In fighting the spread of the H1N1 influenza virus, county health agencies are turning to new weapons — social media such as Twitter and Facebook — to get the public’s attention.
“The big change in communications is that, traditionally, it was: ‘We’re the expert, listen to us, this is what you should do,’” said Kerry Shearer, communication and media officer for Sacramento County Public Health. “Now people turn to the Internet, they’re getting … a variety of information and they’re weighing the information there.

“It’s really a change in the way people collect information and it’s essential for public health agencies to be part of that conversation.” 

SacPublicHealth’s Twitter site is on top of it, whether it’s a tease to a Web page with flood preparedness tips Jan. 21 or dozens of Tweets from H1N1 virus clinics giving timely reports about there being no lines. It culminated in a Jan. 15 Tweet thanking volunteers, staff and the community for pulling off 35 successful clinics with 42,000 people vaccinated.

A Tweet is a posting, kept brief by Twitter guidelines, that the software automatically circulates to people who have signed up as followers. For SacPublicHealth, that’s a group of residents anxious for updates about H1N1 and other worrisome health issues. In late January, the SacPublicHealth Twitter site was showing 821 followers.

“We can respond very quickly to public health issues by providing accurate information and respond to inaccurate rumors or false information,” said Shearer.

“We need as communicators to have access to the same tools the public has.”
Another handy tool is SacPublicHealth’s Facebook page, exchanging information with public “friends.” It has a capacity for longer articles, Web links and even YouTube videos.

Shearer is a one-man mobile health communicator, filming one-minute videos telling “friends” that there were no lines at a high school holding an H1N1 clinic. He uses a Verizon Mi-Fi card, roughly the dimensions of a credit card, to connect his laptop to the Internet and upload material to SacPublicHealth’s Web site, Facebook page or Twitter page. He can set up a “communications desk” in a foldup chair in the corner of a temporary H1N1 clinic in a school or church.

Other agencies are going social media to get the public health word out.
“These tools are useful but they’re not the end-all and be-all,” said Dan Jordan, a research psychologist for the Ventura County Public Health Department who doubles as the social media disseminator. “Different populations of people are Twitter users and others use other systems.”

Ventura County Public Health joined Twitter last August. As of late January, it had 522 followers. The Tweets send followers to the department’s H1N1 Web page. The advent of Twitter drove a lot more people to that page — 40,000 hits in November 2009, compared to less than half that in November 2008, Jordan said.

It’s important for communicators to parse the right words for Twitter and the general Web site.

“Let’s say the medical director tosses off an idea,” Jordan said. “You say, ‘Let’s be specific.’ Pin him down. Exactly what words do you want to use?”

The audience is the general public. “We’re so deep in what we do that we think we’re speaking regular English,” said Jordan. “We’re not. We’re just jargoning it up. When people are looking for a piece of information, they don’t want to wade through a novel.”

Different tools — Twitter, Facebook and the department Web site — reach different audiences.

For answering questions from the public, the department’s general e-mail list for residents who have signed up is most useful, Jordan said.

One e-mailer asked a common question — is it OK to get the H1N1 vaccine and the regular seasonal influenza shot at the same time? The answer is yes. That exchange, posted on the Web site, led to a half-dozen followup questions with answers that were instructive to many people, Jordan said.

“With Twitter, you can send out short messages, very quickly, with access to potentially a very large audience,” said Kate Fowlie, communications officer for Contra Costa Health Services. “We put out updates on H1N1 such as the number of cases, and public health instruction to prevent spread of H1N1. Reporters were picking it up.”

Twitter, Fowlie said, is perfect for emergency communications. She appreciates the feedback  — one Twitter follower asked to clarify Contra Costa County’s statistics on the number of residents with the H1N1 virus.

It’s interesting to follow county items that are “re-Tweeted” (further distributed by other Twitter users) to track what is drawing the greatest response, said Fowlie.
The county site provides links to state and federal authorities (such as to give residents background information.

Contra Costa county government has developed a social media policy. “We have a commitment to work with the media and get information out to the public,” said Fowlie. “Social media is an extension of that.”

The Contra Costa Health Services channel had 597 followers in late January. See

Other health agencies, curious about the power of social media, are making inquiries, said Shearer.

“Management may not understand the revolution that is going on in communications,” he said. “In many cases you need to have an understandable explanation of why is this is important to get started at.”

It’s important to have a model of collaboration for information technology and communications staffers in county government, Shearer said.

“In public health, we’re trying to reach younger people,” he said. “Young people are very connected these days to cell phones and social media of all kinds. It’s important to be where they are.”

A couple of years ago, the county took a flier on YouTube, responding to Sacramento media accounts that public health officials felt were sensationalizing a local outbreak of the MRSA bacterium, said Shearer. MRSA is Methicillin-Resistant Staphylococcus Aureus.

“We used YouTube as a way to get our message out unfiltered,” said Shearer.

It became even more useful in the summer of 2008 with wildfires north of Sacramento blowing smoke into the valley.

Each week, SacPublicHealth posted a YouTube video telling people how to protect themselves from the health effects of smoke. Within a few days, these videos had a couple of thousand people viewing them, Shearer said. It evolved into a formal partnership with the Sacramento Metropolitan Air Quality Management District in disseminating information and sharing response duties.

“They embedded our video on,” said Shearer. The result was a million hits a day, temporarily overwhelming the district’s Web site.

SacPublicHealth started Tweeting in October 2008. “It came in handy with the initial stages of the H1N1 outbreak in April 2009,” said Shearer. “We used Twitter to reach the public and began seeing more and more signups (to be Twitter followers).”

Social media “does require some staff time,” said Shearer. “You can’t just let it languish for weeks on end.”

But it does streamline tasks and make him more efficient, Shearer added. When there’s a snippet of N1N1 news, such as a clinic site changing or a federal change in vaccine eligibility, “I can post it to our Twitter page and it posts to our main Web site and our special H1N1 Web site.

“At numerous clinics, I talked to people who said, ‘I heard about this on Twitter or my wife heard about it on Twitter, and I headed on over because there’s no wait,’” said Shearer. “I don’t think it replaces the other communication tools you’re doing, but it really I think helps you reach additional people you might not reach using traditional means.

“If you do a YouTube search for ‘vaccinations,’ you find a lot of information about why you should never be vaccinated. If you don’t have your agency’s videos about why it’s important to be vaccinated, you’re not going to be part of the conversation.”

Lance Howland can be reached at