The value of WeChat as a source of information on the COVID-19 in China

Xin Chen1, Xi Zhou2, Huan Li2, Jinlan Li2, Hua Jiang1,2

1. Department of General Practice, Shanghai East Hospital, Tongji University School of

Medicine, Shanghai, P. R. China.

2. Department of General Practice, Shanghai East Hospital Ji An Hospital, Ji An, Jiangxi

Provence, P. R. China.

*Correspondence to: Professor Hua Jiang, Department of General Practice, Shanghai East

Hospital, Tongji University School of Medicine, Shanghai, China 200120

Email: huajiang2013@tongji.edu.cn

Phone: +86-13311996820

Address: NO.150, Jimo Road, Pudong District, Shanghai, China

(Submitted: 26 March 2020 – Published online: 30 March 2020)

There is no conflict of interest in this study.

Running Title: WeChat as a source of information on COVID-19

DISCLAIMER

This paper was submitted to the Bulletin of the World Health Organization and was posted to the COVID-19 open site, according to the protocol for public health emergencies for international concern as described in Vasee Moorthy et al. (http://dx.doi.org/10.2471/BLT.20.251561).

The information herein is available for unrestricted use, distribution and reproduction in any medium, provided that the original work is properly cited as indicated by the Creative Commons Attribution 3.0 Intergovernmental Organizations licence (CC BY IGO 3.0).

RECOMMENDED CITATION

Chen X, Zhou X, Li H, Li J & Jiang H. The value of WeChat as a source of information on the COVID-19 in China. [Preprint]. Bull World Health Organ. E-pub: 30 March 2020. doi: http://dx.doi.org/10.2471/BLT.20.256255

Abstract

Background and Purpose: The ongoing pandemic of COVID-19 has caused a number of

health concerns. Adequate dissemination of correct information about the disease would have

helped decrease its spread and the associated anxiety in the population. This study aimed to

examine the value of WeChat as a source of information on the COVID-19 in China.

Methods: This was an observational research study. WeChat was searched on March 18, 2020,

using the key words COVID-19, Novel Coronavirus Pneumonia (in Chinese) and Novel

Coronavirus (in Chinese) for services and articles uploaded in the past 3 months relating to

COVID-19. Services were categorized into 6 groups: real-time dynamics of COVID-19

services, protection and prevention against COVID-19 services, information about COVID-19

services, life services, medical services, and social contribution services. We also recorded

which WeChat function provided these services. Articles were categorized into 4 groups: news

of COVID-19, popular science knowledge of COVID-19, professional knowledge of COVID-

19, and others. We also recorded the sources of these articles.

Results: A total of 26 services and 166 articles were finally included. Among them, the

information about COVID-19 services accounted for the largest proportion among all the

services (23.61%); The Mini Program function accounted for the largest proportion among all

the functions providing COVID-19 services (75.00%); The popular science knowledge of

COVID-19 accounted for the largest proportion among all the articles (40.96%); The

enterprises accounted for the largest proportion among all the article sources (44.58%).

Conclusion: WeChat provides a significant amount of useful services and information on

COVID-19. Considering the multiple functions and growing popularity of WeChat, this media

form should be added as a platform for health communication that is worthy of the attention of

health professionals. WeChat can be considered an important educative tool and service tool

that could play a significant role in the event of global disease outbreaks.

Keywords: WeChat; COVID-19; information; service

Introduction

The current Corona Virus Disease 2019 (COVID-19) was firstly discovered in Wuhan, Hubei

Province, China in December 2019 [1]. On January 30, 2020, the World Health Organization

(WHO) declared this disease a “Public Health Emergency of International Concern”. On

February 7, 2020, it was officially named Novel Coronavirus Pneumonia (NCP) in Chinese by

the Chinese government, then the WHO officially named it COVID-19 in English on February

11, 2020. As of March 18th, 2020, more than 200,000 cases in the world has been laboratory-

confirmed. With the efforts of all walks of life, China's anti-epidemic work has achieved

positive results. Experts in China have enact several guidelines for the prevention and treatment

of COVID-19 [2, 3]. Preventive measures for COVID-19 include a lot, such as identifying the

diseased state, isolating COVID-19 patients, providing supportive measures, and educating the

public about COVID-19. Disseminating the accurate information is critical to encourage people

to follow prevention guidelines and practice specific behaviors to prevent the spread of disease [4, 5]. Awareness of COVID-19 clinical symptoms can lead to early presentation to the

appropriate medical institutions, thereby reducing the disease complications and mortality [6].

