Vaccination under the Pandemic and Political Support (preprint)

This paper examines the impact of COVID-19 vaccination on political support. We exploit Japan’s age-based COVID-19 vaccine roll-out, prioritizing people aged 65 years and older. A regression discontinuity design based on a large-scale online survey reveals that COVID-19 vaccination increases favorable opinions of the vaccination progress in municipalities and infection control measures of municipal governments. By contrast, there is no significant effect on support for the central government. We also discovered that people with chronic diseases and low socioeconomic status are more affected. These results show that reciprocal motives and political information play an important role in evaluating public policies.

SARS-CoV-2 Suppression and Early Closure of Bars and Restaurants: A Longitudinal Natural Experiment (preprint)

Despite severe economic damage, full-service restaurants and bars have been closed in hopes of suppressing the spread of SARS-CoV-2 worldwide. This paper explores whether the early closure of restaurants and bars in February 2021 reduced symptoms of SARS-CoV-2 in Japan. Using a large-scale nationally representative longitudinal survey, we found that the early closure of restaurants and bars decreased the utilization rate among young persons (OR 0.688; CI95 0.515-0.918) and those who visited these places before the pandemic (OR 0.754; CI95 0.594-0.957). However, symptoms of SARS-CoV-2 did not decrease in these active and high-risk subpopulations. Among the more inactive and low-risk subpopulations, such as elderly persons, no discernible impacts are observed in both the utilization of restaurants and bars and the symptoms of SARS-CoV-2. These results suggest that the early closure of restaurants and bars without any other concurrent measures does not contribute to the suppression of SARS-CoV-2.

SARS-CoV-2 Suppression and Early Closure of Bars and Restaurants : A Longitudinal Natural Experiment (preprint)

Despite severe economic damage, full-service restaurants and bars have been closed in hopes of suppressing the spread of SARS-CoV-2 worldwide. This paper explores whether the early closure of restaurants and bars in February 2021 reduced symptoms of SARS-CoV-2 in Japan. Using a large-scale nationally representative longitudinal survey, we found that the early closure of restaurants and bars decreased the utilization rate among young persons (OR 0.688; CI95 0.515-0.918) and those who visited these places before the pandemic (OR 0.754; CI95 0.594-0.957). However, symptoms of SARS-CoV-2 did not decrease in these active and high-risk subpopulations. Among the more inactive and low-risk subpopulations, such as elderly persons, no discernible impacts are observed in both the utilization of restaurants and bars and the symptoms of SARS-CoV-2. These results suggest that the early closure of restaurants and bars without any other concurrent measures does not contribute to the suppression of SARS-CoV-2.

Financial Meltdown in 'Swing Hospitals' during the COVID-19 Outbreak (preprint)

Hospitals in Japan have complete autonomy in deciding whether to admit COVID-19 patients, similar to that of the US. Taking this into account, we estimated the effect of admitting COVID-19 patients on hospital profits, using instrumental variable (IV) regression. Using IVs related to government intervention enabled us to not only estimate the effect of admitting COVID-19 patients among ''swing hospitals,'' where both options (to admit or to not admit COVID-19 patients) could potentially be realized but to also evaluate the effect of government intervention on such hospitals. Our empirical results revealed that monthly profits per bed decreased by approximately JPY 600,000 (≒ USD 6,000) among swing hospitals, which is 15 times the average monthly profits in 2019. This overwhelming financial damage indicates that it would be costly for swing hospitals to treat COVID-19 patients because of their low suitability for admitting such patients. Given the implications of our main results, we propose an alternative strategy to handling surges in patients with new infectious diseases.

Financial Meltdown in Swing Hospitals during the COVID-19 Outbreak (preprint)

Hospitals in Japan have complete autonomy in deciding whether to admit COVID-19 patients, similar to that of the US. Taking this into account, we estimated the effect of admitting COVID-19 patients on hospital profits, using instrumental variable (IV) regression. Using IVs related to government intervention enabled us to not only estimate the effect of admitting COVID-19 patients among "swing hospitals," where both options (to admit or to not admit COVID-19 patients) could potentially be realized but to also evaluate the effect of government intervention on such hospitals. Our empirical results revealed that monthly profits per bed decreased by approximately JPY 600,000 (USD 6,000) among swing hospitals, which is 15 times the average monthly profits in 2019. This overwhelming financial damage indicates that it would be costly for swing hospitals to treat COVID-19 patients because of their low suitability for admitting such patients. Given the implications of our main results, we propose an alternative strategy to handling surges in patients with new infectious diseases.

How Serious Was It? The Impact of Preschool Closure on Mothers' Psychological Distress: Evidence from the First COVID-19 Outbreak (preprint)

During the early days of the first outbreak of the novel coronavirus disease 2019 (COVID-19) in Japan, preschools were exempted from the nationwide school closure, which came into effect on March 2, 2020. However, the decision to close or open preschools was left to each facility and the municipality of their location, and the decision was characterized by high randomness. In addition to this, Japan is the rare country that experienced preschool closure without any heavy restrictions on daily life activities, which makes it possible to separate the effects of preschool closure from the effects of other anti-COVID-19 policies such as lockdown. Utilizing these advantages, we explored the effects of children's absence from preschool during March 2020 on mothers' psychological distress. Our results show that preschool closure caused an immediate deterioration in mothers' psychological state. The effect of children's absence from preschool on moderate psychological distress persisted for at least five months.

What School Closure Left in Its Wake: Contrasting Evidence Between Parents and Children from the First COVID-19 Outbreak (preprint)

To control the spread of COVID-19, the national government of Japan abruptly announced the closure of elementary schools on March 2, 2020, but preschools were exempted from this nationwide school closure. Taking advantage of this natural experiment, we examined how the proactive closure of elementary schools affected various outcomes related to family well-being such as the incidence of domestic violence and marital quality as well as outcomes for children. To identify the causal effects of the school closures, we exploited the discontinuity in the probability of “schooling” at a certain age (in months) and conducted regression discontinuity analyses. The outcomes were measured in both March and August 2020; on the latter occasion, we conducted large-scale online surveys of mothers whose firstborn child was aged 4 to 10 years. The results revealed a slight increase in physical domestic violence by wives in March, but this increase did not persist to August 2020. Furthermore, we found no significant effect in several measures of marital relationship and marital quality. By contrast, even in August, we found significant increases in children’s weight and social media usage as well as in mothers’ anxiety over how to raise their children. These findings together suggest that school closures have no lasting negative effects on marital quality but do have lasting negative impacts on children through lifestyle changes prompted by school closures.