国立感染症研究所

10th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (October 13, 2020).   Document 3

 

Recent infection status

 

Trends in the number of new infections

  • The number of new infections has been increasing in some regions from around the end of September, after 4 consecutive holidays. Various trends, such as sporadic clusters have been observed in some regions, and attention should be paid to future trends in the spread of infection.
  • Importantly, the effective reproduction number has been moving around 1 from the last week of August in Tokyo, Osaka, Hokkaido, and Okinawa, and has recently exceeded 1, when viewed on a nationwide basis. Accordingly, caution is required.
    • Cumulative number of infections in one week per 100,000 people (September 28 to October 4, October 5 to 11): Nationwide (2.78 [3,507↑], 2.84 [3,589↑]), Tokyo (8.84 [1,230↑], 8.84 [1,231↑]), Aichi (1.95 [147↓], 1.35 [102↓]), Osaka (4.14 [365↓], 3.94 [347↓]),Fukuoka (0.59 [30↑], 0.92 [47↑]), and Okinawa (11.08 [161↑], 10.53 [153↓])
    • Percentage of cases in which the infection route cannot be identified (September 26 to October 2): Nationwide, 49.4% (0.8% points↓ from the previous week); Tokyo, 53.8% (1.8% points↑)

Trends in the number of inpatients (*)

  • The number of inpatients is decreasing. The regional rates of secured beds (shown in parenthesis) are similar, but slightly high in some regions.
    • Number of inpatients (October 7): Nationwide, 2,979↓ (11.2%); Tokyo, 996↓ (24.9%); Aichi, 108↓ (13.7%); Osaka, 239↓ (17.9%); Fukuoka, 45↓ (9.2%); and Okinawa, 156↑ (36.3%)
  • The number of severe patients has been decreasing since late August; however, it is nearly the same as last week and seems to be bottoming out.
    • Number of severe patients (October 7): Nationwide, 296↑ (8.7%); Tokyo, 128↑ (25.6%); Aichi, 12↓ (17.1%); Osaka, 37↓ (11.1%); Fukuoka, 6↓ (10.0%); and Okinawa, 28↑ (49.1%)

Test system

  • Although the number of tests conducted varies, the recent ratio of the number of persons determined to be positive to the number of tests is 2.6%, which remains lower than that at the declaration of the state of emergency (8.8% from April 6 to 12).
    • Number of tests (September 21 to 27, September 28 to October 4): Nationwide (101,820↓, 133,770↑), Tokyo (28,525↓, 38,758↑), Aichi (3,861↓, 4,265↑), Osaka (9,280↓, 10,353↑), and Okinawa (1,164↓, 2,026↑)
    • Rate of positive tests (September 21 to 27, September 28 to October 4): Nationwide (2.9% [0.1% points↑ from the previous week], 2.6% [0.3% points↓]), Tokyo (3.7% [0.2% points↑], 3.2% [0.5% points↓]), Aichi (4.8% [0.1% points↓], 3.4% [1.4% points↓]), Osaka (4.2% [0.4% points↓], 3.5% [0.7 points↓]), and Okinawa (6.7% [3.0% points↑], 8.0% [1.3% points↑])

* “Trends regarding inpatients” are based on the Ministry of Health, Labour and Welfare’s “Surveillance regarding the Care and Number of Beds for Patients with the Novel Coronavirus Infection.” In this surveillance, values are surveyed/published at 0:00 on the date of description.
For the number of severe patients, the criteria for persons included differs from that of publication on and before August 14. ↑ and ↓ indicate an increase and decrease, respectively, from the previous week.

 

Evaluation of Recent Infectious Status

 

Infection status

  • The number of new infections has been increasing in some regions from around the end of September, after 4 consecutive holidays. Various trends, such as sporadic clusters have been observed in some regions, and attention should be paid to future trends in the spread of the infection.
  • Importantly, the effective reproduction number has been moving around 1 from the last week of August in Tokyo, Osaka, Hokkaido, and Okinawa, and has recently exceeded 1 on a nationwide basis. Accordingly, caution is required.
  • Infections associated with dining together and workplaces have occurred as social activities have been revitalized. While movement of people is expected to increase, it is necessary to detect signs of a national spread of the infection early, and to respond accordingly.
  • In addition, the proportion of middle-aged and elderly persons among the infected remains high compared to June and July. Furthermore, the proportion of persons in their 40s and 50s is increasing compared to July and August, and attention should be paid to this situation. On the other hand, while the number of severe patients has been decreasing since late August, it has recently remained at the same level as the previous week, and appears to be bottoming out.

