COVID-19 Pandemic In Japan Research Articles

Suicide rates during the COVID-19 pandemic in Japan from April 2020 to December 2021

This study estimated the excess suicidal mortality during the COVID-19 pandemic in Japan. A Poisson regression model was used to assess the association between unemployment rates, expenditure for alcohol, eating out, and suicide, from January 2008 to March 2020. The excess suicidal mortality was assessed by applying the identified model to data from April 2020 to December 2021. The number of estimated excess deaths during COVID-19 was 3397 in men and 2390 in women. COVID-19 may have caused unprecedented psychological distress among people, owing to restricted social gatherings and prolonged uncertainties.

Association of Social Capital and Locus of Control with Perceived Health during the COVID-19 Pandemic in Japan.

Previous studies have indicated that social capital and locus of control influence mental health. Accordingly, we investigated the effect of social capital and locus of control on perceived physical and mental health in the general Japanese population during the COVID-19 pandemic. In order to conduct a cross-sectional study, in 2021, three thousand citizens were randomly selected from the Chitose City Resident Register according to ten strata of sex and age classes between 30 years and 79 years. Because thirteen persons moved away from the city, the survey was conducted for the remaining 2987 citizens. A total of 1430 citizens (712 males, 718 females) responded to the survey with their written informed consent (response rate, 47.9%). As a result, social capital measured three dimensions, namely social support, social participation, and trust and reciprocity, and internal locus of control was significantly inversely associated with it, but external locus of control was significantly positively associated with impaired physical and mental health in male and female subjects after adjustment of lifestyle habits and lifestyle change affected by the pandemic. Strengthening social capital and internal locus of control, and weakening external locus of control, may improve physical and mental health, even if the pandemic would bring about distress. Further longitudinal study is needed to examine the causal relationship among them.

Evaluation of a Webinar for Pharmacists Learning Basic Clinical-Oncology during COVID-19 Pandemic in Japan.

It is essential for oncology pharmacists to update their knowledge, skills, and ethical attitudes. The Japanese Society of Pharmaceutical Oncology is an academic society for healthcare professionals involved in cancer treatment. It has conducted in-person seminars every year to cultivate the knowledge necessary for practicing advanced cancer medicine. Owing to the coronavirus disease (COVID-19) pandemic, the society was obligated to conduct a web-based seminar this year. A questionnaire survey was conducted before and after the webinar to explain how it works and to assess the learning attitudes of beginner and moderately skilled pharmacists in the field of oncology. Questionnaire surveys were conducted with the participants before and after watching the webinar. The questionnaires sought to determine participants' perspectives on the webinar and their knowledge of the seven modules. Of the 1756 webinar attendees, 1661 (94.6%) answered the pre-webinar survey and 1586 (90.3%) answered the post-webinar survey. Results indicate that the median post-webinar knowledge score was significantly higher than the median pre-webinar score (p < 0.001) in all modules. Principal component analysis of the degree of knowledge of seven modules revealed that the improved score group consisted of those from younger age groups, with less experience as pharmacists, non-society members, and those with less experience in past society seminars. Moreover, the web-based seminar provided a uniform learning effect throughout the country without distinguishing between urban and rural learners. The web-based educational program was an acceptable educational tool for Japanese oncology pharmacists.

Parenting, Social Isolation, and Loneliness Among New Parents During the COVID-19 Pandemic in Japan: A Pilot Study.

Parenting, Social Isolation, and Loneliness Among New Parents During the COVID-19 Pandemic in Japan: A Pilot Study.

Corrigendum to Travel behavior changes during the COVID-19 pandemic in Japan: Analyzing the effects of risk perception and social influence on going-out self-restriction [Transp. Res. Interdiscip. Perspect. 7 (2020) 100181

Corrigendum to Travel behavior changes during the COVID-19 pandemic in Japan: Analyzing the effects of risk perception and social influence on going-out self-restriction [Transp. Res. Interdiscip. Perspect. 7 (2020) 100181

Establishing a Universal RT-PCR Testing System Is Essential for the Safe Performance of Scheduled Surgeries During the COVID-19 Pandemic in Japan: A Retrospective Study.

