国立感染症研究所

45th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (July 28, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide has been increasing with approximately 28 per 100,000 population for the latest week of reporting dates. The ratio of this week to last week is 1.54, showing a rapid increase. The number of new cases of infection is increasing not only in the Tokyo metropolitan area, but also in various regions nationwide including the Kansai area. The current spread of infection has never been experienced before. Note that the number of reported cases may be upwardly revised due to the effect of consecutive holidays.

    Effective reproduction number: On a national basis, it remains above 1 at 1.27 most recently (as of July 11). The figure is 1.26 in the Tokyo metropolitan area and 1.39 in the Kansai area.

Analysis of infection status [local trends]

* The value of new cases of infection is the total number for the latest week of reporting dates per 100,000 population.

  1. Tokyo metropolitan area (Tokyo and its 3 neighboring prefectures)

    In Tokyo, the number of new cases of infection has continued to increase, reaching approximately 89. The infection continues to spread rapidly with a ratio of this week to last week of 1.49. The cases of infection are mainly those in their 20s to 40s. The proportion of infected patients aged 65 years or older has decreased to approximately 3%, but the number of them has increased. The numbers of people who should have been hospitalized but forced to receive home care, the inpatients, and those who are arranging hospitalization are increasing. It is indicated that patients requiring high-flow oxygen have also increased. The number of severe patients using mechanical ventilators or artificial heart and lung apparatus have been increasing, with the largest number in those in their 40s to 50s. If the number of infected patients continues to surge, there are concerns about a delay in arrangement of hospitalization and burdens on the medical systems including general practice. On the other hand, in Saitama, Chiba, and Kanagawa, the number of new cases of infection has also been increasing mainly in those in their 20s and 30s, reaching approximately 43, 40, and 45, respectively. In the 3 prefectures, the number of infected patients has surged. In Tokyo, the nighttime population has declined only moderately compared to the time of the last emergency measures. In Chiba, the nighttime population has increased. In Saitama and Kanagawa, the nighttime population is decreasing but no significant decrease has been seen. The spread of infection is expected to continue for the time being mainly in Tokyo.

  2. Okinawa

    The number of new cases of infection has continued to increase to approximately 83. The ratio of this week to the last week is tending to increase to 2.15, showing a rapid re-expansion. New cases are mainly those in their 20s and 30s, but those in the elderly has also increased. The number of inpatients turned upward and the use rate of beds for severe patients remains severe. Both the nighttime and daytime populations have significantly decreased and reached the minimum level during the current emergency measures again. Attention should be paid as to whether the trend leads to the decrease in the number of new cases of infection.

  3. Kansai area

    In Osaka, the number of new cases of infection has continued to increase mainly in those in their 20s and 30s, reaching approximately 36. The infection continues to spread rapidly with a ratio of this week to last week of 1.52. The number of inpatients is increasing, but the use rate of beds for severe patients is approximately 13%. The nighttime population turned downward but remains at a high level, which raises concerns about the spread of infection.
    In Kyoto, Hyogo, and Nara, the number of new cases of infection has been increasing to approximately 19, 16, and 14, respectively. Across the 3 prefectures, the use rate of beds for severe patients continues to be below 20%, but the nighttime population continues to increase in Hyogo and Kyoto. There remain concerns about the spread of infection.

  4. Other than the above

    The number of new cases of infection continues to increase in Hokkaido, Aichi, and Fukuoka, where the priority measures such as for prevention of the spread of disease were lifted, reaching approximately 16, 10, and 21, respectively. In the 3 prefectures, the use rate of beds and the use rate of beds for severe patients remain below 20%. The nighttime population has decreased in the 3 prefectures, but remains at a high level in Hokkaido and Fukuoka, which raises concerns about the spread of infection.
    The number of new cases of infection has increased in other regions, and in Ibaraki, Tochigi, and Ishikawa, the number of new cases remains above 15, showing an upward trend. In Ishikawa, the number of new cases is approximately 38 due to clusters in restaurants and other places while the nighttime population has also increased. The number of severe patients remains unchanged at 1, but the number of inpatients is increasing. Attention will be required.

Analysis of mutant strains

  • As for the B.1.617.2 lineage variant (delta variant), the positive rate in the screening tests (mechanical estimation) is rising to approximately 33% nationwide, which suggests that the delta variant continues to replace the existing strains. Especially in Tokyo, it exceeds 40%.

Future outlook and measures to be taken

  • In Tokyo, Okinawa, Saitama, Chiba, Kanagawa, and Osaka, despite the emergency measures and priority measures, such as for prevention of the spread of disease, the reduction in the de facto population is limited and the spread of infection has not been curbed. As the delta variant replaces the existing strains, the infection is spreading more rapidly than ever before.
  • Especially in Tokyo, the number of infected patients continues to rise and the number of inpatients is increasing mainly in those in their 40s and 50s. There have already been effects on general medical services. With the greater burden on the general medical services including the increase of emergency transportation due to heat strokes, there is great concern that lives that could be saved may not be able to be if the current situation continues. In Saitama, Chiba, Kanagawa, and regions where the infection is spreading, there is great concern that the similar situation to Tokyo may occur in the days ahead. The biggest problem is that the sense of crisis is not shared between the government and citizens.
  • It is required to promptly suppress the spread of infection by thorough implementation of measures based on the basic countermeasures policy revised on July 8 and the remark titled “To prevent the spread of infection during the summer vacation” dated July 16 issued by the chairman of the Subcommittee on Novel Coronavirus Disease Control. It should be reminded that the tightening of infection control in offices and the policy of working from home need to be thoroughly implemented, in addition to basic practices for infection control such as wearing a mask, hand washing, and keeping social distances. In addition, the measures need to be enforced in eating and drinking places. Furthermore, it is necessary to encourage people to visit a hospital early and receive tests proactively, in case of feeling physically sick in the office, school, or at home, even for mild cold symptoms. It is important to thoroughly communicate these efforts.
  • Each local government needs to curb the rapid spread by agile intervention based on the situation of infection and the burden of medical care provision systems. The number of severe patients has generally been reduced compared to the increase in the number of infected patients because of the progress in vaccinations in the elderly. However, to control the rapid spread of infection, it is necessary to grasp the state and prospects of the burden on the public health systems and medical care provision systems, based on the number of inpatients, patients receiving home care, those arranging hospitalization, and other indicators. Based on the premise that the spread of infection will continue for a certain period, it is required to ensure and coordinate the medical care provision systems and public health systems, including securing accommodation facilities and establishing systems for home medical care.