Future actions

  • Active measures should be continued in high risk places such as night clubs and restaurants with hospitality services, which have triggered the spread of the infection in Japan. At the same time, preventive measures against infection while dining together and in workplaces, where clusters are occurring, should be re-confirmed and thoroughly implemented.
  • While a revitalization of movement of people and face-to-face social activities is expected (e.g., an increase in events and travelling, and the resumption of classes at universities), it is important to continue to thoroughly implement basic preventive measures against infection, including avoidance of the “3Cs” and environments where loud conversations are held, wearing of masks indoors, thorough physical distancing, and thorough ventilation.
  • On the other hand, it should be noted that the conditions for the occurrence of clusters have diversified. For example, clusters have occurred at nightlife spots, not only in metropolitan areas but also in provincial cities, and in communities with specific lifestyles such as communal living. It is possible that new sets of circumstances may trigger a spread of the infection, and it is necessary to organize a system to provide appropriate information, according to the characteristics of the persons involved, and to promptly and appropriately address large-scale clusters and cluster chains, which may cause the spread of the infection.
  • The number of new infections is also increasing worldwide (i.e., more than 2 million persons in one week), and the spread of the infection has been remarkable in Europe, etc. While the flow of people to and from overseas is resuming in a step-wise manner, appropriate measures such as quarantines should be considered.
  • In addition, necessary measures should be taken continuously, for example, such as by limiting the number of severe patients/deaths by implementing measures against infection at hospitals/facilities for the elderly, and taking prompt actions against clusters. 

Current Situation of COVID-19 Infection.

8th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (September 10, 2020) Document 3.

 

Latest infection status, etc. (as of September 9, 2020).

Trends in new infections

  • Infections by the time of onset appear to have reached a peak at the end of July across the country, and the effective reproduction number in Tokyo, Osaka, Aichi, Fukuoka, Okinawa and other cities is recently below 1 (as of August 22).
  • New infections are showing a decrease across the country, possibly owing to active measures in high-risk places such as night clubs and similar entertainment establishments where food and beverages are served, cooperation with a request for self-restraint by prefectural governments, and changes in the behavior of citizens; however, the trend in the number of infections varies between regions.
    ・Cumulative number of infections per 100,000 people for one week (September 1 to 7): 3.00 (3,785↓) nationwide, 7.41 (1,032↓) in Tokyo, 2.45 (185↓) in Aichi, 6.24 (550↓) in Osaka, 4.29 (219↓) in Fukuoka, and 6.95 (101↓) in Okinawa
    ・Rate of cases with unknown infection route (August 22 to 28) 50.8% (0.1%↓ from previous week) nationwide, 59.5% (2.4%↓) in Tokyo

Trends among inpatients (*)

  • The number of inpatients shows a decreasing tendency. The ratio of the number of inpatients to the number of available beds (in parenthesis) is similar, but slightly higher in some regions.
    ・Number of inpatients (September 2): 4,993↓ (18.9%) nationwide, 1,418↓ (35.5%) in Tokyo, 289↓ (36.5%) in Aichi, 488↑ (38.1%) in Osaka, 260↓ (53.1%) in Fukuoka, and 256↓ (55.5%) in Okinawa
  • The number of patients with severe disease has been increasing from early July, and have turned to decrease from late August onward.
    ・Number of patients with severe disease (September 2): 324↓ (10.0%) nationwide, 101↑ (20.2%) in Tokyo, 16↓ (22.9%) in Aichi, 61↓ (32.4%) in Osaka, 14↓ (23.3%) in Fukuoka, and 20↓ (40.8%) in Okinawa

Test systems

  • Although the number of tests has fluctuated, the rate of positive test results to the most recent number of tests is 2.9%, which decreased by 1.1% points from the previous week and remains low compared to that under the state of emergency (8.8% from April 6 to 12).
    ・Number of tests (August 31 to September 6): 136,868↑ nationwide, 37,362↑ in Tokyo, 4,110↓ in Aichi, 12,294↑ in Osaka, 8,702↓ in Fukuoka, and 3,513↑ in Okinawa
    ・Rate of positive test results (August 31 to September 6): 2.9% (1.1% points↓ from the previous week) nationwide, 2.8% (1.0% points↓) in Tokyo, 5.0% (1.5% points↓) in Aichi, 4.5% (1.7% points↓) in Osaka, 2.9% (2.2% points↓) in Fukuoka, and 3.0% (5.8% points↓) in Okinawa

* “Trends in numbers of inpatients” are based on “Surveillance of the Status of Care for Patients with Novel Coronavirus Infection and the Number of Beds” by the Ministry of Health, Labour and Welfare. This surveillance is conducted/published at 0:00 on the day of publication. Concerning the number of patients with severe disease, the criteria for the targets differ from those published on August 14 or earlier. ↑ represents increase from the previous week, and ↓ represents decrease.