BackgroundElective orthopedic surgery, as well as the procedures of many surgical departments, have been severely curtailed by coronavirus disease 2019. Here, we aimed to analyze how all surgeons could safely perform essential procedures during the coronavirus disease 2019 pandemic.MethodsA retrospective review of elective surgeries performed between May 15, 2020, and February 28, 2022, was conducted. A screening questionnaire was used, and reverse transcription-polymerase chain reaction testing was assessed in all admitted surgical department patients. Their positivity rate and the positivity rate in our fever outpatient clinic were analyzed.ResultsOf 6099 patients who tested for severe acute respiratory syndrome coronavirus-2 during the study period, eight (0.13%) tested positive. The positive results were seen in four patients undergoing orthopedic surgery, two undergoing respiratory surgery, one undergoing breast surgery, and one undergoing plastic surgery. The number of patients who visited the outpatient clinic for fever was 15,639, including 1640 positive cases (positive rate of 10.5%). The positive rate of preoperative reverse transcription-polymerase chain reaction testing for scheduled surgery was consistently low and did not coincide with the peak of the wave of infection, while the positivity rate of outpatients with fever demonstrated a wave consistent with the national infection situation. All 6091 patients, excluding the eight positive patients, underwent surgery; all patients who underwent surgery were discharged from the hospital without developing coronavirus disease 2019 symptoms.ConclusionsOur findings suggest that the establishment of a universal reverse transcription-polymerase chain reaction testing system is essential for the safe performance of scheduled surgeries during the coronavirus disease 2019 pandemic.

State of emergency and human mobility during the COVID-19 pandemic in Japan

IntroductionThe Japanese government declared a state of emergency (SoE) to control the spread of the coronavirus disease (COVID-19). However, the requirements of these SoE were less stringent than those in other nations. It has not been assessed whether soft containment policies were sufficiently effective in the promotion of social distancing or the reduction of human contact. MethodsMobility changes across different travel destinations, such as, (a) retail and recreation spaces; (b) supermarkets and pharmacies; (c) parks; (d) public transportation; (e) workplaces; and (f) residential areas, were analysed using the Google mobility index to assess social distancing behaviour in all Japanese prefectures between 15 February 2020 and 21 September 2021. The changes were evaluated through the utilisation of an interrupted time-series analysis after adjustment for seasonality and various prefecture-specific fixed-effects, and distinguishment of potential heterogeneity across multiple SoEs and the time that had passed after the declaration. ResultsThe mobility index for retail and recreation exhibited an immediate decline of 7.94 percent-points (95%CI: −8.77 to −7.12) after the declaration of the SoE, and a further decline after the initial period (beta: −1.27 95%CI: −1.43 to −1.11). However, it gradually increased by 0.03 percent-points (95%CI: 0.02–0.03). This trend was similar for mobility in other places. Among the four SoEs, the overall decline in human mobility outside the home was the least significant in the third and fourth SoE, which suggests that people were less compliant with social distancing measures during these periods. ConclusionsAlthough government responses to the pandemic may aid the controlling of human mobility outside the home, their effectiveness may decrease if these interventions are repeated and enforced for extended periods. A combination of these with other measures (i.e. risk-communication strategies) would enable even mild containment and closure policies to effectively curb the spread of the virus.

Prospective Cohort Study of Sociodemographic and Work-Related Factors and Subsequent Unemployment under COVID-19 Pandemic.

The previous studies found that women and low-income households were more likely to experience unemployment prior to the COVID-19 pandemic. However, there is no cohort study to examine the relationship during the COVID-19 pandemic. The aim of this prospective cohort study is to examine the relationship between sociodemographic factors and unemployment during the COVID-19 pandemic in Japan. We surveyed the socioeconomic status, personal characteristics, and occupation of recruited workers at baseline (22–25 December 2020); subsequent unemployment was examined at follow-up (18–19 February 2021). We determined the odds ratio of unemployment by sociodemographic status and occupation. The multivariate model was adjusted for sex and age. Among the 19,941 participants, 725 (3.6%) had experienced unemployment. Multivariate analysis showed significant high unemployment amongst women and participants of younger age, bereaved or divorced, unmarried, of lower income, or with short educational background. By occupation, the unemployment rate of temporary or contract employees and self-employed is high. COVID-19 expelled socially vulnerable groups from employment. This suggests the need for employment and economic support for such individuals.

