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1.
Sex Transm Infect ; 2022 Apr 22.
Article in English | MEDLINE | ID: covidwho-1807506

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has had variable effects on the rates of STIs reported across the globe. This study sought to assess how the number of STI reports changed during the pandemic in Japan. METHODS: We used national infectious disease surveillance data from the National Institute of Infectious Diseases (Tokyo, Japan) for the period between January 2013 and December 2021. We compared reported rates of chlamydia, gonorrhoea, condyloma acuminata and genital herpes, as well as total notifications for HIV/AIDS and syphilis during the pandemic versus previous years in Japan. We used a quasi-Poisson regression to determine whether any given week or month between January 2018 and December 2021 had a significant excess or deficit of STIs. Notification values above or below the 95% upper and lower prediction thresholds were considered as statistically significant. The start of the pandemic was defined as January 2020. RESULTS: Chlamydia generally remained within predicted range during the pandemic period. Reporting of gonorrhoea was significantly higher than expected throughout early-to-mid 2021 but otherwise generally remained within predicted range prior to 2021. Condyloma, herpes and HIV/AIDS reporting were transiently significantly lower than expected throughout the pandemic period, but no significant periods of higher-than-expected reporting were detected. Syphilis showed widespread evidence of significantly lower-than-predicted reporting throughout 2020 but eventually reversed, showing significantly higher-than-predicted reporting in mid-to-late 2021. CONCLUSIONS: The COVID-19 pandemic was associated with variable changes in the reporting of STIs in Japan. Higher-than-predicted reporting was more likely to be observed in the later phases of the pandemic. These changes may have been attributable to pandemic-related changes in sexual behaviour and decreased STI clinic attendance and testing, but further research on the long-term impact of the pandemic on STIs is necessary.

2.
SSM Popul Health ; 18: 101105, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1805211

ABSTRACT

Understanding COVID-19 risk perception may help inform public health messaging aimed at encouraging preventive measures and improving countermeasures against the pandemic. We conducted an online survey of 29,708 Japanese adults in February 2021 and estimated the associations between COVID-19 risk perception and a broad array of individual factors. Two logistic regressions were constructed to estimate factors associated with the risk perception of COVID-19 (defined as responding that one might become infected within the next 6 months), and of severe illness among those who responded that they might become infected (defined as responding that one would become severely ill). After adjusting for covariates, those with a higher perceived risk of the COVID-19 vaccine had higher odds of risk perception for both infection and severe illness. Interestingly, those with higher odds of risk perception of being infected were more likely to report obtaining their information from healthcare workers whereas those with lower odds were more likely to report obtaining their information from the Internet or the government; those with lower odds of risk perception of being severely ill were more likely to report obtaining their information from the Internet. The higher the trust level in the government as a COVID-19 information source, the lower the odds of both risk perception of being infected and becoming severely ill. The higher the trust levels in social networking services as a COVID-19 information source, the higher the odds of risk perception of becoming severely ill. Public health messaging should address the factors identified in our study.

3.
Lancet Reg Health West Pac ; 18: 100330, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1559154

ABSTRACT

BACKGROUND: Optimizing media campaigns for those who were unsure or unwilling to take coronavirus disease (COVID-19) vaccines is required urgently to effectively present public health messages aimed at increasing vaccination coverage. We propose a novel framework for selecting tailor-made media channels and their combinations for this task. METHODS: An online survey was conducted in Japan during February to March, 2021, with 30,053 participants. In addition to their sociodemographic characteristics, it asked the attitude toward vaccination and information sources (i.e., media channels) for COVID-19 issues. Multinomial logic regression was fitted to estimate the combinations of the media channels and their odds ratio (OR) associated with vaccination attitudes. FINDINGS: The proportion of respondents who were unsure or unwilling to take the vaccination was skewed toward younger generation: 58.1% were aged under 35, while 28.1% were 65 years or older. Media channels such as "Non-medical and Non-TV" and "Non-medical and Non-government" were associated with the unsure group: OR (95% Confidence intervals, (CI)) = 1.75 (1.62, 1.89) and 1.53 (1.44, 1.62), respectively. In addition, media channels such as "Newspapers or the Novel Coronavirus Expert Meeting", "Medical or Local government", and "Non-TV" were associated with the unwilling group: OR (95% CI) were 2.00 (1.47, 2.75), 3.13 (2.58, 3.81), and 2.25 (1.84, 2.77), respectively. INTERPRETATION: To effectively approach COVID-19 vaccine unsure and unwilling groups, generation-specific online and offline media campaigns should be optimized to the type of vaccine attitude. FUNDING: Funded by the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009) and the Japan Agency for Medical Research and Development (AMED) (JP20fk0108535).

