Decreased numbers of gastric, colorectal, lung, and breast cancer surgeries performed in 17 cancer-designated hospitals in Gunma Prefecture of Japan during the COVID-19 pandemic.

PURPOSE: This study aims to clarify the influence of the COVID-19 pandemic on cancer surgery in Gunma Prefecture. METHODS: A total of 9839 cases (1406 gastric cancer, 3569 colorectal cancer, 1614 lung cancer, and 3250 breast cancer) from 17 hospitals in Gunma Prefecture were investigated. We compared the number of surgical cases, proportion of cases found by screening, and cStage at the time of the first visit by month in 2020 and 2021 with those in 2019. RESULTS: The rate of decline in cancer surgery was 8.9% in 2020 compared with 2019 (p = 0.0052). Compared with the same month of 2019, in some months of 2020 and 2021, significant decreases were observed in the number of surgeries for gastric and colorectal cancer, the percentage of surgical cases detected by screening in all four cancers, and the proportion of cancers with a relatively early cStage in gastric and breast cancer. CONCLUSIONS: The number of surgical cases of the four cancer types detected by cancer screening decreased in Gunma Prefecture owing to the influence of the COVID-19 pandemic. Furthermore, for some cancer types, the number of operations performed in patients with early-stage cancer is also decreased.

Spontaneous pneumothorax with coronavirus disease 2019 in non-ventilated patients: A single-center retrospective case series.

BACKGROUND: Pneumothorax is a rare complication of coronavirus disease 2019, and many of its associated factors are related to mechanical ventilation. We investigated the incidence and clinical features of patients with pneumothorax and coronavirus disease 2019 at a field hospital for patients who did not require intubation. MATERIALS AND METHODS: An isolated field hospital for COVID-19 patients who did not require ventilation was constructed. Patients who developed pneumothorax were extracted and reviewed retrospectively. RESULTS: Between May 2020 and February 2021, 1061 patients were admitted to this field hospital. Among them, eight patients (0.75%, three men and four women) developed pneumothorax. The mean age at incidence was 79.9 (range: 20-96) years; all patients were over the age of 80 years, except one 20-year-old woman. Six of these eight patients (75%) died. CONCLUSION: Although pneumothorax is a rare complication of coronavirus disease-2019, it is predictive of a poor prognosis in older-adult patients.

Impact of non-pharmaceutical interventions for the COVID-19 pandemic on emergency department patient trends in Japan: a retrospective analysis.

AIM: The coronavirus disease (COVID-19) pandemic massively impacted emergency department (ED) visits. The unavailability of specific therapies or vaccines has made non-pharmaceutical interventions (NPIs) an alternative strategy for COVID-19. We assessed the impact of NPIs (nationwide school closures and state of emergency) on ED visits during the COVID-19 pandemic in Japan. METHODS: This retrospective study compared the trends in ED visits from 1 January to 25 May, 2020 (during the pandemic) with the average during 2015-2019 (before the pandemic). The primary end-point was the change in the number of ED visits during the COVID-19 pandemic with those from before the pandemic, with the NPI application stratified across four periods in 2020: Period 0 (1-15 January), no COVID-19 cases detected in Japan; Period I (16 January-1 March), initial COVID-19 outbreak; Period II (2 March-15 April), nationwide school closures; Period III (16 April-25 May), state of emergency. RESULTS: Compared with before the pandemic, the number of walk-in ED visits significantly decreased by 23.1%, 12.4%, and 24.0% (4,047 versus 3,111; 3,211 versus 2,813; and 3,384 versus 2,573; P < 0.001 for all) in Periods I, II, and III, respectively. The number of ambulance ED visits during the pandemic significantly increased by 8.3% in Period I (1,814 versus 1,964, P = 0.002), whereas there was no significant change in Periods II and III with 2.7% and -3.1% (1,547 versus 1,589 and 1,389 versus 1,346; P = 0.335 and P = 0.284, respectively). CONCLUSIONS: The application of an NPI during the COVID-19 pandemic could have significantly reduced patient attendance in the ED.

Knowledge, Attitude, and Practice During the COVID-19 Pandemic: A Review.

The World Health Organization declared the novel coronavirus (COVID-19) outbreak a global pandemic on March 11, 2020 due to its rapid spread on a global scale. More than 118,000 cases had been reported in 114 countries, and mortality had reached a total of 4291. Scholars have suggested that the level of panic is correlated with knowledge and attitude among the population. This review presents a summary of knowledge, attitude, and practice during the COVID-19 pandemic among healthcare workers, medical students, and populations in the US, the UK, Italy, Jordan, and China in April 2020. Analysis reveals that the level of the knowledge was positive in general, and optimistic attitudes and good practices are held. Utility of substantial knowledge and positive attitudes and practices hopefully can control the spread of COVID-19.