Figures (Number of new infections reported etc.) (PDF)

44th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (July 21, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide is increasing, with approximately 18 per 100,000 population for the latest week of reporting dates. The ratio of this week to last week continues to increase. The number of new cases of infection is increasing not only in the Tokyo metropolitan area, but also in various regions including the Kansai area. The number of severe patients and deaths has stopped decreasing and remains flat. In addition, the proportion of elderly patients among infected patients continues to decrease.

    Effective reproduction number: On a national basis, it exceeds 1 at 1.17 most recently (as of July 4). In the metropolitan area, the figure is 1.17 in the Tokyo metropolitan area and 1.27 in the Kansai area.

Analysis of infection status [local trends]

*The value of new cases of infection is the total number for the latest week of reporting dates per 100,000 population.

  1. Tokyo metropolitan area (Tokyo and its 3 neighboring prefectures)

    In Tokyo, the number of new cases of infection has continued to increase, reaching approximately 59. The ratio of this week to last week is 1.49 and the infection continues to spread rapidly. The cases of infection are mainly those in their 20s to 40s. The number of infected patients aged 65 years or older has increased but the proportion of them has decreased to approximately 4%. The number of severe patients using mechanical ventilators or artificial heart and lung apparatus remains flat, but the numbers of inpatients and those arranging hospitalization are tending to rise while patients requiring high-flow oxygen have also increased. If the number of infected patients continues to increase at this rate, there are concerns about a delay in arrangement of hospitalization and burdens on the medical systems including general practice. On the other hand, in Saitama, Chiba, and Kanagawa, the number of new cases of infection has also been increasing mainly in those in their 20s and 30s, reaching approximately 27, 27, and 33, respectively. The ratio of this week to last in the 3 prefectures has remained at 1 or higher for 3 weeks or more, reaching 1.87 in Saitama and slightly less than 1.4 in both Chiba and Kanagawa, and the number of infected patients has surged. Those in their 30s or younger account for approximately 60% of the new cases. The use rate of beds for severe patients continues to remain below 20%. In Tokyo, the nighttime population has continued to decrease, but the decreasing speed is slower than that during the time of the last emergency measures. In Saitama, the nighttime population has continued to increase. In Chiba and Kanagawa, the trend has remained flat. It has only been a week since the tightening of measures and it is of great concern that the infection may spread for the time being mainly in Tokyo.

  2. Okinawa

    The number of new cases of infection turns upward, reaching approximately 38. New cases are mainly those in their 20s to 30s. On the other hand, the use rate of beds is tending to decrease with the recent decline in the number of new cases of infection. As for the use rate of beds for severe patients, difficult situations continue. Both the nighttime and daytime populations have increased, and particularly the nighttime population returns to the level before the start of the emergency measures, which gives rise to concerns about the spread of infection.

  3. Kansai area

    In Osaka, the number of new cases of infection has continued to increase mainly in those in their 20s, reaching approximately 24. The ratio of this week to last has remained 1 or higher for 2 weeks, reaching 1.89 with an upward trend. The number of infected patients has surged. The number of inpatients shifts from plateau to increase, but the number of severe patients continues to be on a downward trend. The use rate of beds for severe patients remains flat at approximately 12%. As the nighttime population continues to increase, there are concerns about the continuous spread of infection.
    In Kyoto, Hyogo, and Nara, the number of new cases of infection has been increasing to approximately 11, 11, and 10, respectively. Across the 3 prefectures, the use rate of beds for severe patients continues to be below 20%, but the nighttime population continues to increase in Hyogo and Kyoto. Attention needs to be paid to the future movements.

  4. Other than the above

    The number of new cases of infection turns upward again in Hokkaido, Aichi, and Fukuoka, where the priority measures such as for prevention of the spread of disease were lifted, reaching approximately 12, 7, and 10, respectively. In the 3 prefectures, the use rate of beds and the use rate of beds for severe patients remain below 20%. In Hokkaido, Aichi, and Fukuoka, the nighttime population has increased. Particularly, it has rapidly risen in Hokkaido and Fukuoka. The spread of infection is of concern. The number of new cases of infection has increased in other regions, and attention needs to be paid for such prefectures as Ishikawa and Tottori where the number of new cases has risen to above 15.

Analysis of mutant strains

  • Clusters due to the B.1.617.2 lineage variant (delta variant) have been reported and community-acquired infections have also been observed. The positive rate in the screening tests (mechanical estimation) continues to increase to approximately 21% nationwide. The delta variant is suggested to be more infectious than the B.1.1.7 lineage variant (alpha variant). It is expected that the delta variant will continue to replace the existing strains, and therefore it is necessary to pay close attention to it.