Decision making support for cancer patient's treatment strategy during the COVID-19 pandemic in Japan.

e24141 Background: During the COVID-19 pandemic, cancer patients became reluctant to come to the hospital, receive cancer treatment, and were willing to interrupt or postpone treatment due to concerns about infection. The purpose of this study was to discuss effective treatment strategy decision making support for cancer patients during the COVID-19 pandemic. Methods: An online survey was conducted on decision making support among nurses who worked at a cancer care hospital in Japan from May to July 2021. Results: Forty-nine facilities were asked to participate in the survey, and replies were received from 728 respondents; 185 (26.8%) were nurses engaged in the decision making. The most common treatment choice was postponement in 132 patients (73.3%). Nurses who “provided information on measures to prevent COVID-19 infection” were more likely to recognize that “the patient was satisfied with the treatment” (p &lt; 0.05). Nurses who “listened to the patient's thoughts” were less likely to perceive that the patient was “not convinced and continued with the previous treatment” (p &lt; 0.05). Nurses who “listened to the patient's intentions and thoughts after the decision was made,” “followed up on the patient's symptoms and changes in perceptions by telephone,” “followed up on the patient's symptoms and changes in perceptions by videophone”, and “assured the patient that they could take immediate action if symptoms worsened with the physician's permission” more often recognized that the patient “accepted the treatment recommended by the physician although they were not convinced” (p &lt; 0.05). Conclusions: Effective treatment strategy decision making support for cancer patients during the COVID-19 pandemic includes lifestyle guidance for infection prevention, listening to identify the reasons behind patients’ choices, and telenursing for follow-up decision.

Prevalence, characteristics, and psychological outcomes of workplace cyberbullying during the COVID-19 pandemic in Japan: a cross-sectional online survey

BackgroundThe rapid introduction of teleworking due to the coronavirus disease 2019 pandemic has led to concerns about increases in cyberbullying (CB) worldwide. However, little is known about workplace CB in non-Western countries. The first objective was to clarify the prevalence and characteristics regarding workplace CB victimization in Japan. The second objective was to demonstrate the psychological outcomes of CB victimization in combination with traditional bullying (TB).MethodsWe conducted an anonymous, cross-sectional, Internet-based survey targeting regular employees in Japan (N = 1200) in January 2021. We investigated CB victimization using the Inventory of Cyberbullying Acts at Work and TB victimization by using the Short Negative Act Questionnaire. Possible explanatory factors for TB/CB victimization were sociodemographic variables, personality trait, chronic occupational stress, organizational climate, and gratitude at work. We also measured psychological distress, insomnia, and loneliness to assess adverse effects of workplace bullying. Two-step cluster analysis was used in determining the patterns combined with TB and CB victimization. Hierarchical binomial logistic regression analysis was used.ResultsIn total, 8.0% of employees reported experiencing CB on a weekly basis. CB victimization was associated with younger age, managerial position, higher qualitative workload, and active information dissemination via the Internet, and frequency of teleworking. Three clusters based on TB and CB victimization patterns were identified: those who belong to the first cluster suffered neither from TB and CB (81.0%), the second cluster suffered only from TB (14.3%), and the third cluster suffered from both TB and CB (4.8%). The third cluster exhibited higher odds ratios (ORs) and 95% confidence intervals (CIs) for psychological distress (OR = 12.63, 95% CI = 4.20–38.03), insomnia (OR = 6.26, 95% CI = 2.80–14.01), and loneliness (OR = 3.24, 95% CI = 1.74–6.04) compared to the first cluster.ConclusionsThese findings firstly clarify the prevalence and correlated factors of CB victimization among employees in Japan. Further, we showed that psychological wellbeing can be impaired by the coexistence of TB and CB. Our research could be the first step to develop the effective countermeasures against workplace CB.

