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Social Media in Emergency Response
Topic Collection
August 1, 2023

Topic Collection: Social Media in Emergency Response

The use and impact of social media platforms (e.g., Twitter, Facebook, LinkedIn, Snapchat, Instagram, TikTok, and YouTube) has skyrocketed over the past decade and has significantly supplemented—if not nearly replaced—more traditional means of communication for many population groups in the U.S. There are four primary ways that healthcare, public health, and emergency management use social media: posting information for public knowledge, posting to correct misinformation or rumors, obtaining incident information to help allocate resources, and identifying questions and issues to be addressed. 

Recent disasters and mass casualty incidents have highlighted the level to which victims, family members, and responders use social media to communicate about issues such as: their status and location, the effect of the disaster on their surroundings, where and how to locate shelter and supplies, how to volunteer, and health and medical advice.

In addition to building community relationships and emphasizing preparedness and resilience pre-disaster, planners can use social media to identify and monitor potential threats to public health, and communicate with residents about threats (e.g., infectious disease), pending incidents (e.g., severe weather), and the location and availability of services (e.g., shelters and points of distribution). Tools such as crowdsourcing (collecting information from a large group of people via the Internet) and data mining bolster these efforts. Photos and live-streamed video can help amplify messaging, provide locational data, and communicate the urgency of a situation.

Consistency and bi-directional communication is key as healthcare organizations communicate with their communities via social media, since misinformation (the spread of erroneous information), disinformation (the purposeful creation and proliferation of false/misleading information), and malinformation (based on fact, but used out of context to mislead or cause harm) are common on social media (Cybersecurity & Infrastructure Security Agency, 2022). Most recently, the word “infodemic” has been used to refer to the dissemination of too much information, especially misleading information, during an infectious disease outbreak (e.g., World Health Organization, 2023). Social media-specific resources are included in this Collection; the Risk Communications Topic Collection includes additional resources on mis- and disinformation. The ASPR TRACIE Topic Collections on Communication Systems, Cybersecurity, Information Sharing, and Virtual Medical Care Collections may also be of interest.

Because the nature of social media changes so frequently and is used for a wide variety of purposes, the ASPR TRACIE Team primarily includes lessons learned and promising practices from incidents within the past decade and actionable resources specific to our healthcare audience.

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category. 

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Must Reads

APCO International. (2020). Best Practices for The Use of Social Media in Public Safety Communications.
This voluntary standard—developed with input from law enforcement, fire, and medical emergency responders—describes how social media can and should be used during disasters.
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ASPR TRACIE. (2023). ASPR TRACIE Roundtable: Lessons Learned in Health Care Communications.
Speakers representing a wide range of stakeholders and jurisdiction types (national, large/urban, regional, and rural/tribal) shared their perspectives on how they integrated lessons learned during recent incidents into current and future responses. Topics included channels used for outreach and continued engagement, strategies for reaching different community and cultural groups, tracking and countering rumors, and working with partners to create complementary messaging.
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Bui, L. (2017). Digital Disaster Relief: Crowdsourced Responses to Hurricanes, Earthquakes, and Floods Around the World. PLoS Blogs.
The author explains how crowdsourcing, social media monitoring, and other tools can help disaster responders quickly collect information and tailor their on-ground response. These tools can also help volunteers contribute online or help onsite. Links to several tools are provided.
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Chiodo, K., LaForce, S., and Lippincott, B. (2017). ADA National Network Learning Session: Clear & Effective Emergency Communications over Wireless Devices.
This hour-long webinar can help emergency responders tailor their social media messages to ensure they are reaching community members with access and functional needs. Links to transcripts, PowerPoint presentations, and audio and video files are provided.
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Cybersecurity & Infrastructure Security Agency. (2021). Capacity Enhancement Guides for Non-Federal Organizations.
The recommendations in this guide can be implemented by healthcare organizations to keep their social media accounts secure, since compromised accounts could be used to spread misinformation. Suggestions include establishing a social media policy, implementing credential management, setting up multi-factor authentication, vetting third party vendors, and establishing an incident response plan.
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Day, A., O’Shay-Wallace, S., Seeger, M., et al. (2019). Informational Sources, Social Media Use, and Race in the Flint, Michigan, Water Crisis. Communication Studies. 70(3).
The authors studied how race affected how people obtained information during the water crisis in Flint, Michigan. They found that African American participants favored receiving information through their interpersonal networks and were more likely to get information on Instagram.
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Dornsife School of Public Health. (n.d.). Social Media Message Library. (Accessed 4/13/2023.)
Emergency planners can access and customize sample messages and posts for the following categories/populations: Natural Disasters, Infectious Diseases, Accidental Disasters, Intentional Disasters, and Individuals with Access and Functional Needs. Sample messages are provided in three main categories: general updates, response, and recovery.
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Federal Emergency Management Agency. (2021). IS-42: Social Media in Emergency Management.
This interactive, web-based course covers best practices, tools, techniques, and a basic roadmap that can help participants in emergency management build their social media capabilities.
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Gisondi, M., Barber, R., Faust, J., et al. (2022). A Deadly Infodemic: Social Media and the Power of COVID-19 Misinformation. Journal of Medical Internet Research. 24(2):e35552.
This article highlights the role of mis- and disinformation in vaccine hesitancy and the legal and ethical obligations of social media companies to combat misinformation. It also includes recommendations for healthcare providers specific to using social media (e.g., engage patients on social media, partner with influencers to share accurate information).
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Hart, M., Stetten, N., Islam, S., and Pizarro, K. (2017). Twitter and Public Health (Part 2): Qualitative Analysis of How Individual Health Professionals Outside Organizations Use Microblogging to Promote and Disseminate Health-Related Information. JMIR Public Health and Surveillance. 3(4): e54.
The authors examined more than 15,000 tweets to understand how public health professionals used Twitter. Messages were broken into four themes: 1) inform and educate, 2) monitor health statuses and trends, 3) communicate about social justice, and 4) increase professional development.
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Lovari, A. and Bowen, B. (2019). Social Media in Disaster Communication: A Case Study of Strategies, Barriers, and Ethical Implications. Journal of Public Affairs, 20(3).
The authors of this study interviewed state emergency management leaders in South Carolina about their social media strategy during a flood in 2015. The article discusses social media policies, practices, strategies, and models, as well as media relations and communication with the public. Finally, the authors offer recommendations to improve social media communications during future disasters.
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Mikal, J., Wurtz, R., and Grande, S. (2021). Social Media as a Modern Emergency Broadcast System: A Longitudinal Qualitative Study of Social Media During COVID-19 and its Impacts on Social Connection and Social Distancing Compliance. Computers in Human Behavior Reports. 4: 100137.
The authors collected longitudinal, qualitative survey data from 32 adults during the eight weeks most states had issued shelter-in-place orders. Most participants were female and white, which the authors claim align with the general demographic characteristics of social media users. The authors found that while social media was used in a positive manner early in the pandemic, “longitudinal patterns indicate [this] engagement is short-lived with increasing evidence of negative engagement patterns as the pandemic wears on.”
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Patel Murthy, B., Telfair LeBlanc, T., Vagi, S., et al. (2021). Going Viral: The 3 Rs of Social Media Messaging during Public Health Emergencies. Health Security. 19(1): 75–81.
Based on the use of social media during recent natural disasters and the COVID-19 pandemic, the authors developed the principle of 3 Rs to help public health and healthcare better message the public during future events. The Rs stand for review (who is population and how to they communicate?); recognize (what are the needs of the target population?); and respond (how do you tailor messages based on these needs?) Table 1 lists action steps by phase.
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Simon, T., Goldberg, A., and Adini, B. (2015). Socializing in Emergencies—A Review of the Use of Social Media in Emergency Situations. International Journal of Information Management. 35(5): 609-619.
The authors reviewed the literature on the use of social media in emergencies between 2007 and 2014. They highlight how various tools are used by the public, emergency organizations, and academic institutions.
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U.S. Department of Homeland Security. (2014). Using Social Media for Enhanced Situational Awareness and Decision Support. Virtual Social Media Working Group and DHS First Responders Group.
Emergency planners can use the guidance in this document to better understand the use of social media in developing situational awareness (e.g., monitoring, crowdsourcing, and intelligence gathering), and analyzing data (e.g., baseline vs. event detection, and trend analysis). Other sections discuss challenges associated with technology (e.g., the use of third-party platforms, lapses in time and space) and information (e.g., aggregating and filtering, verifying, and integrating).
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U.S. Department of Homeland Security. (2016). From Concept to Reality: Operationalizing Social Media for Preparedness, Response and Recovery. Virtual Social Media Working Group and DHS First Responders Group.
The authors explain how responders can use social media to facilitate decision making during fast-paced disaster responses. Sections on integrating social media technical experts into incident command, the long-term use of social media, and challenges associated with using social media can help planners form their agency’s policies. Case studies are provided at the end of the report.
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Vera-Burgos, C. and Padgett, D. (2020). Using Twitter for Crisis Communications in a Natural Disaster: Hurricane Harvey. Heliyon. 6(9).
This case study highlights how Sylvester Turner, the mayor of Houston during Hurricane Harvey in 2017, communicated successfully with the public via social media in the wake of the storm. The authors describe how healthcare crisis managers can use Twitter during future disasters (e.g., using “we” and “our” to encourage a sense of community, translating a message into languages used in the community, and incorporating local and national hashtags).
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Education and Training