Future outlook and measures to be taken

  • In the most recent situation of infection, the rate of clusters in medical institutions and welfare facilities has decreased. In contrast, infection in workplaces, eating places, schools, and nursing facilities continues to occur, and therefore infection prevention at these places is important. Even for mild cold symptoms, it is necessary to advise people to visit a hospital early and to receive tests using simple kits. Infection often occurs at home. In case of having mild cold symptoms, the person needs to take precautions including wearing a mask even at home.
  • In the past, along with the spread of infection in the Tokyo metropolitan areas, the infection tended to spread over various regions after consecutive holidays. Four consecutive holidays will start from July 22, and the summer vacation and Obon holidays will continue in the days ahead. However, the spread of infection has already been seen in various regions, and each local government needs to work on infection control with a greater sense of crisis to prevent further spread of infection.
  • For that reason, according to the remark titled “To prevent the spread of infection during the summer vacation” dated July 16 issued by the chairman of the Subcommittee on Novel Coronavirus Disease Control, it is necessary to be prudent in moving across prefectures for going back to hometown or traveling, and to minimize the opportunity to gather people who do not usually meet because the risk of the infection spread increases. During the summer vacation including 4 consecutive holidays, it is important to stay at home as much as possible with a family or persons who usually meet.
  • In Tokyo, Okinawa, Saitama, Chiba, Kanagawa, and Osaka, the number of infected patients is rapidly increasing despite the emergency measures and the priority measures, such as for prevention of the spread of disease. It is required to curb the spread of infection early by thoroughly implementing the basic policy revised on July 8. Taking into consideration that infection in eating and drinking places may lead to subsequent infection at home or in the offices, it will be required to take thorough measures for eating and drinking settings including drinking at home and on the street. People are asked to stay at home as much as possible during holidays, and to opt for working from home while ensuring health monitoring and infection control. It is important to refrain from non-essential and non-urgent outings and movements, and to communicate such efforts.
  • Each local government needs to curb the rapid spread by agile intervention based on the situation of infection and the burden of medical care provision systems. Based on the premise that the spread of infection will continue for a certain period, it is required to ensure and coordinate the medical care provision systems and public health systems, including securing accommodation facilities and establishing systems for home medical care.
  • Vaccination has been performed mainly in the elderly, and the proportion of the elderly in the number of new cases of infection has reached the lowest level since autumn last year. Compared with the increase in the number of new cases of infection, the increase in the number of severe patients has been suppressed. In addition, according to the number of infected patients per population by vaccination history, data is showing that the number of infected patients significantly decreased in people aged 65 years or older after receiving the second vaccination, compared to those who did not receive vaccination. Further analyses are needed on these points. As for therapeutic drugs, a new neutralizing antibody drug has obtained fast-track approval, and therefore the treatment options are increasing. On the other hand, the number of the infected patients in their 40s and 50s has been increasing. Efforts to promote vaccination among people other than the elderly should be steadily implemented. As for vaccines, it is also necessary to properly analyze and evaluate the effects associated with the progress of vaccination and to discuss appropriate ways of preventing infection after sufficient progress in vaccination.
  • Regarding the delta variant which has replaced existing strains, it is particularly essential to suppress the spread of infection as much as possible by following the measures: strengthening of nationwide monitoring by screening of the L452R variant, as well as continuously conducting active epidemiological surveys and thorough tests. It is also necessary to continue taking prompt border control measures in line with local statuses of infection.

Figures (Number of new infections reported etc.) (PDF)

43th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (July 14, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide is increasing, with approximately 12 per 100,000 population for the latest week of reporting dates. The ratio of this week to last week has been 1 or higher for two weeks. Spread of infection is remarkable especially in the metropolitan area, mainly in Tokyo, and the effects on the surrounding regions and across the country are of concern. The infection has obviously spread in July also in the Kansai area, and the number of new cases of infection shows an increasing tendency in other regions. On the other hand, the decreasing trend in the number of severe patients and deaths is continuing. In addition, the proportion of elderly patients among infected patients continues to decrease.

    The nationwide effective reproduction number is above 1, 1.05 most recently (as of June 27). In the metropolitan area, the figure is 1.10 in the Tokyo metropolitan area and 1.13 in the Kansai area.

Analysis of infection status [local trends]

*The value of new cases of infection is the total number for the latest week of reporting dates per 100,000 population.

  1. Tokyo metropolitan area (Tokyo and its 3 neighboring prefectures)

    In Tokyo, the number of new cases of infection has continued to increase, reaching approximately 40. The ratio of this week to last week is 1.32. The cases of infection are mainly in those in their 20s to 40s. The persons with infection aged 65 years or older increased but the proportion of them decreased to approximately 4%. The number of inpatients is increasing mainly in those in their 50s or younger. The severe patients are increasing, and has leveled off most recently. The number of new cases of infection has increased in Saitama, Chiba, and Kanagawa, reaching approximately 14, 19, and 24, respectively. The ratio of this week to last week has been 1 or higher for two weeks or more. The nighttime population is slowly decreasing in Tokyo. On the other hand, the nighttime and daytime populations increased in Saitama, Chiba and Kanagawa. The figure rapidly increased in the first week after lifting the Declaration of Emergency State in Tokyo, and it is of great concern that the infection may spread for the time being mainly in Tokyo. The number of new cases of infection in the Tokyo metropolitan area accounts for approximately two-thirds of the entire country. It is necessary to thoroughly take measures to prevent the spread of infection to surrounding regions and across the country.

  2. Okinawa

    The number of new cases of infection has continued to decrease to approximately 23. The cases are mainly in persons in their 20s to 30s, but the proportion of persons with infection aged 60s or older is just below 20%. With decreasing number of new cases of infection, the use rate of beds decreased, patients staying at home and arrangements for hospitalization are in a decreasing trend. The conditions of beds for severe patients are still under severe pressure. The nighttime population stopped increasing and has leveled off. Attention should be paid as to whether the number of new cases of infection is decreasing.

  3. Kansai area

    The number of new cases of infection is in an increasing trend in Osaka, reaching approximately 13. The use rate of beds and the use rate of beds for severe patients remain below 20%. The nighttime population turned to increase again and reached a level as high as that in mid-March, raising concern about the continued spread of infection.
    There is an upward movement in the number of new cases of infection also in Kyoto and Hyogo with a figure of approximately 6 in each.

  4. Other than the above

    The number of new cases of infection appears to going upward in Hokkaido, Aichi, and Fukuoka, where the priority measures such as for prevention of the spread of disease were lifted, reaching approximately 8, 6, and 6, respectively. The nighttime population also increased in Hokkaido and Aichi, and there is concern about rebound.
    The number of new cases of infection increased in other regions, and attention needs to be paid for such prefectures as Iwate, Miyagi, Fukushima, Ibaraki and Ishikawa.