Online education and the mental health of faculty during the COVID-19 pandemic in Japan

While the negative impact of the pandemic on students’ mental health has been studied around the world, very little is known about the mental health of faculty and staff. This research aims to examine mental health among Japanese faculty members who taught online courses during the COVID-19 pandemic. We recruited 537 university faculty members and assessed their mental health using the World Health Organization-Five Well-Being Index (WHO-5), both retrospectively (during the academic year before the onset of the pandemic) and during the pandemic. We also evaluated workload (number of online lectures taught and preparation time per class), difficulty in using information technology (IT) for online classes, and satisfaction with the university support service for online education. As a result, the WHO-5 score during the COVID-19 pandemic was significantly lower than before, and 33.5% of the faculty members were recognized as being at risk for mental illness during the COVID-19 pandemic. A binomial logistic regression analysis revealed two significant risk factors for mental illness—faculty members were more at risk for mental illness when they experienced difficulty in using IT for online classes, and were unsatisfied with the administrative support for online education. The deterioration of mental health during the COVID-19 was not predicted by workload, such as the number of online lectures and preparation time. These results suggest the importance of improving workplace support services, especially IT support, to prevent mental health deterioration among faculty teaching online.

Exploring characteristics of increased suicide during the COVID-19 pandemic in Japan using provisional governmental data

SummaryBackgroundThe Japanese age-standardised death rate of suicide (SDR) had decreased during 2009–2019, but increased in 2020–2021, during the COVID-19 pandemic.MethodsThis study aimed to explain the trend change in the SDR during the pandemic, disaggregated by prefecture, gender, suicide method and household, as compared to predicted SDR derived from pre-pandemic data, using linear mixed-effect and hierarchical linear regression models with robust standard error analyses.FindingsThe SDR was lower during March–June 2020 (during the first wave of the pandemic), but higher during July–December 2020 than the predicted SDR. In 2021, males’ SDR was nearly equal to the predicted SDR, whereas females’ SDR in the metropolitan-region (17.5%: 95% confidence interval: 13.9–21.2%) and non-metropolitan-region (24.7%: 95% confidence interval: 22.8–26.7%) continued to be higher than the predicted SDR. These gender- and region-dependent temporal fluctuations of SDR were synchronised with those of SDRs caused by hanging, at home and single-person-households. Additionally, the rising number of infected patients with the SARS-CoV-2 and polymerase chain reaction (PCR) diagnostic examinations were positively (β = 0.024) and negatively (β =-0.002) related to the SDR during the pandemic, respectively.InterpretationJapanese suicide statistics have previously established that the predominant method and place of suicide were by hanging and at the individual's home, respectively. The present findings suggest that transformed lifestyles during the pandemic, increasing time spent at home, enhanced the suicide risk of Japanese people by hanging and at home.FundingRegional Suicide Countermeasures Emergency Enhancement Fund of Mie Prefecture (2021–40).

Association between Frequency of Conversations and Suicidal Ideation among Medical Students during COVID-19 Pandemic in Japan.

To mitigate the spread of COVID-19, universities in Japan shifted from face-to-face to online classes, which might have reduced social interaction and increased psychiatric problems among students. A self-report questionnaire was administered to fourth-year medical students in Tokyo in May 2021, during the fourth wave of the COVID-19 outbreak, to examine the association between the frequency of conversations and suicidal thoughts. The questionnaire assessed the frequency of conversations and, using part of the Mini International Neuropsychiatric Interview, suicidal ideation. Of the 113 students, 98 (86.7%) responded, of whom 20 (20.4%) had suicidal ideation. Poisson regression analysis revealed that those with less than 1 conversation per week and no conversations at all had a significantly higher risk of suicidal ideation than those with 3 conversations per week or more, after adjusting for personality, family relationship, income level, living alone, number of friends, gender, and age. These results indicate that less frequent conversations increased the risk of suicidal ideation among medical students. Mental health support for students needs to be strengthened if universities suspend face-to-face classes during a pandemic.

Prosthetic and orthotic students' perceptions on online courses during the COVID-19 pandemic in Japan.