Center for Homeland Defense and Security. (2016). Social Network Analysis: An Introduction.
This five-module course provides an overview of social network analysis, how it differs from standard approaches, and what some of the misconceptions are. It also looks at basic terms and concepts that underlie social network analysis.
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* Centers for Disease Control and Prevention. (2012). CDC’s Guide to Writing for Social Media.
Emergency planners can use the guidance in this document to: learn about social media; understand their audiences; write for Facebook and Twitter; develop text messages; and base social media on existing web page content. Sample “hands-on” activities are provided, where readers have the chance to revise draft messages. A checklist, glossary, and links to helpful resources are also included. While some material is dated, the guide contains foundational guidance for emergency planners.
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Centers for Disease Control and Prevention. (2014). CDC’s Crisis and Emergency Risk Communication: Social Media and Mobile Devices.
CDC’s Crisis and Emergency Risk Communication (CERC) manual provides an integrated model for public health professionals to communicate effectively during an emergency. The chapter on social media and mobile devices covers social media’s role with mainstream media, its role in a crisis, and responding to social media regarding serious errors, myths, and misperceptions.
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Chiodo, K., LaForce, S., and Lippincott, B. (2017). ADA National Network Learning Session: Clear & Effective Emergency Communications over Wireless Devices.
This hour-long webinar can help emergency responders tailor their social media messages to ensure they are reaching community members with access and functional needs. Links to transcripts, PowerPoint presentations, and audio and video files are provided.
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Federal Emergency Management Agency. (2021). IS-42: Social Media in Emergency Management.
This interactive, web-based course covers best practices, tools, techniques, and a basic roadmap that can help participants in emergency management build their social media capabilities.
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Lakey, V. (n.d.). Breaking News: PIO and Social Media Roles in Emergency Management and Response. (Accessed 4/13/2023.)
This presentation can help public information officers (PIO) understand and prepare to use social media in an emergency situation. The speaker provides an overview of crisis communication and the role of a PIO, explains to role of social media and associated challenges, and shares actual examples of PIOs using social media to inform the communities they serve.
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* National Center for Disaster Preparedness. (2023). Visualizing Social Media: New Tools for Research and Practice. Earth Institute, Columbia University.
This webpage provides links to the center’s free courses on social media and related articles, reports, and tools.
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General Guidance and Research