Evaluations of Recent Infection Status

Infection status

  • Concerning the nationwide spread of infection from late June onward, new infections are decreasing from the peak seen in the first week of August, and this tendency is continuing through the Obon holiday to the present. The epidemic curve based on the date of onset of the country overall is in a downward trend since July 27 to 29 onward. On the other hand, the trend of the number of infections varies between regions, e.g., spread of the infection in Mie and in Miyagi.
    * Number of new infections per week: 2,983 for July 11 to 17, 4,703 for July 18 to 24, 7,282 for July 25 to 31, 9,454 for August 1 to 7, 8,036 for August 8 to 14, 7,082 for August 15 to 21, 5,560 for August 22 to 28, and 4,323 for August 29 to September 4
  • The effective reproduction number in Tokyo, Osaka, Aichi, Fukuoka, and Okinawa was found to be below 1 most recently on August 22. The value is close to 1 in Tokyo and Osaka, and continuous alert is still necessary for the detection of patients and re-spread of the infection. The rate of positive test results decreased by 1.1% points from the previous week to 2.9%.
  • These results may be achieved by active measures in high-risk places where spread of the infection may be triggered, such as night clubs and similar entertainment establishments where food and beverages are served, and effective cooperation with the request for self-restraint by prefectural governments, and the effects of changes in the behavior of citizens who watch news reports on the spread of infection.
    * Tokyo: May 29 and June 27 Calling people’s attention to visiting the downtown at night, July 10 Publication of comprehensive measures based on the opinion exchange between the national, Tokyo metropolitan, Shinjuku Ward and Toshima Ward governments and experts, July 22, etc. Calling on people to refrain from going out
    Osaka: July 28 Request for self-restraint when participating in banquets and drinking parties of 5 or more people (August 1 to 31)
    Request for closing or shortening business hours of restaurants (August 1 to 15 for Okinawa, August 3 to 31 for Tokyo [through
    September 15 for the 23 Wards], August 5 to 24 for Aichi, and August 6 to 21 for Osaka)
      Restrictions on the number of participants in large-scale events are maintained for the time being from August 1 (July 22)  
  • On the other hand, the proportion of middle-aged and elderly people among people infected with the virus has been on the rise in August; it was fluctuating at higher levels than in June and July, although it is lower than during March to May. Patients with severe disease have also been increasing from early July onward, but turned to decrease from late August.
    *Proportion of people aged 60 years or older among newly infected people: 10% for July 1 to 7, 9% for July 8 to 14, 11% for July 15 to 21, 11% for July 22 to 28, 12% for July 29 to August 4, 18% for August 5 to 11, 22% for August 12 to 18, 22% for August 19 to 25, and 25% for August 26 to September 1.
  • Infection frequently occurred in hospitals and facilities for elderly people after the peak of the epidemic infection spread during March to May. Concerning the epidemics from late June onward, “large-scale” infections in hospitals/facilities are decreasing in the metropolitan area etc., due to early detection, prompt measures to prevent the outbreak and spread of the infection. It is important to continuously take actions to prevent infections in hospitals/facilities, including early detection/prompt measures to minimize the number of patients with severe disease and deaths.

Decrease in fatalities (See the following table and explanation)

  • Concerning the spread of infection from June onward, the increase in the number of patients with severe disease compared to the increase in people infected with the virus became more gradual than in March and April. The adjusted fatality rate (*) for the most recent month of May and August showed a decreasing tendency in people of all ages and for all age groups.
    * The adjusted fatality rate is the risk of death during follow-up among cases diagnosed according to a certain definition. This is the adjusted     estimation of cumulative distribution of the number of days from notification to death. Data update may change the estimation.
  • Based on the data of approximately 6,100 inpatients registered in the registry of the National Center for Global Health and Medicine (cases registered by September 4), the ratio of deaths after hospitalization to cases of hospitalization (by generation/severity at admission) was lower for patients hospitalized on June 6 or later than for those hospitalized on June 5 or earlier for all generations although the background of patients, such as underlying comorbidities may differ.
  • This decrease may be due to such factors as that
    〇The surveillance sensitivity has improved and more infected people can be confirmed (e.g., expanded test systems, active conduct of tests in places with a high risk of infection, and reduction in the number of days to diagnosis)
    〇The proportion of patients among young generations has increased
    〇Relatively healthy elderly people appear to be included (lower ratio of cases of infection in hospitals and facilities than during the spread of infection in March and May)
    〇Measures concerning the standard of care have been promoted
     It is necessary to continuously conduct analyses according to the infection status trends.