Analysis of mutant strains

  • Clusters due to the B.1.617.2 lineage variant (delta variant) have been reported and community-acquired infections have also been observed. The positive rate in the screening tests (mechanical estimation) has increased to approximately 11% nationwide. The delta variant is suggested to be more infectious than the B.1.1.7 lineage variant (alpha variant). It is expected that the delta variant will continue to replace the existing strains, and therefore it is necessary to pay close attention to it.
  • Study results showing vaccine efficacy against variants after the second vaccination have also been reported. It is necessary to continue analysis.

Future outlook and measures to be taken

  • A four-day holiday and summer vacation are coming up providing opportunities to meet people whom one does not usually meet, increasing the risk of spread of infection. It is necessary to minimize such behaviors. Also, in order to prevent the spread of infection in the Tokyo metropolitan area to other regions, caution is required in homecoming visits and movements across prefectural borders. It is necessary to ensure delivery of such messages to citizens.
  • Tokyo was designated as an area under emergency measures on July 8, and the measures for Saitama, Chiba, Kanagawa, Osaka and Okinawa were extended. It is required to curb the spread of infection early by thoroughly implementing the basic policy revised on July 8. It has been suggested that multiple times of participation in eating and drinking in large gatherings or for long hours, and banquets serving alcohol increase the risk of infection. The measures for scenes of eating and drinking including drinking at home and in the streets should be thoroughly taken, considering the fact that the infection in such scenes causes infection at their home and companies. Thorough implementation of teleworking and health monitoring/measures against infection is required in workplaces. It is important to refrain from non-essential and non-urgent outing and movements, and communicate such efforts.
  • In Tokyo, the number of inpatients is in an increasing trend, and the number of severe patients in their 40s and 50s has reached the same level as that observed in the previous phase of infection spread. It is expected to take about two weeks to benefit from reinforcement of measures, and the spread of infection will continue for a while. Therefore, it is required to secure/cooperate with medical provision systems and public health systems according to such circumstances.
  • The number of new cases of infection turned to increase also in other regions. With vaccination for the elderly moving forward, the numbers of severe patients and deaths are in a decreasing trend. Effects of this fact on the evaluation of the condition of medical care provision systems should be examined. However, if the number of infected patients sharply increases, beds for inpatients are estimated to become insufficient ahead of shortage of beds for severe patients. Flexible interventions will be required to curb rapid expansion, if there is a sign of a spread of infection.
  • While clusters at medical institutions and facilities for the elderly are decreasing, they have occurred at workplaces and schools/educational facilities. It is required to take measures, such as thorough preventive measures against infection in such places.
  • While vaccination mainly for the elderly is moving forward, the proportion of the elderly in the new cases of infection has become the lowest since last Autumn, indicating the effect of vaccines. It is necessary to steadily promote vaccination. Strategic vaccination is important, focusing on places with a high risk of infection or the routes of infection in order to control the epidemic. To achieve this, particularly in young people, concern and anxiety need to be wiped out.
  • In addition to prevention of the onset of disease and aggravation, there have been reports on vaccination suggesting its preventive effect on infection. It is necessary to properly analyze and evaluate the effects associated with the progress of vaccination and to discuss appropriate ways of preventing infection after sufficient progress in vaccination.
  • Regarding the delta variant, about which there is much concern surrounding its replacement with existing strains, it is particularly essential to suppress the spread of infection as much as possible by following the measures: strengthening of nationwide monitoring by screening of the L452R variant, as well as active epidemiological surveys and thorough tests for variants. It is also necessary to continue taking prompt border control measures in line with local statuses of infection.

Figures (Number of new infections reported etc.) (PDF)

42th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (July 7, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide turned to increase, with approximately 9 per 100,000 population for the latest week of reporting dates. In Tokyo and the metropolitan area, the number of new cases of infection is increasing and re-expansion of infection is of great concern. While the decreasing trend in the numbers of severe patients and inpatients is continuing with the recent decrease in the number of new cases of infection, an upward movement has already been observed for both inpatients and severe patients in Tokyo. In addition, the proportion of elderly patients among infected patients continues to decrease.

    Effective reproduction number: On a national basis, it exceeds 1, 1.02 most recently (as of June 20). In the metropolitan area, the number is 1.09.

Analysis of infection status [local trends]

*The value of new cases of infection is the total number for the latest week of reporting dates per 100,000 population.

  1. Tokyo metropolitan area (Tokyo and its 3 neighboring prefectures)

    In Tokyo, the number of new cases of infection has continued to increase, reaching approximately 30. The ratio of this week to last week is 1.22, being 1 or higher for two weeks. The new cases are in those in their 10s to 30s, mainly in their 20s. Clusters in schools and educational facilities have occasionally occurred. The proportion of the infected persons aged 65 or older is small, approximately 6% (however, the actual number of infections is increasing, and attention should be paid). The numbers of inpatients and severe patients turned to increase mainly in those in their 50s or younger. The positive rate of PCR test is in an increasing trend. Also in Saitama, Chiba and Kanagawa, the number of new cases of infection is moving upward, reaching approximately 11, 16, and 16, respectively. The nighttime population slightly decreased in Tokyo due to a long spell of rain, etc. The figures have also almost leveled off in Saitama, Chiba and Kanagawa; it rapidly increased in the first week after lifting the Declaration of Emergency State in Tokyo, and there is great concern about further spread of infection mainly in Tokyo. The number of new cases of infection in the Tokyo metropolitan area accounts for approximately two-thirds of the national total. It is necessary to thoroughly take measures to prevent the spread of infection to surrounding regions and across the country.

  2. Okinawa

    The number of new cases of infection is decreasing but remains high, approximately 27. The rate of decrease has slowed down. New cases are mainly in those in their 20s to 30s. With the decreasing number of new cases of infection, the use rate of beds, patients staying at home, and arrangements for hospitalization are decreasing. However, the condition of beds for severe patients in particular are still under severe pressure. While the rate of decrease in the number of new cases of infection is slowing down, the nighttime population is increasing, and future movements should be carefully monitored.