* Centers for Disease Control and Prevention. (2012). CDC’s Guide to Writing for Social Media.
Emergency planners can use the guidance in this document to: learn about social media; understand their audiences; write for Facebook and Twitter; develop text messages; and base social media on existing web page content. Sample “hands-on” activities are provided, where readers have the chance to revise draft messages. A checklist, glossary, and links to helpful resources are also included. While some material is dated, the guide contains foundational guidance for emergency planners.
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Chen, J., and Wang, Y. (2021). Social Media Use for Health Purposes: Systematic Review. Journal of Medical Internet Research. 23(5):e17917.
This literature review analyzes new uses for social media which have emerged since 2013, such as improving health research, social mobilization, and coordinating in-person health services. The authors identify gaps in the understanding of the strategic use of social media, audience segmentation, privacy concerns, and the development of health identity among an audience online.
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Cybersecurity & Infrastructure Security Agency. (2021). Capacity Enhancement Guides for Non-Federal Organizations.
The recommendations in this guide can be implemented by healthcare organizations to keep their social media accounts secure, since compromised accounts could be used to spread misinformation. Suggestions include establishing a social media policy, implementing credential management, setting up multi-factor authentication, vetting third party vendors, and establishing an incident response plan.
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Day, A., O’Shay-Wallace, S., Seeger, M., et al. (2019). Informational Sources, Social Media Use, and Race in the Flint, Michigan, Water Crisis. Communication Studies. 70(3).
The authors studied how race affected how people obtained information during the water crisis in Flint, Michigan. They found that African American participants favored receiving information through their interpersonal networks and were more likely to get information on Instagram.
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Federal Communications Commission. (2016). Social Media & Complementary Alerting Methods – CSRIC V Final Report.
The FCC states that this report has two goals: to advocate for complementary alerting via social media and emphasize the potential opportunity and advantages for social media platforms in emergency alerting. Section 5.2 highlights the advantages of using social media and 5.3 explains challenges and opportunities.
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Lovari, A. and Bowen, B. (2019). Social Media in Disaster Communication: A Case Study of Strategies, Barriers, and Ethical Implications. Journal of Public Affairs, 20(3).
The authors of this study interviewed state emergency management leaders in South Carolina about their social media strategy during a flood in 2015. The article discusses social media policies, practices, strategies, and models, as well as media relations and communication with the public. Finally, the authors offer recommendations to improve social media communications during future disasters.
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Malik, A., Khan, M., and Quan-Haase, A. (2021). Public Health Agencies Outreach through Instagram during the COVID-19 pandemic: Crisis and Emergency Risk Communication Perspective. International Journal of Disaster Risk Reduction. 61.
The authors examined how key health organizations used Instagram and image-based features to communicate with the public about COVID-19; the nature of messages and images and how they align with the CERC model; and how Instagram users engaged with key health organizations’ messaging during the pandemic. They found “an overwhelming level of engagement” when posts included celebrities, infographics, and/or clarified information.
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Mehta, A., Bruns, A., and Newton, J. (2017). Trust, but Verify: Social Media Models for Disaster Management. (Abstract only.) Disasters. 41(3):549-565.
The authors examine three models for using social media in disaster management: information gathering, quasi-journalistic verification, and crowdsourcing. They discuss how emergency management can verify content to maximize public trust and encourage the use of social media after disasters.
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Mikal, J., Wurtz, R., and Grande, S. (2021). Social Media as a Modern Emergency Broadcast System: A Longitudinal Qualitative Study of Social Media During COVID-19 and its Impacts on Social Connection and Social Distancing Compliance. Computers in Human Behavior Reports. 4: 100137.
The authors collected longitudinal, qualitative survey data from 32 adults during the eight weeks most states had issued shelter-in-place orders. Most participants were female and white, which the authors claim align with the general demographic characteristics of social media users. The authors found that while social media was used in a positive manner early in the pandemic, “longitudinal patterns indicate [this] engagement is short-lived with increasing evidence of negative engagement patterns as the pandemic wears on.”
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Muniz-Rodriguez, K., Ofori, S., Bayliss L. (2020). Social Media Use in Emergency Response to Natural Disasters: A Systematic Review with a Public Health Perspective. (Abstract only.) Disaster Medicine and Public Health Preparedness. 14(1): 139-149.
The authors reviewed literature to better understand how social media has been used to both improve the dissemination of emergency warning and response information during and after a natural disaster, and identify various needs (e.g., medical, emotional) after a natural disaster. They found overall positive results, including the reduction in response time to help identify individuals’ location, but emphasized the need for more research on misinformation and rumor control.
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* National Center for Disaster Preparedness. (2023). Visualizing Social Media: New Tools for Research and Practice. Earth Institute, Columbia University.
This webpage provides links to the center’s free courses on social media and related articles, reports, and tools.
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National Child Traumatic Stress Network. (2019). Creating Effective Child and Family Focused Disaster Behavioral Health Messages on Social Media.
The guidance in this document can help child-serving professionals design disaster behavioral health messaging suitable for children and families.
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Patel Murthy, B., Telfair LeBlanc, T., Vagi, S., et al. (2021). Going Viral: The 3 Rs of Social Media Messaging during Public Health Emergencies. Health Security. 19(1): 75–81.
Based on the use of social media during recent natural disasters and the COVID-19 pandemic, the authors developed the principle of 3 Rs to help public health and healthcare better message the public during future events. The Rs stand for review (who is population and how to they communicate?); recognize (what are the needs of the target population?); and respond (how do you tailor messages based on these needs?) Table 1 lists action steps by phase.
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Public Health Communications Collaborative. (2023). Plain Language for Public Health.
This guide provides an overview of plain language principles and includes sections on preparing communications, developing and organizing communications, reviewing and testing, and related resources.
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U.S. Department of Homeland Security. (2014). Using Social Media for Enhanced Situational Awareness and Decision Support. Virtual Social Media Working Group and DHS First Responders Group.
Emergency planners can use the guidance in this document to better understand the use of social media in developing situational awareness (e.g., monitoring, crowdsourcing, and intelligence gathering), and analyzing data (e.g., baseline vs. event detection, and trend analysis). Other sections discuss challenges associated with technology (e.g., the use of third-party platforms, lapses in time and space) and information (e.g., aggregating and filtering, verifying, and integrating).
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U.S. Department of Homeland Security. (2016). From Concept to Reality: Operationalizing Social Media for Preparedness, Response and Recovery. Virtual Social Media Working Group and DHS First Responders Group.
The authors explain how responders can use social media to facilitate decision making during fast-paced disaster responses. Sections on integrating social media technical experts into incident command, the long-term use of social media, and challenges associated with using social media can help planners form their agency’s policies. Case studies are provided at the end of the report.
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* U.S. Department of Homeland Security. (2017). Best Practices for Incorporating Social Media into Exercises: Social Media Working Group for Emergency Services and Disaster Management and DHS (Department of Homeland Security) S&T (Science and Technology) First Responders Group.
This report can help emergency planners learn more about best practices for integrating social media into exercises and explains why social media should be a part of all aspects of disaster planning. It also highlights recent examples and challenges associated with integrating social media into exercises and training.
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Lessons Learned: Floods

