CDC Ebola Response on Twitter Excludes Blind

Image taken from a CDC tweet to show contrast.
This is one of the images tweeted by the CDC. The text contrast is 4.53:1, so it barely passes for large text. At this scaled-down size, however, the question text would fail a contrast test for accessibility.

In the United States, the Centers for Disease Control (CDC) is (or at least is supposed to be) the first line of defense against public health threats like Ebola. It makes sense, then, that the CDC would use social media to assist its efforts to get useful information in front of as many people as possible.

The problem is that the CDC’s efforts on Twitter have fallen prey to reliance on the image attachment. When Twitter proclaims that engagement goes up when images are used, and because tweets limited to 140 characters, it can be pretty compelling to use images to convey a lot more content than would otherwise fit — and it can be styled and better branded.

The CDC Emergency Preparedness and Response account started an Ebola fact campaign, framed as a Q&A series of information nuggets (which makes me think it’s really an Ebola FAQ campaign, but I digress). Here is the text of these tweets so far (no images):

We put together your most common questions about Ebola. Our first #EbolaFact is about sneezing.

— CDC Emergency (@CDCemergency) October 17, 2014 [alt]

Our next #EbolaFact is about how long the virus lives on surfaces, a common question about Ebola.

— CDC Emergency (@CDCemergency) October 17, 2014 [alt]

Our next #EbolaFact is about why health workers wear protective gear if #Ebola virus isn’t airborne.

— CDC Emergency (@CDCemergency) October 18, 2014 [alt]

Today's #EbolaFact is about whether pets can transmit #Ebola.

— CDC Emergency (@CDCemergency) October 19, 2014 [alt]

Our next #EbolaFact is about the incubation period for those exposed to #Ebola.

— CDC Emergency (@CDCemergency) October 20, 2014 [alt]

That’s it. No answers, no context, no links to more information. If you are a blind user, you get nothing of value from these tweets.

The main CDC twitter account makes the same mistake:

Get the facts about #Ebola. Here’s what you need to know about when a person can spread the disease to others.

— CDC (@CDCgov) October 17, 2014 [alt]

Don’t think the White House is doing much better. While the tweets at least include URLs to get more information, the text within the image is not included in its same easily-digestible form, and the data contained in the image is scattered across a long-form article on the site.

Worth sharing: Here are the facts on #Ebola, and what we're doing to respond →

— The White House (@WhiteHouse) October 16, 2014 [alt]

RT to get the word out: Here are the facts on #Ebola:

— The White House (@WhiteHouse) October 16, 2014 [alt]

Easy Fixes

Even if you’re not the CDC, I think there is still a lesson to be learned here — putting all your tweet content into embedded images is a great way to exclude users. Thankfully the CDC can choose from one of three (four?) easy fixes.

Make Supporting Web Pages

The CDC can simply link to the content in the images as equally-short nuggets on its web site. Clear out the cruft of third-party “share” icons, remove the excessive footer, and generally pare the page down to the fastest load possible. To support these users, don’t make them have to navigate to the nugget of content when landing on the page, make it the entire page.

Tweet Your Own Alternative Text

There has been a trend in the accessibility community on Twitter to include or describe images in their own tweets and sometimes in others’ tweets.

It ranges from linking to a longer description, to just a quick inline description, to sometimes a reply to the tweet with the alternative text so the two stay associated within Twitter’s own tweet-linkage display. You might be pleasantly surprised when people thank you.

Use a Tool Meant for This Purpose

Alternatively, look at a tool like Easy Chirp to embed the full text content within the tweet itself. It already has traction in the blind community, so those already familiar with it don’t have to struggle through a learning curve.

Here’s the same tweeted image as CDC’s first Q&A tweet, but this time it has alternative text just one click/tap away (without losing the image for sighted users):

GIFs in Words on Twitter

This one is a bit far-fetched, but convince the @gifsinwords Twitter account to fill the gap. It’s already proven pretty handy to some.

Update: October 21, 2014

These slides might prove interesting related reading (no video that I am aware of): How Companies Engage Customers Around Accessibility on Social Media

Update: October 23, 2014

It looks like both CDCEMergency and CDCgov have each improved a tiny bit in their most recent tweets, insofar as the key point of the message in in the text of the tweet (even if there is still no full alternative text):

Alternative Text (You Can Probably Skip This)

I intentionally didn’t allow any of the images in the examples to embed. I think you should experience the tweets the way a blind user would (with the exception of the opening image with its low contrast). However, I also want to make sure the content is still available to readers. So I am helping the CDC here and including the text from each image above (also linked from each image above).

CDC Ebola Q&A:
Q: Can Ebola spread by coughing? By Sneezing?
A: If a person with Ebola coughs or sneezes on someone and saliva or mucus contacts that person’s eyes, nose or mouth, disease may be spread.

CDC Ebola Q&A:
Q: How long does the virus live outside of body? What effectively kills it outside of body?
A: Ebola on dried on [sic] surfaces such as doorknobs and countertops can survive for several hours; however, virus in body fluids (such as blood) can survive up to several days at room temperature. Ebola is killed with hospital grade disinfectants (such as household bleach).

CDC Ebola Q&A:
Q: If Ebola isn’t airborne, why do health workers wear protective gear?
A: CDC recommends Ebola healthcare workers wear protective gear due to the possibility of large amounts of blood, other body fluids, vomit, or feces present in the environment.

CDC Ebola Q&A:
Q: Can I get Ebola from my dog or cat?
A: At this time, there have been no reports of dogs or cats becoming sick with Ebola or of being able to spread Ebola to people or animals. The chances of a dog or cat being exposed to Ebola virus in the United States is very low as they would have to come into contact with blood and body fluids of a symptomatic persion sick with Ebola.

CDC Ebola Q&A:
Q: What is the incubation period for Ebola?
A: The incubation period, from exposure to when signs or symptoms appear, is to 2 to 21 days, but the average is 8 to 10 days.

Facts about Ebola
When is someone able to spread the disease to others?
Ebola only spreads when people are sick. A patient must have symptoms to spread the disease to others. After 21 days, if an exposed person does not develop symptoms, they will not become sick with Ebola.

Get the facts on Ebola:
Ebola is not spread through: Casual contact, air, water, food in the United States.

Get the facts on Ebola:
You can only get the Ebola virus through direct contact with: body fluids of a person who is sick with or has died from Ebola; objects contaminated with the virus; infected animals.

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