Association between participation in the government subsidy programme for domestic travel and symptoms indicative of COVID-19 infection in Japan: cross-sectional study
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Abstract
To investigate the association between participation in government subsidies for domestic travel (subsidise up to 50% of all travel expenses) introduced nationally in Japan on 22 July 2020 and the incidence of symptoms indicative of COVID-19 infections.
Design
Cross-sectional analysis of nationally representative survey data.
Setting
Internet survey conducted between 25 August and 30 September 2020 in Japan. Sampling weights were used to calculate national estimates.
Participants
25 482 survey respondents (50.3% (12 809) women; mean (SD) age, 48.8 (17.4) years).
Main outcome measures
Incidence rate of five symptoms indicative of the COVID-19 infection (high fever, sore throat, cough, headache, and smell and taste disorder) within the past month of the survey, after adjustment for characteristics of individuals and prefecture fixed effects (effectively comparing individuals living in the same prefecture).
Results
At the time of the survey, 3289 (12.9%) participated in the subsidy programme. After adjusting for potential confounders, we found that participants in the subsidy programme exhibited higher incidence of high fever (adjusted rate, 4.7% for participants vs 3.7% for non-participants; adjusted OR (aOR) 1.83; 95% CI 1.34 to 2.48; p<0.001), sore throat (19.8% vs 11.3%; aOR 2.09; 95% CI 1.37 to 3.19; p=0.002), cough (19.0% vs 11.3%; aOR 1.96; 95% CI 1.26 to 3.01; p=0.008), headache (29.2% vs 25.5%; aOR 1.24; 95% CI 1.08 to 1.44; p=0.006) and smell and taste disorder (2.6% vs 1.8%; aOR 1.98; 95% CI 1.15 to 3.40; p=0.01) compared with non-participants. These findings remained qualitatively unaffected by additional adjustment for the use of 17 preventative measures (eg, social distancing, wearing masks and handwashing) and fear against the COVID-19 infection.
Conclusions
The participation of the government subsidy programme for domestic travel was associated with a higher probability of exhibiting symptoms indicative of the COVID-19 infection.
Article activity feed
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SciScore for 10.1101/2020.12.03.20243352: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources 25 All analyses were conducted using Stata version 15 (College Station, TX; StataCorp LLC.). StataCorpsuggested: (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:Our study has limitations. First, as with any observational study, we could not fully account for unmeasured confounders, and our study was unable to identify the exact mechanisms of the …
SciScore for 10.1101/2020.12.03.20243352: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources 25 All analyses were conducted using Stata version 15 (College Station, TX; StataCorp LLC.). StataCorpsuggested: (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:Our study has limitations. First, as with any observational study, we could not fully account for unmeasured confounders, and our study was unable to identify the exact mechanisms of the association between the subsidy program participation and increased incidence rates of COVID-19-like symptoms. Second, given the cross-sectional design of our study, we could not identify the temporal relationship between the subsidy program and the incidence of the COVID-19-like symptoms. Instead of the government subsidy causing the infection of the COVID-19, it was also possible that individuals who had experienced COVID-19-like symptoms were more likely to utilize the program and travel domestically. However, this explanation may be unlikely given that travel agents and hotels have been introducing strict protocols to ensure that nobody with the COVID-19-like symptoms to use their services, and individuals who spread the virus are likely to face criticism and stigma in Japan incentivizing people with suspected symptoms to stay at home.28 Third, it is likely that some individuals who reported five COVID-19-like symptoms had illnesses that were not COVID-19, as we were unable to collect the data on the confirmed diagnosis of COVID-19 infection (e.g., diagnosis using the PCR test). However, smell and taste disorders, one of the outcomes we used, are known to be highly specific (90% specificity) for the COVID-19 diagnosis,15,26 suggesting these symptoms would be good proxies of the incidence ...
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.
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SciScore for 10.1101/2020.12.03.20243352: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources 25 All analyses were conducted using Stata version 15 (College Station, TX; StataCorp LLC.). StataCorpsuggested: (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:
Our study has limitations. First, as with any observational …
SciScore for 10.1101/2020.12.03.20243352: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources 25 All analyses were conducted using Stata version 15 (College Station, TX; StataCorp LLC.). StataCorpsuggested: (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:
Our study has limitations. First, as with any observational study, we could not fully account for unmeasured confounders, and our study was unable to identify the exact mechanisms of the association between the subsidy program participation and increased incidence rates of COVID19-like symptoms. Second, given the cross-sectional design of our study, we could not identify the temporal relationship between the subsidy program and the incidence of the COVID-19-like symptoms. Instead of the government subsidy causing the infection of the COVID-19, it was also possible that individuals who had experienced COVID-19-like symptoms were more likely to utilize the program and travel domestically. However, this explanation may be unlikely given that travel agents and hotels have been introducing strict protocols to ensure that nobody with the COVID-19-like symptoms to use their services, and individuals who spread the virus are likely to face criticism and stigma in Japan incentivizing people with suspected symptoms to stay at home.28 Third, it is likely that some individuals who reported five COVID-19-like symptoms had illnesses that were not COVID-19, as we were unable to collect the data on the confirmed diagnosis of COVID-19 infection (e.g., diagnosis using the PCR test). However, smell and taste disorders, one of the outcomes we used, are known to be highly specific (90% specificity) for the COVID-19 diagnosis,15,26 suggesting these symptoms would be good proxies of the incidence o...
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.
About SciScore
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