The Impact of Priority Settings at the Start of COVID-19 Mass Vaccination on Subsequent Vaccine Uptake in Japan: One-Year Prospective Cohort Study.

BACKGROUND: Distributing COVID-19 vaccines to the public was an important task for the governments of each country. Because of various limitations, priority settings for vaccination were determined at the time of mass vaccination. However, trends between vaccine intention and uptake, as well as reasons for getting vaccinated or not getting vaccinated, among these groups were understudied, undermining verification of the legitimacy of priority selection. OBJECTIVE: This study aims to illustrate a trend from prior COVID-19 vaccine intention, when the vaccine was not available, to the actual uptake within 1 year when all residents had access to the vaccine, to illustrate a change of reason for getting vaccinated or not getting vaccinated and to examine whether priority settings predicted subsequent vaccination uptake. METHODS: Prospective cohort, web-based, self-administered surveys were conducted in Japan at 3 time points: February 2021, September to October 2021, and February 2022. In total, 13,555 participants (age: mean 53.1, SD 15.9 years) provided valid responses, with a 52.1% follow-up rate. On the basis of the information obtained in February 2021, we identified 3 types of priority groups: health care workers (n=831), people aged ≥65 years (n=4048), and those aged 18 to 64 years with underlying medical conditions (n=1659). The remaining patients were treated as nonpriority (n=7017). Modified Poisson regression analysis with a robust error estimated the risk ratio for COVID-19 vaccine uptake after adjusting for socioeconomic background, health-seeking behavior, attitude toward vaccines, and COVID-19 infection history. RESULTS: In February 2021, a total of 5182 out of 13,555 (38.23%) respondents expressed their intention to get vaccinated. In February 2022, a total of 1570 out of 13,555 (11.6%) respondents completed the third dose and 10,589 (78.1%) respondents completed the second dose. Prior vaccine intention and subsequent vaccine coverage rates were higher in the priority groups. Protection of themselves and their families from potential infection was the most frequent reason for getting vaccinated, whereas concern about side effects was the most frequent reason for hesitation across the groups. Risk ratios for received, reserved, or intended for vaccination in February 2022 were 1.05 (95% CI 1.03-1.07) for the health care worker group, 1.02 (95% CI 1.005-1.03) for the older adult group, and 1.01 (95% CI 0.999-1.03) for the preexisting conditions group compared with the nonpriority group. Prior vaccine intention and confidence in vaccines were strong predictors of vaccine uptake. CONCLUSIONS: The priority settings at the start of the COVID-19 vaccination program had a significant impact on vaccine coverage after 1 year. The priority group for vaccination achieved higher vaccination coverage in February 2022. There was room for improvement among the nonpriority group. The findings of this study are essential for policy makers in Japan and other countries to develop effective vaccination strategies for future pandemics.

Sexual orientation was associated with intention to be vaccinated with a smallpox vaccine against mpox: A cross-sectional preliminary survey in Japan.

This survey aimed to assess the prevalence of intention to receive smallpox vaccine against mpox and its relationship with sexual orientation in Japan. A cross-sectional online survey was conducted in September-October 2022, with 12,900 assigned males and 13,413 assigned females participating. Modified Poisson regression analyses were performed to determine the relationship between vaccine willingness and sexual orientation, adjusting for socioeconomics, trust in government, COVID-19 vaccination status, and frequency of brothel visits. Vaccine willingness was higher in homosexual respondents than heterosexual counterparts, with proportions of 23.1 % among assigned males and 13.4 % among assigned females. Homosexual orientation was significantly associated with vaccine willingness, with prevalence ratios of 1.37 (95 % CI: 1.23-1.54) among assigned males and 1.34 (95 % CI: 1.13-1.59) among assigned females. These findings highlight the need for targeted vaccine promotion campaigns and ongoing monitoring of attitudes towards mpox and vaccine compliance in high-risk groups.