The Correlations between Prefectural Proportions of Infected Persons with COVID-19 and Population-related Factors in Japan

[Objectives: In Japan, the incidence of COVID-19 infection was extremely varied among prefectures. Population-related factors may be related to the incidence of COVID-19. Methods: Proportions of persons infected with COVID-19 and factors such as concentration of population, population density, number of passenger cars, and ratio of those who use public transportation for commuting, were examined by prefecture. Patients whose infection pathways were unknown were also examined. Results: By univariate analysis, both the number of COVID-19 patients and the number of patients whose infection pathways were unknown significantly correlated with all factors. Using multivariate analysis, the incidence of infection was independently correlated with population density. The incidence of patients whose infection pathways were unknown independently correlated with population density and ratio of those who use the public transportation for commuting. Conclusion: The proportions of persons infected with COVID-19 were significantly correlated with population-related factors. These factors may be related to “crowding” and “close contact”. In the post- and with- COVID-19 era, establishment of new life styles, avoiding “crowding” and “close contact” might be important.] 群馬大学大学院医学系研究科公衆衛生学 要 旨 【背景・目的】 COVID─ 19 感染症は世界的なパンデミックの状況となった．日本でも 2020 年 1 月から 5 月にかけて大きな 感染拡大が見られた．中国では，感染率は地域によって大きな差があり，人口密度の高い地域ほど高いことが報告されて いる．本邦においても都道府県ごとの累積感染者数が大きく異なるものの，詳細な検討はない． 【対象と方法】 日本において初発患者が見られた 2020 年 1 月 16 日から多くの都道府県で流行がほぼ終息し始めた 2020 年 5 月 3 ─ 6 日までの約 110 日間における 47 都道府県における COVID ─ 19 に対する PCR 検査陽性者（累積感染者）の数を都 道府県人口で除した累積感染者の割合（累積感染割合）と人口集中度，人口密度，公共交通機関を用いて通勤・通学する 人の割合，人口当たりの乗用車保有台数の指標との相関を単・多変量解析を用いて検討した．さらに COVID ─ 19 感染者の うち，感染経路が不明な者，調査中など明らかな感染経路不明な感染者を感染経路不明割合としてそれぞれの因子との関 連を単・多変量にて解析した．さらに回帰直線の 95％信頼区間を超えて高い感染率を示す都道府県について検討をした． 【結 果】 単変量解析では都道府県別の累積感染割合とすべての因子は有意な相関を示した．多変量解析では累積感染割 合では人口密度が独立した因子として選択された．さらに感染経路不明割合とすべての因子は単変量解析で相関した．同 様に多変量解析では人口密度と公共交通機関を用いて通勤・通学する人の割合が独立した因子として選択された．回帰直 線の 95％信頼区間を超えて感染率の高い都道府県には石川，富山，福井県，高知県，東京都，北海道などが挙げられた． 【結 論】 COVID-19 累積感染割合は人口密度などの因子と強い相関を認め，ポストコロナの時代に向けて 「密集」 ， 「密接」 を回避するライフスタイルの導入が重要と考えられた．95％信頼区間を超えて感染割合の高い都道府県においては観光や 夜の繁華街など人口密集の要因以外が関与している可能性があり，地域別の詳細な解析が今後の感染対策に有用と考えら れた． 緒言 2020 年 6 月の現在，COVID ─ 19 感染は日本では終息の 方向に向かっているものの，世界的な拡大をみせている． COVID ─ 19 は人から人へ感染することが知られており， 感 染者の咳，くしゃみや会話などで生じる飛沫感染が最も重 要な原因として考えられている． 1,2 我が国では「密閉」 ， 「密 集」 ， 「密接」 のいわゆる 3 密を避けることが感染予防に重要 とされている． 3 このうち密集，密接はその地域の人口密度 やライフスタイルに関連しているものと考えられる．中国 の武漢地区においても人口密度が感染率と相関するデータ が示されている 4 ものの，本邦における詳細な解析はみら れない． そこで，密集，密接に関与すると考えられる人口集中度， 人口密度，公共交通機関による通勤・通学率，乗用車の保 有台数の因子と感染割合，特に感染経路不明の感染割合と の相関について解析した．都会では公共交通機関による通 文献情報 キーワード： COVID-19感染症， 人口集中度， 人口密度， 公共交通機関による通勤・通学率， 乗用車の保有台数 投稿履歴： 受付 令和２年６月23日 修正 令和２年６月26日 採択 令和２年６月29日 論文別刷請求先： 調 憲