Bosch, D. (2017). Use of Social Media and E-Government in Disasters: 2016 Louisiana Floods Case Study. (Abstract only.) Journal of Emergency Management. 15(6): 391-405.
The author discusses the strengths and challenges of social media use after the floods that struck Louisiana in 2016. Based on a small survey he conducted, he found that the use of social media increased while more traditional communication channels were compromised. Survey respondents were neutral or dissatisfied with the level of federal government engagement via social media.
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Scott, K. and Errett, N. (2017). Content, Accessibility, and Dissemination of Disaster Information via Social Media During the 2016 Louisiana Floods. (Abstract only.) Journal of Public Health Management and Practice.
The authors analyzed Facebook and Twitter posts made by federal, state, and local government agencies (including public health and emergency management) before, during, and after the flooding events. They scored each post using accessibility and dissemination scales and found that most posts were related to situational awareness and recovery.
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Yeo, J., Connolly Knox, C., and Jung, K. (2018). Unveiling Cultures in Emergency Response Communication Networks on Social Media: Following the 2016 Louisiana Floods. Quality and Quantity. 52(2):519-535.
The authors conducted a social network and content analysis of social media posts to better understand the role of culture in use and language in Louisiana after floods in 2016. They found that faith-based institutions, local authorities, and nonprofits were the main responders on social media. Within each of these groups, the cultural background of the institutions and the keywords used were similar. The authors conclude cultural groups using similar keywords communicate more frequently than those which do not, offering the opportunity for groups with multiple cultural characteristics to bridge information gaps between groups.
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Lessons Learned: Hurricanes

Connolly Knox, C. (2022). Local Emergency Management's Use of Social Media during Disasters: A Case Study of Hurricane Irma. (Abstract only.) Disasters. (Online ahead of print.).
A qualitative analysis of 26 after action reports on Hurricane Irma and focus group sessions helped the author determine challenges associated with using social media after a disaster (e.g., capacity, technical issues, inconsistent messaging, one- versus two-way communication, and timing). The author highlights lessons learned, challenges, and recommendations for future research.
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Genes, N., Chary, M., and Chason, K. (2014). Analysis of Twitter Users’ Sharing of Official New York Storm Response Messages. Medicine 2.0. 3(1): e1.
The authors analyzed tweets disseminated by New York State and City agencies during two storms (Superstorm Sandy and winter blizzard Nemo) to determine which were retweeted most frequently. The most retweeted tweets used simpler wording and shared general tips or photos versus actionable information. These findings suggest that emergency managers consider sharing a variety of information via social media in the event of a disaster.
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Gonzalez Kotala, Z. (2022). When Hurricanes Strike, Social Media Can Save Lives. University of Central Florida Today.
This article describes how a University of Central Florida professor analyzed 23 Florida counties’ use of social media during Hurricane Irma in 2017 as both a communication and an intelligence gathering tool. The professor analyzed after action reports and held focus groups with emergency managers and found that challenges included funding for staff to keep up to speed on information, lack of social media monitoring software, and lack of guidelines for multiple channels. One lesson learned from the study is that the public seeks out information before and during hurricanes more than afterwards, so timeliness is key, as is managing multiple social media accounts.
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Gruebner, O., Lowe, S., Sykora, M., et al. (2017). A Novel Surveillance Approach for Disaster Mental Health. PLoS One. 12(7).
The authors used “advanced sentiment analysis” to examine tweets posted over an 11 day period before, during, and after Hurricane Sandy to highlight basic emotions and determine if they could map excess risk of these emotions. Their analysis revealed spatial clusters and they encourage further study that could help quickly identify community areas where behavioral health assistance is most needed.
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Gubbins, T. and Cozijnsen, R. (2017). Emergency Communications in the Era of Social Media. Presspage.
Social media facilitated emergency communications during Hurricanes Harvey and Irma. The authors highlight how residents used it to request rescue and how responders used it to stay connected when more traditional means of communication were temporarily unavailable.
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Harris Smith, S., Bennett, K.J., and Livinski, A.A. (2014). Evolution of a Search: The Use of Dynamic Twitter Searches During Superstorm Sandy. PLOS Currents Disasters.
The authors explain how the use of a Twitter list combined with Boolean searches helped the U.S. Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Preparedness and Response increased situational awareness and improved the HHS response to Hurricane Sandy.
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Kryvasheyeu, Y., Chen, H., Obradovich, N., et al. (2016). Rapid Assessment of Disaster Damage Using Social Media Activity. Science Advances. 2(3).
The authors analyzed Twitter activity before, during, and after Hurricane Sandy and found that physical disaster effects and real and perceived threats can be observed by studying the intensity and makeup of Twitter’s streams. Emergency managers could use social media data to quickly assess disaster-related damage in their jurisdictions.
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* Olynk Widmar, N., Rash, K., Bir, C., et al. (2022). The Anatomy of Natural Disasters on Online Media: Hurricanes and Wildfires. Natural Hazards. 110(2): 961-998.
The authors studied five hurricanes and four wildfires to understand how online and social media activity varies depending on the type, phase, and geography of a disaster. They found that the volume of online content was greater for hurricanes than wildfires, and that mentions decreased after hurricane landfall or fires were contained, potentially leaving affected populations without support as they recover.
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U.S. Department of Homeland Security. (2013). Lessons Learned: Social Media and Hurricane Sandy. Virtual Social Media Working Group and DHS First Responders Group.
This report shares how social media was used before, during, and in recovery from Hurricane Sandy. It includes best practices, lessons learned, gaps, and issues for further consideration identified by the first responder community.
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Vera-Burgos, C. and Padgett, D. (2020). Using Twitter for Crisis Communications in a Natural Disaster: Hurricane Harvey. Heliyon. 6(9).
This case study highlights how Sylvester Turner, the mayor of Houston during Hurricane Harvey in 2017, communicated successfully with the public via social media in the wake of the storm. The authors describe how healthcare crisis managers can use Twitter during future disasters (e.g., using “we” and “our” to encourage a sense of community, translating a message into languages used in the community, and incorporating local and national hashtags).
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Wyatt, K. (2021). Emergency Response: Comparing Katrina and Ida Reactions. American Military University: Edge.
The author compares the strength, damage, and casualties of Hurricanes Ida and Katrina in Louisiana, noting that Hurricane Ida was stronger than Hurricane Katrina, but that warnings up to five days in advance, levees and flood walls, an overnight curfew, and communicating with those affected by social media mitigated Hurricane Ida’s impacts. The author recommends proactive measures such as enhanced training, communication, and education to prevent severe effects of future storms.
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Lessons Learned: Infectious Disease

