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Volume 27, Number 3—March 2021
Research

Excess All-Cause Deaths during Coronavirus Disease Pandemic, Japan, January–May 20201

Takayuki Kawashima2, Shuhei Nomura2, Yuta Tanoue, Daisuke Yoneoka, Akifumi Eguchi, Chris Fook Sheng Ng, Kentaro Matsuura, Shoi Shi, Koji Makiyama, Shinya Uryu, Yumi Kawamura, Shinichi Takayanagi, Stuart Gilmour, Hiroaki Miyata, Tomimasa Sunagawa, Takuri Takahashi, Yuuki Tsuchihashi, Yusuke Kobayashi, Yuzo Arima, Kazuhiko Kanou, Motoi Suzuki, and Masahiro HashizumeComments to Author 
Author affiliations: Tokyo Institute of Technology, Tokyo, Japan (T. Kawashima); Keio University, Tokyo (T. Kawashima, S. Nomura, Y. Tanoue, D. Yoneoka, A. Eguchi, S. Shi, Y. Kawamura, H. Miyata); The University of Tokyo, Tokyo (S. Nomura, D. Yoneoka, S. Shi, M. Hashizume); Waseda University, Tokyo (Y. Tanoue); St. Luke’s International University, Tokyo (D. Yoneoka, S. Gilmour); Chiba University, Chiba, Japan (A. Eguchi); Nagasaki University, Nagasaki, Japan (C.F.S. Ng); Tokyo University of Science, Tokyo (K. Matsuura); HOXO-M Inc., Tokyo (K. Matsuura, K. Makiyama, S. Takayanagi); RIKEN Center for Biosystems Dynamics Research, Osaka, Japan (S. Shi); National Institute for Environmental Studies, Tokyo (S. Uryu); RIKEN Center for Sustainable Resource Science, Saitama, Japan (Y. Kawamura); National Institute of Infectious Diseases, Tokyo (T. Sunagawa, T. Takahashi, Y. Tsuchihashi, Y. Kobayashi, Y. Arima, K. Kanou, M. Suzuki)

Main Article

Table

Number of observed and excess all-cause deaths, and reported number of COVID-19 deaths, Japan, December 30, 2019–May 31, 2020*

Prefecture No. all-cause deaths
 No. COVID-19 deaths No. tests
Observed Excess Percentage
Hokkaido 27,661 0–115 0.00–0.42 86 14,000
Aomori 7,713 0–36 0.00–0.47 1 850
Iwate 7,588 0–81 0.00–1.07 0 662
Miyagi 10,725 0–57 0.00–0.53 1 2,944
Akita 6,656 0–72 0.00–1.08 0 933
Yamagata 6,606 0–49 0.00–0.74 0 2,659
Fukushima 10,714 0–34 0.00–0.32 0 4,452
Ibaraki 14,443 1–87 0.01–0.60 10 4,628
Tochigi 9,623 13–137 0.14–1.42 0 3,871
Gunma 10,175 31–146 0.30–1.43 19 3,655
Saitama 30,426 14–334 0.05–1.10 48 20,735
Chiba 26,841 51–253 0.19–0.94 45 14,688
Tokyo 52,350 32–330 0.06–0.63 305 38,566
Kanagawa 36,174 0–89 0.00–0.25 82 9,446
Niigata 12,704 0–0 0.00–0.00 0 4,180
Toyama 5,689 18–120 0.32–2.11 22 3,144
Ishikawa 5,538 0–33 0.00–0.60 25 2,723
Fukui 4,045 0–47 0.00–1.16 8 2,631
Yamanashi 4,276 0–60 0.00–1.40 1 3,877
Nagano 11,148 0–29 0.00–0.26 0 2,714
Gifu 9,889 0–31 0.00–0.31 7 3,610
Shizuoka 18,554 2–109 0.01–0.59 1 3,521
Aichi 30,583 7–214 0.02–0.70 34 9,970
Mie 9,056 0–57 0.00–0.63 1 2,505
Shiga 5,606 0–65 0.00–1.16 1 1,856
Kyoto 11,814 0–84 0.00–0.71 17 7,933
Osaka 40,017 6–277 0.01–0.69 83 31,156
Hyogo 25,490 0–69 0.00–0.27 42 11,128
Nara 6,474 21–107 0.32–1.65 2 2,545
Wakayama 5,547 0–66 0.00–1.19 3 3,701
Tottori 3,156 0–44 0.00–1.39 0 1,338
Shimane 4,203 0–73 0.00–1.74 0 1,125
Okayama 9,493 0–75 0.00–0.79 0 1,705
Hiroshima 13,250 0–45 0.00–0.34 3 6,907
Yamaguchi 8,171 0–50 0.00–0.61 0 1,701
Tokushima 4,339 4–71 0.09–1.64 1 741
Kagawa 5,374 8–135 0.15–2.51 0 2,187
Ehime 7,913 0–50 0.00–0.63 4 2,074
Kochi 4,383 0–58 0.00–1.32 3 1,793
Fukuoka 23,346 0–77 0.00–0.33 26 12,634
Saga 4,412 0–53 0.00–1.20 0 1,417
Nagasaki 7,686 0–85 0.00–1.11 1 2,754
Kumamoto 9,340 0–43 0.00–0.46 3 3,924
Oita 6,279 0–52 0.00–0.83 1 3,988
Miyazaki 6,101 0–120 0.00–1.97 0 1,368
Kagoshima 9,309 0–59 0.00–0.63 0 1,859
Okinawa
 5,334
 0–44
 0.00–0.82
 6
 2,863
Total 596,214 208–4,322 0.03–0.72 892 269,661

