Balancing Public & Economic Health in Japan during the COVID-19 Pandemic: A Descriptive Analysis.

Despite loose restrictions and a low mortality rate due to COVID-19, Japan faced the challenge of stabilizing its economy during the pandemic. Here, we analyzed how the Japanese government attempted to maintain a balance between the health of the population and the health of the economy. We used a mix of quantitative data, information from policy documents, and news agency publications. Features of the Japanese government's handling of the pandemic include the lack of constitutional authority to enforce a lockdown, the laxer restrictions compared with other countries in which citizens were advised only to exercise self-restraint and avoid close social contact, and the existence of expert panels that had only an advisory role. Our findings address the slow initial response of the government, which feared that the 2020 Tokyo Olympics would be canceled, and the increased testing when the Olympics were postponed, as well as the expansion of vaccination efforts after the Olympics. In addition, there was a targeted campaign to promote national travel to increase economic revenue in the tourism sector, but this led to an increase in COVID-19 cases.

Inter-prefectural Travel and Network Connectedness During the COVID-19 Pandemic in Japan.

BACKGROUND: Increases in human mobility have been linked to rises in novel coronavirus disease 2019 (COVID-19) transmission. The pandemic era in Japan has been characterized by changes in inter-prefectural mobility across state of emergency (SOE) declarations and travel campaigns, but they have yet to be characterized. METHODS: Using Yahoo Japan mobility data extracted from the smartphones of more than 10 million Japanese residents, we calculated the monthly number of inter-prefectural travel instances, stratified by residential prefecture and destination prefecture. We then used this adjacency matrix to calculate two network connectedness metrics, closeness centrality and effective distance, that reliably predict disease transmission. RESULTS: Inter-prefectural mobility and network connectedness decreased most considerably during the first SOE, but this decrease dampened with each successive SOE. Mobility and network connectedness increased during the Go To Travel campaign. Travel volume between distant prefectures decreased more than travel between prefectures with geographic proximity. Closeness centrality was found to be negatively correlated with the rate of COVID-19 infection across prefectures, with the strength of this association increasing in tandem with the infection rate. Changes in effective distance were more visible among geographically isolated prefectures (Hokkaido and Okinawa) than among metropolitan, central prefectures (Tokyo, Aichi, Osaka, and Fukuoka). CONCLUSION: The magnitude of reductions in human mobility decreased with each subsequent state of emergency, consistent with pandemic fatigue. The association between network connectedness and rates of COVID-19 infection remained visible throughout the entirety of the pandemic period, suggesting that inter-prefectural mobility may have contributed to disease spread.

Changes in Numbers of COVID-19 Cases among Residents of Tourist Resort Areas before and during the "Go To Travel" Campaign: Descriptive Epidemiology in Gunma Prefecture.

The "Go To Travel" campaign in Japan, which encouraged people to travel throughout the country, was implemented in July 2020 to revitalize economic activity that was sluggish due to COVID-19. Although the risk of the spread of infection has been reported for tourists crossing prefectural borders, the spread of infection among residents living in tourist areas is unclear. The present study evaluated the number of COVID-19 cases among residents of tourist resort areas in Gunma Prefecture using a descriptive epidemiological method. Data regarding infected individuals were obtained from public data available on the prefecture's official homepage. Evaluation of epidemic curves showed that the number of cases increased slightly after the start of the campaign, with numbers affected by the occurrence of clusters. Toward the end of 2020, the number of cases increased in both resort and non-resort areas, although the increase was smaller in resort areas. Thus, the increased transmission of cases during the campaign suggested a need to take additional preventive measures, more-so for tourists than for resort area residents.

Effect of control measures on the pattern of COVID-19 Epidemics in Japan.

BACKGROUND: COVID-19 has spread worldwide since its emergence in 2019. In contrast to many other countries with epidemics, Japan differed in that it avoided lockdowns and instead asked people for self-control. A travel campaign was conducted with a sizable budget, but the number of PCR tests was severely limited. These choices may have influenced the course of the epidemic. METHODS: The increase or decrease in the classes of SARS-CoV-2 variants was estimated by analyzing the published sequences with an objective multivariate analysis. This approach observes the samples in multiple directions, digesting complex differences into simpler forms. The results were compared over time with the number of confirmed cases, PCR tests, and overseas visitors. The kinetics of infection were analyzed using the logarithmic growth rate. RESULTS: The declared states of emergency failed to alter the movement of the growth rate. Three epidemic peaks were caused by domestically mutated variants. In other countries, there are few cases in which multiple variants have peaked. However, due to the relaxation of immigration restrictions, several infective variants have been imported from abroad and are currently competing for expansion, creating the fourth peak. By April 2021, these foreign variants exceeded 80%. The chaotic situation in Japan will continue for some time, in part because no effort has been made to identify asymptomatic carriers, and details of the vaccination program are undecided.