With the widespread acceptance of mobile phones, the development of mobile health

promotion and disease prevention are also developing. Surfing the Internet via mobile phones

has become one of the most common ways for the public to access healthcare information. In

China, WeChat is the most popular social app with more than 1 billion users. It can offer text

and voice messages, videos, subscriptions, applets, and many other functions. WeChat has

become a very useful technological tool for health promotion and disease prevention[7, 8]. In the

past, the effect of WeChat has been evaluated as a source of information on diabetes[9],

hypertension[10], cardiovascular disease[11], cancer[12], and other disease[13, 14]. However, the

application value of WeChat as a source of information for infectious disease has not been

evaluated. In this study, we present an analysis of the value of WeChat as a source of

information on the COVID-19 in China.

Materials and Methods

This was an observational research study. Functions in WeChat can be divided into News, Wiki,

Moments, Articles, Videos, Short Videos, Official Accounts, Books, Music, Mini Programs,

and Questions & Answers (Supplementary Figure 1). The sources of the functions in WeChat

can be classified into: government institution, public institution, media institution, enterprise,

and individual. In this study, we evaluated the services related to COVID-19 and articles

containing information about COVID-19. WeChat was searched on March 18, 2020 using the

key words: COVID-19, Novel Coronavirus Pneumonia (in Chinese) and Novel Coronavirus

(in Chinese). Services: Services related to COVID-19 and have positive impact on controlling

COVID-19 were included in this study. Articles: Articles contained information about COVID-

19 and had more than 100,000 reads were included (excluding those duplicated in part or as a

whole).

Two independent researchers viewed and analyzed the content. The kappa coefficient of the

consistency was used to determine the degree of consistency between the two researchers.

Services were categorized into six groups according to their characters: real-time dynamics of

COVID-19 services, protection and prevention against COVID-19 services, information about

COVID-19 services, life services, medical services, and social contribution services. Each

service contained multiple items (Supplementary Figure 2 A, B, C), each item had one or

more choices (Supplementary Figure 2 D). We also recorded which WeChat function

provided these services. Articles were categorized into four groups according to their

characters: news of COVID-19, popular science knowledge of COVID-19, professional

knowledge of COVID-19, and others. We also recorded the sources of these articles. We

performed the analyses with SPSS22.0 (IBM SPSS, Armonk, NY, USA). The constituent ratios

of different groups were calculated. Statistical analyses were performed using the Chi-squared

test or Fisher’s exact test. P < 0.05 was considered significant.

Results

Services:

A total of 26 COVID-19 services were finally included (Table 1). These COVID-19 services

were provided by three functions of WeChat: News, Official Account, and Mini Program. The

kappa coefficient of agreement regarding classification of these services was 1.

Information about COVID-19 services

The real-time dynamics of COVID-19 services contained: the latest news, the real-time

dynamic map of the outbreak, and the rumor refutation; The protection and prevention against

COVID-19 services contained the mask booking platform, the mask booking information, the

other prevention supplies booking platform, and COVID-19 free insurance platform; The

information about COVID-19 services contained: the communities with COVID-19 patients,

the travel route with COVID-19 patients, the personal travel information, the access

management tool, the preventive supplies qualification information, the entry and exit

information, and the personal health code; The life services contained: the food delivery & pick

up services, the medicine delivery & pick up services, and the door-to-door services of cleaning.

The medical services contained: the free medical consultation, the information of specific

hospitals for COVID-19, and the free psychological consultation; The social contribution

services contained: the help for COVID-19 patients, the aid donations, the purchase of

agricultural products, the epidemic tip-off hotline, the volunteer recruitment, and the rumor tip-

off hotline.

Analysis of different COVID-19 services

We found all the real-time dynamics of COVID-19 services were provided by News. All the

protection and prevention against COVID-19 services were provided by Mini Program. The

information about COVID-19 services were provided by the Official Account (5.88%) and the

Mini Program (94.12%). The life services were provided by the Official Account (7.69%) and

the Mini Program (92.31%). The medical services were provided by the Official Account

(12.50%) and the Mini Program (87.50%). The social contribution services were provided by

the Official Account (50.00%) and the Mini Program (50.00%). Among all the services, the

information about COVID-19 services accounted for the largest proportion (23.61%) (Table 2,

Figure 1 A).

In terms of the provider, the real-time dynamics of COVID-19 services were different from the

other five services (p＜ 0.001); the social contribution services were different from the

protection and prevention against COVID-19 services (p=0.002), the information about

COVID-19 services (p=0.014), and the life services (p=0.035).

