State of emergency and human mobility during the COVID-19 pandemic in Japan.

Introduction: The Japanese government declared a state of emergency (SoE) to control the spread of the coronavirus disease (COVID-19). However, the requirements of these SoE were less stringent than those in other nations. It has not been assessed whether soft containment policies were sufficiently effective in the promotion of social distancing or the reduction of human contact. Methods: Mobility changes across different travel destinations, such as, (a) retail and recreation spaces; (b) supermarkets and pharmacies; (c) parks; (d) public transportation; (e) workplaces; and (f) residential areas, were analysed using the Google mobility index to assess social distancing behaviour in all Japanese prefectures between 15 February 2020 and 21 September 2021. The changes were evaluated through the utilisation of an interrupted time-series analysis after adjustment for seasonality and various prefecture-specific fixed-effects, and distinguishment of potential heterogeneity across multiple SoEs and the time that had passed after the declaration. Results: The mobility index for retail and recreation exhibited an immediate decline of 7.94 percent-points (95%CI: -8.77 to -7.12) after the declaration of the SoE, and a further decline after the initial period (beta: -1.27 95%CI: -1.43 to -1.11). However, it gradually increased by 0.03 percent-points (95%CI: 0.02-0.03). This trend was similar for mobility in other places. Among the four SoEs, the overall decline in human mobility outside the home was the least significant in the third and fourth SoE, which suggests that people were less compliant with social distancing measures during these periods. Conclusions: Although government responses to the pandemic may aid the controlling of human mobility outside the home, their effectiveness may decrease if these interventions are repeated and enforced for extended periods. A combination of these with other measures (i.e. risk-communication strategies) would enable even mild containment and closure policies to effectively curb the spread of the virus.

COVID-19 vaccine hesitancy and vaccine passports: a cross-sectional conjoint experiment in Japan.

OBJECTIVES: While the development of vaccines against the Novel Coronavirus (COVID-19) brought hope of establishing herd immunity and ending the global pandemic, vaccine hesitancy can hinder the progress towards herd immunity. In this study, by analysing the data collected when citizens undergo public health restrictions due to the pandemic, we assess the determinants of vaccine hesitancy, reasons for hesitation and potential effectiveness of vaccine passports used to relax public health restrictions on mitigating vaccine hesitancy. DESIGN: Cross-sectional study, longitudinal study and conjoint experimental design. SETTING: An online survey conducted in Japan in July 2021. PARTICIPANTS: A demographically representative sample of 5000 Japanese adults aged 20-74. PRIMARY OUTCOME MEASURES: COVID-19 vaccination intention RESULTS: We found that about 30% of respondents did not intend to get vaccinated or had not yet decided, with major reasons for vaccine hesitancy relating to concerns about the safety and side effects of the vaccine. In line with previous findings, younger age, lower socioeconomic status, and psychological and behavioural factors such as weaker COVID-19 fear were associated with vaccine hesitancy. Easing of public health restrictions such as travel, wearing face masks and dining out at night was associated with an increase in vaccine acceptance by 4%-10%. Moreover, we found that more than 90% of respondents who intended to get vaccinated actually received it while smaller proportions among those undecided and unwilling to get vaccinated did so. CONCLUSION: With a major concern about vaccine safety and side effects, interventions to mitigate against these may help to reduce vaccine hesitancy. Moreover, when citizens are imposed with restrictions, vaccine passports that increase their freedom may be helpful to increase vaccination rates.

The number of suicides under the spread of novel coronavirus infections.

新型コロナウイルス感染症は、仕事、家庭、学校を含めて、我々の生活に大きな影響を与えており、人々は感染を恐れて家族や友人との接触を大幅に制限し、政府も感染拡大防止のための様々な規制・要請を行っている。これに伴い経済活動は大幅に縮小し、失業や企業の倒産の増加も懸念されている。このような状況下で、日本における自殺者数はどのように変化したのか、また、どのような人々・地域が最も影響を受けているのかを明らかにするために、筆者らは、2016年11月〜2020年10月の4年間の月別の市区町村データを用いて、差の差分法(difference-in-difference)により、新型コロナウイルスの感染拡大以降(2020年2月以降)の日本の自殺者数の動向を分析した。分析の結果、日本の自殺者数は過去3年間の同時期と比較して、新型コロナウイルス感染拡大の第1波(2020年2〜6月)では14%程度減少したが、第2波以降(2020年7〜10月)では16%程度増加したことが明らかになった。第2波の増加では、特に、女性(37%)や子ども・青年(49%)における自殺の増加が顕著であった。(著者抄録)

Increase in suicide following an initial decline during the COVID-19 pandemic in Japan.

There is increasing concern that the coronavirus disease 2019 (COVID-19) pandemic could harm psychological health and exacerbate suicide risk. Here, based on month-level records of suicides covering the entire Japanese population in 1,848 administrative units, we assessed whether suicide mortality changed during the pandemic. Using difference-in-difference estimation, we found that monthly suicide rates declined by 14% during the first 5 months of the pandemic (February to June 2020). This could be due to a number of complex reasons, including the government's generous subsidies, reduced working hours and school closure. By contrast, monthly suicide rates increased by 16% during the second wave (July to October 2020), with a larger increase among females (37%) and children and adolescents (49%). Although adverse impacts of the COVID-19 pandemic may remain in the long term, its modifiers (such as government subsidies) may not be sustained. Thus, effective suicide prevention-particularly among vulnerable populations-should be an important public health consideration.