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Wellness

The Covid-19 Pandemic: An Update

Japan’s two largest “Covid-19 cases” waves were autumn 2022 and late 2022 to early 2023.

The same pattern applies to Japan’s daily new deaths.

For charts, please click here.

In summary, Japan’s relatively good 2020 and 2021 experience deteriorated during 2022 into 2023.

It is important therefore to update the data that appeared in our book: Wellness Topics: insights from Japan, section two, chapter one: “Why Japan has had relatively low Covid-19 deaths”.

G7 Countries plus South Korea. Covid-19-related Deaths per One Million Population

USA3,642
UK3,389
Italy3,261
France2,556
Germany2,182
Canada1,538
Japan595
S. Korea700

In terms of policy and people’s behaviors in Japan, a recent research study concluded that the intervention effects e.g. the requirements of the State of Emergencies (SOE) and quasi-SOEs, had positive effects on the adoption of preventive behaviors among individuals, including handwashing, working from home, avoiding traveling and social events.

However, the contribution of information effects, alerting people to the virus threat, was much larger than that of intervention effects, suggesting the importance of how and when information should be communicated to the public to prevent the spread of infection. (1, 2, 3, 4, 5)

We await studies examining the importance of the pre-pandemic health of the respective populations, e.g., with respect to the prevalence of obesity, diabetes, kidney disease, and so on.

References:

  1. Intervention and information effects at the individual level during the COVID-19 pandemic in Japan, by Mateus Silva Chang, Isamu Yamamoto, November 2023
  2. Japan’s voluntary lockdown, by Watanabe T, Yabu T., June 2021
  3. Japan’s voluntary lockdown: further evidence based on age-specific mobile location data, by Watanabe T, Yabu T., 2021
  4. Covid-19 Lockdown Cost/Benefits: A Critical Assessment of the Literature, by Allen DW, 2022
  5. The Immediate Effect of COVID-19 Policies on Social-Distancing Behavior in the United States, by Abouk R, Heydari B, 2021
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Wellness

Estimating Excess Mortality due to the Covid-19 Pandemic

A study published in The Lancet (1) estimates that globally over 2020-21, 18.2 million excess deaths occurred. 191 countries and territories were included.

Japan’s relatively good experience is shown below.

Estimated excess mortality rate per 100,000 (1)

Global120.3
Western Europe140.0
Denmark94.1
France124.2
Germany120.5
Italy227.4
Spain186.7
Sweden91.2
United Kingdom126.8
USA179.3
Canada60.5
Japan44.1
Brazil186.9
India152.5

Excess mortality due to the Covid-19 pandemic is defined as the net difference between the number of deaths during the pandemic (measured by observed or estimated all-cause mortality) and the number of deaths that would be expected based on past trends in all-cause mortality. The study adjusted for late registration and anomalies such as heat waves and used six models to estimate expected mortality.

In addition to estimation issues, the difference between excess mortality and reported Covid-19 deaths might be a function of underdiagnosis due to insufficient testing, reporting challenges, or higher than expected mortality from other diseases due to pandemic-related changes in behaviors or reduced access to health care or other essential services. (1)

For more data, please see the original article or click here.

References:

  1. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21, by Dr Haidong Wang, University of Washington, published in The Lancet, March 2022
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Wellness

Covid-19, Japan’s Elderly, Exercise, and Mental Health

A study (1) examined the prevalence of exercise as a coping strategy among Japanese community-dwelling older adults and its impact on their psychological well-being during the COVID-19 pandemic. Spanning Japan’s first Covid-19 lockdown period, the study covered 618 community-dwelling older adults.

The study concluded: Older adults who walked to maintain their physical and mental health experienced better well-being than those who did not.

This is in line with established scientific research on the relationship between exercise and mental health.

A review (2) of over 1000 academic research studies over 1990-2020 looking at the relationship between exercise and mental health commented:

Physical health is clearly intertwined with mental health in a bidirectional fashion. Scientific evidence shows that changes in thinking patterns and behaviors affect neurological, endocrine, and immune systems. Conversely, disruption in these biological systems negatively impacts mental health.

As well as biological pathways – such as increasing brain neurotransmitters and improving hormone function involved in mental health, exercise appears to improve mental health through social and self-efficacy pathways,

Selected key conclusions are shown below.

