2. Literature Review and Hypothesis Development

2.1. Role of E-Govt
People have perceptions about their government playing a role during an epidemic condition. Perceptions are heightened during an outbreak period, as people are concerned about their protection, and their attitude toward an epidemic outbreak depends on this protection, to some extent. During a quarantine period, as people are isolated, the perceived role of E-Govt may be increased and people might be motivated to play a role in epidemic protection after watching the involvement of E-Govt. In our questionnaire, we asked about trust in E-Govt, which might provide motivation to play an important role in epidemic protection.
The literature shows that the role of government, especially governmental strategies and alertness messages, in any outbreak is progressively enhanced [27]. Communication and interaction with the government has increased in last few years, as the government is interested in engaging its people through social media [28]. The abovementioned literature justifies that the government understands people’s perceptions about the role of E-Govt.
People involved in policy-making are also inspired by social media [29]. Factors involved in sharing information are not described in this literature [30]. Attitudes and awareness is connected to the supposed efficiency of policy-making [31]. Improvement and development in Chinese e-waste has been seen in the last six years [32].This might enhance the people perceptions about E-Govt playing a role in an epidemic outbreak. In Canada, social media was used as tool for facilitation of consumers by government officials [33]. In Latin America, research on E-Govt is increasing and conflicting with what is occurring in the world [34].
One reason we involved E-Govt and online social presence in our research model is that a noteworthy difference was identified the in analysis of awareness about the use of mobile phones to seek health information during critical times [35]. Awareness promotion plays an important role in burn cases [36]. Universal and global research is needed in community health for the use of social media in E-Govt [37].
Our study variables included capability of isolation, quarantine compartment, and interaction methods, which are responsible for occupancy rate isolation [38]. To stop the transfer of infectious disease, isolating infected people from healthy ones is vital [39]. The biggest outbreak of coronavirus, the Middle East respiratory syndrome (MERS), occurred in South Korea in 2015. The main spread of this virus occurred in South Korea from and out of hospitals [40]. As an independent variable, we added role of E-government in our study, because studies were lacking on the emotional influence of MERS outbreaks [41].
Research showed that administration, media, and celebrities play important roles in health promotion on Twitter [42] because people are more attracted to celebrities. Recommendations that are logically expressed have a strong impact on public [43]. Many governments are improving their use of social media in health departments and are trying to provide digital services to their people guidance; especially during outbreaks. To increase the theoretical literature on E-Govt in the health sector, we aimed to fill this gap using a systematic review method to analytically evaluate, recognize, and create research evidence for the use of 2019-nCoV-WOMin connection with the role of E-Govt in protection from COVID-19. We also tried to critically evaluate the role of social media and the willingness to undergo a long quarantine period for protection from this epidemic. Here, per the literature, we take this variable of people’s perception (perceived role) of the role of the Chinese government, which was important because the government provided a plan to withstand the outbreak period. Notably, this is the first critical review of the use of 2019-nCoV-WOM and the role of E-Govt in the COVID-19 epidemic (as independent variables).
Given the above literature, we expected that E-Govt plays a considerable role in the perception of epidemic protection and online social presence and in changing public attitudes toward an epidemic outbreak. Therefore, we hypothesized the following:
Hypothesis 1a (H1a):    Role of E-government considerably affects epidemic protection.
Hypothesis 1b (H1b):    Role of E-government considerably affects online social presence during an outbreak.
Hypothesis 1c (H1c):    Role of E-government considerably affects attitude toward an epidemic outbreak.

