By Jamie Doggett 
This article was originally written for and published in the May 2020 edition of PMLiVE.
My perspective is often taken from analysing healthcare professional conversations on digital channels. In light of recent world events pertaining to the global spread of COVID-19 I wanted to understand what HCPs think about this key issue.
One thing is clear: we find ourselves in a battle; a battle to be faced together as nations; a battle to be faced together across sectors of health, business, education and government. In a press conference on 16th March the Director General of the World Health Organization, Dr. Tedros Adhanom said “We’re all in this together and we can only succeed together so the rule of the game is together”. To help all stakeholders reach optimum alignment, I sought to discover what we can learn from digital channels at this time.
We have seen a huge rise in social media conversations online over the last few weeks. It is sometimes difficult to know where to go, who to listen to and what to believe. Just relating to COVID-19 there have been around a quarter of a billion posts and articles on social media and news channels. I’ve reviewed what pharma and NGOs have been adding to the communications, analysing nearly 1,700 posts from the top 50 pharma companies taken from different social media channels. I wanted to compare and contrast their messages with what healthcare professionals (HCPs) are saying about COVID-19 when mentioning pharma companies. I hoped to see whether what pharma is communicating online is being well received by HCPs.
HCPs and pharmaceutical companies
There were a surprisingly similar number of pharma COVID-19 posts as there were HCP original posts that mentioned a pharma company and COVID-19 (1,698 and 1,488 respectively). The key topic that appeared in a higher share of both HCP and pharma posts, was patients. A colleague of mine recently wrote a passionate piece in which she highlighted, in the midst of all the strategies and tactics of pharma marketing, education and comms, it is important to remember HCPs and pharma have the same goal: the patients. As we tackle this pandemic we can be assured that bringing wellness to those who are sick and preventing as many people as possible from getting sick must be the highest priority for health workers and the industry at large.
HCPs are talking about named drugs a lot more than pharma companies. Discussions about clinical trials and certain peer conversations about treating the disease are examples of conversations where it is challenging for pharma to engage in a public setting or, in some cases, any setting.
The posts in the HCP conversation in which they named a product were often HCPs pleading for access to Gilead’s remdesivir, even asking peers to help. There were questions asked directly to Gilead, and also peers, about Compassionate Use and Extended Access. Gilead shared some positive updates on social media about remdesivir but did not address all HCP concerns. Subsequently, Gilead has dropped remdesivir’s orphan drug designation based on its potential as a coronavirus treatment.
Dear #medtwitter I need help. Two physicians at Maimonides Medical Center, Brooklyn are fighting COVID 19 in MICU. It would be highly appreciated if anyone can help get Remdesivir from Gilead Sciences for compassionate use .
— Girish Nadkarni (@girish_nadkarni) March 21, 2020
While it may be impractical for pharma to engage in direct product conversations or unwise to weigh in on treatment conversations on public social media, there is an opportunity to learn from the conversation of HCPs and consider the best engagement strategy going forward.
The topic that has the closest correlation in level of focus within the conversation between HCPs and pharma is donations. Many pharma companies have posted about how and where they are donating money or protective equipment to support health workers. The amount of posts relating to financial giving was lower by both HCPs and pharma but it can be recognised that pharma is not underselling its charitable efforts nor overpitching its giving. The messaging is resonating with HCPs who are sharing this news and thanking companies for their contribution.
Grateful to our colleagues at @pfizer CTI who generously donated 800 pairs of protective goggles yesterday to aid in @BrighamWomens Hospital’s efforts to contain and treat COVID-19. pic.twitter.com/U4Tol9uyVv
— Paul Yu MD PhD (@bmprii) March 21, 2020
HCPs and Non-Governmental Organisations
In order to see how the topics varied between pharma and NGOs as well as how HCPs are discussing pharma and NGOs in relation to the crisis I ran the same analysis for two global NGOs: the World Health Organization (WHO) and the International Federation of Red Cross and Red Crescent Societies (IFRC). From these two organisations I analysed 21 and 68 Twitter accounts respectively. It was interesting to see how they used global, regional and country-specific (or even state-specific) accounts to share different types of messaging. Sometimes these accounts were used to boost the reach of other Twitter accounts within the same organisation or from different channels.