The effects of the novel coronavirus (COVID-19) pandemic have changed both the traditional teaching methods and clinical placements. To investigate the effects of COVID-19 on the prosthetics and orthotics (P&O) training program in Japan. A cross-sectional national survey. A Google form survey was distributed to students through the heads of the department of P&O program across Japan. Descriptive statistics were used to analyze the data. One hundred sixty-six students (107 males and 59 females) responded to the survey. The respondents' grades were as follows: freshman, 22.3% (n = 37); sophomore, 33.7% (n = 56); junior, 27.1% (n = 45); and senior, 16.9% (n = 28). Forty-seven percent (n = 78) reported that their clinical placements have been cancelled because of the COVID-19 pandemic. Only 15.1% (n = 25) have performed their clinical placements during the pandemic. Regarding career preparation, 16.3% (n = 27) had face-to-face interviews and 10.2% (n = 17) have reported being interviewed online. Of a total of 44 respondents who were interviewed for jobs in P&O industries and rehabilitation centers, 79.5% (n = 35) job appointments have been cancelled and 15.9% (n = 7) postponed. The event of the COVID-19 pandemic has proved necessary to renew the traditional teaching and learning model in colleges worldwide. Most students have been affected by clinical placements and career preparation. Therefore, promoting telehealth in the existing rehabilitation facilities and P&O industries to provide services might be an alternative method to address students' clinical placements in similar life condition events.

Sociodemographic factors and self-restraint from social behaviors during the COVID-19 pandemic in Japan: A cross-sectional study

The control of human flow has led to better control of COVID-19 infections. Japan’s state of emergency, unlike other countries, is not legally binding but is rather a request for individual self-restraint; thus, factors must be identified that do not respond to self-restraint, and countermeasures considered for those factors to enhance its efficacy. We examined the relationship between sociodemographic factors and self-restraint toward social behaviors during a pandemic in Japan. This cross-sectional study used data for February 18–19, 2021, obtained from an internet survey; 19,560 participants aged 20–65 were included in the analysis. We identified five relevant behaviors: (1) taking a day trip; (2) eating out with five people or more; (3) gathering with friends and colleagues; (4) shopping for other than daily necessities; (5) shopping for daily necessities. Multilevel logistic regression analyses were used to examine the relationship between sociodemographic factors and self-restraint for each of the behaviors. Results showed that for behaviors other than shopping for daily necessities, women, those aged 60–65, married people, highly educated people, high-income earners, desk workers and those who mainly work with interpersonal communication, and those with underlying disease reported more self-restraint. Older people had less self-restraint than younger people toward shopping for daily necessities; an underlying disease had no effect on the identified behavior. Specialized interventions for these groups that include recommendations for greater self-restraint may improve the efficacy of the implementing measures that request self-restraint.

Situation of food assistance users and the association with change in socioeconomic status during COVID-19 pandemic in Japan

Objective This study aimed to understand the situation of the users of food assistance activities during the COVID-19 pandemic, and to examine the relationship with the changes in socioeconomic conditions.Methods A total of 33,004 (16,065 men and 16,939 men) people aged 20 or older who cooperated with an online survey in February 2021 were included in the analysis. The analysis was conducted by classifying users of one of the following types of food assistance as food assistance users and other users as non-users: eating on site (e.g., children's cafeteria), receiving food at a specific location (e.g., food pantry), or having food delivered to their home (e.g., emergency home food delivery). A multiple logistic regression analysis was used to calculate the adjusted odds ratios (95% confidence interval (CI)) for the association between food assistance use and changes in socioeconomic status, which was assessed based on the employment status and household monthly income just before and during the COVID-19 pandemic.Results The number of users of food assistance was 3,071 (9.3%). Of these, 1,549 (4.7%) were users of children's cafeterias, 1,296 (3.9%) were users of food pantries, and 2,236 (6.8%) were users of emergency home food delivery (with duplicate responses). The adjusted odds ratio for food assistance use was 1.47 (95% CI 1.28-1.70) for those with changes in employment status compared to those with no changes. The adjusted odds ratio for food assistance use was 1.89 (1.65-2.15) for those with reduced income and 1.67 (1.37-2.03) for those with increased household income compared to those with no changes. The adjusted odds ratios for food assistance use were higher for those with changes in employment status and/or household income than those with no changes in both.Conclusions One in ten individuals used food assistance during the COVID-19 pandemic. It was suggested that many of the users of food assistance had changed their employment status or household income during the COVID-19 pandemic. In the future, it will be necessary to establish a public-private system that can provide information on local food assistance to people whose socioeconomic status has changed rapidly.

