• The number of new cases per day in the US appears to be peaking (April 2020)
•  
• If people are not serious about Covid-19, what can be done? (May 2020)
•  
• Really recent information can be really helpful during this pandemic. (July 2020)
•  
• The USA has less than 5% of the world’s population but over 22% of the deaths from coronavirus (September 2020)

• Why did the WHO say people could get re-infected? (May 2020)
•  
• More fakery with virus data: If the same person is tested three times and is eventually positive, my state counts it as three separate cases. This is padding the numbers. (May 2020)
•  
• The CDCs stats show that in Ohio only 173 people have died from COVID-19. But our official Ohio Department of Health numbers are 1,019. (May 2020)
•  
• Trials to develop a treatment state that cases where the infection was not confirmed by a test, may now be counted. (May 2020)

• We are in this together and need to all do our part to flatten the curve
•  
• New Zealand has crushed the covid-19 curve with just one death
•  
• The curve inside prisons is not flattening – reported cases have tripled over the last seven days.
•  
• New York has 778 new deaths, but overall we are flattening the curve, he says
•  
• A flattened curve is not a symmetrical curve and this means that deaths could continue for a long time
•  
• Some people think that covid-19 and flattening the curve is over, but they should work in a hospital for 10 hours

• The Washington-based NPR media organisation broadcast that a state governor was reluctant to open businesses unless testing rates were dramatically increased.
•  
• The UK Telegraph announced that Britain had been secretly flying 1000s of coronavirus tests to America … as problems were reported in UK laboratories.

• I am actually terrified at how many people are going to die from this disease (June 2020)
•  
• There is this fear lingering in society, in people’s minds, in my parents minds (May 2020)
•  
• We are afraid of this contagious disease covid-19 (June 2020)
•  
• Warning, panic – mass uses of hand gels could create superbugs (August 2020)
•  
• Covid-19 is an example of how we Indians are ignoring the problem – I am scared of dying (June 2020)
•  
• Canadians have all developed fear of COVID-19 (May 2020)

• He wants us to inject ourselves with bleach. No, I do not believe him. (April 2020)
•  
• Trump says he will not approve COVID-19 package without TAX Cut that offers ZERO relief for 30M unemployed (May 2020)
•  
• I believe that Trump will now attempt to blame these protests for the spread of the virus (June 2020)
•  
• Has Donald Trump apologized to the families of 130,000 people who died unnecessarily? (July 2020)
•  
• So the president is never going to have a coronavirus response plan? (August 2020)
•  
• Trump should be tried by the UN for crimes against humanity. (September 2020)

• Was calling the disease a pandemic, a fraudulent deep state fear mongering plot to remove Trump? (September 2020)

Both the international and domestic media have reported most of the Trump administration’s misguided decisions that have produced one of the world’s worst examples of risk communication and led to the tragic number of deaths across America that is still continuing in 2021. Some US polls had predicted that Trump’s use of Twitter as a platform of invective, fabrication, and half-truths, would cost him the next election (Shepard, 2019). Baccini, Brodeur & Weymouth (2021) estimate that Trump most probably would have won the 2020 election if the COVID-19 rate had been 5 percent lower. Even with four years of significant polarising behaviour, regular confrontations, outright sexist and racist conduct, scandals and impeachment ordeals, Trump still won more votes in 2020 (excluding Biden) – over 74 million – than any other candidates in the history of American polling before the 2020 election. If the pandemic did not arrive in 2020, then the Trump administration may have been re-elected (Parker, Dawsey, Viser & Scherer, 2020; Youde, 2021).

The concept of the ‘mask’

Although not appearing at the top of the monthly corpus tables, from the very beginning of the 2020 pandemic the wearing of masks has been a much debated and ambivalent precaution to avoid the spread of infection in health announcements around the world (Cheng, Lam & Leung, 2020). In the corpus, the word ‘mask’ ranks about 40th in terms of frequency overall, but was 11th in July. The contextual background to the wearing of masks was one of confusion and disbelief because of the contradictory recommendations that were released around the world by various government and health authorities.