2.2. COVID-19-Word of Mouth
WOM provides new directions to people’s thoughts and views about any condition, and especially during an epidemic outbreak. Nowadays, the top trend is COVID-19 epidemic conditions discussed in news and online social websites.
Many studies in the last 10 years proved that there has been a large increase in the number of people willing to find health information on the Internet. An increase in the number of social profiles providing health information was also observed [44]. Electroencephalography inter-subject correlation (EEG-ISC) was improved by an increase in resilient health communication [45]. The people of Wuhan felt great confidence in sharing their views during data collection during the COVID-19 epidemic outbreak quarantine.
Health promotions broadcast by the media are used to promote awareness. For young Italian people, the messages were mostly about health and the environment [46]. This is significant because health experts have been using it as a motivational tool during the treatment of patients [47] and because histories of patients with similar symptoms are important for predictions [48]. This may be helpful for the emotional treatment of patients in the future. Conversely, the most important aspect of health promotions is increasing people’s patience and keeping them calm during the quarantine period to avoid anxiety. The Chinese government improved public endurance by their emotional awareness through message sharing, which encouraged people to share their views [26]. It is a common for people to first think that social media information is only rumors during an outbreak; as such, people were at risk of being ignorant of health information shared by the government or by individuals.
To provide better and urgent cure, people should know the signs and symptoms of corona viruses. Many symptoms of the novel COVID-19-infected pneumonia (NCIP) have been described by researchers; they include increased body temperature, dry cough, and body pain [49]. The Chinese government promoted awareness among people through social media, so that individuals showing signs of COVID-19would immediately understand and contact medical experts for treatment and minimize further spread of the virus. Only online 2019-nCoV-WOM was used for the quarantine period in China, especially in Wuhan and Anhui; some other countries soon after implemented quarantine measures. This means the Chinese government played a positive role in the safety of people.
The above-mentioned research demonstrated the importance of online 2019-nCoV-WOM. So, we tried to explore the positive effect of 2019-nCoV-WOM on online social presence in our research using exclusive mediating variables. We expected that 2019-nCoV-WOM not only significantly affects perceptions of epidemic protection in terms of individuals’ online social presence, but also influences changes in attitude toward the epidemic outbreak. So, we hypothesized the following:
Hypothesis 2a (H2a)    COVID-19 word of mouth considerably affects epidemic protection.
Hypothesis 2b (H2b):    COVID-19 word of mouth considerably affects online social presence.
Hypothesis 2c (H2c):    COVID-19 word of mouth considerably affects attitude toward the epidemic outbreak.

2.3. Epidemic Protection from COVID-19and Its Mediating Role
Everyone is concerned with their protection in any condition, but particularly during an epidemic outbreak. The protection factor might affect social presence, but as people are isolated during quarantine, this factor changes the effect on online social presence in other ways.
Individuals’ attitudes toward fitness is boosted by viewing health information posted on Facebook in video form [3]. People’s responses to epidemic protection increase especially during quarantine because they are at home and have more free time. Individuals with prolonged health problems acknowledged caretakers’ guidance more than other adults in the U.S., but they did not obtain physical exercise guidance for good health [50]. The COVID-19 epidemic protection urged people to increase their online social presence to enhance public emotions for epidemic protection.
The empirical studies mentioned above encouraged us to relate epidemic protection as a dependent variable due to obtaining specific information to protect online users during the quarantine period. Here, we took this variable as people’s perception to ensure their safety. China is more conscious about health due to the one-child policy, free Internet to obtain information, and the perception of being safe through obtaining safety measures. Therefore, we hypothesized the following:
Hypothesis 3a (H3a):    Epidemic protection considerably affects online social presence.
The literature discussed above indicated that assuming the role of E-Govt in online social presence of the public is mediated by epidemic protection and 2019-nCoV-WOM affects online social presence. However, we suspected that 2019-nCoV-WOM is boosted by the psychological perception of epidemic protection. So, we hypothesized the following:
Hypothesis 3c (H3c):    Epidemic protection mediates the association between COVID-19 word of mouth and online social presence.
Hypothesis 4b (H4b):    Epidemic protection mediates the association between role of E-government and online social presence.

