tetano
Editor, Senior Moderator
Int J Epidemiol
. 2021 Oct 28;dyab216.
doi: 10.1093/ije/dyab216. Online ahead of print.
Reduced mortality during the COVID-19 outbreak in Japan, 2020: a two-stage interrupted time-series design
Daisuke Onozuka[SUP] 1 [/SUP], Yuta Tanoue[SUP] 2 3 [/SUP], Shuhei Nomura[SUP] 3 4 [/SUP], Takayuki Kawashima[SUP] 3 5 [/SUP], Daisuke Yoneoka[SUP] 3 4 6 [/SUP], Akifumi Eguchi[SUP] 3 7 [/SUP], Chris Fook Sheng Ng[SUP] 8 [/SUP], Kentaro Matsuura[SUP] 9 10 [/SUP], Shoi Shi[SUP] 11 12 [/SUP], Koji Makiyama[SUP] 10 [/SUP], Shinya Uryu[SUP] 13 [/SUP], Yumi Kawamura[SUP] 14 [/SUP], Shinichi Takayanagi[SUP] 10 [/SUP], Stuart Gilmour[SUP] 6 [/SUP], Takehiko I Hayashi[SUP] 15 [/SUP], Hiroaki Miyata[SUP] 3 [/SUP], Francesco Sera[SUP] 16 [/SUP], Tomimasa Sunagawa[SUP] 17 [/SUP], Takuri Takahashi[SUP] 17 [/SUP], Yuuki Tsuchihashi[SUP] 17 [/SUP], Yusuke Kobayashi[SUP] 17 [/SUP], Yuzo Arima[SUP] 17 [/SUP], Kazuhiko Kanou[SUP] 17 [/SUP], Motoi Suzuki[SUP] 17 [/SUP], Masahiro Hashizume[SUP] 4 [/SUP]
Affiliations
Abstract
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.
Keywords: All-cause death; COVID-19; Japan; excess mortality; two-stage interrupted time-series design.
. 2021 Oct 28;dyab216.
doi: 10.1093/ije/dyab216. Online ahead of print.
Reduced mortality during the COVID-19 outbreak in Japan, 2020: a two-stage interrupted time-series design
Daisuke Onozuka[SUP] 1 [/SUP], Yuta Tanoue[SUP] 2 3 [/SUP], Shuhei Nomura[SUP] 3 4 [/SUP], Takayuki Kawashima[SUP] 3 5 [/SUP], Daisuke Yoneoka[SUP] 3 4 6 [/SUP], Akifumi Eguchi[SUP] 3 7 [/SUP], Chris Fook Sheng Ng[SUP] 8 [/SUP], Kentaro Matsuura[SUP] 9 10 [/SUP], Shoi Shi[SUP] 11 12 [/SUP], Koji Makiyama[SUP] 10 [/SUP], Shinya Uryu[SUP] 13 [/SUP], Yumi Kawamura[SUP] 14 [/SUP], Shinichi Takayanagi[SUP] 10 [/SUP], Stuart Gilmour[SUP] 6 [/SUP], Takehiko I Hayashi[SUP] 15 [/SUP], Hiroaki Miyata[SUP] 3 [/SUP], Francesco Sera[SUP] 16 [/SUP], Tomimasa Sunagawa[SUP] 17 [/SUP], Takuri Takahashi[SUP] 17 [/SUP], Yuuki Tsuchihashi[SUP] 17 [/SUP], Yusuke Kobayashi[SUP] 17 [/SUP], Yuzo Arima[SUP] 17 [/SUP], Kazuhiko Kanou[SUP] 17 [/SUP], Motoi Suzuki[SUP] 17 [/SUP], Masahiro Hashizume[SUP] 4 [/SUP]
Affiliations
- PMID: 34718594
- DOI: 10.1093/ije/dyab216
Abstract
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.
Keywords: All-cause death; COVID-19; Japan; excess mortality; two-stage interrupted time-series design.