*The national-level cumulative number of excess all-cause deaths was calculated by summing the excess all-cause deaths of 47 prefectures (25). COVID-19, coronavirus disease.

Main Article

References
  1. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020 [cited 2020 Aug 4]. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020
  2. Lisboa Bastos  M, Tavaziva  G, Abidi  SK, Campbell  JR, Haraoui  LP, Johnston  JC, et al. Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis. BMJ. 2020;370:m2516. DOIPubMedGoogle Scholar
  3. Kucirka  LM, Lauer  SA, Laeyendecker  O, Boon  D, Lessler  J. Variation in false-negative rate of reverse transcriptase polymerase chain reaction-based SARS-CoV-2 tests by time since exposure. Ann Intern Med. 2020;173:262–7. DOIPubMedGoogle Scholar
  4. Pulla  P. What counts as a covid-19 death? BMJ. 2020;370:m2859. DOIPubMedGoogle Scholar
  5. Kaufman  HW, Chen  Z, Niles  J, Fesko  Y. Changes in the number of US patients with newly identified cancer before and during the coronavirus disease 2019 (COVID-19) pandemic. JAMA Netw Open. 2020;3:e2017267. DOIPubMedGoogle Scholar
  6. Garcia  S, Albaghdadi  MS, Meraj  PM, Schmidt  C, Garberich  R, Jaffer  FA, et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol. 2020;75:2871–2. DOIPubMedGoogle Scholar
  7. BBC News. Coronavirus: older people being ‘airbrushed’ out of virus figures [cited 2020 Sep 3]. https://www.bbc.com/news/uk-52275823
  8. Farrington  CP, Andrews  NJ, Beale  AD, Catchpole  MA. A statistical algorithm for the early detection of outbreaks of infectious disease. J R Stat Soc Ser A Stat Soc. 1996;159:547–63. DOIGoogle Scholar
  9. Noufaily  A, Enki  DG, Farrington  P, Garthwaite  P, Andrews  N, Charlett  A. An improved algorithm for outbreak detection in multiple surveillance systems. Stat Med. 2013;32:1206–22. DOIPubMedGoogle Scholar
  10. Michelozzi  P, de’Donato  F, Scortichini  M, Pezzotti  P, Stafoggia  M, De Sario  M, et al. Temporal dynamics in total excess mortality and COVID-19 deaths in Italian cities. BMC Public Health. 2020;20:1238. DOIPubMedGoogle Scholar
  11. Krieger  N, Chen  JT, Waterman  PD. Excess mortality in men and women in Massachusetts during the COVID-19 pandemic. Lancet. 2020;395:1829. DOIPubMedGoogle Scholar
  12. Banerjee  A, Pasea  L, Harris  S, Gonzalez-Izquierdo  A, Torralbo  A, Shallcross  L, et al. Estimating excess 1-year mortality associated with the COVID-19 pandemic according to underlying conditions and age: a population-based cohort study. Lancet. 2020;395:1715–25. DOIPubMedGoogle Scholar
  13. Burki  T. England and Wales see 20 000 excess deaths in care homes. Lancet. 2020;395:1602. DOIPubMedGoogle Scholar
  14. Centers for Disease Control and Prevention. Preliminary estimate of excess mortality during the COVID-19 outbreak—New York City, March 11–May 2, 2020 [cited 2020 Aug 5]. https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e5.htm
  15. Vestergaard  LS, Nielsen  J, Richter  L, Schmid  D, Bustos  N, Braeye  T, et al.; ECDC Public Health Emergency Team for COVID-19. Excess all-cause mortality during the COVID-19 pandemic in Europe - preliminary pooled estimates from the EuroMOMO network, March to April 2020. Euro Surveill. 2020;25:2001214. DOIPubMedGoogle Scholar
  16. Charu  V, Simonsen  L, Lustig  R, Steiner  C, Viboud  C. Mortality burden of the 2009-10 influenza pandemic in the United States: improving the timeliness of influenza severity estimates using inpatient mortality records. Influenza Other Respir Viruses. 2013;7:863–71. DOIPubMedGoogle Scholar