2.4. Attitudes toward Epidemic Outbreak and Its Mediating Role
A study showed that people’s attitudes toward an epidemic outbreak are more influenced by information on social media compared with physical discussion because source reliability has no impact on the health information provided online [51].People obtain information about the outbreak through social media and mobile health apps [26].However, a risk of client secrecy exists because online services are substantially affected by the happiness of clients [52].We took attitudes toward an epidemic outbreak as a mediating effect, meaning that attitudes toward an epidemic outbreak will promote or mediate the relationship of two independent variables and social online presence, as shown in Figure 2.
Research showed that the availability of a vaccine for an epidemic affects people’s attitudes toward the outbreak; for publicizing a vaccine, online sources are important. During epidemics, curiosity about a vaccine is more influenced by publicity, not by the epidemic conditions. However, vaccine uptake is also influenced by the epidemic condition when epidemic increases [53]. Recommendations by doctors, friends, and relatives stimulate people [54] as they discuss their responses to epidemics.
People who are isolated during an epidemic must recognize the importance of protection [55]. Research in Toronto, Canada, proved the willingness of people to participate in studies and the stress experienced by medical experts due to wearing of caring apparatus and being infected by disease in Canada. As these medical experts were involved in attempting to cure a disease about which they had little knowledge, they were worried that they would be next targets when they saw their coworkers becoming sick and dying due to the epidemic [56].
Lack of trust in government was observed in the public in Korea when attempting to control the MERS epidemic [57]. However, our focus was on the effect of 2019-nCoV-WOM and the role of E-Govt to protect the people during long-term outbreak, and to examine the response of people during the quarantine period. We supposed that public attitude toward epidemics affects their online social presence. In China, people are willing to share news and have positive attitudes when sharing the good news about protection. So, we hypothesized the following:
Hypothesis 3b (H3b):    Attitude toward epidemic outbreak considerably affects online social presence.
The attitude of the public toward a situation impacts their online social presence and affects the role of E-Govt and 2019-nCoV-WOM on online social presence. This means that if the attitude of the public is positive, it mediates role of E-Govt and online social presence. Hence, we hypothesized that:
Hypothesis 4c (H4c):    Attitude toward epidemic outbreak mediates the association between COVID-19 word of mouth and online social presence.
Hypothesis 5b (H5b):    Attitude toward epidemic outbreak mediates the association between the role of E-government and online social presence.

2.5. Online Social Presence in Epidemic Outbreak
According to social presence theory [58], social presence is about intimacy, feeling of closeness, familiarity, immediacy, and urgency to exchange information and motives in society. Online social presence is important during epidemic outbreak quarantine periods. It not only plays an important role in the coordination of society but also in the creation of motives.
Online social presence is predicted by online streaming, mediating communal television pleasure [26].
Among the magnitudes of social presence (telepresence and social presence), online social presence indirectly plays a role in the mediating direction. Findings encouraged innovative marketing policy through which participation can be optimistic by refining presence fundamentals [59]. People are more attracted toward celebrities, which strengthens online social presence [60]. So, if celebrities are active during outbreak periods, they can motivate people to increase their online social presence.
In addition, human sympathy is apparent on online sites and especially social sites, representing their online social presence and recognizing their interactions and feelings [58,61].
The capability of a platform to deliver personal indications and increase online social presence willingness [59] is interceded by useful commitments [62]. Every website provides specific confidentiality, which is expressively affected by online social presence [63]. Private platforms are facilitated by online social presence [64], so we predicted that they also affect the online response of people in quarantine during epidemics.
Sociability, pleasure, and belief are emotive reactions that reconcile social presence [59]. These three responses were felt across the Chinese nation during the COVID-19 outbreak. People believe that we will overcome this deadly virus and people were seen to be more emotional and social during this pandemic. Online social presence varies from their level of appointment, which reveals intellectual burden [65]. Contribution by people is inspired by their social value [66]. Addiction to social networking sites (SNS) also improves online social presence and increases people’s pleasure when interacting socially, also improving social communication and gratification [26]. Online social presence influences online engagement [67].