Future actions

  • New infections are decreasing; however, they may increase again in the future. Necessary measures should continuously be taken, e.g., basic preventive measures against infection such as avoiding the “3Cs” and environments where loud voices are raised, wearing a mask indoors, keeping a proper physical distance, and thorough ventilation, measures against infections in hospitals/facilities for elderly people, and prompt actions against cluster outbreaks.
  • It is especially important to reinforce active measures in high-risk places such as night clubs and similar entertainment establishments where food and beverages are served, where spread of the infection is triggered in Japan.
  • On the other hand, spread of infection may be triggered in different places in the future, and it is required to organize a system to take prompt and appropriate actions against large-scale clusters and cluster chains that may be the origin of infection spread by referring to overseas findings. It is also necessary to take note of the possibility of unexpected re-spread in some regions.
  • The infection status should continuously be monitored/evaluated, and prompt actions should be taken to drastically expand the test systems, secure medical care provision systems, and organize the system of health centers based on “Future Actions for Novel Coronavirus Infections” (determined by the Novel Coronavirus Infections Control Headquarters on August 28, 2020). Investigation should also promptly be promoted to review the operations of the authorities concerning the recommendations for hospitalization in the Infectious Diseases Control Act in accordance with the discussion in the working group established in this advisory board.

 Comparison of adjusted fatality rate: Estimation as of August 30 and Ratio of deaths after hospitalization to the cases of hospitalization due to novel coronavirus infections (PDF).

 

7th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (September 1st, 2020).

 

Recent infection status, etc. (as of September 1st, 2020)

Trends in the number of new infections

  • Infections by the time of onset appear to have reached a peak at the end of July across the country, and the effective reproduction number in all major cities is recently below 1.
  • New infections are showing a slight decrease across the country, possibly owing to active measures in high-risk places such as night clubs and similar entertainment establishments where food and beverages are served, cooperation with a request for self-restraint by prefectural governments, and changes in the behavior of citizens; however, the trend in the number of infections varies between regions.

Cumulative number of infections per 100,000 people for one week (August 25 to 31): 4.13 (5,209↓) nationwide, 9.98 (1,389↓) in Tokyo, 4.05 (306↓) in Aichi, 7.36 (648↓) in Osaka, 8.41 (429↓) in Fukuoka, and 15.97 (232↓) in Okinawa

Rate of cases of unknown infection route (August 22 to 28): 50.8% (0.1%↓ from previous week) nationwide, 59.5% (2.4%↓) in Tokyo

Trends in the number of inpatients (*)

  • The number of inpatients is decreasing slightly, though it is at a high level. The ratio of the number of inpatients to the number of available beds (in parenthesis) shows a similar trend; it is increasing in some regions in particular and remains high.
    ・Number of inpatients (August 26): 5,581↓ (24.5%) nationwide, 1,588↓ (48.1%) in Tokyo, 369↑ (46.6%) in Aichi, 483↓ (38.4%) in Osaka, 272↓ (55.5%) in Fukuoka, and 289 ↓ (62.7%) in Okinawa
  • The number of patients with severe disease has been increasing from early July; however, it is at a similar level to that during the previous week and has not reached the peak that was seen around April (381 [April 28]).
    ・Number of patients with severe disease (August 26): 331 (274↓) (11.5% [9.6%]*) nationwide, 83 (43↓) (20.8% [10.5%]*) in Tokyo, 21↑ (30.0%) in Aichi, 72↑ (38.3%) in Osaka, 16↓ (26.7%) in Fukuoka, and 24↓ (49.0%) in Okinawa

Test system

  • Although the number of tests fluctuated, the rate of positive test results to the most recent number of tests is 4.0%, which decreased by 0.3% points from the previous week and remains low compared to that under the state of emergency (8.8% from April 6 to 12).
    ・Number of tests (August 24 to 30): 133,493↓ nationwide, 36,090↓ in Tokyo, 4,707↓ in Aichi, 10,634↓ in Osaka, 8,878↓ in Fukuoka, and 2,632↓ in Okinawa
    ・Rate of positive test results (August 24 to 30): 4.0% (0.3% points↓ from previous week) nationwide, 3.8% (0.3% points↓) in Tokyo, 6.5% (1.9% points↓) in Aichi, 6.2% (0.9% points) ) in Osaka, 5.1% (0.5% points ↑) in Fukuoka, and 8.8% (1.8% points↑) in Okinawa
 
“Trends in numbers of inpatients” are based on “Surveillance of the Status of Care for Patients with Novel Coronavirus Infection and the Number of Beds” by the Ministry of Health, Labour and Welfare. This surveillance is conducted/published at 0:00 on the day of publication. Concerning the number of patients with severe disease, the criteria for the targets differ from those published on August 14 or earlier. The figures in parentheses represent comparison with the same criteria for the previous week. ↑ represents an increase from the previous week, and ↓ represents a decrease.

