Effect of COVID-19 infection related experiences on outing behaviors when a state of emergency is declared: a cohort study

  1. Takahiro Mori
  2. Tomohisa Nagata
  3. Kazunori Ikegami
  4. Ayako Hino
  5. Seiichiro Tateishi
  6. Mayumi Tsuji
  7. Shinya Matsuda
  8. Yoshihisa Fujino
  9. Koji Mori
  10. the CORoNaWork project

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Abstract

Background

Restricting the movement of the public to gathering places and limiting close physical contact are effective measures against COVID-19 infection. In Japan, states of emergency have been declared in specific prefectures to reduce public movement and control COVID-19 transmission. We investigated how COVID-19 infection related experiences including people with a history of infection, people with a history of close contact, and people whose acquaintances have been infected, affected self-restraint related to outing behaviors during the second state of emergency in Japan.

Methods

A prospective cohort study was conducted among workers aged 20–65 years using data from an internet survey. The baseline survey was conducted on December 22–25, 2020, and a follow-up survey was on February 18–19, 2021. There were 19,941 participants who completed both surveys and were included in the final analysis. We identified eight outing behaviors: (1) eating out (4 people or fewer); (2) eating out (5 people or more); (3) gathering with friends and colleagues; (4) day trip; (5) overnight trip (excluding visiting home); (6) visiting home; (7) shopping for daily necessities; and (8) shopping for other than daily necessities. We set self-restraint regarding each outing behavior after the second state of emergency was declared in January 2021 as the dependent variable, and COVID-19 infection related experiences as independent variables. Odds ratios were estimated using multilevel logistic regression analyses.

Results

Significant differences by COVID-19 infection related experiences were identified: compared to people without COVID-19 related experiences, people with a history of COVID-19 were less likely self-restraint from most outing behaviors. People whose acquaintance had been diagnosed with COVID-19 were significantly more likely to refrain from most outing behaviors. There was no significant difference in any outing behaviors for people with a history of close contact only.

Conclusions

To maximize the effect of a state of emergency, health authorities should disseminate information for each person in the target population, taking into account potential differences related to the COVID-19 infection related experiences.

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  1. ScreenIT

    SciScore for 10.1101/2021.08.20.21262364: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The present study was approved by the Ethics Committee of the University of Occupational and Environmental Health, Japan (Approval numbers: R2-079 and R3-006).
    Consent: Informed consent was obtained in the form of the website from all participants.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All analyses were conducted using Stata Statistical Software (Release 16; StataCorp LLC, College Station, TX, USA).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are several limitations to this study. First, we conducted an internet survey, which includes the possibility of selection bias. However, sampling was balanced by sex, age, occupation, and area of residence at the start of the study to reduce the potential for bias. Second, the follow-up survey was conducted two months after the baseline survey. We classified the familiarity of infection using data from the baseline survey, so there may have been new people infected in the intervening two months. However, the ratio in each category implies that the number of newly applicable people was very small, and unlikely to significantly affect the results. Third, the outcome of interest in this survey was a decrease in self-restraint, but those who were not originally outing at all before the second state of emergency was declared were included in the group who did not respond to self-restraint. However, the movement of people during the non-declaration period does not appear to have been significantly suppressed compared with before the COVID-19 epidemic [13]. This implies that there would have been few people in this category who did not go out at all during the non-declaration period.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2021.08.20.21262364 on medRxiv