Underestimation of COVID-19 cases in Japan: an analysis of RT-PCR testing for COVID-19 among 47 prefectures in Japan
Authors
Sawano, ToyoakiKotera, Yasuhiro
Ozaki, Akihiko
Murayama, Anju
Tanimoto, Tetsuya
Sah, Ranjit
Wang, Jiwei
Affiliation
Fukushima Medical University, JapanUniversity of Derby
Tohoku University, Japan
Medical Governance Research Institute, Minato-ku, Tokyo, Japan
National Public Health Laboratory, Kathmandu, Nepal
Fudan University, Shanghai, China
Issue Date
2020-06-19
Metadata
Show full item recordAbstract
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.Citation
Sawano, T., Kotera, Y., Ozaki, A., Murayama, A., Tanimoto, Y., Sah, R. and Wang, J. (2020). 'Underestimation of COVID-19 cases in Japan: An analysis of RT- 4 PCR testing for COVID-19 among 47 prefectures in Japan'. QJM: An International Journal of Medicine, pp, 1-26.Publisher
Oxford University PressJournal
QJM: An International Journal of MedicineDOI
10.1093/qjmed/hcaa209Additional Links
https://academic.oup.com/qjmedhttps://academic.oup.com/qjmed/article/doi/10.1093/qjmed/hcaa209/5861542?searchresult=1
Type
ArticleLanguage
enISSN
1460-2725EISSN
1460-2393ae974a485f413a2113503eed53cd6c53
10.1093/qjmed/hcaa209