 

 

9th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (September 24, 2020). Document 3

 

Recent infection status

 

Trends in the number of new infections

  • Infections by time of onset nationwide are decreasing from the peak seen at the end of July, but this trend appears to have slowed down. Since the last week of August, the effective reproduction number in Tokyo, Osaka, and Aichi has remained approximately 1, and the latest nationwide number is also close to 1.
  • New infections were showing a decrease nationwide, possibly owing to active measures in high-risk places such as night clubs and similar entertainment establishments where food and beverages are served, cooperation with the request for self-restraint by prefectural governments, and changes in the behavior of citizens; however, the number of new infections is showing a slight increase and attention should be paid to this trend.
    ▪ Cumulative number of infections per 100,000 population for one week (September 9 to 15 and 16 to 22): 2.96 (3,731↑) and 2.61 (3,287↓) nationwide, 9.02 (1,255↑) and 8.05 (1,120↓) in Tokyo, 2.79 (211↑) and 2.52 (190↓) in Aichi, 6.37 (561↑) and 5.04 (444↓) in Osaka, and 2.27 (116↓) and 0.92 (47↓) in Fukuoka
    ▪ Rate of cases with unknown infection route (September 12 to 18): 48.4% (0.5%↓ from previous week) nationwide, 50.5% (3.5%↓) in Tokyo

Trends in the number of inpatients (*)

  • The number of inpatients is showing a decreasing tendency. The ratio of the number of inpatients to the number of available beds (in parentheses) is similar, but slightly higher in some regions.
    ・Number of inpatients (September 16): 3,754↓ (14.2%) nationwide, 1,234↓ (30.9%) in Tokyo, 172↓ (21.7%) in Aichi, 375↓ (28.3%) in Osaka, 144↓ (29.4%) in Fukuoka, and 145↓ (31.2%) in Okinawa
  • The number of patients with severe disease has been increasing from early July, but has been decreasing since late August onward.
    ・Number of patients with severe disease (September 16): 316 (300↓) (9.6% [9.1%]) nationwide, 116↑ (23.2%) in Tokyo, and 19↑ (27.1%) in Aichi,51 (35↓) (19.5% [13.4%]) in Osaka (*), 10↓ (16.7%) in Fukuoka, and 22↑ (41.5%) in Okinawa

Test system

  • Although the number of tests has fluctuated, the rate of positive test results to the most recent number of tests is 2.9%, which remains low compared to that under the state of emergency (8.8% from April 6 to 12). However, attention should be paid to the influence of a decrease in the number of tests due to 4 consecutive holidays (Silver Week).
    ・Number of tests (September 7 to 13 and 14 to 20 [*]): 126,734↓ and 81,024↓ nationwide, 37,369↑ and 19,614↓ in Tokyo, 4,315↑ and 3,006↓ in Aichi, 9,986↓ and 6,409 in Osaka, and 6,652 ↓ and 4,899↓ in Fukuoka
    ・Rate of positive test results (September 7 to 13 and 14 to 20 [*]): 2.9% (0.1% points↓ from the previous week) and 4.3% (1.4% points↑) nationwide, 3.3% (0.5% points↑) and 6.1% (2.8% points↑) in Tokyo, 4.6% (0.4% points↓) and 6.9% (2.3% points ↑) in Aichi, 5.7% (1.2% points↓) and 7.2% (1.5% points↑) in Osaka, and 1.9% (1.0% points↓) and 1.2% (0.7 points↓) in Fukuoka
*“Trends in numbers of inpatients” are based on “Surveillance of the Status of Care for Patients with Novel Coronavirus Infection and the Number of Beds” by the Ministry of Health, Labour and Welfare. This surveillance is conducted/published at 0:00 on the day of publication.

Concerning the number of patients with severe disease, the criteria for targets differ from those published on August 14 or earlier. ↑ represents an increase from the previous week, and ↓ represents a decrease.
*Concerning the number of patients with severe disease, the criteria for the targets differ from those published from September 16. The figures in parentheses represent comparison with the same criteria for the previous week.
*Numbers of tests between 9/14 and 20 are provisional, and do not include some results obtained from private laboratories and medical institutions. The rates of positive test results are also provisional since these figures were obtained by dividing the number of positive patients by the number of tests.