Analysis of different functions

Meanwhile, we found the News only provided functions for the real-time dynamics of COVID-

19 services; The Official Account provided functions for the information about COVID-19

services (16.67%), life services (16.67%), medical services (16.67%) and social contribution

services (50.00%); The Mini Program function provided functions for the protection and

prevention against COVID-19 services (29.63%), the information about COVID-19 (29.63%),

the life services (22.22%), the medical services (12.96%), and the social contribution services

(5.56%). Among all the functions, the Mini Program accounted for the largest proportion

(75.00%) (Table 2, Figure 1 B).

In terms of the services, the News group was different from the Official Account group

(p=0.001) and the Mini Program group (p＜ 0.001); the Official Account group was also

different from the Mini Program group(p=0.012);

Articles:

A total of 166 COVID-19 articles were finally included (Table 3). The kappa coefficient of

agreement regarding classification of these services was 0.98. The sources of these articles

were government, public institution, media institution, enterprise, and individual.

Analysis of different articles

We found the sources of the news of COVID-19 were the government institutions (33.33%),

the public institutions (3.92%), the media institutions (21.57%), the enterprises (39.22%), and

the individuals (1.96%); The sources of the COVID-19 popular science knowledge were the

government institutions (2.94%), the public institutions (11.76%), the media institutions

(5.88%), the enterprises (48.53%) and the individuals (30.88%); The sources of the COVID-

19 professional science knowledge were the government institutions (4.35%), the media

institutions (21.74%), the enterprises (30.43%) and the individuals (43.48%); The sources of

others were the public institutions (4.17%), the media institutions (16.67%), the enterprises

(58.33%) and the individuals (20.83%). Among all the articles, the popular science knowledge

of COVID-19 accounted for the largest proportion (40.96%) (Table 2, Figure 1 A).

In terms of the article source, the news of COVID-19 group was different from the COVID-19

popular science knowledge group (p＜ 0.001).

Analysis of different article sources

Meanwhile, we found the government institutions provided the COVID-19 news (85.00%),

popular science knowledge of COVID-19 (10.00%), and the professional knowledge of

COVID-19 (5.00%); The public institutions provided the COVID-19 news (18.18%), the

popular science knowledge of COVID-19 (72.73%), and others (9.09%); The media

institutions provided the COVID-19 news (45.83%), the popular science knowledge of

COVID-19 (16.67%), the professional knowledge of COVID-19 (20.83), and others (16.67%);

The enterprises mainly provided the COVID-19 news (27.02%), the COVID-19 popular

science knowledge (44.59%), the professional knowledge of COVID-19 (9.46%), and others

(18.92%); The individuals provided the COVID-19 news (2.70%), the COVID-19 popular

science knowledge (56.76%), the COVID-19 professional science knowledge (27.03%), and

others (13.51%). Among all the sources, the enterprises accounted for the largest proportion

(44.58%)(Table 2, Figure 1 A).

In terms of the article type, the government institution group was different from the public

institution group (p=0.001), the media institution group (p=0.040), the enterprise (p＜ 0.001),

and the individual group (p＜ 0.001); the public institution group was different from the media

institution (p=0.011); the media institution group was different from the individual group (p＜

0.001); the enterprise group was different from the individual group (p=0.003).

Discussion

On the day of analysis (March 18, 2020), we found a serious of services for COVID-19 have

been provided on WeChat; The information about COVID-19 services accounted for the largest

proportion among all the services; The Mini Program function accounted for the largest

proportion among all the functions providing COVID-19 services; The popular science

knowledge of COVID-19 accounted for the largest proportion among all the articles; The

enterprises accounted for the largest proportion among all the article sources.

WeChat is widely used in China and is an important source of information for many people.

Timely and comprehensive information and knowledge (such as the latest news, and the real-

time dynamic map) of the epidemic situation is not only conducive to raising public awareness

of prevention, but also to easing public anxiety. In the past 3 months, there were many rumors

or misleading information in WeChat, these may mislead people and increase the public

anxiety. So WeChat set the rumor refutation service with setting up special team to handle the

rumors and encouraging people to report misleading information. In view of the difficulty in

purchasing epidemic prevention supplies during the period of travel limitation, WeChat has set

up reservation services (such as the mask booking platform, and the other prevention supplies

booking platform) for purchasing online to ensure the procurement of epidemic prevention

supplies and reduce public anxiety. Moreover, at the initial stage of the epidemic, some sellers

produced and sold unqualified preventive supplies, so WeChat also set up relevant services

