Effect of emergency declaration on mental health during the COVID-19 pandemic in Japan: A social network service-based difference-in-differences approach.

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.

Perceptions Related to Nursing and Nursing Staff in Long-Term Care Settings during the COVID-19 Pandemic Era: Using Social Networking Service.

PURPOSE: The purpose of this study was to investigate what opinions and perceptions people have about nursing and the role of nursing staff in nursing homes (NHs) on Social Networking Service (SNS) by analyzing large-scale data through social big-data analysis. METHODS: This study investigated changes in perception related to nursing and nursing staff in NHs during the COVID-19 pandemic era using target channels (blogs, cafes, Instagram, communities, Twitter, etc.). Data were collected on the channel from 12 September 2019 to 11 September 2020, 6 months before and after 12 March 2020 when the COVID-19 pandemic was declared. Selected keywords included "nursing," "nurse," and "nursing staff," and included words were "long-term care settings," "geriatric hospital," and "nursing home." Text mining, opinion mining, and social network analysis were conducted. RESULTS: After the COVID-19 pandemic, the frequency of keywords increased about 1.5 times compared to before. In March 2020 when the COVID-19 pandemic was declared, the negative phrase "be infected" ranked number one, resulting in a sharp 8% rise in the percentage of negative words in that month. The related words that have risen in rank significantly, or were newly ranked in the Top 30 after the pandemic, were related with COVID-19. CONCLUSION: The public began to realize the role of nursing staff in the prevention and management of mass infection in NHs and the importance of nursing staff after the pandemic. Further studies should examine the perceptions of those who have received nursing services and include a wide range of foreign channels.

Trend change of the transmission route of COVID-19-related symptoms in Japan.

OBJECTIVES: The Japanese prime minister declared a state of emergency on April 7 2020 to combat the outbreak of coronavirus disease 2019 (COVID-19). This declaration was unique in the sense that it was essentially driven by the voluntary restraint of the residents. We examined the change of the infection route by investigating contact experiences with COVID-19-positive cases. STUDY DESIGN: This study is a population-level questionnaire-based study using a social networking service (SNS). METHODS: To assess the impact of the declaration, this study used population-level questionnaire data collected from an SNS with 121,375 respondents (between March 27 and May 5) to assess the change in transmission routes over the study period, which was measured by investigating the association between COVID-19-related symptoms and (self-reported) contact with COVID-19-infected individuals. RESULTS: The results of this study show that the declaration prevented infections in the workplace, but increased domestic infections as people stayed at home. However, after April 24, workplace infections started to increase again, driven by the increase in community-acquired infections. CONCLUSIONS: While careful interpretation is necessary because our data are self-reported from voluntary SNS users, these findings indicate the impact of the declaration on the change in transmission routes of COVID-19 over time in Japan.

The relationship between fever rate and telework implementation as a social distancing measure against the COVID-19 pandemic in Japan.

OBJECTIVES: On March 28, the Japanese government decided on the "Basic Policies for Novel Coronavirus Disease Control" and called on the public to thoroughly implement social distancing measures (i.e., behavioral restrictions to limit the frequency and intensity of human contact), especially telework. METHODS: We used population-level questionnaire data from a social networking service (SNS), with 275,560 respondents from March 5 to April 6, to evaluate the relationship between telework implementation and the presence of a fever (body temperature higher than 37.5 °C) within 1 month as a surrogate indicator of COVID-19 infection, by occupation type and age-group. RESULTS: Among company employees, statistical significance was identified in the 15- to 29-year and 30- to 59-year age-groups, showing higher fever rates in the non-teleworker group (for the 15- to 29-year age-group, non-teleworkers: 7.64%; teleworkers: 6.45%; P = 0.02; for the 30- to 59-year age-group, non-teleworkers: 3.46%; teleworkers: 3.14%; P = 0.02). CONCLUSIONS: Telework remains a controversial topic in Japan as the government called for emergency measures. Although caution is warranted in interpreting our findings because our data are limited to the voluntary SNS users, they will be essential to push forward with more measures to promote social distancing measures in the midst of Japan's current tense political climate.