Prolonged Symptoms after COVID-19 in Japan: A Nationwide Survey of the Symptoms and Their Impact on Patients' Quality of Life.

BACKGROUND: Clinical details of long COVID are still not well understood because of potential confounding with a wide range of pre-existing comorbidities. METHODS: The present study used datasets from a nationwide, cross-sectional, online survey. We determined which prolonged symptoms were more likely to be associated with post-COVID condition after adjusting for a wide range of comorbidities and baseline characteristics. This study also used the EuroQol 5 Dimension 5 Level (EQ-5D-5L) and Somatic Symptom Scale-8 to assess health-related quality of life (QOL) and somatic symptoms in individuals with a previous history of COVID-19, defined as the diagnosis of COVID-19 made at least 2 months prior to the online survey. RESULTS: In total, 19,784 respondents were included for analysis; of these, 2397 (12.1%) had a previous history of COVID-19. The absolute difference of adjusted prevalence of symptoms attributed to prolonged symptoms after COVID-19 ranged from -0.4% to +2.0%. Headache (adjusted odds ratio [aOR]: 1.22; 95% confidence interval [95% CI]:1.07-1.39), chest discomfort (aOR:1.34, 95% CI:1.01-1.77), dysgeusia (aOR: 2.05, 95% CI: 1.39-3.04), and dysosmia (aOR: 1.96, 95% CI: 1.35-2.84) were independently associated with a previous history of COVID-19. Individuals with a previous history of COVID-19 had lower health-related QOL scores. CONCLUSIONS: After adjusting for potential comorbidities and confounders, clinical symptoms, such as headache, chest discomfort, dysgeusia, and dysosmia, were found to be independently associated with a previous history of COVID-19, which was diagnosed 2 or more months previously. These protracted symptoms might have impacted QOL and the overall somatic symptom burden in subjects with a previous history of COVID-19.

Psychological Distress During the Coronavirus Disease 2019 Pandemic and Associated Factors Among Undergraduate Students in Japan.

OBJECTIVE: This cross-sectional study aimed to examine factors potentially associated with psychological distress among undergraduate students during the coronavirus disease 2019 pandemic in Japan. METHODS: We analyzed data of 958 undergraduates (median age 20 y; 56.8% women) from a Web-based, self-administered questionnaire survey conducted from August to September 2020. Prevalence ratios (PRs) for psychological distress defined as 5 points or over of the Kessler Psychological Distress Scale (K6) were calculated by Poisson regression models. RESULTS: The proportion of psychological distress was 40.0%. In the mutually-adjusted model, the following were significantly associated with psychological distress: decreases in household income to 50-99% of the prepandemic amount compared with no change (PR = 1.48), newly experiencing unpaid wages compared with no experience (PR = 1.44), insufficient money to buy necessities compared with no shortage (PR = 1.45), receiving a student loan or scholarship compared with none (PR = 1.27), and communication 1 to 3 times a month compared with at least once a week (PR = 1.22). In contrast, school closure during the pandemic compared with no closure was inversely associated with psychological distress (PR = 0.78). CONCLUSIONS: Among undergraduate students in Japan, economic difficulties significantly predicted psychological distress.

Voluntary suspension of medically-assisted reproduction during the COVID-19 pandemic in Japan: a nationwide internet survey.

We explored whether coronavirus disease 2019 (COVID-19)-related distress was associated with voluntary suspension of medically-assisted reproduction (MAR) treatment from April to May 2020 in Japan. Data for 1,096 candidate respondents were collected from a Japanese nationwide cross-sectional internet survey distributed from August 25 to September 30, 2020. Multiple logistic regression was performed to clarify the association between voluntary suspension of MAR treatment and the Fear of COVID-19 Scale (FVC-19S) score. High FCV-19S score was inversely associated with voluntary suspension of MAR treatment compared to low FCV-19S score among women (OR = 0.28, 95% CI = 0.10-0.84). Age-stratified analyses revealed that low FVC-19S score was significantly associated with voluntary suspension of MAR treatment among women aged < 35 years (OR = 3.86, 95% CI = 1.35-11.0). In contrast, the association between FVC-19S score and voluntary suspension of MAR treatment was reversed and not significant among women aged ≥ 35 years (OR = 0.67, 95% CI = 0.24-1.84). COVID-19-related distress was significantly associated with voluntary suspension of MAR treatment among women aged < 35 years, and this association was reversed but not significant among women aged ≥ 35 years.

Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan.

OBJECTIVES: We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic. DESIGN: Cross-sectional online survey. SETTING: Community cohort study in Japan. PARTICIPANTS: The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20-59 years. MAIN OUTCOME MEASURES: The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis. STATISTICAL METHODS: Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected. RESULTS: Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation. CONCLUSION: Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.

Post-COVID Health-related Quality of Life and Somatic Symptoms: A National Survey in Japan

Background : The characteristics and risk factors of post-COVID-19 condition affecting health-related quality of life and the symptom burden are unclear. Methods : The present, cross-sectional study used the JASTIS (Japan Society and New Tobacco Internet Survey) database. EQ-5D-5L and Somatic Symptom Scale-8 were used to assess health-related quality of life and somatic symptoms, respectively. The participants were classified into a no-COVID-19, COVID-19 not requiring oxygen therapy or COVID-19 requiring oxygen therapy group. First, the entire cohort was analyzed. Then, sensitivity analysis was performed after excluding patients in the no-COVID-19 group with a history of close contact with individuals known to have the disease. Findings : In total, 30130 individuals (mean age: 47.8;females: 51.2%), including 539 and 805 with COVID-19 requiring and not requiring oxygen therapy, respectively, participated. The analysis of the entire cohort as well as the sensitivity analysis demonstrated that individuals with a history of COVID-19 had significantly lower EQ-5D-5L and significantly higher SSS-8 scores than those with no COVID-19 history. The group requiring oxygen therapy was associated with significantly lower EQ-5D-5L and higher SSS-8 scores than the group not requiring oxygen therapy. Propensity-score matching confirmed these results. Furthermore, two or more COVID-19 vaccinations were independently associated with high EQ-5D-5L and low SSS-8 scores (P < 0.001). Interpretation : The participants with a COVID-19 history, especially those with severe disease, had a significantly higher somatic symptom burden. Analysis after adjusting for potential confounders found that their quality-of-life was also severely affected. Vaccination is crucial to addressing these symptoms, especially in high-risk patients.

Association between watching wide show as a reliable COVID-19 information source and preventive behaviors: A nationwide survey in Japan.

INTRODUCTION: Current pandemic prompted a surge in the television (TV) news watching. However, its influence is poorly understood. In Japan, wide show, a major genre of soft news TV programs, broadcasted COVID-19 for long hours, and was pointed out that it broadcasted COVID-19 sensationally, arousing fear and anxiety, and that it criticized individuals gathering in closed places. Thus, wide show may promote preventive behaviors but also produce fear or anxiety and aggressiveness towards others not engaging in preventive behaviors. We examined this issue using large-scale nationwide data. METHODS: We analyzed the cross-sectional data of 25,482 individuals from the Japan COVID-19 and Society Internet Survey conducted in 2020. Participants reported the type of COVID-19 information sources including TV news and wide show, and their trustworthiness. We calculated multivariable-adjusted prevalence ratios (PRs) of engaging in recommended preventive behaviors strictly (defined as always engaging in hand washing, mask wearing, and attempting to keep physical distancing) and alerting others not engaging in preventive behaviors, respectively. RESULTS: About 72.4% of the participants obtained information from TV news with reliance, while corresponding values were 50.3% for wide show. Overall, 32.8% engaged in recommended preventive behaviors strictly, and 9.6% alerted others. Watching wide show both with and without reliance were significantly associated with alerting others (adjusted PRs: 1.48 and 1.34, respectively) but not associated with preventive behaviors. Watching TV news was neither associated with strict preventive behaviors nor alerting others. CONCLUSION: Watching TV news and wide show was not associated with strict preventive behaviors; watching wide show was associated with only alerting others. Although causality is unclear, actions may be needed for TV stations broadcasting wide show to understand own influences on society in a timely manner amid the health emergencies.

