Describing the impact of the COVID-19 pandemic on alcohol-induced blackout tweets.

INTRODUCTION AND

aimsCOVID-19, considered a pandemic by the World Health Organization, overwhelmed hospitals in the USA. In parallel to the growing pandemic, alcohol sales grew in the USA, with people stockpiling alcohol. Alcohol-induced blackouts are one particularly concerning consequence of heavy drinking, and the extent to which blackout prevalence may change in the context of a pandemic is unknown. The purpose of the current study is to describe the prevalence of publicly available tweets in the USA referencing alcohol-induced blackouts prior to and during the COVID-19 outbreak. DESIGN AND

methodsWe used Crimson Hexagon's ForSight tool to access all original English tweets written in the USA that referenced alcohol-related blackouts in 2019 and 2020. Using infoveillance methods, we tracked changes in the number and proportion of tweets about blackouts.

resultsMore alcohol-related blackout tweets were written between 13 March and 24 April in 2020 than 2019. In addition, a greater proportion of all tweets referenced blackouts in 2020 than in 2019. In the period prior to the 'stay at home' orders (January to mid-March), the proportion of blackout tweets were higher in 2020 than 2019. DISCUSSION AND

conclusionOur findings demonstrate that references to high-risk drinking persist during the pandemic despite restrictions on large social gatherings. Given that the internet is a common source of information for COVID-19, the frequent posting about blackouts during this period might normalise the behaviour. This is concerning because alcohol use increases susceptibility to COVID-19, and alcohol-related mortality can further tax hospital resources.