  17. Vestergaard  LS, Nielsen  J, Krause  TG, Espenhain  L, Tersago  K, Bustos Sierra  N, et al. Excess all-cause and influenza-attributable mortality in Europe, December 2016 to February 2017. Euro Surveill. 2017;22:30506. DOIPubMedGoogle Scholar
  18. Ministry of Health. Labour and Welfare. Press conference on COVID-19 on December 11, 2020 [cited 2020 Sep 3]. https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/newpage_00032.html
  19. Cabinet Secretariat. [COVID-19] press conference by the Prime Minister regarding the declaration of a state of emergency [cited 2020 Aug 4]. https://japan.kantei.go.jp/98_abe/statement/202004/_00001.html
  20. Ministry of Health. Labour and Welfare. Outline of vital statistics in Japan [cited 2020 Aug 4]. https://www.mhlw.go.jp/english/database/db-hw/outline/index.html
  21. Centers for Disease Control and Prevention. Excess deaths associated with COVID-19 [cited 2020 Aug 4]. https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
  22. Bédubourg  G, Le Strat  Y. Evaluation and comparison of statistical methods for early temporal detection of outbreaks: A simulation-based study. PLoS One. 2017;12:e0181227. DOIPubMedGoogle Scholar
  23. Cameron  AC, Trivedi  PK. Regression-based tests for overdispersion in the Poisson model. J Econom. 1990;46:347–64. DOIGoogle Scholar
  24. National Institute of Infectious Diseases. Report week correspondence table [in Japanese] [cited 2020 Aug 4]. https://www.niid.go.jp/niid/ja/calendar.html
  25. Toyo Keizai Online. Coronavirus disease (COVID-19) situation report in Japan. 2020 [cited 2020 Aug 5]. https://toyokeizai.net/sp/visual/tko/covid19/en.html
  26. Olson  DR, Heffernan  RT, Paladini  M, Konty  K, Weiss  D, Mostashari  F. Monitoring the impact of influenza by age: emergency department fever and respiratory complaint surveillance in New York City. PLoS Med. 2007;4:e247. DOIPubMedGoogle Scholar
  27. The Economist. Tracking covid-19 excess deaths across countries [cited 2020 Sep 3]. https://www.economist.com/graphic-detail/2020/07/15/tracking-covid-19-excess-deaths-across-countries
  28. Ministry of Health. Labour and Welfare. Message to the public about holding events [in Japanese] [cited 2020 Sep 7]. https://www.mhlw.go.jp/stf/seisakunitsuite/newpage_00002.html#20
  29. The Japan Times. Japan traffic accidents fall in first half amid pandemic [cited 2020 Aug 4]. https://www.japantimes.co.jp/news/2020/07/28/national/japan-traffic-accidents-fall-first-half-amid-pandemic/
  30. Ministry of Health. Labour and Welfare. Domestic incidence of new coronavirus infections (at 18:00 pm on May 27, 2020) [in Japanese] [cited 2020 Sep 3]. https://www.mhlw.go.jp/content/10906000/000634824.pdf
  31. Weinberger  DM, Chen  J, Cohen  T, Crawford  FW, Mostashari  F, Olson  D, et al. Estimation of excess deaths associated with the COVID-19 pandemic in the United States, March to May 2020. JAMA Intern Med. 2020;180:1336–44. DOIPubMedGoogle Scholar

Main Article

1A part of the estimates of excess all-cause deaths through May 2020, including those for all ages, reported in this article was also reported on the website of the National Institute of Infectious Diseases in Japan on August 31, 2020 (https://www.niid.go.jp/niid/ja/from-idsc/493-guidelines/9835-excess-mortality-20aug.html).

2These first authors contributed equally to this article.

Page created: December 22, 2020
Page updated: February 21, 2021
Page reviewed: February 21, 2021
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