Impact of COVID-19 Pandemic on the Influenza Vaccination and Predictors of Influenza Vaccination in Japan: A Cross-sectional Study.

OBJECTIVE: With the current global pandemic of COVID-19, there is concern that an influenza outbreak could exacerbate the health care burden. Improving the influenza vaccination rate is becoming more critical because controlling the spread of influenza is essential for reducing excess mortality. Therefore, we investigated whether the influenza vaccination rate changed during the COVID-19 pandemic in Japan and identified the factors associated with influenza vaccination uptake. DESIGN: This cross-sectional study used data from an Internet survey with adjustments to approximate a nationally representative estimate using inverse probability weighting. SETTING: A total of 23 142 respondents, aged 15 to 80 years, were evaluated to estimate weighted percentages and prevalence ratios with 95% confidence intervals of influenza vaccination in the period 2020-2021. RESULTS: Overall, in the period 2020-2021, the influenza vaccination rate rose from 38.1% before the COVID-19 pandemic to 44.6%. "Using traditional media" was a positive predictor of influenza vaccination uptake. "Using social media," "COVID-19 vaccine hesitancy," and "living in a prefecture with a high proportion of COVID-19 cases" were negative predictors. CONCLUSIONS: It is crucial to use predictors of influenza vaccination, such as how to use the media, for promoting a more widespread influenza vaccination uptake. The results of this study may be helpful in improving influenza vaccination rates, which could reduce the burden on health care services during outbreaks of influenza and COVID-19.

Is discontinuation of dental treatment related to exacerbation of systemic medical diseases in Japan?

Aims Since it is known that oral problems affect various medical diseases, the effects of restrictions on visits for dental treatment on exacerbations of various systemic medical diseases were examined.Method and materials The data were used from the Japan COVID-19 and Society Internet Survey, a large-scale internet survey conducted in 2021 (n = 28,175). The questionnaires were distributed to 33,081 candidates who were selected to represent the Japanese population regarding age, sex and residential prefecture using a simple random sampling procedure. Patients currently undergoing treatment for diabetes mellitus, hypertension, asthma, cardiocerebrovascular disease, hyperlipidemia, atopic dermatitis, and mental illness, such as depression, were extracted from the total participants. Then, whether discontinuation of dental treatment affected the exacerbation of their systemic disease was examined.Results Overall, 50-60% of patients with each systemic disease had continued to receive dental treatment, and 4-8% of them had discontinued dental treatment. On univariate and multivariate analyses, discontinuation of dental treatment is a risk factor in the exacerbation of diabetes mellitus, hypertensive conditions, asthma, cardiocerebrovascular disease and hyperlipidemia.Conclusion The present epidemiological study showed the relationship between oral health and systemic health, which can provide meaningful insights regarding future medical-dental collaboration in Japan.

Decline in Partner-Accompanied Births during the COVID-19 Pandemic in Japan: A Nationwide Cross-Sectional Internet-Based Study

The study objective was to describe trends in partner-accompanied birth between January 2019 and August 2021 and examine the associations of partner-accompanied birth with women's psychological distress and partners' housework and parenting. A total of 5605 women who had a live singleton birth between January 2019 and August 2021 and had a partner participated in this nationwide internet-based survey between July and August 2021 in Japan. The percentages of women's intentions and actual experience of partner-accompanied births were calculated per month. Associations of partner-accompanied birth with scores on the Kessler Psychological Distress Scale (K6) ≥10, partners' participation in housework and parenting, and factors associated with having a partner-accompanied birth were examined using a multivariable Poisson regression model. The proportion of women who had partner-accompanied births was 65.7% between January 2019 and March 2020, dropping to 32.1% between April 2020 and August 2021. Partner-accompanied birth was not associated with a K6 score ≥10, but was significantly associated with the partner's daily housework and parenting (adjusted prevalence ratio 1.08, 95% CI 1.02–1.14). Partner-accompanied births have been substantially restricted since the beginning of the COVID-19 pandemic. The right to a birth partner should be protected, while addressing infection control.

