Basic demographic characteristics of the participants
The study included 10,905 participants recruited within 48 hours. After excluding 566 invalid questionnaires, 10,399 questionnaires were included for analysis (Figure 1). Among the valid questionnaires, 9653 (98.1%) were finished by domestic participants and 192 (1.9%) were from abroad. Most participants were from southern China (Figure 2). A total of 4,768 (46.1%) participants were male and 7,539 (72.9%) were married. In terms of age, 7,888 (76.3%) participants were between 18 and 44 years old and 370 (3.6%) were between 60 and 74 years old. There were 2,588 (25.0%) health care workers and 8,347 (80.7%) participants received tertiary education. As Hubei was the center of the epidemic, the characteristics of participants were compared between Hubei and other regions. Basic characteristics were presented in Table 1.
A total of 9,845 (95.2%) participants heard of the disease and the rest 494 (4.8%) participants did not. Subsequent analysis was performed with data of the 9,845 participants. The majority of participants received the information about COVID-19 from the internet, followed by television (Additional file 2). Less than 10% of participants knew about the disease from other sources, including word of mouth (from family members, neighbors or grassroots cadres), newspapers or magazines and hospitals.
Public knowledge regarding COVID-19
Public knowledge regarding epidemiological characteristics of COVID-19
Overall, the public knowledge regarding epidemiological characteristics of COVID-19 were similar between participants from Hubei and other places.
In terms of pathogen, 8,505 (86.4%) participants considered COVID-19 was caused by virus, while 1.5% (143/9,845) considered it as bacteria, 8.9% (876/9,845) participants thought both virus and bacteria were pathogens of COVID-19 and 3.3% (321/9,845) had no idea. There were 98.0% (9,647/9,845), 75.1% (7,389/9,845), 68.8% (6,771/9,845) and 94.0% (9,251/9,845) of the participants believed in droplet transmission, aerosol transmission, fecal-oral transmission and contact transmission, respectively. More participants from Hubei believed in fecal-oral transmission. There were 91.9% (9,046/9,845) and 39.1% (3,845/9,845) participants believed there were person-to-person transmission and animal-to-person transmission, respectively. Totally 58.2% (5,727/9,845) and 50.3% (4,950/9,845) participants believed the virus could be transmitted through talking and shaking hands with others, respectively. Seniors were considered as susceptible population by 98.8% (9,729/9,845) participants. Only 65.7% (6,465/9,845) participants recognized children as susceptible population (Table 2).
Public knowledge regarding symptoms, therapies and personal protection of COVID-19
More than 95% of the participants recognized fever and cough as the symptoms of COVID-19 which had good consistency between participants from Hubei and other regions. More participants from Hubei recognized debilitation as a symptom of COVID-19 compared with those from other regions (93.7% vs 91.3%, P=0.004, Table 3). Less people in Hubei deemed nasal congestion, rhinorrhea and sore throat as the symptoms of COVID-19 (Table 3, all P<0.01).
As for therapies, most participants believed there were no specific treatment for COVID-19 (85.2%), and only 5.7% (566/9,845) of the population considered there was specific vaccine to prevent the disease. There were 46.5% (4,581/9,845) of the participants agreed with the efficacy of integrative Chinese and Western medicine. It seemed more participants from Hubei had confidence in efficacy of traditional Chinese medicine compared with those from other regions (19.1% vs 16.8%, P=0.046). More participants from Hubei considered plasma of convalescent patients as effective therapy (68.0% vs 62.1%, P<0.001).
The overall awareness score was averagely 17.8±2.7 in 9,845 participants. Young adults, participants received tertiary education, and healthcare workers had higher awareness score compared with other participants (all P<0.01, Table 4). In terms of regional difference, those from Hubei had lower overall awareness score compared with other regions (16.9±2.5 vs 17.1±2.5, P=0.01, Table 4). There was no difference in awareness score between those who were extremely anxious about the epidemic and those not, as well as those who highly agreed with the effectiveness of overall control measures and those not (all P>0.05).
Psychological state regarding COVID-19
About 28.2% (2,777/9,845, Table 5) of the population worried about being infected extremely. More people worried about their relatives and friends than themselves (41.4% vs 28.2%, P<0.001). More participants in Hubei worried about themselves, relatives and friends being infected compared with those in other regions. Participants in Hubei were statistically more anxious and affected compared with those in other regions. But there was no significant correlation between the anxiety and the number of regional existing cases (Figure 3, r=0.193, P=0.316).
Public attitude towards the systematic control measures for COVID-19
Staying at home during Spring Festival was considered to be necessary by 93.7% of the participants, while 88.2% of the participants agreed with the effectiveness. Closing down shopping malls and cancelling mass events were considered necessary by 92.1% participants and 88.6% believed these were effective. Overall, 74.1% (7,295/9,845) of the participants acknowledged that the overall control measures towards this epidemic was effective and only 1.3% did not. Yet less people in Hubei acknowledged its effectiveness (59.1% vs 76.2%, P<0.001). Moderate negative correlation was noticed between the overall agreement and the number of regional existing cases (Figure 4, r=-0.492, P=0.007).