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      Effect of the Tokyo 2020 Summer Olympic Games on COVID-19 incidence in Japan: a synthetic control approach

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          Abstract

          Background

          The Tokyo 2020 Summer Olympic Games (23 July–8 August 2021) were held in the middle of Japan’s fifth wave of COVID-19, when the number of cases was on the rise, and coincided with the fourth state of emergency implemented by the host city, Tokyo.

          Aim

          This study aimed to assess whether the hosting of the Games was associated with a change in the number of COVID-19 cases in Japan using a synthetic control method.

          Methods

          A weighted average of control countries with a variety of predictors was used to estimate the counterfactual trajectory of daily COVID-19 cases per 1 000 000 population in the absence of the Games in Japan. Outcome and predictor data were extracted using official and open sources spanning several countries. The predictors comprise the most recent country-level annual or daily data accessible during the Games, including the stringency of the government’s COVID-19 response, testing capacity and vaccination capacity; human mobility index; electoral democracy index and demographic, socioeconomic, health and weather information. After excluding countries with missing data, 42 countries were ultimately used as control countries.

          Results

          The number of observed cases per 1 000 000 population on the last day of the Games was 109.2 (7-day average), which was 115.7% higher than the counterfactual trajectory comprising 51.0 confirmed cases per 1 000 000 population. During the Olympic period (since 23 July), the observed cumulative number of cases was 61.0% higher than the counterfactual trajectory, comprising 143 072 and 89 210 confirmed cases (p=0.023), respectively. The counterfactual trajectory lagged 10 days behind the observed trends.

          Conclusions

          Given the increasing likelihood that new emerging infectious diseases will be reported in the future, we believe that the results of this study should serve as a sentinel warning for upcoming mega-events during COVID-19 and future pandemics.

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          Most cited references35

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          Synthetic Control Methods for Comparative Case Studies: Estimating the Effect of California’s Tobacco Control Program

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            Comparative Politics and the Synthetic Control Method

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              The Economic Costs of Conflict: A Case Study of the Basque Country

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2022
                20 September 2022
                20 September 2022
                : 12
                : 9
                Affiliations
                [1 ]departmentInfectious Disease Surveillance Center , National Institute of Infectious Diseases , Tokyo, Japan
                [2 ]The Tokyo Foundation for Policy Research , Tokyo, Japan
                [3 ]departmentDepartment of Sustainable Health Science , Chiba University , Chiba, Japan
                [4 ]departmentDepartment of Political Studies , Gakushuin University , Tokyo, Japan
                [5 ]departmentDepartment of Mathematical and Computing Science , Tokyo Institute of Technology , Tokyo, Japan
                [6 ]departmentInstitute for Business and Finance , Waseda University , Tokyo, Japan
                [7 ]departmentDepartment of cancer epidemiology , Osaka International Cancer Institute , Osaka, Japan
                [8 ]departmentDepartment of Health Policy and Management , Keio University , Tokyo, Japan
                [9 ]departmentMedical Education Program , Washington University in St Louis School of Medicine , St Louis, Missouri, USA
                Author notes
                [Correspondence to ] Professor Shuhei Nomura; nom3.shu@ 123456gmail.com
                Article
                bmjopen-2022-061444
                10.1136/bmjopen-2022-061444
                9490294
                36127076
                4b4f5551-88f1-438a-b0fe-2d1bcf2788c3
                © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

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                Health Policy
                1506
                2474
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                Original research
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                Medicine
                covid-19,public health,health policy
                Medicine
                covid-19, public health, health policy

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