How Twitter could save your life

Inane chat about runny noses, or pandemic predictor?

Back in 2010 AMC set up co-ordinated “zombie attacks” in major cities around the world to promote its zombie thriller series The Walking Dead. Gaggles of blood-dripping “walkers” invaded trains and lurched around landmarks like Big Ben and The Prado Museum. Just one small scratch, or, worse, a desperate, flesh-eating bite, and you would become a zombie too – in the drama, of course.

AMC’s most popular programme now pulls in over 12 million viewers per episode and has nearly 1.5 million Twitter followers, each obsessed with the dramatic, but scarily plausible, scenario of a true life version of blockbuster films like Outbreak, Contagion or 28 Days later.

But as Twitter continually proves itself to be such an adept viral tool, the sheer number of users – which is 500 million and counting – flocking to its pages could make it a hefty ally in the fight to contain such an outbreak. Twitter, it seems, may not only be the best place to send a  meme like the walking dead  ‘viral’, but also the perfect platform for stopping a virus dead in its tracks.

Twitter users react to current events and tweets contain real-time information about their perspective and location. If Lori Grimes, for example, had been on Twitter, could word have spread faster than The Walking Dead’s zombie outbreak? And could Contagion’s MEV-1 virus have been prevented if Beth Emhoff had tweeted about her supposed cold symptoms?

These questions might read like science fiction, but Professor Simon Hay at the UK’s University of Oxford believes there is a “revolution occurring” in the amount of public health data that is available through social media, particularly from Twitter.

While scientists have traditionally used mapping techniques to track outbreaks, it is just 4 per cent of infectious diseases that have been effectively mapped. New technology is required to improve results and Twitter could provide the answer.

In fact, Twitter has already provided geo-positioned information to inform scientists about public health. A study from the University of Iowa proved that content embedded in Twitter feeds relating to the H1N1 flu outbreak in 2009 allowed the tracking of “rapidly-evolving public sentiment” and “actual disease activity”.

By using Twitter's streaming application programmer's interface (API), the study explored public sentiment from 29 April to 1 June 2009 by identifying 951,697 tweets out of 334,840,972 that matched specified search terms, such as flu, swine, influenza, H1N1 and illness.

The second phase selected 4,199,166 tweets – which conformed to certain guidelines, such as they had to be in English and originate from the US – from eight million influenza-related tweets that included relevant keywords sent between 1 October and 31 December 2009. The study found that these Twitter feeds actually predicted outbreaks one to two weeks in advance of traditional surveillance.

Scientists are currently struggling to map the current outbreak of the H7N9 avian influenza virus in China – which is considered by the World Health Organisation to be a “serious threat” (126 have been infected to date and 24 have died), despite it not spreading through people as yet – so why isn’t Twitter’s data stream being utilised?

Could it be due to the lack of Twitter users in China? According to a programmer (@ooof) on the South China Morning Post blog, the number of live active Twitter users could be as little as 18,000. If this number was more, would scientists have been better able to predict this very real threat to our society’s health?

As an online flu detector exists in the UK, which has been created by a team at the University of Bristol through identifying keywords from Twitter’s geo-located content, then couldn’t similar programs be used to identify and predict other, more serious, infections?

Twitter has come a long way since it launched, when it attracted intense criticism from naysayers questioning why they would want to tweet inane information about an erupting spot or runny nose. But, in the battle against pandemic outbreaks, it is ironically these kinds of observations that could empower Twitter to become a sophisticated tool and actually be more than just a social lifesaver in the future.

Frances Cook is a freelance energy, transport and lifestyle reporter. She has worked for NRI Digital.

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Wrists, knees, terrible rages – I felt overwhelmed when Barry came to see me

I teach my registrars to be aware how a consultation is making them feel: that can give valuable clues to the patient’s own emotional state.

To begin with, it seemed that Barry’s wrists were the problem. He told me about the pain he was experiencing, the pins and needles that came and went in his hands. I started to examine him. His palms were calloused, his fingers thick and stubby, veterans of the heavy work he’d undertaken throughout his 57 years. Even as I assessed this first problem, he mentioned his knees. I moved on to look at those. Then it was his back. I couldn’t get to grips with one thing before he veered to the next.

I teach my registrars to be aware how a consultation is making them feel: that can give valuable clues to the patient’s own emotional state. Barry was making me feel overwhelmed, the more so as I learned that he’d been experiencing all these problems for years.

“Why are you coming to see me about them now,” I asked, “rather than six months ago – or in six months’ time?”

“I need some time off, doc.”

There was something about the way he wouldn’t meet my gaze. And again, that feeling of being overwhelmed.

“What’s going on at work?” I asked him.

His tone hardened as he told me how he’d lost his temper a couple of days earlier. How one of the others had been winding him up, and something inside him had snapped, and he’d taken a swing at his workmate and landed a punch.

Barry had walked out and hadn’t been back. I tried to find out if he’d heard from his boss about the incident, if he knew what was likely to happen next.

He told me he didn’t care.

We talked some more. I learned that he’d been uncharacteristically short-tempered for months; his partner was fed up with being shouted at. Sleep had gone to pot, and Barry had taken to drinking heavily to knock himself out at night. He was smoking twice his usual amount. Men like Barry often don’t experience depression as classic low mood and tearfulness; they become filled with rage and turn in on themselves, repelling those closest to them in the process.

Depression is a complex condition, with roots that can frequently be traced right back to childhood experiences, but bouts are often precipitated by problems with relationships, work, money, or health. In Barry’s case, the main factor turned out to be his job. He’d been an HGV driver but at the start of the year his company had lost its operator’s licence. To keep the business afloat, his boss had diversified. Barry hated what he now had to do. He was now a “catcher”.

I didn’t know what that meant. Getting up at the crack of dawn, he told me, driving to some factory farm somewhere, entering huge sheds and spending hours catching chickens, thousands upon thousands of them, shoving them into crates, stashing the crates on a lorry, working under relentless pressure to get the sheds cleared and the birds off to the next stage of the food production chain.

“It’s a young man’s game,” he told me. “It’s crippling me, all that bending and catching.”

It wasn’t really his joints, though. Men like Barry can find it hard to talk about difficult emotion, but it was there in his eyes. I had a sudden understanding: Barry, capturing bird after panicking bird, stuffing them into the transport containers, the air full of alarmed clucking and dislodged feathers. Hour after hour of it. It was traumatising him, but he couldn’t admit anything so poncey.

“I just want to get back to driving.”

That would mean landing a new job, and he doubted he would be able to do so, not at his age. He couldn’t take just any old work, either: he had to earn a decent wage to keep up with a still sizeable mortgage.

We talked about how antidepressants might improve his symptoms, and made a plan to tackle the alcohol. I signed him off to give him some respite and a chance to look for new work – the one thing that was going to resolve his depression. But in the meantime, he felt as trapped as the chickens that he cornered, day after soul-destroying day.

Phil Whitaker’s novel “Sister Sebastian’s Library” will be published by Salt in September

This article first appeared in the 21 July 2016 issue of the New Statesman, The English Revolt