# The Role of AI-Based Chatbots in Public Health Emergencies: A Narrative Review
## 1 Introduction  
The world is witnessing an increasing frequency of infectious disease outbreaks, such as the COVID-19, Ebola, and mpox pandemics, which exposed significant gaps in public health communication and crisis management [1]. In these scenarios, the dissemination of timely and accurate information is critical to control the spread of disease and manage public anxiety. Digital health solutions [2] have emerged as essential tools to address these challenges, offering scalable, immediate, and reliable communication solutions because, during these health emergencies, traditional communication channels are often saturated. In this context, artificial intelligence (AI)-based chatbots have emerged as powerful tools to address the growing need for immediate and reliable responses during public health crises. These AI-driven systems, capable of engaging in human-like conversations, offer a scalable solution to handle increased public inquiries and provide crucial information around the clock [3]. Despite their potential, the adoption of AI chatbots in public health remains an ongoing challenge. Initially, the technology faced considerable resistance due to concerns about the accuracy of the information provided, ethical implications, and the risk of misuse. Early research highlighted AI's limitations in comprehending complex human emotions and the dangers of misinformation, which could heighten public anxiety during health crises [4]. For example, [PERSON] et al. [5] found that public trust in AI systems was initially low, driven by fears of biased or inaccurate responses. However, as the technology has advanced, so has its perceived utility. Innovations in natural language processing (NLP) and machine learning (ML) have greatly enhanced chatbots' ability to generate accurate, contextually relevant responses [6]. Moreover, the COVID-19 pandemic acted as a turning point, accelerating the widespread adoption of AI chatbots as healthcare systems worldwide struggled to cope with the overwhelming demand for reliable information and support [7]. The shift from skepticism to optimism can be attributed to several factors. First, the demonstrated ability of chatbots to handle large volumes of inquiries in real-time has alleviated some of the initial concerns about their reliability [8]. Second, the integration of AI chatbots into existing healthcare systems has shown tangible benefits, such as reducing the workload on healthcare professionals and improving patient outcomes through timely information dissemination [9]. Finally, the development of more sophisticated models, such as GPT-4, has enhanced the ability of chatbots to understand and respond to complex queries, further building trust among users [10]. The potential of AI chatbots in public health emergencies is manifold. First, they serve as frontline communicators, offering real-time answers to citizens' questions about symptoms, preventive measures, and local health guidelines [11]. This immediate access to information helps to alleviate public anxiety and promote adherence to health protocols, which is critical to curbing the spread of infectious diseases [12]. In addition, by providing accurate and consistent information, AI chatbots play a key role in countering the spread of misinformation, which has been identified as a significant challenge during health crises [13]. Beyond their role in public communication, AI chatbots also offer substantial support to healthcare systems. By sorting requests and providing initial guidance, these systems can help reduce the burden on healthcare providers, allowing them to focus on more complex cases and critical patient care [7]. This is especially valuable during the peak of epidemics, when healthcare resources are often limited. In addition, chatbots can help with data collection and analysis, providing health authorities with valuable information about public concerns and epidemic progression [8]. The implementation of artificial intelligence chatbots in healthcare emergencies, however, is not without its challenges.