4.
Int J Epidemiol ; 51(1): 75-84, 2022 02 18.
Article in English | MEDLINE | ID: covidwho-1493814

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) continues to be a major global health burden. This study aims to estimate the all-cause excess mortality occurring in the COVID-19 outbreak in Japan, 2020, by sex and age group. METHODS: Daily time series of mortality for the period January 2015-December 2020 in all 47 prefectures of Japan were obtained from the Ministry of Health, Labour and Welfare, Japan. A two-stage interrupted time-series design was used to calculate excess mortality. In the first stage, we estimated excess mortality by prefecture using quasi-Poisson regression models in combination with distributed lag non-linear models, adjusting for seasonal and long-term variations, weather conditions and influenza activity. In the second stage, we used a random-effects multivariate meta-analysis to synthesize prefecture-specific estimates at the nationwide level. RESULTS: In 2020, we estimated an all-cause excess mortality of -20 982 deaths [95% empirical confidence intervals (eCI): -38 367 to -5472] in Japan, which corresponded to a percentage excess of -1.7% (95% eCI: -3.1 to -0.5) relative to the expected value. Reduced deaths were observed for both sexes and in all age groups except those aged <60 and 70-79 years. CONCLUSIONS: All-cause mortality during the COVID-19 outbreak in Japan in 2020 was decreased compared with a historical baseline. Further evaluation of cause-specific excess mortality is warranted.


Subject(s)
COVID-19 , Disease Outbreaks , Female , Humans , Interrupted Time Series Analysis , Japan/epidemiology , Male , Mortality , SARS-CoV-2
5.
Stat Med ; 40(28): 6277-6294, 2021 12 10.
Article in English | MEDLINE | ID: covidwho-1396959

ABSTRACT

The demand for rapid surveillance and early detection of local outbreaks has been growing recently. The rapid surveillance can select timely and appropriate interventions toward controlling the spread of emerging infectious diseases, such as the coronavirus disease 2019 (COVID-19). The Farrington algorithm was originally proposed by Farrington et al (1996), extended by Noufaily et al (2012), and is commonly used to estimate excess death. However, one of the major challenges in implementing this algorithm is the lack of historical information required to train it, especially for emerging diseases. Without sufficient training data the estimation/prediction accuracy of this algorithm can suffer leading to poor outbreak detection. We propose a new statistical algorithm-the geographically weighted generalized Farrington (GWGF) algorithm-by incorporating both geographically varying and geographically invariant covariates, as well as geographical information to analyze time series count data sampled from a spatially correlated process for estimating excess death. The algorithm is a type of local quasi-likelihood-based regression with geographical weights and is designed to achieve a stable detection of outbreaks even when the number of time points is small. We validate the outbreak detection performance by using extensive numerical experiments and real-data analysis in Japan during COVID-19 pandemic. We show that the GWGF algorithm succeeds in improving recall without reducing the level of precision compared with the conventional Farrington algorithm.


Subject(s)
COVID-19 , Pandemics , Algorithms , Disease Outbreaks/prevention & control , Humans , Likelihood Functions , SARS-CoV-2
6.
Sci Prog ; 104(3): 368504211029793, 2021.
Article in English | MEDLINE | ID: covidwho-1369465

ABSTRACT

Strong lockdowns to control COVID-19 pandemic have been enforced globally and strongly restricted social activities with consequent negative effects on mental health. Japan has effectively implemented a unique voluntary policy to control COVID-19, but the mental health impact of the policy has not been examined on a large scale. In this study, we examined the effect of the first declaration on the mental health of affected residents. We used population-level questionnaire data of 17,400 people living under the state of emergency and 9208 who were not through a social-networking-service app and applied a difference-in-differences regression model to estimate the causal effect of the declaration of the state of emergency on psychological wellbeing, stratified by job category. No statistically significant effect of the declaration was observed among all job categories. This suggests that residents' psychological situation has gradually changed, possibly influenced by other factors such as the surrounding environment, rather than the declaration itself. Given that Japan has a unique policy to control COVID-19 instead of a strict lockdown, our results showed the Japanese-style policy may serve as a form of harm reduction strategy, to control the epidemic with minimal psychological harm, and enable a policy that balances disease control and mental health. Caution is necessary that this study used self-reported data from a limited time period before and after the first declaration in April 2020.