 

Evaluation of Recent Infectious Status

 

Infection status

  • New infections have been decreasing from the peak seen nationwide in the first week of August, but this trend appears to have slowed down. The epidemic curve based on the date of onset has shown a downward trend from the peak seen on July 27 to 29, but this trend has slowed down. The rate of positive test results decreased by 0.1% points from the previous week to 2.9%. (during the week of September 13)
  • Since the first week of August, new infections have been decreasing, possibly due to active measures in high-risk places where spread of the infection may be triggered, such as night clubs and similar entertainment establishments where food and beverages are served, effective cooperation with the request for self-restraint by prefectural governments, and the effects of changes in the behavior of citizens who watch news reports on the spread of infection.
  • On the other hand, since the last week of August, the decreasing trend in new infections has stopped and a slight increasing trend has been observed in multiple municipalities. Attention should be paid to these trends. In particular, the effective reproduction number in Tokyo, Osaka, and Aichi remains approximately 1 and the latest nationwide number is also close to 1. This suggests that the infection has spread through such opportunities as business dinners and workplace contacts as social activities are increasing. It is necessary to pay continuous attention to prevent the spread of infection nationwide, including the influence of increased movement of people during the Silver Week holidays and the influence of a decreased number of tests.
  • The proportion of middle-aged and elderly people among infected patients has also been fluctuating at higher levels than in June and July, and continuous attention should therefore be paid. On the other hand, the number of patients with severe disease has been increasing from early July, and has turned to decrease from late August onward.
  • It is necessary to note that the spread of infection continues around the world with approximately 300,000 new infections reported every day.

Future actions

  • It is necessary to continue with active measures in high-risk places such as night clubs and similar entertainment establishments where food and beverages are served, where spread of the infection is triggered in Japan, and to reinforce measures against opportunities to develop cluster infections, including business dinners and workplace contacts. Movement of people and face-to-face social activities are expected to increase (e.g., holding of events, travel, resumption of on-campus classes). Therefore, the necessary measures should be thoroughly applied, e.g., basic preventive measures against infection such as avoiding the “3Cs” and environments where loud voices are raised, the wearing of masks indoors, keeping a proper physical distance, and thorough ventilation.
  • It is also necessary to minimize the number of patients with severe disease and deaths by implementing measures against infection in hospitals/facilities for elderly people. The required measures should continuously be taken, including prompt actions against cluster outbreaks.
  • On the other hand, spread of infection may be triggered in different places in the future, and it is required to organize a system of taking prompt and appropriate actions against large-scale clusters and cluster chains that may be the origin of infection spread in reference to overseas findings. It is also necessary to take note of possible unexpected re-spread in some regions.

Number of new infections (per 100,000 people) etc. (PDF)

 

Current Situation of COVID-19 Infection.

5th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (August 6th, 2020).

 

Current Situation of Infection, August 5th, 2020.

Trends in the number of new infections

  • The infection has continued to spread at restaurants with hospitality services, and through eating and drinking with friends and acquaintances, mainly in urban areas, but it is also spreading in rural areas.
  • The number of new infections is increasing nationwide, and is increasing rapidly in some areas.
  • Cumulative number of infected persons per 100,000 population per week (from July 30 through August 5) 

Nationwide: 7.33 (9,248), Tokyo: 17.41 (2,424), Aichi: 14.38 (1,086), Osaka: 14.37 (1,266),

Fukuoka: 16.58 (846), Okinawa: 30.32 (439)

  • Percentage of cases with unknown routes of infection (from July 25 through 31)

Nationwide: 52%, Tokyo: 59%

Trends in the number of hospitalized patients

  • The number of inpatients is increasing, as is the ratio of the number of inpatients to the number of hospital beds secured for those patients (shown in parentheses).
  • Number of inpatients (as of July 28; August 5 for Tokyo): Nationwide: 4,034 (20%), Tokyo: 1,475 (45%), Aichi: 195 (39%),

Osaka: 534 (42%), Fukuoka: 183 (37%), Okinawa: 83 (37%)

  • On the other hand, the number of severely ill patients is currently low, but is gradually increasing. The ratio of the number of severely ill patients to the number of hospital beds secured for severely ill patients (shown in parentheses) is also gradually increasing.
  • Number of severely ill patients (as of July 28; August 5 for Tokyo): Nationwide: 92 (4%), Tokyo: 21 (5%), Aichi: 2 (7%),

Osaka: 13 (7%), Fukuoka: 5 (8%), Okinawa: 2 (5%)

Test System

  • In the last week, the number of test cases increased by 48%. The percentage of positive tests also increased to 6.7% (+0.7% points from the previous week), which is lower than when the state of emergency was declared (8.8% during the period from April 6 through 12); however, some local governments report a sharp increase.
  • Number of tests (from July 27 through August 2): Nationwide: 127,700 (+48%), Tokyo: 32,605 (+36%), Aichi: 5,661 (+92%),

Osaka: 11,287 (+42%), Fukuoka: 10,312 (+95%), Okinawa: 3,433 (+143%)

  • Percentage of positive tests (from July 27 through August 2): Nationwide: 6.7% (+0.7% points), Tokyo: 7.0% (-0.7% points),

