The coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus [1]. Cases of COVID-19 first emerged in late December 2019, when a mysterious illness was reported in Wuhan, China. The cause of the disease was soon confirmed as a novel coronavirus, and the infection has since spread to many countries worldwide and has become a pandemic disease [2]. Several websites have published information about COVID-19 and have given different instructions to their users about ways to prevent the spread of the virus, such as keeping a distance between themselves and others, using masks, and washing their hands [3]. Social media has become a source of disseminating information to the public. Many individuals will experience isolation during hospitalization or when quarantining at home [4]. Social media can be an efficient source of information and an effective means for staying abreast of the vast amount of medical knowledge [5].

Prior to the outbreak of COVID-19, people already relied on social media to gather information and news, and since the outbreak in December 2019, people in many countries have relied on social media to obtain information about the virus. In addition, people in Iraqi Kurdistan depend on social media. Internet use is strongly associated with behaviors related to health information; users write about their health on various social media platforms [6]. According to Kemp [7], there were 29.82 million internet users and 21 million social media users in Iraq in January 2020. Therefore, internet data, including data from social media platforms such as Twitter, have been used extensively in the past 20 years to study health patterns and better understand infectious disease outbreaks, a field known as infodemiology or (if used as surveillance tool) infoveillance [8].

At the time of writing, the global spread of COVID-19 is still a rapidly evolving situation. The Kurdistan Regional Government (KRG) created a webpage [9], which is regularly updated by the Ministry of Health, to communicate information about COVID-19 cases in Kurdistan. According to government statements, only the Ministry of Health or the World Health Organization (WHO) is qualified to confirm COVID-19 cases in Iraqi Kurdistan. Nevertheless, most people rely on social media and look for information on social media platforms instead of using the official KRG webpage.

According to statements from the KRG’s Ministry of Health, as of April 10, 2020, the total number of confirmed cases is 324, including 3 deaths, 134 recovered patients, and 187 active cases [9]. The main objective of this early study is to investigate the relationship between using social media platforms and the spreading of panic during this COVID-19 outbreak.

The first study on social media during a pandemic dates back to the 2009 H1N1 pandemic, tracking the prevalence of misinformation (determined as 4.5%), terminology use ("H1N1" versus "swine flu"), public sentiments and fear, and relationships between case incidence and public concern [10]. Previous studies used the internet to collect data related to diseases, such as the search frequency of hand washing, hand sanitizer, and antiseptic topics [11]. The WHO declared that they are currently fighting not only an international epidemic but also a social media infodemic, with some media claiming that the coronavirus is the first true social media infodemic because it has accelerated information and misinformation worldwide and is fueling panic and fear among people [12]. This is an unproven but testable hypothesis, because users of social media use the platforms to express their emotions, feelings, and thoughts, which can be a valuable source of data for researching mental health [13].

ABC News reported a poll claiming that in the age of social media, anxiety about the coronavirus spreads faster than the virus itself, resulting in public panic worldwide [14]. On the other hand, social media is also a practical platform for the spreading of public health messages to audiences [15].

Brewer on BBC News [16] posits that hearing a lot of information and news about COVID-19 has affected the public and created panic, causing people to live with anxiety. Similarly, Rothschild and Fischer [17] claimed that social media is spreading fear and panic among social media users. Correspondingly, in the discussion on social media, Cellan-Jones [18] stated that people depend on social media to gain information and facts about COVID-19, as some countries use filters, which is why social media gives some information but not all the facts.

After COVID-19 appeared and was transmitted to other countries outside of Mainland China, people turned to social media to know more about the virus. According to Molla [19], in just 24 hours, there were 19 million mentions of COVID-19 across social media and news sites worldwide.

The mass media has been called on to take responsibility for providing correct information and aiding comprehension among citizens [20]. Frenkel et al [21] reports that after the WHO claimed that social media companies were fueling misinformation on COVID-19 worldwide, some social media companies tried to remove false information from their platforms.

Victor [22] claims that in today’s digital age, Chinese citizens could not get enough facts about COVID-19, which is why they depended on social media and widely shared their information, photos, and videos, sometimes inaccurately. Likewise, in India, the government has asked top social media companies like Facebook, YouTube, TikTok, ShareChat, and Twitter to stop publishing misinformation, as it creates panic among people. Similarly, Emmott [23] noted that, according to a European Union document, Russian media has published a “significant disinformation campaign” about the COVID-19 outbreak to create panic among the public in Western countries.