Al-Surimi, K., Khalifa, M., Bahkali, S., et al. (2017). The Potential of Social Media and Internet-Based Data in Preventing and Fighting Infectious Diseases: From Internet to Twitter. (Abstract only.) Advances in Experimental Medicine and Biology. 972: 131-139.
The authors describe the role social media can play in tracking, communicating about, and reporting emerging infectious diseases (e.g., Severe Acute Respiratory Syndrome, Ebola, and Zika).
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Albrecht, S. S., Aronowitz, S. V., Buttenheim, A. M., et al. (2022). Lessons Learned from Dear Pandemic, a Social Media-Based Science Communication Project Targeting the COVID-19 Infodemic. Journal of Public Health Reports, 137(3):449-456.
This article discusses the rapid spread of mis- and disinformation about the COVID-19 pandemic on social media, part of an “infodemic” of available information. The authors describe the “Dear Pandemic” social media project, an innovative and multidisciplinary effort to disseminate trusted scientific information and enable media literacy around social media content.
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ASPR TRACIE. (2023). ASPR TRACIE Roundtable: Lessons Learned in Health Care Communications.
Speakers representing a wide range of stakeholders and jurisdiction types (national, large/urban, regional, and rural/tribal) shared their perspectives on how they integrated lessons learned during recent incidents into current and future responses. Topics included channels used for outreach and continued engagement, strategies for reaching different community and cultural groups, tracking and countering rumors, and working with partners to create complementary messaging.
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Barata, G., Shores, K., and Alperin, L. (2018). Local Chatter or International Buzz? Language Differences on Posts about Zika Research on Twitter and Facebook. PLoS One. 13(1).
A study of zika-related social media found that while most posts are in English, Facebook posts are more likely than tweets to be in a study author’s primary language. The authors of this article suggest Facebook is a more effective way to communicate in native languages of affected countries.
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Basch, C. H., Basch, C. E., Hillyer, G., et al. (2022). Social Media, Public Health, and Community Mitigation of COVID-19: Challenges, Risks, and Benefits. Journal of Medical Internet Research. 24(4):e36804.
The authors discuss the challenges, risks, and benefits of social media during the COVID-19 pandemic. Challenges identified include guidance changing as scientific research is developed, as well as disagreement among public health experts about recommendations. Best practices include disseminating clear messages as the situation evolves, maximizing partnerships with vetted content creators, and targeting messages at a heterogeneous audience.
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Dennis, A., Robin, C., and Carter, H. (2022). The Social Media Response to Twice-Weekly Mass Asymptomatic Testing in England. BMC Public Health. 22(1):182.
This article discusses the public response to a recommendation that all people in England take two asymptomatic COVID-19 tests per week. The authors evaluated 5,783 comments on social media and public comments of online news articles using framework analysis and found them to be negative overall. Recommendations for improvement in healthcare use of social media in similar situations included providing more open communication about the purpose of testing, and information about the accuracy of tests, monetary support for people requiring isolation, and ensuring accessibility for populations with access and functional needs.
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Gisondi, M., Barber, R., Faust, J., et al. (2022). A Deadly Infodemic: Social Media and the Power of COVID-19 Misinformation. Journal of Medical Internet Research. 24(2):e35552.
This article highlights the role of mis- and disinformation in vaccine hesitancy and the legal and ethical obligations of social media companies to combat misinformation. It also includes recommendations for healthcare providers specific to using social media (e.g., engage patients on social media, partner with influencers to share accurate information).
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Hadi, T. and Fleshler, K. (2016). Integrating Social Media Monitoring Into Public Health Emergency Response Operations. Disaster Medicine and Public Health Preparedness. 1-6.
The authors describe how they used social media monitoring during public health emergency responses in New York City, including Ebola and Legionnaire’s responses and for planned events. They offer concepts and implementations that can be applied to other agencies who want to build a social media monitoring team.
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Hadi, T., MacGregor, J., and Lauren, M. (2017). Social Media Monitoring: 2016 Zika Response in NYC. Health Security. Health Security. 15(4).
This article highlights how the New York City Social Media Monitoring Team (SMMT) coordinated the 2016 Zika planning and response efforts. The authors encourage local health departments leading or supporting emergency response to dedicate staff to monitoring social media to improve real-time situational awareness and understanding of public perception.
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Hart, M., Stetten, N., Islam, S., and Pizarro, K. (2017). Twitter and Public Health (Part 2): Qualitative Analysis of How Individual Health Professionals Outside Organizations Use Microblogging to Promote and Disseminate Health-Related Information. JMIR Public Health and Surveillance. 3(4): e54.
The authors examined more than 15,000 tweets to understand how public health professionals used Twitter. Messages were broken into four themes: 1) inform and educate, 2) monitor health statuses and trends, 3) communicate about social justice, and 4) increase professional development.
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Hildebrand, S. and Waite, B. (2021). Local Emergency Management Social Media Use During the COVID-19 Pandemic. (Abstract only.) Journal of Emergency Management. 19(7):83-97.
The authors analyzed the results of a survey of emergency managers to understand their proficiency in and use of social media platforms during the COVID-19 pandemic. The findings help explain government responses to the pandemic and can inform healthcare emergency managers’ communications plans for future emergencies.
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Hurst, N. (2018). Can Social Media Help Us Spot Vaccine Scares and Predict Outbreaks? Smithsonian.com.
The author shares information gathered from the 2015 Disneyland measles outbreak and highlights pros and cons associated with using social media to measure and track vaccine acceptance/doubt and anticipate disease peaks.
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Islam, M., Sarkar, T., Kahn, S., et al. (2020). COVID-19–Related Infodemic and Its Impact on Public Health: A Global Social Media Analysis. American Journal of Tropical Medicine and Hygiene. 103(4):1621-1629.
The authors reviewed social media data to determine the amount of misinformation present in COVID-19 posts. They found that 82% of 2,276 reports with available text ratings were false and recommend health agencies track COVID-19 misinformation and engage their communities to combat misinformation.
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Lazer, D. and Kennedy, R. (2015). What We Can Learn From the Epic Failure of Google Flu Trends. Wired.
The authors examine the miscalculation of Google Flu Trends in 2013 and explain the challenges and potential associated with using Big Data to predict and monitor disease.
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Marchette, D. and Hohman, E. (2015). Using Twitter to Detect and Investigate Disease Outbreaks. (Abstract only.) Online Journal of Public Health Informatics. 7(1): e147.
The authors describe how they aggregated and filtered Twitter data to identify “events”—data with an unusual count that is then assessed by an analyst. They then used this method to analyze social media surrounding the Boston Marathon bombing, New Year’s festivities, and the Ebola outbreak.
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Merchant, R. and Lurie, N. (2020). Social Media and Emergency Preparedness in Response to Novel Coronavirus. Journal of the American Medical Association. 323(20):2011-2012.
This article discusses how social media was used by healthcare organizations early in the COVID-19 pandemic to track infection and share just-in-time training with the workforce. The authors recommend the use of pop-up banners and amplified messages from healthcare organizations and clinicians to direct users to trusted sources. They also describe how to use social media to counteract misinformation, as a referral system for healthcare, to accelerate research, and to encourage a culture of preparedness.
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* Otto, L. (2021). Mapping the Harm of COVID-19 Misinformation on Social Media. UWM Report.
The authors of this article examined social media using GIS, finding a correlation between the location of where misinformation spread and the number of COVID-19 infections and deaths in the weeks afterwards. The author identified prominent messages and mapped them onto the parts of the country where they were most prevalent.
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Sleigh, J., Amann, J., Schneider, M., et al. (2021). Qualitative Analysis of Visual Risk Communication on Twitter During the COVID-19 Pandemic. BMC Public Health. 810.
The authors used software to locate Twitter’s most retweeted COVID-19 messages from January-October 2020. Messages had to include visuals, be in English, come from verified accounts, and contain select keywords. Using a content analysis, they found that communications early in the pandemic were from media, health, and government institutions, but personal accounts had the highest retweet count. While more messages focused on “health loss,” “health gain” messages were retweeted more often.
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Smolinski, M. (2017). How Crowd-Sourcing Technology is Monitoring Zika and Other Health Conditions During the Olympics. The Blog, Huffington Post.
Health officials in Brazil sponsored the development of Guardiões da Saúde, an app (available in seven languages) that monitored the health of participating citizens and visitors to the Olympics. Users would answer questions about their health on a daily basis and the app provided information about care and prevention.
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Topf, J., and Williams, P. (2021). COVID-19, Social Media, and the Role of the Public Physician. Blood Purification. 14:1-7.
By surveying physicians with a public presence on social media, the authors analyzed the role these doctors played in combatting misinformation about the COVID-19 pandemic and the infodemic. They found that “public physicians’” online audience grew during the COVID-19 pandemic, allowing these doctors to provide good information and correct rumors, stigma, and refute conspiracies.
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Vos, S., Sutton, J., Gibson, C.B., et al. (2020). #Ebola: Emergency Risk Messages on Social Media. (Abstract only.) Health Security. 18(6):461-472.
This article discusses the challenges associated with measuring effectiveness of emergency risk communication via social media in the context of the 2014 Ebola outbreak. The authors evaluated 2,915 messages shared by local, state, and federal public health officials on social media during the outbreak, finding positive results healthcare organizations can consider when updating their risk communications plans.
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Wang, Y., Hao, H. and Platt, L. S. (2021). Examining Risk and Crisis Communications of Government Agencies and Stakeholders During Early-stages of COVID-19 on Twitter. Journal of Computers in Human Behavior, 114:106568.
This article describes a comprehensive review of the use of Twitter to communicate risks and protective measures to the public during the COVID-19 pandemic. After examining more than 13,000 COVID-19-related tweets, the authors found inconsistencies in messaging, but that coordination improved over time. The findings can be used by healthcare communications professionals in future crises.
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White, B., Melton, C., Zareie, P., et al. (2023). Exploring Celebrity Influence on Public Attitude Towards the COVID-19 Pandemic: Social Media Shared Sentiment Analysis. BMJ Health & Care Informatics. 30(1):e100665.
The authors examined the sentiment of 13 million tweets to understand how the public and people in the public eye reacted to the COVID-19 pandemic on social media. They found that tweet sentiments were shaped by risk perceptions, political ideology, and protective health behaviors.
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Wong, R., Harris, J., Staub, M., and Bernhardt, J. (2017). Local Health Departments Tweeting About Ebola: Characteristics and Messaging. (Abstract only.) Journal of Public Health Management and Practice. 23(2): e16-e24.
The study team collected all Ebola-related tweets sent by nearly 300 local health departments (LHDs) across the U.S. from September 3 to November 2, 2014 and analyzed their characteristics. The majority of Ebola tweets provided information, and the rest shared information on preparedness or shared news or promoted events. The authors recommend that LHDs use Twitter during public health emergencies “to ensure timeline dissemination of critical information.”
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Lessons Learned: Mass Violence