Aichi: 18.5% (+3% points), Osaka: 11.1% (+1.4% points), Fukuoka: 7.4% (-0.3% points), Okinawa: 9.5% (+6.6% points)

  • The average number of “onset-diagnosis days” declined, then leveled off.
  • Average number of “onset-diagnosis days” (from July 13 through 19): Nationwide: 5.2, Tokyo: 5.2

*Mid-April (from April 13 through 19): Nationwide: 7.6, Tokyo: 9.0

 

Evaluation of the Current Situation of Infection

  • Mainly in urban areas, the infection is continuing to spread at restaurants with hospitality services, and through eating and drinking with friends and acquaintances; however, the infection is also spreading in rural areas. The speed of the spread of infection is close to that observed in March and April due to its rapid spread in some areas, which is an alarming situation.
  • On the other hand, since the infection is continuing to spread mainly among the younger generation, which differs from the situation in March and April, the ratio of hospitalized or severely ill patients remains low, compared to the number of infected people. However, the infection is gradually spreading to middle-aged persons and the elderly, and the number of severely ill patients is gradually increasing.
  • With respect to the fact that the increase in the number of severely ill patients is moderate compared to the increase in the number of infected people, in addition to the increasing trend for infection among the younger generation, it is considered that early diagnosis has become possible, and treatments that contribute to the prevention of aggravation may have certain effects. However, at the present time, sufficient evidence has not been obtained and further analysis is required.
  • With respect to the route of infection, etc., in those areas where there is an increasing number of infections, the proportion of infected persons with an unknown route of infection remains at a high level. Furthermore, infections in homes, medical institutions, elderly care facilities, etc. have continued to be reported.
  • In addition, clusters have thus far been detected mainly in places such as restaurants with hospitality services, Japanese-style bars (Izakaya), and office meetings, where the “3Cs” (closed spaces, crowded places, and close contact settings) overlap and people talk in a loud voice.
  • For the above reasons, in order to prevent the spread of infection, it is strongly required to continue to take basic infection control measures, such as avoiding environments where the “3Cs” overlap and people talk in a loud voice, wearing a mask indoors, thorough physical distancing, and thorough ventilation.
  • At present, if such basic infection control measures are taken, it is unlikely that the infection will be spread via shopping at nearby supermarkets, using public transportation when commuting, working in the office, or the like.
  • On the other hand, continued outbreaks and increases in the number of new infections have already adversely affected public health centers and medical institutions, and there are concerns regarding the tightness of the medical care provision system in some areas. This situation requires prompt measures to reduce the number of new infections, in order to reduce the burden on the public health system and the medical care provision system. This trend has been seen in some prefectures.
  • It is necessary to continue to monitor and evaluate the situation of infection, and to promptly ensure a sufficient medical care provision system, for example, by expanding the number of hospital beds and securing accommodation and medical treatment facilities. In addition, if it is difficult to provide medical care using these facilities, based on the number of persons to be accepted, etc., it will be necessary to promptly inspect the status of the medical care provision system, including examination and development of a system to ensure that patients with mild symptoms or who are asymptomatic, and present a low risk of serious illness receive appropriate medical care at home (including the response when a patient’s physical condition deteriorates, as well as the provision of meals).

 5th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (August 6th, 2020)  Document 3 (PDF).

国立感染症研究所では、当研究所で分離されたCOVID-19の原因ウイルス(SARS-CoV-2)の分与について、まだ、他施設では入手が困難であったことから本業務を優先的に実施してきました。しかしながら、すでに国内外の試験研究機関等約100カ所に分与していることから、本業務を優先的に実施することを2020年6月30日をもって終了致します。尚、以後、本件に関する個別の相談先は病原体担当部(ウイルス第三部、メール:This email address is being protected from spambots. You need JavaScript enabled to view it. )となります。

過去記事「新型コロナウイルスの分与について」

<Rapid report>Outbreak of novel coronavirus disease (COVID-19) on a cruise ship docked in Nagasaki City: preliminary interim report

Posted date 2020/6/3

In this report, we describe an outbreak of novel coronavirus disease (COVID-19) that occurred on the cruise ship, “Costa Atlantica”, docked in Nagasaki City, Nagasaki Prefecture. This report provides information pertaining to the confirmation of a cluster of COVID-19 cases, the initial test results, and the early situation on the ship. Response activities are currently ongoing, and this report should be considered as preliminary and interim.

On 29 January 2020, the Italian cruise ship, “Costa Atlantica”, entered Nagasaki Port and docked inside the port on 20 February, remaining there until 25 March for ship repairs. Since then, given the enhanced quarantine measures implemented globally, departure became difficult and the ship continued to remain in Nagasaki Port. All persons on the ship were crew members, with 623 persons on board on 20 April 2020. Many were young male adults; 523 (84%) were men with a median age of 31 years (range: 19-69 years). The majority were of foreign nationality, with the Philippines, India, Indonesia, and China (listed in descending order) contributing the largest number of crew members.