Subject(s)
COVID-19/psychology , Mental Health/statistics & numerical data , Quarantine/psychology , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Japan , Mobile Applications , Social Networking
7.
Psychiatry Res ; 305: 114173, 2021 11.
Article in English | MEDLINE | ID: covidwho-1364413

ABSTRACT

Using daily vital statistics data from the Japanese Ministry of Health, Labour and Welfare, we provide the first weekly and age-group-specific estimates of the additional suicide burden during the COVID-19 pandemic in Japan by gender, from January through November 2020. Our results indicate that compared with the previous five years, suicide cases in 2020 in Japan have increased from late July to November for women in all age groups and for men in the 20-29 and 80+ years age group. Targeted interventions based on age and gender might be more effective in reducing suicide during the COVID-19 pandemic in Japan.


Subject(s)
COVID-19 , Suicide , Vital Statistics , Child, Preschool , Female , Humans , Japan/epidemiology , Male , Pandemics , SARS-CoV-2
8.
J Urban Health ; 98(5): 635-641, 2021 10.
Article in English | MEDLINE | ID: covidwho-1351336

ABSTRACT

In the COVID-19 era, movement restrictions are crucial to slow virus transmission and have been implemented in most parts of the world, including Japan. To find new insights on human mobility and movement restrictions encouraged (but not forced) by the emergency declaration in Japan, we analyzed mobility data at 35 major stations and downtown areas in Japan-each defined as an area overlaid by several 125-meter grids-from September 1, 2019 to March 19, 2021. Data on the total number of unique individuals per hour passing through each area were obtained from Yahoo Japan Corporation (i.e., more than 13,500 data points for each area). We examined the temporal trend in the ratio of the rolling seven-day daily average of the total population to a baseline on January 16, 2020, by ten-year age groups in five time frames. We demonstrated that the degree and trend of mobility decline after the declaration of a state of emergency varies across age groups and even at the subregional level. We demonstrated that monitoring dynamic geographic and temporal mobility information stratified by detailed population characteristics can help guide not only exit strategies from an ongoing emergency declaration, but also initial response strategies before the next possible resurgence. Combining such detailed data with data on vaccination coverage and COVID-19 incidence (including the status of the health care delivery system) can help governments and local authorities develop community-specific mobility restriction policies. This could include strengthening incentives to stay home and raising awareness of cognitive errors that weaken people's resolve to refrain from nonessential movement.


Subject(s)
COVID-19 , Pandemics , Humans , Japan/epidemiology , Longitudinal Studies , SARS-CoV-2
9.
Lancet Reg Health West Pac ; 14: 100223, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1331033

ABSTRACT

BACKGROUND: Identifying and understanding reasons for being unsure or unwilling regarding intention to be vaccinated against coronavirus disease (COVID-19) may help to inform future public health messages aimed at increasing vaccination coverage. We analyzed a broad array of individual's psychological dispositions with regard to decision-making about COVID-19 vaccination in Japan. METHODS: A nationally representative cross-sectional web survey was conducted with 30053 Japanese adults aged 20 years or older at the end of February 2021. In addition to the question on the individual's intention to be vaccinated against COVID-19, respondents were asked about their sociodemographic, health-related, and psychological characteristics as well as information sources about COVID-19 and their levels of trust. Also, those who responded 'not sure' or 'no' regarding intention to take COVID-19 vaccine were asked why. Multinomial logistic regression with sparse group Lasso (Least Absolute Shrinkage and Selection Operator) penalty was used to compute adjusted odds ratios for factors associated with the intention (not sure/no versus yes). FINDINGS: The percentages of respondents who answered 'not sure' or 'no' regarding intention to be vaccinated against COVID-19 vaccine were 32.9% and 11.0%, respectively. After adjusting for covariates, the perceived risks of COVID-19, perceived risk of a COVID-19 vaccine, perceived benefits of a COVID-19 vaccine, trust in scientists and public authorities, and the belief that healthcare workers should be vaccinated were significantly associated with vaccination intention. Several sources of information about COVID-19 were also significantly associated with vaccination intention, including physicians, nurses, and television, medical information sites with lower odds of being unsure or unwilling, and internet news sites, YouTube, family members, and scientists and researchers with higher odds. The higher the level of trust in television as a source of COVID-19 information, the higher the odds of responding 'not sure' (odds ratio 1.11, 95% confidence interval 1.01-1.21). We also demonstrated that many respondents presented concerns about the side effects and safety of a COVID-19 vaccine as a major reason for being unsure or unwilling. To decide whether or not to get the vaccine, many respondents requested more information about the compatibilities between the vaccine and their personal health conditions, whether other people had been vaccinated, the effectiveness of vaccines against variants, and doctors' recommendations. INTERPRETATION: Our findings suggest that public health messaging based on the sociodemographic and psychological characteristics of those who are unsure or unwilling regarding intention to be vaccinated against COVID-19 vaccine may help to increase vaccine uptake amongst this population. FUNDING: The present work was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009).