Callcut, R., Moore, S., Wakam, G., et al. (2017). Finding The Signal in the Noise: Could Social Media Be Utilized for Early Hospital Notification of Multiple Casualty Events? PLoS One. 12(10):e0186118.
The authors analyzed 3.8 million tweets from five disasters (the Boston Marathon bombing, a plane crash in San Francisco, the earthquake that struck the Napa area, the Sandy Hook mass shooting, and the Marysville mass shooting) from their onset until one week after the event. They found that tweets about the incidents began less than two minutes after the event, and that using a 200 tweet per minute threshold to notify local hospitals of a possible large-scale disaster would have alerted hospitals before the first patient’s arrival. The authors conclude that monitoring social media could be a tool for disaster response and more research should be done to determine whether the threshold concept is useful in practice.
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Straub, F., Cambria, J., Castor, J., et al. (2017). Rescue, Response, and Resilience: A Critical Incident Review of the Orlando Public Safety Response to the Attack on the Pulse Nightclub. Office of Community Oriented Policing Services.
This comprehensive report describes the unified response the City of Orlando carried out during and after the Orlando Pulse nightclub attack. While slightly more focused on law enforcement, the report shares numerous lessons learned from several perspectives, including: leadership and relationships; media and public information (e.g., the use of social media and the importance of having one organization responsible for sharing information via one platform); and community engagement and relationships.
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Lessons Learned: Tornadoes

