• Areej Khokhar, Aaron Spaulding, Zuhair Niazi, Sikander Ailawadhi, Rami Manochakian, Asher Chanan-Khan, Shehzad Niazi, and Taimur Sher.
• University of North Florida, Jacksonville, FL, USA.
• J Prim Care Community Health. 2021 Jan 1; 12: 2150132721995450.

ImportanceSocial media is widely used by various segments of society. Its role as a tool of communication by the Public Health Departments in the U.S. remains unknown.ObjectiveTo determine the impact of the COVID-19 pandemic on social media following of the Public Health Departments of the 50 States of the U.S.Design, Setting, And ParticipantsData were collected by visiting the Public Health Department web page for each social media platform. State-level demographics were collected from the U.S. Census Bureau. The Center for Disease Control and Prevention was utilized to collect information regarding the Governance of each State's Public Health Department. Health rankings were collected from "America's Health Rankings" 2019 Annual report from the United Health Foundation. The U.S. News and World Report Education Rankings were utilized to provide information regarding the public education of each State.ExposureData were pulled on 3 separate dates: first on March 5th (baseline and pre-national emergency declaration (NED) for COVID-19), March 18th (week following NED), and March 25th (2 weeks after NED). In addition, a variable identifying the total change across platforms was also created. All data were collected at the State level.Main OutcomeOverall, the social media following of the state Public Health Departments was very low. There was a significant increase in the public interest in following the Public Health Departments during the early phase of the COVID-19 pandemic.ResultsWith the declaration of National Emergency, there was a 150% increase in overall public following of the State Public Health Departments in the U.S. The increase was most noted in the Midwest and South regions of the U.S. The overall following in the pandemic "hotspots," such as New York, California, and Florida, was significantly lower. Interesting correlations were noted between various demographic variables, health, and education ranking of the States and the social media following of their Health Departments.Conclusion And RelevanceSocial media following of Public Health Departments across all States of the U.S. was very low. Though, the social media following significantly increased during the early course of the COVID-19 pandemic, but it still remains low. Significant opportunity exists for Public Health Departments to improve social media use to engage the public better.

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