In a contemporary discussion on the effects of media, one researcher [24] stated that in some countries, social media impacted the buying crisis, when many people tried to buy toilet paper and other items because of the spreading fear of COVID-19 on social media. According to the newspaper The Star [25], social media is responsible for much of the panic surrounding COVID-19, internationally leading to a situation where social media companies tried to eradicate posts about COVID-19 from their platforms. Furthermore, Devlin [26] stated that people saw posts of empty shops on social media, which created panic related to food shortages. Additionally, Kent [27] noted that social media gave everyone the chance to share information with everyone else, which is why people posted on social media as soon as they heard something about COVID-19. In addition, it is noted that publishing inaccurate information on social media networks about the spread of diseases will have a negative impact on public health and people’s mental health [28]. The public sphere in the 21st century has undergone a transformation generated by the adoption of online communication technologies. New media has become an important source of health information and a platform for discussing personal experiences, opinions, and concerns regarding health, illnesses, and treatment [28]. Similarly, Dillon [29] noted that people spend a lot of time on social media and may see cases of panic buying in various countries during the COVID-19 pandemic, which can spread panic further. In addition, El-Terk [30] showed that nowadays everyone is an expert because everyone tries to have a voice and send a message about COVID-19. Correspondingly, Garrett [31] explained that we gave power to social media to create fear about COVID-19, as we all publish panic-inducing information and it circulates.

Merchant and Lurie [32] found that at present, due to the development of social media, many methods of communicating and disseminating information and news are available to the public. These are fast and effective and can spread true information as well as misinformation. In addition, La et al [33] said that many countries did not circulate information to the public about the COVID-19 outbreak or were unable to provide the public with the information they needed; thus, people relied on the information they could find on social media. The Vietnamese case is a successful example of dealing with social media in the right way. The country's Ministry of Health created accounts on social media networks, and through those accounts, they published information about COVID-19 to the public.

Mian and Khan [34] argue that there has been a worldwide increase in the spread of fake news and misinformation about COVID-19, with misinformation such as the lab theory on the origin of the virus allegedly "originating" on social media. Correspondingly, Petric and others [35,36] believe that “media coverage has highlighted COVID-19 as a unique threat, rather than one of many, which has added to panic, stress.” Depoux and others [37-40] determined that social media has played three main roles in the COVID-19 outbreak in most countries. First, facts about the outbreak were published on social media. Second, misinformation, fake news, and inaccurate information about the outbreak was published on social media. Third, social media created fear and panic about the outbreak worldwide.

Little or no evidence is available on the perception and impact of social media during this pandemic, in particular within non-Western communities such as Iraqui Kurdistan.

As media professionals working at a public university in the Kurdistan Region of Iraq, we conclude from the study results that social media has played a significant role in affecting the public during the COVID-19 crisis. The regression analysis of the study indicates that there is a significant positive statistical correlation (R=.8701) between social media and spreading panic about COVID-19. Moreover, we can see that it has had a psychological effect, primarily on the younger generation, where 40.2% (n=135/336) of the respondents aged 18-35 years were affected. People are gathering information from governmental sources that have eroded, and people are far more likely to get their information from social media than from any other sources. People are also unable to discern which information on social media is true and which is false, thus causing more panic and rumors about the true nature of the epidemic.

One could argue that the panic caused by widespread information about COVID-19 in the Kurdistan Region of Iraq is worse than the number of COVID-19 cases and will have a longer-lasting effect. It is important to communicate this to health professionals in the region and for media experts to work with these professionals to ensure that only well-vetted information is disseminated to the public. It is also important to engage the Ministry of Health and the Ministry of Education in this effort to be prepared for future epidemics or health situations. This pandemic has certainly helped the authors identify the need for educating consumers on health topics found through social media.

There were various research limitations, most importantly these are self-reported data from self-selected participants, and the lockdown period was a constraint to gather more representative data. It was difficult to find participants who wished to participate in this study.

As media experts and educators, we have an important role to play both now and in the future of Kurdistan. We must work to educate media consumers on what constitutes good and reliable information and how to critically think through this information. Since younger people are also consuming information from social media and then spreading it to their family and friends, universities are ideal places to design courses and symposiums that can help students and faculty discern how to search for, find, and evaluate health information in the case of an epidemic or pandemic.