Ripberger, J., Jenkins-Smith, H., Silva, C., et al. (2014). Social Media and Severe Weather: Do Tweets Provide a Valid Indicator of Public Attention to Severe Weather Risk Communication? Weather, Climate, and Society. 6(520-530).
The authors analyzed over 3 million tweets between 25 April and 11 November 2012 to determine if Twitter activity was a good indicator of public attention to severe weather communication. Overall results supported the notion that social media data can be used to develop valid indicators of real-time attention to severe weather communication, but the authors suggest that researchers “develop a system that is capable of separating the signal (tweets from attentive members of the public) from the noise (everything else) in near–real time” to help communicators meaningfully track the effect of their messages on attention as they are disseminated.
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Stephens, K. (2011). Joplin Tornado Demonstrates Social Media’s 5 Key Roles in Disaster Response and Recovery. idisaster 2.0.
Social media was used after the tornado to: document the event, enable survivors to list themselves as safe (and find their loved ones), provide survivors with information on getting assistance, and help survivors locate lost items (e.g., pets and medical records).
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Williams, R., Williams, G., and Burton, D. (2012). The Use of Social Media for Disaster Recovery. University of Missouri Extension.
The authors share lessons they learned from creating and maintaining the "Joplin Tornado Info" and "Branson Tornado Info" Facebook pages. The guidance in this document can help emergency managers set up their own social media platforms and draft messages before an incident occurs.
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Lessons Learned: Wildfires

Gabbert, B. (2019). Social Media Can Help Identify Evacuation Patterns. Wildfire Today.
The author describes the work of a professor who analyzed Facebook evacuation data following the Mendocino Complex Fire and Camp Fire in California in 2018. For the Mendocino Complex Fire, she found that evacuation patterns were dispersed, but the data showed people returning to their homes after the fire. After the Camp Fire, less people returned home because more areas were destroyed. The results show that awareness of these trends can help healthcare workers identify where additional support can be provided.
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Marfori, M.T., Campbell, S., Garvey, K., et al. (2020). Public Health Messaging During Extreme Smoke Events: Are We Hitting the Mark? Frontiers in Public Health. 8:465.
The authors conducted interviews with 24 households in Tasmania affected by a severe smoke event. Respondents shared challenges they encountered with social media (e.g., misinformation, timeliness, not enough messaging on the health risks from smoke). The authors emphasize the need to use multiple methods of communication to reach the public, keep social media messaging simple, and ensure that all health risk information is provided by a trusted source.
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* Olynk Widmar, N., Rash, K., Bir, C., et al. (2022). The Anatomy of Natural Disasters on Online Media: Hurricanes and Wildfires. Natural Hazards. 110(2): 961-998.
The authors studied five hurricanes and four wildfires to understand how online and social media activity varies depending on the type, phase, and geography of a disaster. They found that the volume of online content was greater for hurricanes than wildfires, and that mentions decreased after hurricane landfall or fires were contained, potentially leaving affected populations without support as they recover.
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Zhong, X., Duckham, M., Chong, D, and Tolhurst, K. (2016). Real-Time Estimation of Wildfire Perimeters from Curated Crowdsourcing. Scientific Reports. 6: 24206.
The authors describe an automated technique for real-time tracking of wildfire perimeters based on publicly available crowdsourced data collected from telephone calls to emergency services. This data allowed them to detect and track perimeters in real time, accurately, in two wildfires years apart.
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Misinformation and Disinformation

Aiyer, I., Shaik, L., Kashyap, R., et al. (2022). COVID-19 Misinformation: A Potent Co-Factor in the COVID-19 Pandemic. Cureus. 14(10):e30026.
This article reviews the scope of the COVID-19 “infodemic,” which, amid social media misinformation and a lack of credible sources and strategies for disseminating health information, challenged health authorities responsible for disseminating COVID-19 vaccines. The authors call for partnership between scientists, public health agencies, government, and social media companies to combat misinformation.
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Centers for Disease Control and Prevention. (2021). How to Address COVID-19 Vaccine Misinformation.
This webpage highlights strategies to combat mis- and disinformation which affected COVID-19 vaccine confidence and vaccine uptake in the U.S. Strategies for addressing COVID-19 misinformation through social media listening and monitoring tools are shared and links to resources including a community engagement playbook and a case study from Tennessee’s COVID-19 Health Disparity Task Force.
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Malecki, K., Keating, J., and Safdar, N. (2021). Crisis Communication and Public Perception of COVID-19 Risk in the Era of Social Media. Clinical Infectious Diseases. 72(4):697-702.
The authors discuss how cultural and economic factors such as the spread of misinformation on social media have impacted risk communication during COVID-19. They distinguish between hazard (the prevalence of exposure, infection, and illness) and outrage (the public’s response to messages about the hazard) as components of risk calculation and acceptance and provide strategies for applying risk communication principles.
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* Otto, L. (2021). Mapping the Harm of COVID-19 Misinformation on Social Media. UWM Report.
The authors of this article examined social media using GIS, finding a correlation between the location of where misinformation spread and the number of COVID-19 infections and deaths in the weeks afterwards. The author identified prominent messages and mapped them onto the parts of the country where they were most prevalent.
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Plans, Tools, and Templates