Decline in Partner-Accompanied Births during the COVID-19 Pandemic in Japan: A Nationwide Cross-Sectional Internet-Based Study.

The study objective was to describe trends in partner-accompanied birth between January 2019 and August 2021 and examine the associations of partner-accompanied birth with women's psychological distress and partners' housework and parenting. A total of 5605 women who had a live singleton birth between January 2019 and August 2021 and had a partner participated in this nationwide internet-based survey between July and August 2021 in Japan. The percentages of women's intentions and actual experience of partner-accompanied births were calculated per month. Associations of partner-accompanied birth with scores on the Kessler Psychological Distress Scale (K6) ≥10, partners' participation in housework and parenting, and factors associated with having a partner-accompanied birth were examined using a multivariable Poisson regression model. The proportion of women who had partner-accompanied births was 65.7% between January 2019 and March 2020, dropping to 32.1% between April 2020 and August 2021. Partner-accompanied birth was not associated with a K6 score ≥10, but was significantly associated with the partner's daily housework and parenting (adjusted prevalence ratio 1.08, 95% CI 1.02-1.14). Partner-accompanied births have been substantially restricted since the beginning of the COVID-19 pandemic. The right to a birth partner should be protected, while addressing infection control.

Longitudinal Association of Working From Home on Work Functioning Impairment in Desk Workers During COVID-19 Pandemic: A Nationwide Cohort Study.

OBJECTIVE: This study clarifies the longitudinal association between working from home and work functioning impairment among desk workers. METHODS: Nationwide surveys were conducted from 2020 to 2022, analyzing 3532 desk workers who never worked from home before the COVID-19 pandemic. RESULTS: The adjusted hazard ratio (95% confidence intervals) of working from home at least once a month or more with the composite result (incidence of work functioning or reduced work participation) was 1.22 (1.04-1.43). The cause-specific hazard ratios of work functioning impairment and reduced work participation were 1.30 (1.04-1.61) and 1.13 (0.86-1.47). CONCLUSIONS: Working from home could be longitudinally associated with work functioning impairment, especially for workers who are in higher positions. Workers and policy makers should be aware of the potential risk of working from home regarding presenteeism.

Changes in social isolation and loneliness prevalence during the COVID-19 pandemic in Japan: The JACSIS 2020-2021 study.

Objective: The recent coronavirus disease 2019 (COVID-19) outbreak has changed people's social connections with others and society. This study aimed to describe changes in the prevalence of social isolation and loneliness by demographic characteristics, socioeconomic status, health conditions, and outbreak situations in residential prefectures among Japanese people between the first year (2020) and the second year (2021) of the COVID-19 pandemic. Methods: We used data from the Japan COVID-19 and Society Internet Survey (JACSIS) study, a large-scale web-based nationwide survey conducted with 53,657 participants aged 15-79 years in August-September 2020 and September-October 2021 (25,482 and 28,175 participants, respectively). Social isolation was defined as less than once a week in the total frequency of contact with family members or relatives who were living apart and friends/neighbors. Loneliness was assessed using the three-item University of California, Los Angeles (UCLA) Loneliness Scale (score range, 3-12). We used generalized estimating equations to estimate the prevalence of social isolation and loneliness in each year and the difference in prevalence between 2020 and 2021. Results: The weighted proportion (95% confidence interval) of social isolation in the total sample was 27.4% (25.9, 28.9) in 2020 and 22.7% (21.9, 23.5) in 2021, representing a change of -4.7 percentage points (-6.3, -3.1). The weighted mean scores of the UCLA Loneliness Scale were 5.03 (4.86, 5.20) in 2020 and 5.86 (5.81, 5.91) in 2021, representing a change of 0.83 points (0.66, 1.00). The detailed trend changes for social isolation and loneliness were noted in the demographic subgroups of socioeconomic status, health conditions, and outbreak situation in the residential prefecture. Conclusion: Social isolation decreased from the first to the second year of the COVID-19 pandemic, whereas loneliness increased. Assessing the COVID-19 pandemic's impact on social isolation and loneliness contributes to understanding who was particularly vulnerable during the pandemic.