  3. Kansai area

    The number of new cases of infection has leveled off or slightly increased in Osaka, Kyoto, and Hyogo, i.e., about 9, 5, and 4, respectively. In all of these prefectures, the numbers of inpatients and severe patients are in a decreasing trend, and the use rate of beds and the use rate of beds for severe patients are under 20%. In Osaka and Hyogo, the nighttime and daytime populations, which rapidly increased in the week after lifting the Declaration of Emergency State, decreased due to a spell of rain, etc. In Kyoto, the nighttime population has continued to increase. Particularly in Osaka, rebound is of strong concern if the de facto population continues to increase, and alert is required for the situation.

  4. Aichi

    The number of new cases of infection has continued to decrease to approximately 4. The numbers of inpatients and severe patients are in a decreasing trend, and the use rate of beds and the use rate of beds for severe patients are under 20%. The number of new cases of infection is expected to decrease from now on, but the nighttime population is increasing. Attention should be paid as to whether the downward trend in the number of new cases of infection will continue.

  5. Hokkaido

    The number of new cases of infection has stopped decreasing, approximately 4. In Sapporo City, the center of infection spread, the number is approximately 8. The numbers of inpatients and severe patients are in a decreasing trend, and the use rate of beds and the use rate of beds for severe patients are under 20%. The nighttime population, which rapidly increased in the week after lifting the Declaration of Emergency State,has almost leveled off. Attention should be paid as to whether the decreasing trend in the number of new cases of infection continues.

  6. Fukuoka

    The number of new cases of infection has stopped decreasing, approximately 4. The numbers of inpatients and severe patients are in a decreasing trend, and the use rate of beds and the use rate of beds for severe patients are under 20%. Although the daytime population has remarkably increased, the nighttime population remains at a low level. Attention should be paid as to whether the decreasing trend in the number of new cases of infection continues.

Analysis of mutant strains

  • Clusters due to the B.1.617.2 lineage variant (delta variant) have been reported and community-acquired infections have also been observed. The positive rate in the screening tests (mechanical estimation) is still at a low level of approximately 7% nationwide, but it has increased. The delta variant is suggested to be more infectious than the B.1.1.7 lineage variant (alpha variant). It is supposed that the delta variant will continue to replace the existing strains, and therefore it is necessary to pay close attention to it.
  • Study results showing vaccine efficacy against variants after the second vaccination have also been reported. It is necessary to continue analysis.

Future outlook and measures to be taken

  • The number of new cases of infection mainly in young persons is increasing in Tokyo, and the spread of infection is expected to continue, e.g., the ratio of this week to last week of 1 or higher, and increase in the positive rate of tests. Traveling across prefectural borders will become active in 4-day holidays, summer vacation, and the Obon holidays, etc., involving opportunities to meet people whom one does not usually meet, possibly associated with different behaviors than usual. Therefore, further spread of infection or effects on various regions are of great concern. The numbers of inpatients and severe patients are already in an increasing trend in Tokyo, with severe patients in their 40s or 50s at the same level as that in the previous phase of infection spread. Therefore, measures to suppress the infection should be thoroughly taken. It has been indicated that the risk of infection increases by multiple times of participation in eating and drinking in large gatherings or for long hours, and in banquets serving alcohol. There are some restaurants that serve alcohol until late at night and some people without a mask during a meal. It is important to thoroughly take and strengthen measures in situations of eating and drinking through active patrol and encouragement. The rate of decrease in the number of new cases of infection has slowed down in Okinawa. Despite improved scores in the standards for the medical care provision system, the severe condition still exists especially in the beds for severe patients. It is necessary to thoroughly implement measures.
  • The number of new cases of infection being halted or leveling off turned to increase also in other regions. Vaccination for the elderly is going well, and the numbers of severe patients and deaths are in a decreasing trend. Effects of this fact on the evaluation of the conditions of medical care provision systems should be examined. If the number of infected patients sharply increases, beds for inpatients are estimated to become insufficient ahead of shortage of beds for severe patients. Therefore, when the priority measures, such as for prevention of the spread of disease are lifted, the measures should be mitigated step by step according to local infection statuses. And flexible interventions will be required to curb rapid expansion, if there is a sign of a spread of infection.
  • A four-day holiday and summer vacation are coming soon under these circumstances. It is necessary to promptly deliver messages as to what measures are required.
  • While vaccination has been moved forward mainly for the elderly, the proportion of the elderly in new cases of infection has become the lowest since last Autumn, indicating the effect of vaccines. It is necessary to steadily promote vaccination. Strategic vaccination is important focusing on places with a high risk of infection or the routes of infection in order to control the epidemic. To achieve this, concern and anxiety need to be wiped out particularly in young people.
  • In addition to prevention of the onset of disease and aggravation, there have been reports on vaccination suggesting its preventive effect on infection. It is necessary to properly analyze and evaluate the effects associated with the progress of vaccination and to discuss appropriate ways of preventing infection after sufficient progress in vaccination.
  • Regarding the delta variant, about which there is much concern surrounding its replacement with existing strains, it is particularly essential to suppress the spread of infection as much as possible by following the measures: strengthening of nationwide monitoring by screening of the L452R variant, as well as active epidemiological surveys and thorough tests for variants. It is also necessary to continue taking prompt border control measures in line with the status of infection in each country.

Figures (Number of new infections reported etc.) (PDF)

41th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (June 30, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • Although the number of new cases of infection nationwide continued to decline on the basis of reporting dates, it has levelled off and started to slightly increase to approximately 8 per 100,000 population for the latest week. In Tokyo and the metropolitan area, the number of new cases of infection turned upward and re-expansion of infection is of great concern. On the other hand, along with the decrease in the number of new cases of infection, the numbers of severe patients and deaths have decreased. In addition, the proportion of elderly patients among infected patients continues to decrease.

    It remains below 1 at 0.87 (as of June 13) nationwide, but it is on an upward trend. In the metropolitan area, the number is 1.00.

Analysis of infection status [local trends]

*The value of new cases of infection is the number of people per 100,000 in the total number for the latest week on the basis of reporting dates.