During the Spanish Flu pandemic of 1918, the wearing of masks and physical distancing were the two mainstays of public health responses. The guidelines mandated the wearing of masks and staying a safe distance from other people – probably the only treatments that actually worked in 1918, but this not what occurred in 2020. At the start of the pandemic in Australia, health announcements recommend against the wearing of masks to decrease infection rates. On 16 March 2020 the Australian Dept of Health stated ‘… masks are not currently recommended for use by healthy members of the public for the prevention of infections like coronavirus.’ The same thing occurred with early WHO recommendations, and also UK and US health announcements. Paradoxically, the wearing of masks for some Australians was not only a part of their culture to protect themselves from traffic fumes and industrial pollution, but also necessary during the early 2020 bushfire smoke crisis. The mystery was that a mask might not protect against a disease, but can a mask increase the risk of infection? The early warnings against the use of masks would have been logically baffling to many people at the beginning of the pandemic.

These Twitter messages typify some of the confusion surrounding the wearing of masks:

In July, the Australian health agencies then officially changed their minds and did an about face saying that face coverings are not only an acceptable precaution but mandated under certain risky conditions (Vic Dept of Health & Human Services, July 19, 2020). Grocery stores then began to recommend the wearing of masks for all its customers. In many parts of Australia, masks were compulsory in order to attend a doctor’s surgery, a hospital or a nursing home. This sudden change in policy remains questionable.

One possible reason for this change in public policy is a conspiracy theory that appears to have some academic and media support (Feng, et al., 2020; Lopez, 2020; Wetsman, 2020). The early anti-mask guidelines may have been a way of conserving existing personal protective equipment (PPE) that was running critically low in most countries because China, the main supplier of this equipment, was also experiencing drastic shortages. Western governments may have predicted that if the pandemic was to escalate then creating a lack of PPE by recommending masks would result in panic buying and shortages, similar to shortages of toilet paper in grocery stores. Without the masks, doctors and nurses would be denied protection and inevitably fall sick with the virus, while the general public hoarded vast amounts of PPE. Such equipment could also experience massive increases in price if demand exceeded supply. Governments could find that they were unable to afford the price-gouged masks, gowns and gloves for their frontline workers. The problem with this gambit is that, if true, Western governments were possibly increasing the risk of infection for members of the general public, in order to protect their healthcare workers. Many people probably began losing trust in their government, the WHO and healthcare authorities at this point in time. The wearing of masks was problematic for some Twitter users before the worldwide change of policy:

According to the ABC, then US presidential contender, Joe Biden, made a point of wearing a mask from May 26, 2020 (see https://www.abc.net.au/news/2020-05-26/joe-biden-first-public-appearance-in-two-months/12285690). He then continuously delivered speeches with a mask covering his face, making his voice muffled and unclear. On Twitter, the word, ‘mask’ became a more significant concept in July probably due to Biden’s visually signalling that masks were useful to wear, and also because Donald Trump began to espouse the same ethic, albeit reluctantly. The medical community also realised that the virus could be spread through minute aerosols from just talking and breathing, so the mask went from protecting uninfected persons to preventing infected people from spreading the disease. Masks had a dual purpose and people did not need the more expensive N95 type masks – they could simply use surgical masks, or even home-made ones. However, it is unclear if the public fully understood the science that predicted that there might exist non-symptomatic carriers of the disease and that a mask should be worn to protect others (not the wearer) in public gatherings (Kolstoe, 2020).