Descriptive epidemiology of 516 confirmed cases of novel coronavirus infection reported by the national epidemiological surveillance of infectious diseases (NESID) system and active epidemiological surveillance (as of March 23, 2020)

Posted date 2020/4/9

On February 1, 2020, novel coronavirus infectious disease (COVID-19) was added as a designated infectious disease under the Infectious Diseases Control Law, article 6 in paragraph 8, requiring physicians to immediately report diagnosed novel coronavirus infection cases to the public health center in their jurisdiction. Additionally, active epidemiological investigation became possible, as stipulated in the Infectious Diseases Control Law, article 15.

The primary sources of data in this report were lab-confirmed novel coronavirus infection cases (including asymptomatic SARS-CoV-2 infection cases) reported through both the National Epidemiological Surveillance of Infectious Diseases (NESID) system and the active epidemiological investigation program, as of March 23. Cases reported by local public health centers through NESID were linked to cases monitored daily for follow-up by members of the Novel Coronavirus Response Headquarters team at the Ministry of Health, Labour and Welfare (MHLW), via the active epidemiological investigation program. This report provides an update to the previous report for the data as of March 9 (https://www.niid.go.jp/niid/en/2019-ncov-e/2484-idsc/9497-covid19-14-200309-e.html), and is the third update thus far. As data collection is ongoing, the data may be revised or updated accordingly in the future. It should also be noted that there is delayed reporting or cases still in the process of notification for some cases. As such, there may be a difference in the number of cases in this report versus those officially reported by MHLW. It is expected that this difference will be gradually resolved in the future, but caution is required.

Descriptive epidemiology of 287 confirmed cases of new coronavirus infection reported by the national epidemiological surveillance of infectious disease system (NESID) and active epidemiological surveillance (as of March 9, 2020)

Posted date 2020/3/17

On February 1, 2020, new coronavirus infectious disease (COVID-19) was added as a designated infectious disease under the Infectious Diseases Control Law, article 6 in paragraph 8, which required doctors to immediately report diagnosed COVID-19 cases to the public health center in their jurisdiction. These reported cases were aggregated through the national epidemiological surveillance of infectious diseases (NESID) system. Additionally, active epidemiological investigation could then be conducted, as stipulated in the Infectious Diseases Control Law, article 15.

The primary sources of data in this report were lab-confirmed COVID-19 cases reported through NESID and active epidemiological investigations, as of March 9. Data in NESID were aggregated from reporting by local public health centers. Daily data in active epidemiological investigation by local public health centers were aggregated by teams from the Novel Coronavirus Response Headquarters at the Ministry of Health, Labor, and Welfare (MHLW). This updated report provides additions to the report published on February 24 (https://www.niid.go.jp/niid/en/2019-ncov-e/2484-idsc/9473-2019-ncov-08-e-2.html). As data collection is ongoing, this report may be revised or updated accordingly in the future. It should also be noted that there are cases in which there may have been delayed reporting or case notification not yet completed. As such, there may be a difference in the number of cases reviewed in this report versus those under active investigation by MHLW. It is expected that this difference will be resolved in the future, but please note that there may be a difference.

Descriptive epidemiology of 112 confirmed cases of novel coronavirus infectious disease (COVID-19) as reported by the national epidemiological surveillance of infectious diseases (NESID) system and active epidemiological investigation (as of February 24, 2020)

 

On February 1, 2020, the novel coronavirus infectious disease (COVID-19) was added as a designated infectious disease under the Infectious Diseases Control Law, article 6 in paragraph 8, which requires doctors to immediately report diagnosed COVID-19 cases to the public health center in their jurisdiction. These reported cases are aggregated through the national epidemiological surveillance of infectious diseases (NESID) system. Additionally, active epidemiological investigation can be conducted, as stipulated in the Infectious Diseases Control Law, article 15.

The primary sources of data in this report were lab-confirmed COVID-19 cases notified through NESID and active epidemiological investigations, as of February 24. Data in NESID are aggregated from reporting by local public health centers. Daily data in active epidemiological investigation by local public health centers were aggregated by teams from the Novel Coronavirus Response Headquarters at the Ministry of Health, Labor, and Welfare (MHLW). As data collection is ongoing, this report may be revised or updated accordingly in the future. It should also be noted that there are cases in which there may be delayed reporting or case notification has not been completed. As such, there may be a difference in the number of cases reviewed in this report versus those under active investigation by MHLW. It is expected that this difference will be resolved in the future, but please note that there may be a difference.

Copyright 1998 National Institute of Infectious Diseases, Japan

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