JMIR Publications

ABSTRACT

Background:

Lockdowns and “stay-at-home” orders announced internationally for COVID-19 have led to physical and social distancing, with reports of many individuals experiencing social isolation and loneliness. Although the emergency declaration in Japan was declared as a mild lockdown which was requested by government without penalties for violations, the lockdown measures, including social isolation, had a several influences on people’s lives and mental health like other countries. In Japan, a state of emergency was declared multiple times; thus, it is necessary to examine the influence of the transition to social isolation caused by repeated emergency declarations and the deterioration of mental health associated with these changes.

Objective:

This study longitudinally investigated the transition to social isolation and its related factors during the “mild lockdown” under two declared states of emergency in Japan.

Methods:

We collected data on 7893 inhabitants (46.8% women, 49.6 ± 13.7 years) living in the seven prefectures where the first emergency declaration measure were first applied. The investigations were performed online in the final phase of the first and second states of emergency: phase 1 (between May 11 and = 12, 2020) and phase 2 (between February 24 and 28, 2021).

Results:

Forty-nine percent of the participants remained socially isolated through phases 1 and 2 and 12% were socially isolated in phase 2, even though they were not socially isolated in phase 1. There were more participants with persistent social isolation in unmarried or those without children and low household income groups, and the persistent social isolation group had fewer cohabitants compared to other transition pattern groups. The nonparametric Bayesian co-clustering results showed that most of the clusters in which there were participants without social isolation throughout Phases 1 and 2 had healthy behaviors, more interactions, good relationships, and lower levels of loneliness and psychological stress. Furthermore, the cluster in which relationships deteriorated in Phase 1 recovered in Phase 2. Comparatively, the clusters with social isolation throughout Phases 1 and 2 were divided into clusters with increased loneliness and psychological stress; clusters were close to the average scores of the participants in this study. Among these clusters, the clusters with increased loneliness and psychological stress were particularly notable for deteriorating relationships and less online interaction.

Conclusions:

This study revealed the actual state of transition to social isolation and related psychological, social, and behavioral factors under repeated declarations of a state of emergency. These results are expected to be useful in constructing intervention methods that fit individual characteristics for people in social isolation during a pandemic.