10.
Lancet Reg Health West Pac ; 3: 100016, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1281486

ABSTRACT

BACKGROUND: On April 7, 2020, the Japanese government declared a state of emergency regarding the novel coronavirus (COVID-19). Given the nation-wide spread of the coronavirus in major Japanese cities and the rapid increase in the number of cases with untraceable infection routes, large-scale monitoring for capturing the current epidemiological situation of COVID-19 in Japan is urgently required. METHODS: A chatbot-based healthcare system named COOPERA (COvid-19: Operation for Personalized Empowerment to Render smart prevention And AN care seeking) was developed to surveil the Japanese epidemiological situation in real-time. COOPERA asked questions regarding personal information, location, preventive actions, COVID-19 related symptoms and their residence. Empirical Bayes estimates of the age-sex-standardized incidence rate and disease mapping approach using scan statistics were utilized to identify the geographical distribution of the symptoms in Tokyo and their spatial correlation r with the identified COVID-19 cases. FINDINGS: We analyzed 353,010 participants from Tokyo recruited from 27th March to 6th April 2020. The mean (SD) age of participants was 42.7 (12.3), and 63.4%, 36.4% or 0.2% were female, male, or others, respectively. 95.6% of participants had no subjective symptoms. We identified several geographical clusters with high spatial correlation (r = 0.9), especially in downtown areas in central Tokyo such as Shibuya and Shinjuku. INTERPRETATION: With the global spread of COVID-19, medical resources are being depleted. A new system to monitor the epidemiological situation, COOPERA, can provide insights to assist political decision to tackle the epidemic. In addition, given that Japan has not had a strong lockdown policy to weaken the spread of the infection, our result would be useful for preparing for the second wave in other countries during the next flu season without a strong lockdown. FUNDING: The present work was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009).

12.
Int J Environ Res Public Health ; 18(6)2021 03 22.
Article in English | MEDLINE | ID: covidwho-1154376

ABSTRACT

We evaluated the impact of the new coronavirus disease (COVID-19) on healthcare access in Japan in terms of the number of outpatients and hospitalized patients as well as the length of hospital stays, during the first wave of the pandemic, up to June 2020. This observational study evaluated the monthly average number of outpatients per day at hospitals, the average number of hospitalized patients per day, and the average length of hospital stays per patient, from December 2010 to June 2020, using the hospital reports data, which are open aggregated data on the utilization of hospitals from the Ministry of Health, Labour and Welfare. These numbers were compared with those from the same period of previous years, using a quasi-Poisson regression model. We found a nationwide decrease in the number of outpatients in general hospitals and hospitalized patients, particularly in long-term care beds in Japan, as well as the excess length of hospital stays among psychiatric care patients during the first wave of the COVID-19. This limited access to healthcare demonstrated the importance of the long-term health monitoring of vulnerable populations and the need for urgent management support to healthcare facilities in preparation for possible prolonged pandemics in the future.


