Reduced mortality during the COVID-19 outbreak in Japan, 2020: a two-stage interrupted time-series design.

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.

Suicide by gender and 10-year age groups during the COVID-19 pandemic vs previous five years in Japan: An analysis of national vital statistics.

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.

Reviews on common objectives and evaluation indicators for risk communication activities from 2011 to 2017.

BACKGROUND: Risk communication is widely accepted as a significant factor for policy makers, academic researchers, and practitioners in diverse fields. However, there remains a lack of comprehensive knowledge about how risk communication is currently conducted across fields and about the way risk communication is evaluated. METHODOLOGY: This study systematically searched for materials from three scholarly search engines and one journal with a single search term of "risk communication." The eligibility assessment selected peer-reviewed articles published in English that evaluated risk communication activities. Emphasis was placed on articles published in recent years accounting for about half of the pre-selected ones. Data on field of study, intervention timing, target audience, communication type, and objectives/evaluation indicators was extracted from the articles. Patterns of objectives/evaluation indicators used in risk communication activities were compared with those of the definitions and purposes of risk communication stated by relevant organizations. Association analysis was conducted based on study fields and objectives/evaluation indicators. RESULTS: The screening process yielded 292 articles that were published between 2011 and 2017 in various fields, such as medicine, food safety, chemical substances, and disasters/emergencies. The review process showed that many activities were performed in the medical field, during non-/pre-crisis periods. Recent activities primarily targeted citizens/Non-Profit Organizations (NPOs), and was disseminated in the form of large group or mass communication. While "knowledge increase," "change in risk perception and concern alleviation," and "decision making and behavior change" were commonly addressed in practice, "trust-building" and "reduction in psychological distress" were rarely focused. The analysis also indicated that the medical field tends to perform risk communication at the individual or small group level, in contrast to the food safety field. Further, risk communications in the non-/pre-crisis period are more likely to aim at "changes in risk perception and concern alleviation" than those in the crisis period. Risk communications that aim at "changes in risk perception and concern alleviation" are likely to be presented in a large group or mass communication, whereas those that aim at "decision making and behavior change" are likely to be conducted at the individual or small group level. CONCLUSION: An overview of recent activities may provide those who engage in risk communication with an opportunity to learn from practices in different fields or those conducted in different intervention timings. Devoting greater attention to trust building and reduction in psychological distress and exploring non-citizen/NPO stakeholders' needs would be beneficial across academic and professional disciplines.