(such as the preventive supplies qualification information) to disclose their information to the

public. Since epidemic prevention and control required nationwide participation, a hotline has

been set up in WeChat to tip off the epidemic information. As population movement would

increase the difficulty of epidemic prevention and control, WeChat has set up the services (such

as the travel route with COVID-19 patients, and the personal travel information) of timely

making epidemic information of transportation and public places public, so that people who

had close contact with patients could be timely detected and isolated. In addition, information

on the communities and other locations with infected patients could also be searched in WeChat

to further raise public awareness of prevention (such as the communities with COVID-19

patients). There are many other services in WeChat such as the free medical consultation, the

information of specific hospitals for COVID-19, and the free psychological consultation to

decrease the public anxiety. The COVID-19 not only threatened people's health, but also

affected their quality of life. In order to prevent and control the epidemic, people were restricted

to travel, leading to a decline in national consumption level which might put some groups (such

as farmers, small business retailers) at risk of bankruptcy. We found that WeChat provided

services more than the epidemic prevention and control, it also provided services for life (such

as food delivery & pick up services, and door-to-door services of cleaning) and social

contributions (such as the purchase of agricultural products). To some extent, this has solved

the inconvenience of people's life and eased the pressure of some groups.

For the services, we found the COVID-19 information services accounted for the largest

proportion among all the services. The COVID-19 information services could help the public

take timely preventive measures, as well as timely isolation and treatment, which were crucial

in the prevention and control of COVID-19. With the exception of the real-time dynamics of

COVID-19 services, other services were primarily provided by the Mini Program. This might

because WeChat Mini Program is an application that can be used without downloading and

installation. Users can open the application by searching or scanning in WeChat. For

developers, the cost and difficulty of WeChat Mini Program development is lower than that of

APP. It can achieve functions of searching, offline code scanning, dialogue sharing, message

notification, Mini Program switch, and Official Account association. Among them, through the

Official Account association, users can realize the jump between the Official Account and the

WeChat Mini Program. Moreover, WeChat Mini Program can log in jointly with WeChat and

interoperate with the user data of existing App.

For the articles, we found the government institution mainly provided the COVID-19 news,

releasing data related to COVID-19 in real time (such as the number of infected, suspected,

cured, dead, etc.). This might because the government could collect and analyze the official

data of each region, the data was more credible. Moreover, many media or enterprise official

accounts would interpret and forward the information after the news was published by the

government institutions, so that more people could get the relevant information in a more

intuitive way. The popular science knowledge of COVID-19 accounted for the largest

proportion among all the articles. This meant the primary concern of the public during the

outbreak was what was COVID-19 and how to prevent COVID-19. Among all the article

sources, the enterprises accounted for the largest proportion. Many enterprises such as

pharmaceutical companies and medical services companies pushed COVID-19 relevant

information on WeChat platform. They generally had professional teams and could collect and

summarize information comprehensively. In addition, many enterprises had established contact

with doctors and experts in related fields to inform the public of correct knowledge of epidemic

prevention and control. Due to WeChat’s large number of users and diverse functions, it has

played a very important role in the prevention and control of the epidemic. People can get

services and information simply by installing the WeChat. In addition to the roles mentioned

above, WeChat plays many other important functions. For example, for the past 3 months,

travel restrictions have been imposed in most parts of the country, WeChat has become an

important tool for many people to connect with the outside world and friends. Therefore, the

role of WeChat in China's epidemic prevention can provide reference for other countries in the

future.

In this study, we comprehensively analyzed the services and articles that related to COVID-19.

This not only demonstrated the role of WeChat in epidemic prevention and control, but also

reflected the public response and needs to health emergencies. Future work could analyze the

roles of other forms of information dissemination (such as videos, short videos, books, etc.) or

other applications (such as Twitter, Facebook, etc. ) in epidemic prevention and control.

Previous studies have proven that YouTube might be a significant resource for dissemination

of information on public health issues like the H1N1 influenza pandemic, the West Nile virus

infection, and the Ebola Virus Disease[15-17]. Pandey A et al.[15]found the useful videos

represented 61.3% of all videos of H1N1 influenza, and the viewership of useful videos was

higher, but there was no difference in viewership per day. Dubey D et al.[16]found although the

useful videos represented 72% of all videos of West Nile virus, there was significantly higher

total viewership and viewership per day for the non-useful videos. Pathak R et al.[17]reported

73.73% videos of Ebola Virus Disease were classified as useful. Independent users were more

likely to post misleading videos whereas news agencies were most likely to post useful videos.

