JOURNAL OF MEDICAL INTERNET RESEARCH Ahmad & Murad Original Paper The Impact of Social Media on Panic During the COVID-19 Pandemic in Iraqi Kurdistan: Online Questionnaire Study Araz Ramazan Ahmad1,2*, MA, PhD; Hersh Rasool Murad3*, MA, PhD 1Department of Administration, College of Humanities, University of Raparin, Ranya - Al Sulaimaniyah, Iraq 2Department of International Relations & Diplomacy, Faculty of Administrative Sciences and Economics, Tishk International University, Erbil, Iraq 3Department of Public Relations & Marketing, Technical College of Administration, Sulaimani Polytechnic University, Sulaimani, Iraq *all authors contributed equally Corresponding Author: Araz Ramazan Ahmad, MA, PhD Department of Administration College of Humanities University of Raparin Main Road Ranya - Al Sulaimaniyah, 46012 Iraq Phone: 964 7701573122 Email: [email protected] Abstract Background: In the first few months of 2020, information and news reports about the coronavirus disease (COVID-19) were rapidly published and shared on social media and social networking sites. While the field of infodemiology has studied information patterns on the Web and in social media for at least 18 years, the COVID-19 pandemic has been referred to as the first social media infodemic. However, there is limited evidence about whether and how the social media infodemic has spread panic and affected the mental health of social media users. Objective: The aim of this study is to determine how social media affects self-reported mental health and the spread of panic about COVID-19 in the Kurdistan Region of Iraq. Methods: To carry out this study, an online questionnaire was prepared and conducted in Iraqi Kurdistan, and a total of 516 social media users were sampled. This study deployed a content analysis method for data analysis. Correspondingly, data were analyzed using SPSS software. Results: Participants reported that social media has a significant impact on spreading fear and panic related to the COVID-19 outbreak in Iraqi Kurdistan, with a potential negative influence on people's mental health and psychological well-being. Facebook was the most used social media network for spreading panic about the COVID-19 outbreak in Iraq. We found a significant positive statistical correlation between self-reported social media use and the spread of panic related to COVID-19 (R=.8701). Our results showed that the majority of youths aged 18-35 years are facing psychological anxiety. Conclusions: During lockdown, people are using social media platforms to gain information about COVID-19. The nature of the impact of social media panic among people varies depending on an individual©s gender, age, and level of education. Social media has played a key role in spreading anxiety about the COVID-19 outbreak in Iraqi Kurdistan. (J Med Internet Res 2020;22(5):e19556) doi: 10.2196/19556 KEYWORDS social media; COVID-19; infodemic; panic; mental health; fake news; misinformation; impact; Kurdistan region; Iraq http://www.jmir.org/2020/5/e19556/ J Med Internet Res 2020 | vol. 22 | iss. 5 | e19556 | p. 1 (page number not for citation purposes) XSL·FO RenderX JOURNAL OF MEDICAL INTERNET RESEARCH Ahmad & Murad between case incidence and public concern [10]. Previous Introduction studies used the internet to collect data related to diseases, such Background as the search frequency of hand washing, hand sanitizer, and antiseptic topics [11]. The WHO declared that they are currently The coronavirus disease (COVID-19) is an infectious disease fighting not only an international epidemic but also a social caused by a newly discovered coronavirus [1]. Cases of media infodemic, with some media claiming that the coronavirus COVID-19 first emerged in late December 2019, when a is the first true social media infodemic because it has accelerated mysterious illness was reported in Wuhan, China. The cause of information and misinformation worldwide and is fueling panic the disease was soon confirmed as a novel coronavirus, and the and fear among people [12]. This is an unproven but testable infection has since spread to many countries worldwide and has hypothesis, because users of social media use the platforms to become a pandemic disease [2]. Several websites have published express their emotions, feelings, and thoughts, which can be a information about COVID-19 and have given different valuable source of data for researching mental health [13]. instructions to their users about ways to prevent the spread of the virus, such as keeping a distance between themselves and ABC News reported a poll claiming that in the age of social others, using masks, and washing their hands [3]. Social media media, anxiety about the coronavirus spreads faster than the has become a source of disseminating information to the public. virus itself, resulting in public panic worldwide [14]. On the Many individuals will experience isolation during hospitalization other hand, social media is also a practical platform for the or when quarantining at home [4]. Social media can be an spreading of public health messages to audiences [15]. efficient