[Prevalence of COVID-19 vaccination and approval rating of the social implementation of its certification: the Japan COVID-19 and Society Internet Survey (JACSIS) in September and October 2021].

Objective　We aimed to investigate the prevalence of COVID-19 vaccination and approval rating of the social implementation of its certification to stimulate economic activities such as travel and restaurant use ("vaccine passport").Methods　Using data from the Japan COVID-19 and Society Internet Survey (JACSIS) conducted in September-October 2021, we calculated the prevalence of the COVID-19 vaccination and prevalence ratios by educational level and occupation. We also analyzed the reasons for (not) being vaccinated. In addition, we examined the association between the percentage of respondents who thought that the "vaccine passport" should be used for economic recovery and socioeconomic status/trust in government vaccine information.Results　Of 27,423 survey participants (aged 20-79 years; 13,884 women and 13,539 men), the prevalence of COVID-19 vaccination was 74.8%, whereas 1,695 (6.2%) "wanted to be vaccinated after seeing how it went," and 1,742 (6.3%) indicated an "unwillingness to vaccinate." The prevalence of COVID-19 vaccination did not differ between women and men. In addition, the prevalence among people who graduated from university/graduate school was significantly higher than that of high school graduates (adjusted prevalence ratio, 1.09; 95% confidence interval (95% CI): 1.07-1.12). Regarding occupation, the adjusted prevalence ratio of "professional/technical" to "office workers" was 1.05 (95% CI: 1.01-1.07). Among the "vaccinated (twice)" group, the most common reason for vaccination was "do not want to infect family members or others" (53.0%). Among the "unwillingness to vaccinate" group, the largest percentage indicated "because I am worried about adverse reactions" (44.5%). Among the "unwillingness to vaccinate" group, only 12.2% of respondents answered that the "vaccine passport" should be utilized for economic recovery, while 41.8% of the "vaccinated (twice)" group agreed with having the "vaccine passport" (adjusted prevalence ratio, 0.30; 95% CI: 0.25-0.37). By occupation, the highest percentage was the "sales and marketing" workers (40.4%). This proportion was significantly higher in the "strongly or fairly agree" group (49.5%) for the reliability of vaccine information from the government than in the "neither agree nor disagree" group (27.5%, P<0.01).Conclusion　Differences in the prevalence of COVID-19 vaccination were found by socioeconomic status. In addition, trust in government information was associated with an approval rating of the social implementation of the "vaccine passport" in Japan. However, the results suggest that citizens' expectations and interests are not high regarding the use of the "vaccine passport" to stimulate economic activity.

Association Between Toothbrushing Habits and COVID-19 Symptoms.

OBJECTIVES: The association between toothbrushing and coronavirus disease 2019 (COVID-19) infections is unknown. The aim of this study was to test the hypothesis that the change in time and frequency of toothbrushing is associated with having COVID-19 symptoms. METHODS: In this 8-month retrospective cohort study, we used the data from the Japan COVID-19 and Society Internet Survey (JACSIS; N = 22,366), which was conducted between August and September 2020. The logistic regression analyses were used to calculate the odds ratios (ORs) of having the 3 main COVID-19 symptoms (high fever, cough, and taste and smell disorder). Confounders were age, sex, educational attainment, equivalised income level, self-rated health, health literacy, and living area. RESULTS: The mean age of the participants was 49 years (SD = ±17.3), and 49.2% were male. Overall 2704 (12.1%) participants changed (increased or decreased) the time and frequency of toothbrushing, whilst 19,662 (87.9%) did not change. Only 60 participants (0.3%) had the 3 main COVID-19 symptoms. All logistic regression models showed that those who had a change in time and frequency of toothbrushing had higher odds of having the 3 main COVID-19 symptoms compared to those who had unchanged time and frequency of toothbrushing. The ORs ranged from 6.00 (95% confidence interval [CI], 3.60-9.99) in the crude model to 4.08 (95% CI, 2.38-6.98) in the fully adjusted model. CONCLUSIONS: The change in time and frequency of toothbrushing from before to after the COVID-19 pandemic was associated with having the 3 main COVID-19 symptoms.