The concept of ‘vaccine’

At the beginning of the pandemic, this concept was grounded in the belief that only a vaccine would allow the coronavirus to stop spreading but that effective vaccines were not yet developed, not tested and not approved for use. This concept became an increasingly important idea in the last three months of Twitter corpus reflecting the mainstream media and Twitter user speculation of new vaccines from independent companies. The sentiment was mixed, with optimism, caution and apprehension apparent in the corpus:

Prior to November 2020, the main hope for countries with soaring infection rates, and second waves had been the potential arrival of a trustworthy vaccine that would protect the population and signify an end to the devastation that COVID-19 had caused. This scenario was possibly the only hope for the USA which had 4   of the world’s population but an estimated 25 percent of the confirmed cases of coronavirus – the numbers could be much higher because testing kits have been a problem for American health agencies. The UK and various parts of Europe, and Asia have also been experiencing second and third wave lockdowns and stay-at-home orders, while some parts of the world – Vietnam, New Zealand, Australia, and Iceland – have come close to taming the disease.

As can be seen from the cited tweets, the issues surrounding the vaccine are not only those espoused by anti-vaxxers, but also relate to timing and distribution, safety issues and the gradual recognition that a vaccine would not be a panacea for the disease. From the very beginning of the pandemic a COVID-19 vaccine was discussed by the media as being the only certain solution the oncoming pandemic. The WHO reported on dozens of possible vaccination start-ups as early as March 26, 2020, most which were in pre-clinical stages of development (see https://www.who.int/blueprint/priority-diseases/key-action/Novel_Coronavirus_Landscape_nCoV_ Mar26.PDF). Reports followed anticipating a possible vaccine in early 2021 and reminding us that such vaccines normally take an average of 10 years to develop (Le, et al., 2020). The existence of unknown side-effects due to such rapid development has become anxiety-producing for many people, especially those who are not infected (Robertson, et al., 2021).

On December 8, 2020, the rollout of the Pfizer/BioNTech vaccine began in the UK, but sadly this was not the end of the virus and its effects, as many might have believed. Elderly, at-risk people living in nursing homes, the staff that care for them and frontline hospital workers were the first to obtain the new vaccine in the UK, from the 800,000 doses that were ready to be used. Apart from low temperature storage problems of the Pfizer vaccine, and distributing vast numbers of doses, the main problem is still how long will a vaccine’s protection actually last? The simple answer is no-one really knows. The same is true of the other recently announced vaccines as well. The scenario might be that the COVID-19 vaccines will not give 100 % protection and may not last more than six months, leading to the same situation as the flu vaccine that needs to be taken annually for people to be protected. It is also unlikely that all people will agree to take the vaccine meaning that the virus will be still be active in the community, just like seasonal colds and influenza that affect us every year (Tedros, 2020). While it may take a year to vaccinate the entire world, there are still questions to be answered about whether all children will need the to be treated, or even if all nursing home staff will need to have the vaccination. Side-effects of the new vaccines will also be a stumbling block to mass immunisation. In April 2021, vaccines are the number one debated Covid concept in the mainstream media and will probably remain so for the remainder of the year.

Final thoughts

As previously stated, in 2016, Twitter was the first of the social media platforms to change its identity from a social media app to a news app, perhaps as a strategic move to enhance its popularity. From its early beginnings of sharing ideas, photos and videos, Twitter now has more news organisations and journalists represented on its platform than any of the others. Twitter is by far the most news-friendly and research-friendly of all the social platforms. Twitter is also predominantly a real-time platform for breaking news about sports, politics, pandemics or any other item of interest, with word limits that require short and snappy posts that perfectly suit the headlines and photographs of traditional news stories (Neuberger, Hofe & Nuernbergk, 2014). Unlike Facebook and most other social media apps, Twitter is often described as hybrid broadcast communication medium analogous to mainstream media (Cha, Benevenuto, Haddadi & Gummadi, 2012). The fact that so many mainstream journalists have adopted Twitter as their breaking news medium of choice only reinforces this view of Twitter as a broadcast medium for certain topics.

Thus, by surveying the concepts on Twitter surrounding the coronavirus, this paper may have also been simultaneously analysing the mainstream media contributions to the pandemic’s discussion. It could be the case that Twitter’s COVID-19 concepts simply mirror those of the mainstream media in many ways. As early as 2013, research found that Twitter covered most of events as found in newswire providers and can be faster at delivering breaking news (Petrovic, et al., 2013). This would suggest useful follow-up research to this paper.

