive and Social Medicine, College of Medicine, University of Ibadan.
77. Nshakira N, Kristensen M, Ssali F, Whyte SR. Appropriate treatment of malaria? Use of antimalarial drugs for children’s fevers in district medical units, drug shops and homes in eastern Uganda. Trop Med Int Health. 2002;7(4):309-16. doi: 10.1046/j.1365-3156.2002.00858.x.
78. Marsh VM, Mutemi WM, Muturi J, Haaland A, Watkins WM, Otieno G, et al. Changing home treatment of childhood fevers by training shop keepers in rural Kenya. Trop Med and Int Health. 1999;4(5):383-9. doi: 10.1046/j.1365-3156.1999.00403.x.
79. Okoro BA, Jones IO. Pattern of drug therapy in home management of diarrhoea in rural communities of Nigeria. J Diarrhoeal Dis Res. 1995;13(3):151-4.
80. Twebaze, D. A Literature Review of Care-seeking Practices for Major Childhood Illnesses in Uganda. BASICS II for the United States Agency for International Development. Arlington, VA: 2001.
81. Basco LK. Molecular epidemiology of malaria in Cameroon. XIX. Quality of antimalarial drugs used for self-medication. Am J Trop Med Hyg. 2004;70(3):245-50.
82. Yan L, Hai-Tao Z, Yang X, Maolin W, Chuan S, Jing L, et al. Prediction of criticality in patients with severe Covid-19 infection using three clinical features: a machine learning-based prognostic model with clinical data in Wuhan. medRxiv. 2020. doi: https://doi.org/10.1101/2020.02.27.20028027.
83. Kachur SP, Black C, Abdulla S, Goodman C. Putting the genie back in the bottle? Availability and presentation of oral artemisinin compounds at retail pharmacies in urban Dar-es-Salaam. Malar J. 2006;5:25. doi: 10.1186/1475-2875-5-25.
84. Wang M, Cao R, Zhang L, Yang X, Liu J, XU M. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269-71. doi: 10.1038/s41422-020-0282-0.
85. Zumla A, Chan JF, Azhar EI, Hui DS, Yuen KY. Coronaviruses - drug discovery and therapeutic options. Nat Rev Drug Discov. 2016;15(5):327-47. doi: 10.1038/nrd.2015.37.
86. Mulangu S, Dodd LE, Davey RT Jr, Tshiani Mbaya O, Proschan M, Mukadi D, et al. A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics. N Engl J Med. 2019;381(24):2293-303. doi: 10.1056/NEJMoa1910993.
87. Warren TK, Jordan R, Lo MK, Ray AS, Mackman RL, Soloveva V, et al. Therapeutic efficacy of the small molecule GS-5734 against Ebola virus in rhesus monkeys. Nature. 2016;531(7594):381-5. doi: 10.1038/nature17180.
88. Vincent MJ, Bergeron E, Benjannet S, Erickson BR, Rollin PE, Ksiazek TG, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J. 2005,2:69 doi:10.1186/1743-422X-2-69. doi: 10.1186/1743-422X-2-69.
89. Mackenzie AH. Dose refinements in long-term therapy of rheumatoid arthritis with antimalarials. Am J Med. 1983; 75(1A):40-5. doi: 10.1016/0002-9343(83)91269-x.
90. Savarino A, Di Trani L, Donatelli I, Cauda R, Cassone A. New insights into the antiviral effects of chloroquine. Lancet Infect Dis. 2006;6(2):67-9. doi: 10.1016/S1473-3099(06)70361-9.
91. Professor Didier Raoult’s Study On Chloroquine. Available from: https://www.wired.com/story/an-old-malaria-drug-may-fight-covid-19-and-silicon-valleys-into-it/
92. BCG Vaccine Controversy and COVID-19. Available from: https://www.lemonde.fr/afrique/article/2020/04/08/non-l-afrique-n-est-pas-ni-de-pres-ni-de-loin-la-cible-privilegiee-des-essais-cliniques_6035948_3212.html?fbclid=IwAR2mpr2bygSVQQv73lGbK4FAS41K1atH0odiIJzBkDhgFuc0liF7Ng79xw8.
93. Yang Y, Lu QB, Liu MJ, Wang YX, Zhang AR, Jalali N, et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China. medRxiv. 2020. doi: http://dx.doi.org/10.1101/2020.02.10.20021675.
94. Wilder-Smith A, Boggild A. Sentinel surveillance in travel medicine: 20 years of GeoSentinel publications (1999-2018). J Travel Med. 2018;25(1). doi: 10.1093/jtm/tay139.

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