Open AccessBehavioral factors associated with SARS‐CoV‐2 infection in Japan
Author(s) -
Arashiro Takeshi,
Arima Yuzo,
Muraoka Hirokazu,
Sato Akihiro,
Oba Kunihiro,
Uehara Yuki,
Arioka Hiroko,
Yanai Hideki,
Yanagisawa Naoki,
Nagura Yoshito,
Kato Yasuyuki,
Kato Hideaki,
Ueda Akihiro,
Ishii Koji,
Ooki Takao,
Oka Hideaki,
Nishida Yusuke,
Stucky Ashley,
Miyahara Reiko,
Smith Chris,
Hibberd Martin,
Ariyoshi Koya,
Suzuki Motoi
Publication year - 2022
Publication title -
influenza and other respiratory viruses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.743
H-Index - 57
eISSN - 1750-2659
pISSN - 1750-2640
DOI - 10.1111/irv.12992
Subject(s) - medicine , interquartile range , covid-19 , odds ratio , demography , infection control , young adult , environmental health , virology , surgery , outbreak , infectious disease (medical specialty) , disease , sociology
Background The relative burden of COVID‐19 has been less severe in Japan. One reason for this may be the uniquely strict restrictions imposed upon bars/restaurants. To assess if this approach was appropriately targeting high‐risk individuals, we examined behavioral factors associated with SARS‐CoV‐2 infection in the community. Methods This multicenter case–control study involved individuals receiving SARS‐CoV‐2 testing in June–August 2021. Behavioral exposures in the past 2 weeks were collected via questionnaire. SARS‐CoV‐2 PCR‐positive individuals were cases, while PCR‐negative individuals were controls. Results The analysis included 778 individuals (266 [34.2%] positives; median age [interquartile range] 33 [27–43] years). Attending three or more social gatherings was associated with SARS‐CoV‐2 infection (adjusted odds ratio [aOR] 2.00 [95% CI 1.31–3.05]). Attending gatherings with alcohol (aOR 2.29 [1.53–3.42]), at bars/restaurants (aOR 1.55 [1.04–2.30]), outdoors/at parks (aOR 2.87 [1.01–8.13]), at night (aOR 2.07 [1.40–3.04]), five or more people (aOR 1.81 [1.00–3.30]), 2 hours or longer (aOR 1.76 [1.14–2.71]), not wearing a mask during gatherings (aOR 4.18 [2.29–7.64]), and cloth mask use (aOR 1.77 [1.11–2.83]) were associated with infection. Going to karaoke (aOR 2.53 [1.25–5.09]) and to a gym (aOR 1.87 [1.11–3.16]) were also associated with infection. Factors not associated with infection included visiting a cafe with others, ordering takeout, using food delivery services, eating out by oneself, and work/school/travel‐related exposures including teleworking. Conclusions We identified multiple behavioral factors associated with SARS‐CoV‐2 infection, many of which were in line with the policy/risk communication implemented in Japan. Rapid assessment of risk factors can inform decision making.