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Article

Estimation of the Actual Incidence of Coronavirus Disease (COVID-19) in Emergent Hotspots: The Example of Hokkaido, Japan during February–March 2020

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Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan
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Global Health Program, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei 10055, Taiwan
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Graduate School of Advanced Integrated Studies in Human Survivability, Kyoto University, Yoshida-Nakaadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
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Hakubi Center for Advanced Research, Kyoto University, Yoshidahonmachi, Sakyo-ku, Kyoto 606-8306, Japan
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School of Public Health, Kyoto University, Yoshidakonoe cho, Sakyo ku, Kyoto 606-8501, Japan
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Research Center for Zoonosis Control, Hokkaido University, Kita 19 Jo Nishi 10 Chome, Kita-ku, Sapporo-shi, Hokkaido 001-0019, Japan
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Core Research for Evolutional Science and Technology (CREST), Japan Science and Technology Agency, Honcho 4-1-8, Kawaguchi, Saitama 332-0012, Japan
*
Author to whom correspondence should be addressed.
Academic Editor: Emmanuel Andrès
J. Clin. Med. 2021, 10(11), 2392; https://doi.org/10.3390/jcm10112392
Received: 16 March 2021 / Revised: 19 May 2021 / Accepted: 24 May 2021 / Published: 28 May 2021
Following the first report of the coronavirus disease 2019 (COVID-19) in Sapporo city, Hokkaido Prefecture, Japan, on 14 February 2020, a surge of cases was observed in Hokkaido during February and March. As of 6 March, 90 cases were diagnosed in Hokkaido. Unfortunately, many infected persons may not have been recognized due to having mild or no symptoms during the initial months of the outbreak. We therefore aimed to predict the actual number of COVID-19 cases in (i) Hokkaido Prefecture and (ii) Sapporo city using data on cases diagnosed outside these areas. Two statistical frameworks involving a balance equation and an extrapolated linear regression model with a negative binomial link were used for deriving both estimates, respectively. The estimated cumulative incidence in Hokkaido as of 27 February was 2,297 cases (95% confidence interval (CI): 382–7091) based on data on travelers outbound from Hokkaido. The cumulative incidence in Sapporo city as of 28 February was estimated at 2233 cases (95% CI: 0–4893) based on the count of confirmed cases within Hokkaido. Both approaches resulted in similar estimates, indicating a higher incidence of infections in Hokkaido than were detected by the surveillance system. This quantification of the gap between detected and estimated cases helped to inform the public health response at the beginning of the pandemic and provided insight into the possible scope of undetected transmission for future assessments. View Full-Text
Keywords: epidemiology; travel medicine; COVID-19; emerging infectious diseases epidemiology; travel medicine; COVID-19; emerging infectious diseases
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MDPI and ACS Style

Akhmetzhanov, A.R.; Mizumoto, K.; Jung, S.-M.; Linton, N.M.; Omori, R.; Nishiura, H. Estimation of the Actual Incidence of Coronavirus Disease (COVID-19) in Emergent Hotspots: The Example of Hokkaido, Japan during February–March 2020. J. Clin. Med. 2021, 10, 2392. https://doi.org/10.3390/jcm10112392

AMA Style

Akhmetzhanov AR, Mizumoto K, Jung S-M, Linton NM, Omori R, Nishiura H. Estimation of the Actual Incidence of Coronavirus Disease (COVID-19) in Emergent Hotspots: The Example of Hokkaido, Japan during February–March 2020. Journal of Clinical Medicine. 2021; 10(11):2392. https://doi.org/10.3390/jcm10112392

Chicago/Turabian Style

Akhmetzhanov, Andrei R., Kenji Mizumoto, Sung-Mok Jung, Natalie M. Linton, Ryosuke Omori, and Hiroshi Nishiura. 2021. "Estimation of the Actual Incidence of Coronavirus Disease (COVID-19) in Emergent Hotspots: The Example of Hokkaido, Japan during February–March 2020" Journal of Clinical Medicine 10, no. 11: 2392. https://doi.org/10.3390/jcm10112392

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