  1. Tokyo metropolitan area (Tokyo and its 3 neighboring prefectures)

    In Tokyo, the number of new cases of infection turned upward to approximately 25 and the ratio of this week to last week has increased to 1.22. The new cases are those in their 10s to 30s, mainly in their 20s. Clusters in schools and educational facilities have occasionally occurred. The proportion of patients aged 65 years or older is small at approximately 5%. The number of severe patients is tending to decrease. In Saitama, the number of new cases of infection has increased to approximately 9 and the ratio of this week to last week is 1.24. In Chiba and Kanagawa, the number has levelled off and started to slightly increase to approximately 13 and 15, respectively. The ratio of this week to last week exceeded 1 most recently. In the entire metropolitan area, new cases of infection are mainly those in their 20s. In Tokyo, the nighttime population has increased by 18% in the first week since the declaration of a state of emergency was lifted. The late-night population has also surged. In Saitama, Chiba, and Kanagawa, the de facto population has notably increased in the late afternoon when alcohol can be served. The nighttime population has also increased. Particularly in Tokyo, there is strong concern about a spread of infection in future. Measures should be thoroughly implemented to avoid a spread of infection to surrounding areas and the whole country       

  2. Okinawa

    The number of new cases of infection remains high at approximately 33, but continues to decrease. New cases are mainly in those in their 20s to 30s. The use rate of beds remains high, and the hospitalization rate is on the upward trend as the number of patients receiving home care and those arranging hospitalization are decreasing in association with the decrease in the number of new cases of infection. The nighttime population continues to increase and the number of new cases of infection remains high. But the speed of decrease has slowed. Attention should be paid to future trends.

  3. Kansai area

    In Osaka, the number of new cases of infection has stopped decreasing and remains flat at approximately 8. In Kyoto and Hyogo, the number has continued to decrease to approximately 4 and 3, respectively. The numbers of inpatients and severe patients are also tending to decrease, showing improvement. In Osaka, both nighttime and daytime populations have rapidly increased in the first week since the declaration of a state of emergency was lifted. The late-night population has also surged. In Hyogo and Kyoto, the nighttime population has increased. Particularly in Osaka, if the de facto population continues to increase, there is strong concern about a rebound and caution is required.

  4. Aichi

    The number of new cases of infection has continued to decrease to approximately 5. As the number of new cases of infection has decreased, the numbers of inpatients and severe patients have also decreased, and the use rate of beds both for inpatients and for severe patients is decreasing. The number of new cases of infection is expected to decrease, but the de facto population has notably increased in the late afternoon when alcohol can be served. The nighttime population has also increased and careful monitoring is needed as to whether the decreasing trend of new cases of infection continues.

  5. Hokkaido

    The number of new cases of infection has continued to decrease to approximately 4. In Sapporo City, the center of infection spread, the number has decreased to approximately 9. The number of new cases of infection is expected to decrease in future, but the nighttime population has rapidly increased in the first week since the declaration of a state of emergency was lifted. Attention should be paid to whether the downward trend in the number of new infections continues.

  6. Fukuoka

    The number of new cases of infection has continued to decrease to approximately 4. As the number of new cases of infection has decreased, the numbers of inpatients and severe patients have also decreased, and the use rate of beds both for inpatients and for severe patients is decreasing. The number of new cases of infection is expected to decrease, but the de facto population has notably increased in the late afternoon when alcohol can be served. The nighttime population has also increased and careful monitoring is needed as to whether the decreasing trend of new cases of infection continues.

  7. Other than the above

    In Fukui, the number of new cases of infection is approximately 15. Although the number has recently turned downward, it has increased mainly among people involved in restaurants and therefore attention should be paid.

Analysis of mutant strains

  • Clusters due to the B.1.617.2 lineage variant (delta variant) have been reported and community-acquired infections are also observed. The positive rate in the screening tests (mechanical estimation) is still at a low level of approximately 5% nationwide, but it has increased. The delta variant is suggested to be more infectious than the B.1.1.7 lineage variant (alpha variant). It is indicated that the delta variant will continue to replace the existing strains, and therefore it is necessary to pay close attention to it.
  • Study results showing vaccine efficacy against variants after the second vaccination have also been reported. It is necessary to continue analysis.

Future outlook and measures to be taken

  • In Tokyo, the number of new cases of infection has turned upward. There is strong concern about further spread of infection in Tokyo and the metropolitan area and its impact on various areas. Thorough implementation of measures is required particularly in Tokyo, given the experiences where the flow of people increased and rebounded immediately after the measures were lifted as well as the possibility that infection will spread faster than before due to the delta variant. There are some restaurants that serve alcohol until late at night and some people without a mask during a meal. It is important to strengthen measures in situations of eating and drinking. As for other areas, the ratio of this week to last week has increased in some regions and the measures need to be thoroughly ensured.
  • In many of regions where emergency measures and priority measures, such as for prevention of the spread of disease are applied as well as regions where these measures were lifted, the flow of people has sharply increased. Therefore, the decrease in the number of new cases of infection has been slowed or halted, or shifted from plateau to increase in some areas. Vaccination in the elderly has been promoted and the numbers of severe patients and deaths continue to decline. However, if the number of infected patients sharply increases, beds for inpatients are estimated to become insufficient ahead of shortage of beds for severe patients. Flexible interventions will be required to curb rapid expansion, if there is a sign of a spread of infection.
  • According to the recently compiled “Measures after June 21, 2021,” vaccinations are needed to be steadily promoted, including workplace vaccination, and necessary efforts should be steadily continued to curb the spread of infection.
  • Vaccinations have been promoted mainly in the elderly. There are reports suggesting the effect of infection prevention in addition to the prevention of onset and aggravation. It is necessary to properly assess the impacts of vaccination on the situation of infection, changes in the number of inpatients, the situation of arranging hospitalization, the rate of hospitalization, and the number of severe cases, as well as the associated burden on the medical care provision systems. In addition to promoting vaccination steadily in future, strategic vaccination is important focusing on places with a high risk of infection or the routes of infection in order to control the epidemic. Particularly in young people, concern and anxiety need to be wiped out.
  • Regarding the delta variant, about which there is much concern surrounding its replacement with existing strains, it is particularly essential to suppress the spread of infection as much as possible by following the measures: strengthening of nationwide monitoring by screening of the L452R variant, as well as active epidemiological surveys and thorough tests for variants. It is also necessary to continue taking prompt border control measures.

