TY - JOUR
T1 - Assessing the regional impact of Japan's COVID-19 state of emergency declaration
T2 - A population-level observational study using social networking services
AU - Yoneoka, Daisuke
AU - Shi, Shoi
AU - Nomura, Shuhei
AU - Tanoue, Yuta
AU - Kawashima, Takayuki
AU - Eguchi, Akifumi
AU - Matsuura, Kentaro
AU - Makiyama, Koji
AU - Uryu, Shinya
AU - Ejima, Keisuke
AU - Sakamoto, Haruka
AU - Taniguchi, Toshibumi
AU - Kunishima, Hiroyuki
AU - Gilmour, Stuart
AU - Nishiura, Hiroshi
AU - Miyata, Hiroaki
N1 - Funding Information:
Funding The present work was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan ('H29-Gantaisaku-ippan-009').
Publisher Copyright:
© BMJ Publishing Group Limited 2020.
PY - 2021/2/15
Y1 - 2021/2/15
N2 - Objective On 7 April 2020, the Japanese government declared a state of emergency in response to the novel coronavirus outbreak. To estimate the impact of the declaration on regional cities with low numbers of COVID-19 cases, large-scale surveillance to capture the current epidemiological situation of COVID-19 was urgently conducted in this study. Design Cohort study. Setting Social networking service (SNS)-based online survey conducted in five prefectures of Japan: Tottori, Kagawa, Shimane, Tokushima and Okayama. Participants 127 121 participants from the five prefectures surveyed between 24 March and 5 May 2020. Interventions An SNS-based healthcare system named COOPERA (COvid-19: Operation for Personalized Empowerment to Render smart prevention And care seeking) was launched. It asks questions regarding postcode, personal information, preventive actions, and current and past symptoms related to COVID-19. Primary and secondary outcome measures Empirical Bayes estimates of age-sex-standardised incidence rate (EBSIR) of symptoms and the spatial correlation between the number of those who reported having symptoms and the number of COVID-19 cases were examined to identify the geographical distribution of symptoms in the five prefectures. Results 97.8% of participants had no subjective symptoms. We identified several geographical clusters of fever with significant spatial correlation (r=0.67) with the number of confirmed COVID-19 cases, especially in the urban centres of prefectural capital cities. Conclusions Given that there are still several high-risk areas measured by EBSIR, careful discussion on which areas should be reopened at the end of the state of emergency is urgently required using real-time SNS system to monitor the nationwide epidemic.
AB - Objective On 7 April 2020, the Japanese government declared a state of emergency in response to the novel coronavirus outbreak. To estimate the impact of the declaration on regional cities with low numbers of COVID-19 cases, large-scale surveillance to capture the current epidemiological situation of COVID-19 was urgently conducted in this study. Design Cohort study. Setting Social networking service (SNS)-based online survey conducted in five prefectures of Japan: Tottori, Kagawa, Shimane, Tokushima and Okayama. Participants 127 121 participants from the five prefectures surveyed between 24 March and 5 May 2020. Interventions An SNS-based healthcare system named COOPERA (COvid-19: Operation for Personalized Empowerment to Render smart prevention And care seeking) was launched. It asks questions regarding postcode, personal information, preventive actions, and current and past symptoms related to COVID-19. Primary and secondary outcome measures Empirical Bayes estimates of age-sex-standardised incidence rate (EBSIR) of symptoms and the spatial correlation between the number of those who reported having symptoms and the number of COVID-19 cases were examined to identify the geographical distribution of symptoms in the five prefectures. Results 97.8% of participants had no subjective symptoms. We identified several geographical clusters of fever with significant spatial correlation (r=0.67) with the number of confirmed COVID-19 cases, especially in the urban centres of prefectural capital cities. Conclusions Given that there are still several high-risk areas measured by EBSIR, careful discussion on which areas should be reopened at the end of the state of emergency is urgently required using real-time SNS system to monitor the nationwide epidemic.
KW - COVID-19
KW - epidemiology
KW - health policy
KW - infectious diseases
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U2 - 10.1136/bmjopen-2020-042002
DO - 10.1136/bmjopen-2020-042002
M3 - Article
C2 - 33589454
AN - SCOPUS:85100929155
SN - 2044-6055
VL - 11
JO - BMJ open
JF - BMJ open
IS - 2
M1 - e042002
ER -