Subject(s)
COVID-19 , Coronavirus , Humans , Japan/epidemiology , Pandemics , SARS-CoV-2
13.
Emerg Infect Dis ; 27(3): 789-795, 2021 03.
Article in English | MEDLINE | ID: covidwho-1100024

ABSTRACT

To provide insight into the mortality burden of coronavirus disease (COVID-19) in Japan, we estimated the excess all-cause deaths for each week during the pandemic, January-May 2020, by prefecture and age group. We applied quasi-Poisson regression models to vital statistics data. Excess deaths were expressed as the range of differences between the observed and expected number of all-cause deaths and the 95% upper bound of the 1-sided prediction interval. A total of 208-4,322 all-cause excess deaths at the national level indicated a 0.03%-0.72% excess in the observed number of deaths. Prefecture and age structure consistency between the reported COVID-19 deaths and our estimates was weak, suggesting the need to use cause-specific analyses to distinguish between direct and indirect consequences of COVID-19.


Subject(s)
COVID-19/mortality , COVID-19/diagnosis , Cause of Death , Humans , Japan/epidemiology , Mortality , SARS-CoV-2
14.
BMJ Open ; 11(2): e042002, 2021 02 15.
Article in English | MEDLINE | ID: covidwho-1085262

ABSTRACT

OBJECTIVE: On 7 April 2020, the Japanese government declared a state of emergency in response to the novel coronavirus outbreak. To estimate the impact of the declaration on regional cities with low numbers of COVID-19 cases, large-scale surveillance to capture the current epidemiological situation of COVID-19 was urgently conducted in this study. DESIGN: Cohort study. SETTING: Social networking service (SNS)-based online survey conducted in five prefectures of Japan: Tottori, Kagawa, Shimane, Tokushima and Okayama. PARTICIPANTS: 127 121 participants from the five prefectures surveyed between 24 March and 5 May 2020. INTERVENTIONS: An SNS-based healthcare system named COOPERA (COvid-19: Operation for Personalized Empowerment to Render smart prevention And care seeking) was launched. It asks questions regarding postcode, personal information, preventive actions, and current and past symptoms related to COVID-19. PRIMARY AND SECONDARY OUTCOME MEASURES: Empirical Bayes estimates of age-sex-standardised incidence rate (EBSIR) of symptoms and the spatial correlation between the number of those who reported having symptoms and the number of COVID-19 cases were examined to identify the geographical distribution of symptoms in the five prefectures. RESULTS: 97.8% of participants had no subjective symptoms. We identified several geographical clusters of fever with significant spatial correlation (r=0.67) with the number of confirmed COVID-19 cases, especially in the urban centres of prefectural capital cities. CONCLUSIONS: Given that there are still several high-risk areas measured by EBSIR, careful discussion on which areas should be reopened at the end of the state of emergency is urgently required using real-time SNS system to monitor the nationwide epidemic.


Subject(s)
COVID-19/epidemiology , Social Networking , Adolescent , Adult , Aged , Aged, 80 and over , Bayes Theorem , Cohort Studies , Epidemiological Monitoring , Female , Humans , Japan/epidemiology , Male , Middle Aged , Young Adult
15.
Sci Rep ; 11(1): 3109, 2021 02 04.
Article in English | MEDLINE | ID: covidwho-1065947

ABSTRACT

The international spread of COVID-19 infection has attracted global attention, but the impact of local or domestic travel restriction on public transportation network remains unclear. Passenger volume data for the domestic public transportation network in Japan and the time at which the first confirmed COVID-19 case was observed in each prefecture were extracted from public data sources. A survival approach in which a hazard was modeled as a function of the closeness centrality on the network was utilized to estimate the risk of importation of COVID-19 in each prefecture. A total of 46 prefectures with imported cases were identified. Hypothetical scenario analyses indicated that both strategies of locking down the metropolitan areas and restricting domestic airline travel would be equally effective in reducing the risk of importation of COVID-19. While caution is necessary that the data were limited to June 2020 when the pandemic was in its initial stage and that no other virus spreading routes have been considered, domestic travel restrictions were effective to prevent the spread of COVID-19 on public transportation network in Japan. Instead of lockdown that might seriously damage the economy, milder travel restrictions could have the similar impact on controlling the domestic transmission of COVID-19.