Limitations of the study

A major limitation of this paper’s data collection methods was that only English language tweets were collected and analysed. This was due to the fact that the author did not have the resources to translate Chinese, Russian, Indian or other languages into English for standardised content analysis. It could be the case that non-English language tweets could have resulted in differently ranked concepts, which would have necessitated extended summative analysis. The global website, Our World in Data (https://ourworldindata.org) has collected a myriad of ongoing statistics on most countries since the pandemic began. The results show the huge range of effects of coronavirus on all of the participating countries. Such a multiplicity of effects could easily have led to a range of individual pre-occupations, if county of origin was identified in the corpus. Unfortunately, this was not possible, and this paper’s findings need to be understood with this caveat in mind.

However, what is largely missing from the English language Twitter discussion is the fact that the disease has had a mysterious origin and acted differently to any other disease that humanity has faced before. These particular characteristics of the novel coronavirus are probably its most worrying features, and the ones that have produced the most fear and anxiety around the world. This fear of the unknown is rarely directly expressed by either the media reports or by the Twitter corpus. Fear of unknown diseases however does evolve over time as research into the disease becomes more sophisticated and the world relaxes into resigned acceptance. The ultimate acceptance of the Spanish Flu over time will probably recur with COVID-19.

While the UK experienced second and third wave lockdowns, and Australia experienced infection clusters since September 2020, a constant unknown has been the number of non-identified positive cases in the community at any one point in time – so-called false negatives. This is perhaps the major stumbling block for all Australians and their leaders. There is also confusion over the classification of positive COVID-19 tests. The least problematic cases are those patients who acquired the infection overseas from a known source; a slightly more problematic source are ‘locally acquired’ infections from a known source. But the most problematic cases are labelled ‘community transmission’ where the sources are completely unknown. Early studies from Wuhan estimated that the infection rate was 1.40 to 6.69, meaning that for every identified case there would be a median of 2.79 unidentified cases in the community (Meehan, et al., 2020). This figure fluctuates according to country, and researcher, but is not always reported by the media or Twitter. Nature Research (December 21, 2020) reported that 90 percent of positive cases were missed in France during their early lockdown, accounting for their subsequent waves after restrictions were eased. NSW figures may be comparable because of unidentified cases with no symptoms (Scott, August 2020). The concept, ‘transmission’ however is ranked a low 450th concept in the Twitter corpus indicating lack of understanding about the ramifications of the different acquisition scenarios.

Missed cases might never be identified – these infected people recover by themselves and may never be the wiser. Such people do not need to be hospitalised but may infect a new cohort of patients. This process could be occurring in so-called hot spots, where testing regimes tend to increase markedly, thus revealing these otherwise missed cases. Health department frustration over unknown contact tracing may simply be that these new cases are revealed by greater testing. The problem is that the exact figure of missed cases is unable to be accurately detected, unlike the positive cases, so we may never be able to eradicate the virus and Australia will continuously experience cycles of localised outbreaks, sudden blame and anxiety, state government border closures, social restrictions and area lockdowns, but ensuing community improvement to a precarious normalcy.

The devastation of the 1918 Spanish Flu arguably ended after about two years without a vaccine or effective medical treatment (Martini, Gazzaniga, Bragazzi & Barberis, 2019). At that time, affected people either died or developed immunity. This might be one endgame scenario for COVID-19. Another is the optimistic prospect of global mass vaccination for 2021. As the USA Fox News (December 11, 2020) network stated, ‘such is life’ – this might be the only thing we can expect for the future.

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About the author

Dr Ray Archee teaches professional writing and research at Western Sydney University, and has also specialised in mediated communication, education and technology for most of his career. He has worked as a computer journalist, school teacher and consultant in new technology areas. His research paper in this issue is specifically aimed at researchers and historians ten years from now, as well as people with very short memories in the present.

Email: r.archee@westernsydney.edu.au