source of information and an effective means for Brewer on BBC News [16] posits that hearing a lot of staying abreast of the vast amount of medical knowledge [5]. information and news about COVID-19 has affected the public COVID-19 Cases in Iraqi Kurdistan and created panic, causing people to live with anxiety. Similarly, Rothschild and Fischer [17] claimed that social media is Prior to the outbreak of COVID-19, people already relied on spreading fear and panic among social media users. social media to gather information and news, and since the Correspondingly, in the discussion on social media, Cellan-Jones outbreak in December 2019, people in many countries have [18] stated that people depend on social media to gain relied on social media to obtain information about the virus. In information and facts about COVID-19, as some countries use addition, people in Iraqi Kurdistan depend on social media. filters, which is why social media gives some information but Internet use is strongly associated with behaviors related to not all the facts. health information; users write about their health on various social media platforms [6]. According to Kemp [7], there were After COVID-19 appeared and was transmitted to other 29.82 million internet users and 21 million social media users countries outside of Mainland China, people turned to social in Iraq in January 2020. Therefore, internet data, including data media to know more about the virus. According to Molla [19], from social media platforms such as Twitter, have been used in just 24 hours, there were 19 million mentions of COVID-19 extensively in the past 20 years to study health patterns and across social media and news sites worldwide. better understand infectious disease outbreaks, a field known The mass media has been called on to take responsibility for as infodemiology or (if used as surveillance tool) infoveillance providing correct information and aiding comprehension among [8]. citizens [20]. Frenkel et al [21] reports that after the WHO At the time of writing, the global spread of COVID-19 is still claimed that social media companies were fueling a rapidly evolving situation. The Kurdistan Regional misinformation on COVID-19 worldwide, some social media Government (KRG) created a webpage [9], which is regularly companies tried to remove false information from their updated by the Ministry of Health, to communicate information platforms. about COVID-19 cases in Kurdistan. According to government Victor [22] claims that in today's digital age, Chinese citizens statements, only the Ministry of Health or the World Health could not get enough facts about COVID-19, which is why they Organization (WHO) is qualified to confirm COVID-19 cases depended on social media and widely shared their information, in Iraqi Kurdistan. Nevertheless, most people rely on social photos, and videos, sometimes inaccurately. Likewise, in India, media and look for information on social media platforms the government has asked top social media companies like instead of using the official KRG webpage. Facebook, YouTube, TikTok, ShareChat, and Twitter to stop According to statements from the KRG's Ministry of Health, publishing misinformation, as it creates panic among people. as of April 10, 2020, the total number of confirmed cases is Similarly, Emmott [23] noted that, according to a European 324, including 3 deaths, 134 recovered patients, and 187 active Union document, Russian media has published a ªsignificant cases [9]. The main objective of this early study is to investigate disinformation campaignº about the COVID-19 outbreak to the relationship between using social media platforms and the create panic among the public in Western countries. spreading of panic during this COVID-19 outbreak. In a contemporary discussion on the effects of media, one Literature Review researcher [24] stated that in some countries, social media The first study on social media during a pandemic dates back impacted the buying crisis, when many people tried to buy toilet to the 2009 H1N1 pandemic, tracking the prevalence of paper and other items because of the spreading fear of misinformation (determined as 4.5%), terminology use ("H1N1" COVID-19 on social media. According to the newspaper The versus "swine flu"), public sentiments and fear, and relationships Star [25], social media is responsible for much of the panic http://www.jmir.org/2020/5/e19556/ J Med Internet Res 2020 | vol. 22 | iss. 5 | e19556 | p. 2 (page number not for citation purposes) XSL·FO RenderX JOURNAL OF MEDICAL INTERNET RESEARCH Ahmad & Murad surrounding COVID-19, internationally leading to a situation misinformation, fake news, and inaccurate information about where social media companies tried to eradicate posts about the outbreak was published on social media. Third, social media COVID-19 from their platforms. Furthermore, Devlin [26] created fear and panic about the outbreak worldwide. stated that people saw posts of empty shops on social media, Little or no evidence is available on the perception and impact which created panic related to food shortages.