Underestimation of COVID-19 cases in Japan: an analysis of RT-PCR testing for COVID-19 among 47 prefectures in Japan
Journal article
Authors | Sawano, Toyoaki, Kotera, Y., Ozaki, Akihiko, Murayama, Anju, Tanimoto, Tetsuya, Sah, Ranjit and Wang, Jiwei |
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Abstract | Under the unique Japanese policy to restrict reverse transcriptase-polymerase chain reaction (RT-PCR) testing against severe acute respiratory syndrome coronavirus 2, a nationwide number of its confirmed cases and mortality remains to be low. Yet the information is lacking on geographical differences of these measures and their associated factors. Evaluation of prefecture-based geographical differences and associated predictors for the incidence and number of RT-PCR tests for COVID-19. Cross-sectional study using regression and correlation analysis. We retrieved domestic laboratory-confirmed cases, deaths, and the number of RT-PCR testing for COVID-19 from January 15 to April 6, 2020 in 47 prefectures in Japan, using publicly-available data by the Ministry of Health, Labour and Welfare. We did descriptive analyses of these three measures and identified significant predictors for the incidence and RT-PCR testing through multiple regression analyses and correlates with the number of deaths through correlation analysis. The median prefectural-level incidence and number of RT-PCR testing per 100,000 population were 1.14 and 38.6, respectively. Multiple regression analyses revealed that significant predictors for the incidence were prefectural-level population (p < 0.001) and the number of RT-PCR testing (p = 0.03); and those for RT-PCR testing were the incidence (p = 0.025), available beds (p = 0.045) and cluster infections (p = 0.034). Considering bidirectional association between the incidence and RT-PCR testing, there may have been an underdiagnosed population for the infection. The restraint policy for RT-PCR testing should be revisited to meet the increasing demand under the COVID-19 epidemic. |
Keywords | public health; Epidemiology; emergency medicine |
Year | 2020 |
Journal | QJM: An International Journal of Medicine |
Publisher | Oxford University Press |
ISSN | 1460-2725 |
1460-2393 | |
Digital Object Identifier (DOI) | https://doi.org/10.1093/qjmed/hcaa209 |
Web address (URL) | http://hdl.handle.net/10545/624958 |
hdl:10545/624958 | |
Publication dates | 19 Jun 2020 |
Publication process dates | |
Deposited | 07 Jul 2020, 14:50 |
Accepted | Jun 2020 |
Contributors | Fukushima Medical University, Japan, University of Derby, Tohoku University, Japan, Medical Governance Research Institute, Minato-ku, Tokyo, Japan, National Public Health Laboratory, Kathmandu, Nepal and Fudan University, Shanghai, China |
File | File Access Level Open |
File |
https://repository.derby.ac.uk/item/934w7/underestimation-of-covid-19-cases-in-japan-an-analysis-of-rt-pcr-testing-for-covid-19-among-47-prefectures-in-japan
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