Exercise and Mental Health: Move Your Mental Health study (2) selected conclusions
Does exercise and physical activity benefit mental health?
89% of all published peer-reviewed research between 1990 and 2020 found a positive, statistically significant relationship between exercise/physical activity and mental health.
How much exercise and how often?
Overall, three to five 30-45-minute moderate to vigorous exercise sessions per week appear to deliver optimal mental health benefits (3)
What type of exercise?
High-intensity exercise regimens are generally more effective than low-intensity regimens (4)
Mindfulness-based activities like yoga and tai chi, though they can be lower intensity forms of movement, deliver more mental health benefits than walking
What mental health outcomes are most impacted by exercise?
Exercise is strongly associated with general mental and emotional well-being including reduced stress, and improved mood and quality of life
Evidence strongly supports cardiovascular/aerobic exercise for reducing depression, showing medium to large effect sizes
Evidence shows moderate but reliable effect sizes for cardiovascular/aerobic exercise reducing symptoms in people with anxiety disorders
Yoga and other mindful exercises such as Tai Chi and Qigong show strong evidence for reducing symptoms of anxiety and depression
Source: Move Your Mental Health, (2) Conceptasia, January 2022

References:

  1. Exercise as a coping strategy and its impact on the psychological well-being of Japanese community-dwelling older adults during the COVID-19 pandemic: A longitudinal study, by Manami Ejiri, Hisashi Kawai, Takeshi Kera, Kazshige Ihara, Yoshinori Fujiwara, Yutaka Watanabe, Hirohiko Hirano, Hunkyung Kim, and Shuichi Obuchi, September 2021
  2. Move Your Mental Health, A review of the scientific evidence on the role of exercise and physical activity on mental health, by John W. Brick, mental foundation, May 2021
  3. Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study, by Chekroud, S. R., Gueorguieva, R., Zheutlin, A. B., Paulus, M., Krumholz, H. M., Krystal, J. H., & Chekroud, A. M., 2018
  4. Exercise in the treatment of clinical anxiety in general practice – a systematic review and meta-analysis, by Aylett, E., Small, N. & Bower, P., 2018
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Wellness

The 2020 Lockdown and the Missing Japanese Women Runners

The media reported a global running boom during the lockdowns of 2020. (1, 2, 3, 4)

However, recently released data for Japan show a decline in women’s participation 2020 versus 2018. (5) The survey has been conducted every two years since 1998.

On a variety of measures Japan’s running participation rate, 2020 versus 2018, has risen:

Participation rate (%), Running, Three frequency measures

 20182020
Once a week or more  
Overall5.35.6
Male7.88.7
Female2.82.6
Once a month or more  
Overall6.47.0
Once a year or more  
Overall9.310.2
Male12.914.9
Female5.85.6

Source: Sasakawa Sports Foundation, (5) Conceptasia, November 2021

However, the increasing participation rate, 2020 versus 2018, is entirely driven by men

Data by gender and age is available for the “Once a year or more” measure. The decline in participation of women in their thirties, 2020 versus 2018, is notably pronounced. The data is in the supporting paper, here.

An obvious observation is that with kindergartens and schools closed, those with young children would be forced to provide continuous care at home. This is likely to be most prevalent amongst parents in their thirties.

Time and more data will enable stronger conclusions.

Running is regarded as one of the best exercises for easing stress. (2) This reflects its rhythmic nature enabling experienced runners to get “into the zone.”

Unexpected childcare responsibilities and a loss of a stress-reduction technique could result in mental wellness issues for some Japanese women in their thirties.

References

  1. Asics: New study explores the world’s new-found love of running, June 2020. https://www.asics.com/za/en-za/blog/article/new-study-explores-the-world%27s-new-found-love-of-running
  2. Stylist: Running in lockdown: why have so many women turned to jogging for their mental health? https://www.stylist.co.uk/fitness-health/running-mental-health-lockdown/494980
  3. Runners World: 2020 Was a Crazy Running Year. Here’s the Data to Prove It, December 2020 https://www.runnersworld.com/news/a34949046/2020-year-in-running-data/
  4. Run Repeat: Exercise is Up 88% During COVID-19 [12,913 Person Study], August 2021. https://runrepeat.com/exercise-covid-19-study
  5. Sasakawa Sports Foundation, October 2021: Jogging / running estimated population, record high of 10.55 million https://re-how.net/all/1435656/
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Wellness

Ominous Indications for the Domestic Travel Recovery

Travel group JTB has published a survey on this year’s summer season (July 20 to August 31) domestic travel intentions. (1)

Domestic travel expenditures are forecast to be ¥1.32 trillion. The chart below puts this in context. 2021 is forecast to be down 59% versus the pre-covid 2012-2019 average expenditure of ¥3.22 trillion.

2020 summer season expenditures were ¥1.22 trillion.

Ominous indications include:

  1. Schools are on holiday for the full period this year, in contrast to 2020 when many schools stayed open for weeks to catch up with missed studies. Precluded last year, more families were expected to travel this year.
  2. International travel is still impractical for the second year. Holidaying domestically was expected to benefit.
  3. The survey included intentions by age group. The 60 and over group is now 70% vaccinated, and yet has the lowest “Will go/Will probably go” travel intentions at just 14%. The young, 29 and under, have the highest at 31%.

Pre-Covid-19, the summer season was some 20-25% of annual domestic trips.