Acharya, S. (2020). Social Media Toolkit: A Primer for Local Health Department PIOs and Communications Professionals. National Association of County and City Health Officials.
This toolkit is for local health departments and healthcare organizations providing science-based and credible health information to the populations they serve. The author emphasizes researching audiences to personalize social media messages, using the right platform, and knowing stakeholders’ habits and trends. Free to NACCHO members.
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Agility Recovery. (2013). Social Media and Disaster Communications Checklist.
This concise (though slightly dated) checklist can help emergency planners create a social media plan. It includes steps to take before, during, and after a disaster and links to social media platform pages for more information.
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APCO International. (2020). Best Practices for The Use of Social Media in Public Safety Communications.
This voluntary standard—developed with input from law enforcement, fire, and medical emergency responders—describes how social media can and should be used during disasters.
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Bui, L. (2017). Digital Disaster Relief: Crowdsourced Responses to Hurricanes, Earthquakes, and Floods Around the World. PLoS Blogs.
The author explains how crowdsourcing, social media monitoring, and other tools can help disaster responders quickly collect information and tailor their on-ground response. These tools can also help volunteers contribute online or help onsite. Links to several tools are provided.
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Dornsife School of Public Health. (n.d.). Social Media Message Library. (Accessed 4/13/2023.)
Emergency planners can access and customize sample messages and posts for the following categories/populations: Natural Disasters, Infectious Diseases, Accidental Disasters, Intentional Disasters, and Individuals with Access and Functional Needs. Sample messages are provided in three main categories: general updates, response, and recovery.
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Drexel University. (n.d.). Using Social Media in a Disaster. (Accessed 4/13/2023.)
This webpage can be used as a checklist and includes lists of actions emergency planners can take before and during a disaster to ensure their social media messages are as helpful, timely, and informative as possible.
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Gualtieri, L., Bhatt, S., Shayani, A., et al. (2020). Social Media Toolkit for COVID-19: Guidance for Communicating Critical Information and Updates to Your Local Community through Social Media. Massachusetts Local Board of Health.
This toolkit for health agencies and healthcare organizations explains the value of social media use, how to choose audience-appropriate social media platforms, how to tailor the message for the platform, highlights best practices, and provides examples of effective posts used in Massachusetts.
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Maxwell School of Citizenship and Public Affairs. (2015). Social Media Monitoring for Emergency Managers: A Comprehensive Guide.
This highly visual report is structured around three key stages about monitoring social media before, during, and after an emergency. Each phase includes suggestions for implementation, key lessons learned, and examples.
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Mitcham, D., Taylor, M., and Harris, C. (2021). Utilizing Social Media for Information Dispersal during Local Disasters: The Communication Hub Framework for Local Emergency Management. International Journal of Environmental Research and Public Health. 18(20):10784.
Because social media has become a ubiquitous source of information during disasters, emergency managers have turned to it for crisis communications with the public. The authors of this article propose the “Communication Hub Framework” to use relationships with key members of the community to communicate with the public and patients during a disaster. The framework may be useful to healthcare organizations when devising a strategy for social media communications in their communities.
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Twitter. (2019). TweetDeck.
TweetDeck allows users to customize their Twitter experience (e.g., build and organize collections), track specific topics, events, and hashtags, and manage multiple accounts.
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* U.S. Department of Homeland Security. (2017). Best Practices for Incorporating Social Media into Exercises: Social Media Working Group for Emergency Services and Disaster Management and DHS (Department of Homeland Security) S&T (Science and Technology) First Responders Group.
This report can help emergency planners learn more about best practices for integrating social media into exercises and explains why social media should be a part of all aspects of disaster planning. It also highlights recent examples and challenges associated with integrating social media into exercises and training.
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U.S. Department of Homeland Security. (2019). Social Media Strategy. Virtual Social Media Working Group and DHS First Responders Group.
In addition to listing the benefits and challenges associated with implementing social media for public safety (including public health, emergency management, fire, and law enforcement), this document includes links to examples for each type of platform (e.g., mobile texting, Twitter profiles, Facebook, LinkedIn, photo and video sharing).
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World Health Organization. (2021). Tackling COVID-19 Misinformation: A Social Media Toolkit for Healthcare Practitioners.
This toolkit provides messages and techniques that healthcare practitioners may use to increase vaccine confidence among their patients. Users may download desktop or mobile versions of the toolkit.
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Agencies and Organizations

Centers for Disease Control and Prevention. Social Media at CDC.
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Cybersecurity & Infrastructure Security Agency. Mis, Dis, Malinformation.
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Disaster Response on Facebook.
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National Center for Disaster Preparedness. Visualizing Social Media: New Tools for Research and Practice.
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Ready.gov. Social Media Preparedness Toolkits.
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U.S. Department of Homeland Security. Social Media Working Group for Emergency Services and Disaster Management Program.
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This ASPR TRACIE Topic Collection was updated in April 2023 and comprehensively reviewed by the following subject matter experts (listed in alphabetical order): Eric Alberts, Senior Director, Emergency Management, Orlando Health; James Bolen, MS, Planning Section Chief, Butler County, State of Ohio AHIMT; Peter Brewster, Program Manager, Office of Emergency Management, Veterans Health Administration; April Finnen, Senior Communications Specialist, U.S. Food and Drug Administration; John Hick, MD, Hennepin Healthcare; Elizabeth Jarrett, Public Affairs Specialist, ASPR Web Communications; James Paturas, Director, Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System; Mary Russell, EdD MSN, Healthcare Emergency Response Coalition, Palm Beach County, Florida; and Molly Rutledge, M.A., M.S., Chief Clinical Consultant for Rehabilitation Specialists, IHS.

It was first comprehensively reviewed in February 2018 by Kelly Bennett, MPH, Data and Analytics Branch Chief, U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR), Division of Fusion; Suzanne Bernier, CEM, CBCP, MBCI, President, SB Crisis Consulting; Pete Brewster, Program Manager, Office of Emergency Management, Veterans Health Administration; John Hick, MD, HHS ASPR and Hennepin County Medical Center; Elizabeth Jarrett, M.A., Public Affairs Specialist, HHS ASPR; Caitlyn Lutfy, MPH, Health Communication Specialist, Centers for Disease Control and Prevention (CDC); Dave Nichols, CEM, Medical Reserve & Workforce Deployment Manager, Public Health Preparedness, Public Health Seattle & King County (WA); Sarah Perlstein, MPP, Contract Support, Department of Homeland Security (DHS) Science and Technology Directorate (S&T); Barbara Reynolds, Ph.D., Director of Public Affairs, CDC; Mary Russell, EdD, MSN, Healthcare Emergency Response Coalition, Palm Beach County, Florida; Mary Kay Rutan, Communication Manager, VA Sunshine Healthcare Network (VISN 8), U.S. Department of Veterans Affairs; Brittney Seiler, MPA, HHS ASPR; L. Corey Sloan, M.A., M.S., EMT-P, Deputy Chief of EMS, NTA EMS Rescue, Bethany, MO; and Christopher Tarantino, Master Exercise Practitioner, Lead Consultant/Instructor, CEO of Epicenter Media & Training.

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