Assessment of Traffic Accidents in Japan during the COVID-19 Pandemic vs. Previous Years: A Preliminary Report.

Beginning in April 2020, social distancing measures were implemented to mitigate the COVID-19 pandemic in Japan. We assessed whether traffic accident rates had decreased from April 2020 to December 2021 as compared with previous years. The analysis included 2,934,477 traffic accidents, and the trend of decreasing rates of traffic accidents in recent years and seasonal fluctuations in traffic accidents were considered. The yearly change in the traffic accident rate between 2015 and 2019 was estimated, and the traffic accident rate in 2020 and 2021 was predicted. This was followed by the comparison of observed vs. predicted traffic accident rate. In 2020, the observed vs. expected rates of traffic accidents were lower in April to December 2020, and the rate of traffic accidents in Japan was 30–40% lower in April–May 2020 than would be expected based on trends from previous years. In 2021, rates of traffic accidents remained lower than expected between January and November, but the magnitude of decrease was not as pronounced. These findings could be explained by social distancing policies, including the declaration of the state of emergency, and the relaxation of public health and social measures over time.

Changes in marriage, divorce and births during the COVID-19 pandemic in Japan

IntroductionMarriage, divorce and fertility are declining in Japan. There is concern that the COVID-19 pandemic may have accelerated the decrease in marriages and births while increasing the number of divorces....

‘Not finding causal effect’ is not ‘finding no causal effect’ of school closure on COVID-19

In a paper recently published in Nature Medicine, Fukumoto et al. tried to assess the government-led school closure policy during the early phase of the COVID-19 pandemic in Japan. They compared the reported incidence rates between municipalities that had and had not implemented school closure in selected periods from March–May 2020, where they matched for various potential confounders, and claimed that there was no causal effect on the incidence rates of COVID-19. However, the effective sample size (ESS) of their dataset had been substantially reduced in the process of matching due to imbalanced covariates between the treatment (i.e. with closure) and control (without closure) municipalities, which led to the wide uncertainty in the estimates. Despite the study title starting with "No causal effect of school closures", their results are insufficient to exclude the possibility of a strong mitigating effect of school closure on incidence of COVID-19. In this replication/reanalysis study, we showed that the confidence intervals of the effect estimates from Fukumoto et al. included a 100% relative reduction in COVID-19 incidence. Simulations of a hypothetical 50% or 80% mitigating effect hardly yielded statistical significance with the same study design and sample size. We also showed that matching of variables that had large influence on propensity scores (e.g. prefecture dummy variables) may have been incomplete.

COVID‐19 vaccination did not improve employee mental health: A prospective study in an early phase of vaccination in Japan

ObjectivesThis study aimed to examine the effectiveness of vaccination to improve mental health among employees in Japan based on a prospective study.MethodsThe data were retrieved from the Employee Cohort Study conducted during the COVID‐19 pandemic in Japan (E‐ COCO‐J) at T1 (4–10 February 2021) and T2 (22–29 June 2021). Psychological distress was measured by using an 18‐item scale of the Brief Job Stress Questionnaire (BJSQ). The analytic sample was limited to individuals employed at both T1 and T2 without missing covariates. Vaccination status was measured at T2. Statistical analysis was conducted to test the differential change in the psychological distress at T1 and T2 with the time × group interactions by using repeated ANOVA, adjusting for the covariates (gender, age, marital status, education, chronic disease, company size, industry, and occupation).ResultsOf the total sample (N = 948), 105 (11.1%) were vaccinated at least once at T2. The crude mean scores of psychological distress at T1 and T2 were 41.8 and 42.0 for vaccinated participants and 41.2 and 41.2 for nonvaccinated participants, respectively, with no significant effect of having been vaccinated (Cohen's d = 0.02, P = 0.833). After adjusting the covariates, there was no significance (P = 0.446).ConclusionsThe COVID‐19 vaccination was supposed to have a limited effect on mental health among Japanese employees in an early phase of vaccination. To keep providing mental health care for employees is important even after starting the vaccination program.