Figures (Number of new infections reported etc.) (PDF)

40th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (June 23, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide has been declining with approximately 8 per 100,000 population for the latest week of reporting dates. There is generally a downward trend in regions where the infection spread.
  • Along with the decrease in the number of new cases of infection, the numbers of severe patients and deaths have decreased. In addition, the proportion of elderly patients among infected patients tends to decrease. However, there are regions where the decreasing speed has slowed due to an increasing trend in the flow of people, and there is concern about a possible future rebound in these regions. In particular, in Tokyo and the metropolitan area, the number of new cases of infection stopped decreasing and is remaining flat, and therefore it is necessary to take thorough measures to prevent a rebound.  

    The nationwide effective reproduction number has been below 1 at 0.80 (as of June 6).

Analysis of infection status [local trends]

*The value of new cases of infection is the total number for the latest week of reporting dates per 100,000 population.

  1. Okinawa

    The number of new cases of infection remains high at approximately 40, but continues to decrease. New cases are mainly in those in their 20s to 30s. The use rate of beds remains high, and the hospitalization rate has been increasing as the number of patients receiving home care and those arranging hospitalization are decreasing in association with the decrease in the number of new cases of infection. The number of new cases of infection is expected to decrease in future, but both nighttime and daytime populations started to increase after new cases of infection turned downward. Attention should be paid to whether the upward trend in the de facto population continues.

  2. Tokyo metropolitan area (Tokyo and its 3 neighboring prefectures)

    In Tokyo and Chiba, the number of new cases of infection has leveled off and has started to increase to approximately 20 and 12, respectively. In Tokyo, new cases are mainly in those in their 20s and the number of infected patients is high in the urban central area. In Saitama and Kanagawa, the number of new cases of infection has been on a downward trend to approximately 7 and 14, respectively. In Tokyo, the nighttime population continued to increase but has started to decline slightly since last week. We need to pay close attention to future movements. In Chiba and Kanagawa, the nighttime population has slightly decreased from staying flat. The nighttime population in Saitama has increased. There is concern that it is becoming difficult to obtain cooperation with the measures. Particularly in Tokyo, if the upward trend in the de facto population continues, there is strong concern about a rebound and caution is therefore required.

  3. Kansai Area

    In Osaka, Hyogo, and Kyoto, the number of new cases of infection has been decreasing to approximately 7, 3, and 4, respectively. As the number of new cases of infection has been decreasing, there has been some improvement, such as a decrease in the number of inpatients and severe patients, but clusters in facilities for the elderly are continuing. In Osaka, the nighttime and daytime populations continue to increase and have returned to the level at the start of the third declaration of a state of emergency. In Hyogo, the nighttime population remains at a level lower than the minimum value during the second declaration of a state of emergency. In Kyoto, it has increased again in the latest week. The number of new cases of infection is expected to decrease, but careful monitoring is necessary, also of the de facto population.

  4. Aichi

    The number of new cases of infection has continued to decrease to approximately 8. As the number of new cases of infection has decreased, the numbers of inpatients and severe patients have also decreased, and the use rate of beds both for inpatients and for severe patients is decreasing. The nighttime population remains at a low level. Although the number of new cases of infection may decrease in future, attention should be paid as to whether these trends will continue.

  5. Hokkaido

    The number of new cases of infection has continued to decrease to approximately 8. In Sapporo City, the center of infection spread, the number has decreased to approximately 15. The number of new cases of infection is expected to decrease in future. However, the nighttime population, which had continued to decrease, started to increase and then stayed flat for the latest week. Attention should be paid to whether the decreasing trend in the number of new cases of infection continues. The use rate of beds has remained high in Sapporo City.

  6. Fukuoka

    The number of new cases of infection has continued to decrease to approximately 5. As the number of new cases of infection has decreased, the numbers of inpatients and severe patients have also decreased, and the use rate of beds both for inpatients and for severe patients is decreasing. The nighttime population remains at a low level. The number of new cases of infection is expected to decrease in future, but it is necessary to carefully monitor whether these trends will continue.

  7. Other than the above

    In Yamanashi, the number of new cases of infection is approximately 19. The number increases due to the occurrence of clusters and it should be watched carefully.

Analysis of mutant strains

  • Clusters due to the B.1.617.2 lineage variant (delta variant) have been reported. In some regions, the percentage of screening tests (mechanical estimation) is several tens of percents because of the effects of clusters, but approximately 3% nationwide. However, it is indicated that the delta variant will continue to replace the existing strains, and therefore it is necessary to pay close attention to it. In addition, the delta variant is suggested to be more infectious than the B.1.1.7 lineage variant (alpha variant). Study results showing vaccine efficacy against variants after the second vaccination have also been reported. It is necessary to continue analysis.

Future outlook and measures to be taken

  • Emergency measures and priority measures, such as for prevention of the spread of disease (priority measures) have been lifted and eased in many regions since June 21. This is attributed to the steady results of these measures, including the decrease in the number of new cases of infection and the reduction in the burden on the medical care provision systems owing to the cooperation of citizens and business operators. Cooperation of people is still essential to avoid a rapid rebound in future.
  • The downward trend in the number of new cases of infection may continue nationwide in the future, but there is strong concern about a possible rebound, given the experiences where the flow of people increased and rebounded immediately after the measures were lifted as well as the possibility that infection will spread faster than before due to alpha and delta variants. Particularly in Tokyo, which has great impact across the country, a future rebound is strongly concerned in case the flow of people and people gathering cannot be restricted by thorough implementation of priority measures.
  • Vaccinations have mainly been performed in elderly people and are expected to prevent serious disease. However, the existing strains may continue to be replaced by the delta variant. If the number of infected patients continues to surge after a rebound, the number of severe patients may increase and the medical care provision systems will be overwhelmed.
  • According to the recently compiled “Measures after June 21, 2021,” vaccination is needed to be steadily promoted including workplace vaccination and necessary efforts should be continued to curb the spread of infection. Based on the current situation of infection, prompt actions including tightening of measures are essential. Each local government should conduct necessary measures in a timely manner if there is any sign of the spread of infection.
  • Concerning the delta variant, which is concerned about replacement with the existing strains, it is particularly essential to suppress the spread of infection as much as possible by following the measures: strengthening of nationwide monitoring by screening of the L452R variant that aimed to cover 40% of all positive patients, as well as active epidemiological surveys and thorough tests for variants. It is also necessary to continue taking prompt border control measures.
  • In addition, in the course of promoting vaccination, it is necessary to consider future measures along with the appropriate evaluation of the impact on the situation of infection, changes in the number of inpatients, the rate of hospitalization, and the number of severe cases, as well as the associated burden on the medical care provision systems.

