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Original article Public holidays increased the transmission of COVID-19 in Japan, 2020–2021: a mathematical modelling study
Jiaying Qiaoorcid , Hiroshi Nishiuraorcid
Epidemiol Health 2024;e2024025
DOI: https://doi.org/10.4178/epih.e2024025 [Accepted]
Published online: January 22, 2024
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Kyoto University, Kyoto, Japan
Corresponding author:  Hiroshi Nishiura,
Email: nishiura.hiroshi.5r@kyoto-u.ac.jp
Received: 17 October 2023   • Revised: 18 December 2023   • Accepted: 6 January 2024

OBJECTIVES
Although the role of specific holidays in modifying transmission dynamics of infectious diseases has received some research attention, the epidemiological impact of public holidays on the transmission of coronavirus disease 2019 (COVID-19) remains unclear.
METHODS
To assess the extent of increased transmission frequency during public holidays, we collected COVID-19 incidence and mobility data in Hokkaido, Tokyo, Aichi, and Osaka from 15 February 2020 to 30 September 2021. Models linking the estimated effective reproduction number (Rt) with raw or adjusted mobility, public holidays, and the state of emergency declaration were developed. The best-fit model included public holidays as an essential input variable, and was used to calculate counterfactuals of Rt in the absence of holidays.
RESULTS
During public holidays, on average, Rt increased by 5.71%, 3.19%, 4.84%, and 24.82% in Hokkaido, Tokyo, Aichi, and Osaka, respectively, resulting in a total increase of 580 (95% confidence interval [CI], 213–954), 2,209 (95% CI, 1,230–3,201), 1,086 (95% CI, 478–1,686), and 5,211 (95% CI, 4,554–5,867) cases that were attributable to the impact of public holidays.
CONCLUSIONS
Public holidays intensified the transmission of COVID-19, highlighting the importance of considering public holidays in designing appropriate public health and social measures in the future.


Epidemiol Health : Epidemiology and Health