Subject(s)
COVID-19 , Travel/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Japan , Pandemics , Transportation/statistics & numerical data
16.
Sci Total Environ ; 768: 144723, 2021 May 10.
Article in English | MEDLINE | ID: covidwho-1065583

ABSTRACT

In Japan, in response to the spread of the new coronavirus disease (COVID-19), a 'new normal' in the era of the COVID-19 was proposed by the government, which calls for thorough wearing of masks as an infection control measure in the era of the COVID-19, but related heat illness has been a great concern this summer. We applied quasi-Poisson regression models to the daily number of emergency transportations due to heat illness from 2008 to 2020 from the Fire and Disaster Management Agency, Ministry of Internal Affairs and Communications, Japan, to estimate the expected weekly number of emergency transportations from heat illness, with adjustment for their long-term trend and the weather conditions, including temperatures. We found that, at the national level, the number of heat illness emergency transports did not significantly increase or decrease from the annual trend in 2020. By prefecture, on the other hand, there were some prefectures in which the number of heat illness emergency transports was less than the average year, and most of them were in the week of August 10-16. By age group, the number of heat illness emergency transports in the 0-17 and 18-64 age groups was particularly low in some prefectures, and by severity, those in mild cases was particularly low. A caution is necessary that there is a possibility that a decrease in cases possibly associated with COVID-19 measures, such as, outdoor activity restrictions at schools/universities and cancellation of public events, may offset the possible increase in heat illness cases occurring elsewhere associated with wearing masks. Given that the end of the COVID-19 pandemic is not expected yet, continuous and appropriate awareness-raising activities to prevent heat-related illness remain important.


Subject(s)
COVID-19 , Coronavirus , Heat Stress Disorders , Humans , Japan , Life Style , Pandemics , SARS-CoV-2
17.
Psychiatry Res ; 295: 113622, 2021 01.
Article in English | MEDLINE | ID: covidwho-963843

ABSTRACT

Suicide is an extreme consequence of the psychological burden associated with the coronavirus disease 2019 (COVID-19) counter-measures. A quasi-Poisson regression was applied to monthly suicide mortality data obtained from the National Police Agency to estimate the gender-specific excess/exiguous suicide deaths during the COVID-19 pandemic in Japan up to September 2020. We found excess suicide deaths among women in July, August and September, but not among men. Our results indicate the importance of COVID-19 related suicide prevention, especially for women. Timely access to mental health care and financial and social support is urgently needed, as is optimal treatment for mental illness.


Subject(s)
COVID-19 , Cause of Death/trends , Suicide, Completed/statistics & numerical data , Adult , Female , Humans , Japan/epidemiology , Male , Pandemics , Sex Factors , Suicide, Completed/trends
18.
Inj Epidemiol ; 7(1): 66, 2021 Jan 18.
Article in English | MEDLINE | ID: covidwho-949104

ABSTRACT

BACKGROUND: In Japan, the latest estimates of excess all-cause deaths through January to July 2020 showed that the overall (direct and indirect) mortality burden from the Coronavirus Disease 2019 (COVID-19) in Japan was relatively low compared to Europe and the United States. However, consistency between the reported number of COVID-19 deaths and excess all-cause deaths was limited across prefectures, suggesting the necessity of distinguishing the direct and indirect consequences of COVID-19 by cause-specific analysis. To examine whether deaths from road injuries decreased during the COVID-19 pandemic in Japan, consistent with a possible reduction of road transport activity connected to Japan's state of emergency declaration, we estimated the exiguous deaths from road injuries in each week from January to September 2020 by 47 prefectures. METHODS: To estimate the expected weekly number of deaths from road injuries, a quasi-Poisson regression was applied to daily traffic fatalities data obtained from Traffic Accident Research and Data Analysis, Japan. We set two thresholds, point estimate and lower bound of the two-sided 95% prediction interval, for exiguous deaths, and report the range of differences between the observed number of deaths and each of these thresholds as exiguous deaths. RESULTS: Since January 2020, in a few weeks the observed deaths from road injuries fell below the 95% lower bound, such as April 6-12 (exiguous deaths 5-21, percent deficit 2.82-38.14), May 4-10 (8-23, 21.05-43.01), July 20-26 (12-29, 30.77-51.53), and August 3-9 (3-20, 7.32-34.41). However, those less than the 95% lower bound were also observed in weeks in the previous years. CONCLUSIONS: The number of road traffic fatalities during the COVID-19 pandemic in Japan has decreased slightly, but not significantly, in several weeks compared with the average year. This suggests that the relatively small changes in excess all-cause mortality observed in Japan during the COVID-19 pandemic could not be explained simply by an offsetting reduction in traffic deaths. Considering a variety of other indirect effects, evaluating an independent, unbiased measure of COVID-19-related mortality burden could provide insight into the design of future broad-based infectious disease counter-measures and offer lessons to other countries.