Fear of COVID-19 Among Japanese Workers and Exacerbation of Chronic Pain: A Nationwide Cross-Sectional Study.

OBJECTIVE: To evaluate the association between fear of the coronavirus disease 2019 (COVID-19) and exacerbated chronic pain among workers during the pandemic, as well as productivity loss. METHODS: We collected data using Internet-based self-reported questionnaires, on fear of COVID-19, work productivity status, exacerbation of chronic pain during the pandemic, and several confounding factors. RESULTS: The multivariate logistic regression analysis showed that a high level of fear of COVID-19 was associated with an increased exacerbation of chronic pain (adjusted odds ratio, 2.31; 95% confidence interval, 1.21-4.44). Meanwhile, the presence of fear of COVID-19 and exacerbated chronic pain were associated with productivity impairment (adjusted odds ratio, 2.03; 95% confidence interval, 1.44-2.85). CONCLUSIONS: Our study shows that workers' fear of COVID-19 is correlated with exacerbated chronic pain and risk of presenteeism.

Proposed Cut-Off Score for the Japanese Version of the Fear of Coronavirus Disease 2019 Scale (FCV-19S): Evidence from a Large-Scale National Survey in Japan.

The Fear of coronavirus disease 2019 (COVID-19) Scale (FCV-19S) is a seven-item self-administered psychological scale for measuring the fear of this disease. The scale has been widely adapted and validated worldwide. This study aimed to propose a cut-off score for the validated Japanese version of the FCV-19S. We conducted a nationwide online survey and included 26,286 respondents in the analysis. Respondents answered questions on their sociodemographic characteristics, and using the FCV-19S and six-item Kessler Psychological Distress Scale, we measured psychological distress and assessed whether the fear of COVID-19 interfered with their daily lives. A total score of ≥21 points was considered adequate to identify those with psychological distress or difficulties in daily living because of the fear of COVID-19. This cut-off score will contribute to mental health assessment during the COVID-19 pandemic.

Association between Poverty and Refraining from Seeking Medical Care during the COVID-19 Pandemic in Japan: A Prospective Cohort Study.

This limited study examined how low household income affected avoidant behaviors to seek medical care during the pandemic. We investigated an association between household income below the relative poverty line and refraining from seeking medical care (RSMC) in a longitudinal study during the COVID-19 pandemic. We conducted an analysis of a population-based internet cohort in Japan. Individuals aged 20 to 79 years old living in Japan participated in the internet surveys between 2020 and 2021. The primary outcome was the RSMC of regular visits and new symptoms in 2021. A total of 19,672 individuals were included in the analysis. Household income below the relative poverty line in 2020 was significantly associated with refraining from seeking regular medical visits for men and women (for men, odds ratio: 1.28; confidence interval: 1.19, 1.83; for women, odds ratio: 1.42; confidence interval: 1.14, 1.82) in 2021, after accounting for RSMC in 2020. Relative poverty in 2020 was also associated with the RSMC of new symptoms among men (for males, odds ratio: 1.32; confidence interval: 1.05, 1.66) in 2021 after adjusting for covariates. The study suggested the need to alleviate the financial burden of vulnerable people seeking medical care and advocate for making necessary medical visits, even in a pandemic.