Italian and Japanese public attention toward balneotherapy in the COVID-19 era

Italian and Japanese public widely use balneotherapy. The population interest in balneotherapy in coronavirus disease-2019(COVID-19) era should be investigated. Therefore, we aimed to exploit Google Trends analysis, as a measure of peoples’interestin balneotherapy, in two countries, Italy and Japan. In this infodemiology study, Google Trends was queried for the lay termswidely used by the Italian population to refer to the balneotherapy setting (terme + termale) and by the Japanese to refer to thebathing place and balneotherapy facilities (温泉+スパ). The internet searches in 2020 were compared to overlapping time spansin 2016–2019 and were correlated with new confirmed cases/deaths. This study demonstrated that from February 23 to June 20,2020, and from October 4 to December 26, 2020, the internet searches of the Italian words corresponding to balneotherapy werestatistically significantly decreased; however, the internet searches were not significantly different in June 21 to October 3, 2020,compared to overlapping time spans in 2016–2019 in Italy. The study also showed that from March 15 to September 5, 2020, andfrom November 29 to December 26, 2020, the internet searches of the Japanese words corresponding to balneotherapy werestatistically significantly decreased; however, the internet searches were significantly increased in September 13 to November 7,2020, and were not significantly different in November 8 to 28, 2020, compared to overlapping time spans in 2016–2019 inJapan. There were significant negative correlations between the relative search volume and number of new cases (rho=−0.634;p<0.001)/deaths (rho=−0.856; p<0.001) in Italy and the number of new deaths (rho=−0.348; p=0.012) in Japan. Populationinterest in balneotherapy has changed in the COVID-19 era both in Italy and Japan. During the early stage of pandemic (March toJune), the interest was lower. After this early stage, the interest showed a recovery in both countries. In Italy, the populationinterest reached to its prior levels in late June through early October, with a peak in August. In Japan, the recovery exceeded theprior 4-year levels in mid-September through early November. Then, both countries demonstrated a decline in interest: began inearly October in Italy and late November in Japan. This information would allow us to understand/address the populationresponse in the pandemic in respect of the balneotherapy and would guide the preparedness of healthcare providers and plannersboth in this pandemic and future similar situations.