19.
Lancet Reg Health West Pac ; 1: 100011, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-741396

ABSTRACT

BACKGROUND: In the absence of widespread testing, symptomatic monitoring efforts may allow for understanding the epidemiological situation of the spread of coronavirus disease 2019 (COVID-19) in Japan. We obtained data from a social networking service (SNS) messaging application that monitors self-reported COVID-19 related symptoms in real time in Fukuoka Prefecture, Japan. We aimed at not only understanding the epidemiological situation of COVID-19 in the prefecture, but also highlighting the usefulness of symptomatic monitoring approaches that rely on self-reporting using SNS during a pandemic, and informing the assessment of Japan's emergency declaration over COVID-19. METHODS: We analysed symptoms data (fever over 37.5° and a strong feeling of weariness or shortness of breath), reported voluntarily via SNS chatbot by 227,898 residents of Fukuoka Prefecture during March 27 to May 3, 2020, including April 7, when a state of emergency was declared. We estimated the spatial correlation coefficient between the number of the self-reported cases of COVID-19 related symptoms and the number of PCR confirmed COVID-19 cases in the period (obtained from the prefecture website); and estimated the empirical Bayes age- and sex-standardised incidence ratio (EBSIR) of the symptoms in the period, compared before and after the declaration. The number of symptom cases was weighted by age and sex to reflect the regional population distribution according to the 2015 national census. FINDINGS: Of the participants, 3.47% reported symptoms. There was a strong spatial correlation of 0.847 (p < 0.001) at municipality level between the weighted number of self-reported symptoms and the number of COVID-19 cases for both symptoms. The EBSIR at post-code level was not likely to change remarkably before and after the declaration of the emergency, but the gap in EBSIR between high-risk and low-risk areas appeared to have increased after the declaration. INTERPRETATION: While caution is necessary as the data was limited to SNS users, the self-reported COVID-19 related symptoms considered in the study had high epidemiological evaluation ability. In addition, though based on visual assessment, after the declaration of the emergency, regional containment of the infection risk might have strengthened to some extent. SNS, which can provide a high level of real-time, voluntary symptom data collection, can be used to assess the epidemiology of a pandemic, as well as to assist in policy assessments such as emergency declarations. FUNDING: The present work was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009).

20.
Bull World Health Organ ; 98(8): 518-529, 2020 Aug 01.
Article in English | MEDLINE | ID: covidwho-707108

ABSTRACT

OBJECTIVE: To estimate the effect of airline travel restrictions on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) importation. METHODS: We extracted passenger volume data for the entire global airline network, as well as the dates of the implementation of travel restrictions and the observation of the first case of coronavirus disease (COVID-19) in each country or territory, from publicly available sources. We calculated effective distance between every airport and the city of Wuhan, China. We modelled the risk of SARS-CoV-2 importation by estimating survival probability, expressing median time of importation as a function of effective distance. We calculated the relative change in importation risk under three different hypothetical scenarios that all resulted in different passenger volumes. FINDINGS: We identified 28 countries with imported cases of COVID-19 as at 26 February 2020. The arrival time of the virus at these countries ranged from 39 to 80 days since identification of the first case in Wuhan. Our analysis of relative change in risk indicated that strategies of reducing global passenger volume and imposing travel restrictions at a further 10 hub airports would be equally effective in reducing the risk of importation of SARS-CoV-2; however, this reduction is very limited with a close-to-zero median relative change in risk. CONCLUSION: The hypothetical variations in observed travel restrictions were not sufficient to prevent the global spread of SARS-CoV-2; further research should also consider travel by land and sea. Our study highlights the importance of strengthening local capacities for disease monitoring and control.


Subject(s)
Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Travel/legislation & jurisprudence , Aircraft/legislation & jurisprudence , Airports/standards , Betacoronavirus , COVID-19 , Coronavirus Infections/transmission , Humans , Models, Statistical , Pneumonia, Viral/transmission , Risk Assessment , SARS-CoV-2 , Time Factors
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