In our study, we didn’t record the reads of articles and the number of days since upload to

calculate the read per day. Because in WeChat, when an article gets more than 100,000 reads,

it only shows 100,000 + reads, so it's impossible to calculate the exact number of total reads

the reads per day. As WeChat has a special team to handle the rumors, articles with misleading

information would be deleted in time. Therefore, there was no article with misleading

information in this study. Finally, this study presented a snapshot only of information available

on WeChat in China during the initial phase of the pandemic. WeChat content might have

shifted over time, and the outbreak has expanded worldwide.

Conclusion

WeChat provides a significant amount of useful services and information on COVID-19.

Considering the multiple functions and growing popularity of WeChat, this media form should

be added as a platform for health communication that is worthy of the attention of health

professionals. WeChat can be considered an important educative tool and service tool that

could play a significant role in the event of global disease outbreaks.

Acknowledgement

This work was supported by Important Weak Subject Construction Project of Pudong Health

and Family Planning Commission of Shanghai (Grant No. PWZbr2017-06).

Author Contributions

XC wrote the manuscript; XC and XZ analyzed the data and created the figures; HL and JL

collected the data; HJ devised the study.

Competing Interests

The authors declare no competing interests.

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Figure1 (A) Proportion of different services

Figure1 (B) Proportion of different service providers

16.67%

22.22%

23.61%

18.06%

11.11%8.33%

Figure1 (A) Proportion of different services

Real-time dynamics of COVID-19 services

Protection and prevention against COVID-19 services

Information about COVID-19 services

Life services

Medical services

Social contribution service

16.67%

8.33%

75.00%

Figure1 (B) Proportion of different service providers

News

Official Account

Mini Program

Figure2 (A) Proportion of different articles

Figure2 (B) Proportion of different article sources

30.72%

40.96%

13.86%

14.46%

Figure 2 (A) Proportion of different articles

News of COVID-19

Popular science knowledge of COVID-19

Professional knowledge of COVID-19

Others

12.05%

6.63%

14.46%

44.58%

22.29%

Figure 2 (B) Proportion of different article sources

Government

Public institution

Media institution

Enterprise

Individual

Table1 Information about COVID-19 services

Real-time dynamics of COVID-

19 services

Protection and prevention

against COVID-19 services Information about COVID-19 services Life services Medical services

Social contribution

services

Latest news (n=6) Mask booking platform (n=4)

Communities with COVID-19 patients

(n=6)

Food delivery & pick up services

(n=9) Free medical consultation (n=5)

Help for COVID-19

patients (n=1)

Real-time dynamic map of the

outbreak (n=5)

Mask booking information

(n=3)

Travel route with COVID-19 patients

(n=3)

Medicine delivery & pick up

services (n=3)

Information of specific

hospitals for COVID-19 (n=2) Aid donations (n=1)

Rumor refutation (n=1)

Other protection supplies

booking platform (n=3) Personal travel information (n=3)

Door-to-door services of cleaning

(n=1)

Free psychological consultation

(n=1)

Purchase of agricultural

products (n=1)

COVID-19 free insurance

platform (n=6) Access management tool (n=2)

Epidemic tip-off hotline

(n=1)

Preventive supplies qualification information (n=1)

Volunteer

recruitment(n=1)

Entry and exit information (n=1)

Rumor tip-off hotline

(n=1)

Personal health code (n=1)

Table 2 Numbers of different COVID-19 services and their providers

COVID-19 services News Official Account Mini Program Total

Real-time dynamics of COVID-19 services 12 0 0 12

Protection and prevention against COVID-19 services 0 0 16 16

Information about COVID-19 services 0 1 16 17

Life services 0 1 12 13

Medical services 0 1 7 8

Social contribution service 0 3 3 6

Total 12 6 54 72

Table 3 Numbers of different COVID-19 articles and their sources

Articles content Government institutions Public institutions Media institutions Enterprises Individuals Total

News of COVID-19 17 2 11 20 1 51

Popular science knowledge of COVID-19 2 8 4 33 21 68

Professional knowledge of COVID-19 1 0 5 7 10 23

Others 0 1 4 14 5 24

Total 20 11 24 74 37 166

Supplementary Figure 1: The functions of WeChat

A B

C D

Supplementary Figure 2: The services for COVID-19 in WeChat

A B

C D