Nomura Shuhei, Kawashima Takayuki, Yoneoka Daisuke, Tanoue Yuta, Eguchi Akifumi, Gilmour Stuart, Hashizume Masahiro
Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Inj Epidemiol. 2021 Jan 18;7(1):66. doi: 10.1186/s40621-020-00294-7.
In Japan, the latest estimates of excess all-cause deaths through January to July 2020 showed that the overall (direct and indirect) mortality burden from the Coronavirus Disease 2019 (COVID-19) in Japan was relatively low compared to Europe and the United States. However, consistency between the reported number of COVID-19 deaths and excess all-cause deaths was limited across prefectures, suggesting the necessity of distinguishing the direct and indirect consequences of COVID-19 by cause-specific analysis. To examine whether deaths from road injuries decreased during the COVID-19 pandemic in Japan, consistent with a possible reduction of road transport activity connected to Japan's state of emergency declaration, we estimated the exiguous deaths from road injuries in each week from January to September 2020 by 47 prefectures.
To estimate the expected weekly number of deaths from road injuries, a quasi-Poisson regression was applied to daily traffic fatalities data obtained from Traffic Accident Research and Data Analysis, Japan. We set two thresholds, point estimate and lower bound of the two-sided 95% prediction interval, for exiguous deaths, and report the range of differences between the observed number of deaths and each of these thresholds as exiguous deaths.
Since January 2020, in a few weeks the observed deaths from road injuries fell below the 95% lower bound, such as April 6-12 (exiguous deaths 5-21, percent deficit 2.82-38.14), May 4-10 (8-23, 21.05-43.01), July 20-26 (12-29, 30.77-51.53), and August 3-9 (3-20, 7.32-34.41). However, those less than the 95% lower bound were also observed in weeks in the previous years.
The number of road traffic fatalities during the COVID-19 pandemic in Japan has decreased slightly, but not significantly, in several weeks compared with the average year. This suggests that the relatively small changes in excess all-cause mortality observed in Japan during the COVID-19 pandemic could not be explained simply by an offsetting reduction in traffic deaths. Considering a variety of other indirect effects, evaluating an independent, unbiased measure of COVID-19-related mortality burden could provide insight into the design of future broad-based infectious disease counter-measures and offer lessons to other countries.
在日本，对2020年1月至7月全因超额死亡的最新估计表明，与欧洲和美国相比，日本2019冠状病毒病（COVID-19）的总体（直接和间接）死亡负担相对较低。然而，各都道府县上报的COVID-19死亡人数与全因超额死亡人数之间的一致性有限，这表明有必要通过特定病因分析来区分COVID-19的直接和间接后果。为了研究在日本COVID-19大流行期间道路伤害死亡人数是否减少，这与因日本发布紧急声明可能导致的道路运输活动减少相一致，我们估算了2020年1月至9月每周47个都道府县的道路伤害死亡人数。
为了估算道路伤害的预期每周死亡人数，我们对从日本交通事故研究与数据分析中心获得的每日交通死亡数据应用了拟泊松回归。我们为死亡人数设置了两个阈值，即双侧95%预测区间的点估计值和下限，并将观察到的死亡人数与每个阈值之间的差异范围报告为死亡人数。
自2020年1月以来，在一些周内，观察到的道路伤害死亡人数低于95%下限，如4月6日至12日（死亡人数5 - 21，赤字百分比2.82 - 38.14）、5月4日至10日（8 - 23，21.05 - 43.01）、7月20日至26日（12 - 29，30.77 - 51.53）以及8月3日至9日（3 - 20，7.32 - 34.41）。然而，在往年的一些周内也观察到了低于95%下限的情况。
与平均年份相比，日本COVID-19大流行期间的道路交通死亡人数在几周内略有下降，但并不显著。这表明在日本COVID-19大流行期间观察到的全因超额死亡率相对较小的变化不能简单地通过交通死亡人数的抵消性减少来解释。考虑到各种其他间接影响，评估与COVID-19相关的死亡负担的独立、无偏衡量指标可以为未来广泛的传染病应对措施的设计提供见解，并为其他国家提供经验教训。
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