Public awareness, emotional reactions and human mobility in response to the COVID-19 outbreak in China- A population-based ecological study

Background: The outbreak of COVID-19 generated severe emotional reactions, and restricted mobility was a crucial measure to reduce the spread of the virus. This study describes the changes in public emotional reactions and mobility patterns in the Chinese population during the COVID-19 outbreak. Methods: We collected data on public emotional reactions in response to the outbreak through Weibo, the Chinese Twitter, between January 1st and March 31st, 2020. Using anonymized location-tracking information, we analyzed the daily mobility patterns of approximately 90% of Sichuan residents. Results: There were three distinct phases of the emotional and behavioral reactions to the COVID-19 outbreak. The alarm phase (January 19th�26th) was a restriction-free period, characterized by few new daily cases, but enormous public negative emotions (the number of negative comments per Weibo post increased by 246.9 per day, 95%CI: 122.5�371.3), and a substantial increase in self-limiting mobility (from 45.6% to 54.5%, changing by 1.5% per day, 95%CI: 0.7%�2.3%). The epidemic phase (January 27th�February 15th) exhibited rapidly increasing numbers of new daily cases, decreasing expression of negative emotions (a decrease of 27.3 negative comments per post per day, 95%CI:-40.4�-14.2), and a stabilized level of self-limiting mobility. The relief phase (February 16th�March 31st) had a steady decline in new daily cases and decreasing levels of negative emotion and self-limiting mobility. Conclusions: During the COVID-19 outbreak in China, the public�s emotional reaction was strongest before the actual peak of the outbreak and declined thereafter. The change in human mobility patterns occurred before the implementation of restriction orders, suggesting a possible link between emotion and behavior.