There are similarities between the topics discussed by these NGOs and pharma such as education and patients. And, while HCPs needs are also alike when mentioning WHO or IFRC, there is one obvious omission: named products. Compared to the same data in pharma conversations, there is also a much closer alignment between what NGOs are posting about COVID-19 and what HCPs post about when mentioning those NGOs.
The largest outlier in the HCP conversation is the use of the word ‘pandemic’. It was seen, when mentioning WHO or IFRC, HCPs are often using the word pandemic to refer to the current state of events in their online posts. While defining COVID-19 as a pandemic, WHO have been less likely to use the word in their online posts. Right now the choice of words to use in COVID-19 communications is critical and we must make conscious decisions about using words like pandemic, crisis and outbreak. Terms like these often are simply statements of fact giving an accurate view on current affairs but social media can become an incubator for fear so we must be careful to bring the accurate truth in what we share while protecting the wellbeing and mental health of users.
A call to action to #protect #HealthWorkforce during #COVID19 pandemic.
Data from Italy are still concerning, urging to align local practices to @WHO guidance#OneHealth #OneWorkforce
STOP internal policy-formulation at facility- level with "interpretations" of the standards https://t.co/XnwTIoYpGl
— Dario Trapani (@darioT_) March 18, 2020
While, from a terminology perspective there is quite a difference in the level of use of the word pandemic online, NGOs are talking about the fight against COVID-19, which is resonating with HCPs. The concept of ‘fighting’ a disease has been used positivity in health messaging but has also been criticised when relating to a patient’s individual fight with a disease. It can infer a patient is at fault for not fighting hard enough if they lose their battle with cancer, for example. However, in this instance there is a challenge we are facing collectively in which everyone can play a part and ‘victory’ can be achieved by peoples’ actions. Therefore words like ‘war’, ‘fight’ and ‘battle’ are being seen within the COVID-19 online conversations. There are many other closely aligned topics that HCPs and NGOs are giving a similar level of focus to such as hand washing, symptoms, treatments and patients.
Serological tests are a game-changer to fight #COVID19 but the key is to ensure only quality rapid kits get validated for use in country @KenyaKacp @KenyaMedics_KMA @KmpdcOfficial @MOH_Kenya @daktari1 @mdjkitulu @WHO @WHOKenya @andrewsuleh @GeoffreyOmuse @anniesyox @ValerieMagutu https://t.co/9rNZRLsvxm
— 𝗗𝗿 𝗔𝗵𝗺𝗲𝗱 𝗞𝗮𝗹𝗲𝗯𝗶, 𝕆𝔾𝕎 (@DrAhmedKalebi) March 22, 2020
It’s important to know the difference between terms like #socialdistancing and #isolation when it comes to protecting our health, as well as vulnerable people and health care workers. Learn more and let’s fight #COVID19 together! https://t.co/1ToCRENT2F #stayhome pic.twitter.com/c9VMshQd4y
— Canadian Red Cross (@redcrosscanada) March 25, 2020
Beyond the connection between HCPs and pharma or NGOs, I am encouraged to see collaborations such as Clover and GSK evaluating a vaccine candidate and Pfizer and Biontech doing the same. Recently the Bill and Melinda Gates Foundation brought together an ‘unprecedented’ coronavirus partnership with the industry. A number of top pharma companies are included in the newly formed partnership the COVID-19 Therapeutics Accelerator including Eli Lilly, J&J, Merck, Novartis, Pfizer and Sanofi. Such unprecedented actions are required for what has been repeatedly called unprecedented times.
Scientific advice relating to COIVD-19 is constantly being updated.Those responding to this are having to demonstrate the true meaning of the word ‘agile’. Governments and entire health systems are thinking fast and attempting to steer the massive vessels that nations are.
As pharmaceutical companies show their ability to do the same they have the potential to quite literally bring hope to the entire world.
We can be sure that over the next few weeks and months we will see innovation and hope grow until long term solutions are found. Depending on your disposition you may consider us still to be groping around in the dark of night or that we are just starting to experience the first lights of dawn. Either way, we know in time the light at the end of the tunnel will come and to reiterate Dr Adhanom, we will continue to stand together.