In our book, “J-Wellness 2020: The economics, career options, and investment opportunities” we forecasted that inbound tourism would take five years, to 2025, to recover. It is beginning to look like domestic travel will need a similar length of time.

References:

  1. July Survey Predicts 40 million Domestic Tourists for Japan in Summer, Nippon.com, 6 August 2021
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Wellness

Suicides and Covid-19

Japan’s National Police Agency releases monthly data on suicides on a timely basis. Other countries are more reticent. The latest US data, for example, is 2018. Japanese suicides rose 3.7% in 2020, up by 750 people to 20,919. This was the first increase in 11 years.

How to interpret the data?

The Covid-19 pandemic and the associated government policy responses are an easy explanation.

The pandemic/policy responses have caused:

  1. An increase in unemployment, financial insecurity
  2. A deterioration in mental wellness resiliency due to social isolation, fear of infection, potential stigma, and victimization
  3. Stay-at-home lockdowns, confinement, heightened risks of domestic violence, child neglect/abuse
  4. Mental health services’ access problems
  5. Increased bereavement, intensified by separation issues

The above is in addition to 6) the exacerbation of already present mental illness, such as depression, post-traumatic stress disorder, etc.

However, the above just changes the question to:

What is the relative importance of the factors?

Has the pick-up in suicides been more, or less, than experts in the field expected?

To address these questions a model is needed. This is discussed and presented in our 8-page PDF article, link at the end, below.

Conclusions

Reflecting how employment, one’s company, remains at the core of identity in Japan, suicides are relatively sensitive to economic factors (proxied by the unemployment rate) even when modified for additional material factors.

Based on this modified unemployment rate model, the increase in the number of suicides in 2020 could have been over 1,000, rather than the 750 recorded.

Japanese unemployment peaked at 3.1% in October 2020 and had fallen to 2.9% in December.

To expect suicides in Japan to fall year-overt-year in 2021, we must hope for the 2021 annual unemployment rate to be below the 2.8% rate of 2020.

The full 8-page PDF article is here:

https://wellnessasianopportunities.com/wp-content/uploads/2021/02/Suicides-and-Covid-19-M.pdf

Categories
Wellness

J-Wellness 2020

Published August 2020; Available on Amazon

Wellness is about helping people to live well.

2020 was anticipated to be a joyous celebration of athletic prowess at the Tokyo Summer Olympics and Paralympic Games, and a discovery by the world of Japan’s Wellness-related activities (J-Wellness) that underpin the world’s longest national life expectancy.

Instead, in the face of the ongoing global pandemic and devastated economies, people are in survival mode, looking to Wellness to boost their immune systems as their first line of defence against the “Shingata Coronavirus”, the new-form coronavirus as the Japanese call it.

J-Wellness is both ancient traditions and pro-active modern practices. Zen meditation for Mental Wellness, the tea ceremony for the antioxidants-rich green tea (antioxidants protect the body against cellular damage and disease), and onsen (hot springs for quiet contemplation of nature with hydrotherapy benefits and seasonal, local cuisine fine dinners), are not part of the daily routine of the average Japanese. However, community awareness, drinking green tea and bathing are everyday practices. Traditional nutritionally balanced Japanese cuisine lives on in daily bento boxes for lunch eaten at schools and at office desks. The past intermingles with the present.

Government programs have been striving to reduce lifestyle diseases associated with sedentary and stressful living for decades. This has involved specific health and wellness targets. For example, to reduce obesity, the Metabo Law, 2008, set maximum waist measurements at 33.5 inches for men and 35.4 inches for women, with education support given to those who exceeded these levels. In addition, local governments and companies are potentially liable to fines. Currently, 26% of Japan’s population aged 15 or older are overweight, defined as having a BMI of 25 or more; it is 71% in the United States, 64% in the U.K.

Since we believe that Japan’s relatively low “Shingata Coronavirus” related death rate relative to other nations importantly reflects the good life-style behaviours of J-Wellness, our message has become more urgent. The global environment is now far grimmer, but the value of J-Wellness to the world has become even more important.

Categories
Wellness

J-Wellness & Covid-19: Why Japan has had relatively low deaths

Covid-19 related deaths per 100,000 people: the data

There have been very marked differences between countries in Covid-19 related deaths (measured per 100,000 people to normalise for countries’ different population sizes). The Deaths per 100,000 people for the G20 countries (China is not included due to perceived data issues; Spain is a G20 permanent guest, not a member, but is included) is 24.0.

Japan’s Deaths per 100,000 people is 1.3. The Deaths per 100,000 people for the USA is 63.3, a rate 49 times higher than Japan’s.

We believe that Japan’s relatively low Covid-19 related death rate importantly reflects the good life-style behaviours of J-Wellness. To see if the data agrees, please read the full 11-page PDF article: https://wellnessasianopportunities.com/wp-content/uploads/2021/02/J-Wellness-Covid-19-Why-Japan-has-had-relatively-low-deaths-October-2020.pdf