Figures (Number of new infections reported etc.) (PDF)

39th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (June 16, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide has been declining with approximately 9 per 100,000 population for the latest week of reporting dates. There is a downward trend in regions where the infection has spread. However, there are regions where the decreasing speed has slowed due to an increase in the flow of people, and there is concern about a possible future rebound in these regions.
  • Along with the decrease in the number of new cases of infection, the numbers of severe patients and deaths have decreased.    

    The nationwide effective reproduction number has been declining and remains below 1 at 0.78 (as of May 30).

Analysis of infection status [local trends]

  *The value of new cases of infection is the total number for the latest week of reporting dates per 100,000 population.

  1. (1) Okinawa
    • The number of new cases of infection remains high at approximately 62, but continues to decrease. New cases are mainly in their 20s to 30s and the proportion of minors is also increasing. The use rate of beds remains high, and the hospitalization rate has been increasing as the number of patients receiving home care and those arranging hospitalization are decreasing in association with the decrease in the number of new cases of infection. Schools have been closed due to an increase in the number of infected patients aged 19 years and younger. The nighttime and daytime populations have decreased since the start of the emergency measures. Although the number of new cases of infection may decrease in the future, attention should be paid as to whether these trends will continue.
  2. (2) Hokkaido
    • The number of new cases of infection has continued to decrease to approximately 17. In Sapporo City, the center of infection spread, the number has decreased, but is still at a higher level of approximately 29. The number of new cases of infection is expected to decrease in the future, but the nighttime population, which had continued to decrease, has started to increase. Attention should be paid as to whether the downward trend in the number of new infections will continue. The use rate of beds has remained high in Sapporo City.
  3. (3) Kansai area
    • In Osaka, Hyogo, and Kyoto, the number of new cases of infection has been decreasing to approximately 9, 5, and 8, respectively. As the number of new cases of infection has been decreasing, there has been some improvement such as a decrease in the number of inpatients and severe patients, but clusters in facilities for the elderly are continuing. In Osaka, the nighttime and daytime populations are increasing, but remain at the level of the minimum value during the second declaration of a state of emergency. In Hyogo, the nighttime population remains at a level lower than the minimum value during the second declaration of a state of emergency. In Kyoto, there has been a slight decrease during the latest week. The number of new cases of infection is expected to decrease, but careful monitoring is necessary, also of the de facto population.
  4. (4) Metropolitan area (Tokyo and its 3 neighboring prefectures) 
    • In Tokyo, Saitama, Chiba, and Kanagawa, the number of new cases of infection has been decreasing to approximately 19, 8, 11, and 14, respectively. The ratio of this week to last week has been below approximately 1, but the level remains higher and the decreasing speed slower compared to the Kansai area. Particularly in Chiba and Kanagawa, it is almost flat. In Tokyo, both the nighttime and daytime populations have increased for 5 consecutive weeks. The numbers are returning to the level before the start of the declaration of a state of emergency. In Saitama, the number remains flat, but in Chiba and Kanagawa, both the nighttime and daytime populations have increased from the previous week. There is concern that it is becoming difficult to obtain cooperation with the measures. Particularly in Tokyo, if the upward trend will continue, there is strong concern about rebound and caution is therefore required.
  5. (5) Chukyo area
    • In Aichi, the number of new cases of infection has been decreasing to approximately 12. As the number of new cases of infection has decreased, the number of inpatients and severe patients has decreased, and the use rate of beds both for inpatients and for severe patients is decreasing. The nighttime population has increased slightly but remains at a low level. Although the number of new cases of infection may decrease in the future, attention should be paid as to whether these trends will continue.
    • In Gifu, the number of new cases of infection has been decreasing to approximately 7. The nighttime and daytime populations remain at a low level, and the number of new cases of infection is expected to decrease in the future. In Mie, the number has been decreasing to approximately 5. The nighttime population has been increasing, which leads to concern about possible rebound.
  6. (6) Other areas under emergency measures (Fukuoka, Okayama and Hiroshima)
    • In Fukuoka, the number of new cases of infection has been decreasing to approximately 6. As the number of new cases of infection has decreased, the numbers of inpatients and severe patients have also decreased, and the use rate of beds both for inpatients and for severe patients is decreasing. The nighttime population remains at a low level. The number of new cases of infection is expected to decrease in the future, but it is necessary to carefully watch whether these trends will continue.
    • In Okayama and Hiroshima, the number of new cases of infection has been decreasing to approximately 3 and 7, respectively. As the number of new cases of infection has decreased, the numbers of inpatients and severe patients have also decreased, and the use rate of beds both for inpatients and for severe patients is a on a downward trend. In Okayama, the hospitalization rate exceeds 50%. The nighttime population remains at a low level in both prefectures and the number of new cases of infection is expected to decrease in the future, but attention should be paid as to whether the downward trend in the number of new infections will continue.
  7. (7) Areas other than those listed above
    • In Yamanashi, the number of new cases of infection is approximately 17. The number increased due to the occurrence of clusters and then started to decrease, but it should be watched carefully.

Analysis of mutant strains

  • The proportion of variants of B.1.1.7 lineage (alpha variant) has become approximately 80% of the national total in screening tests, suggesting that the existing strains have almost completely been replaced by mutant strains, except for some regions. In addition, the number of reports of B.1.617.2 lineage variants (including delta variant) is increasing.
  • It has also been reported that the existing strains have being replaced by delta variants overseas, and that this strain may be more infectious and transmissible than alpha variants. It is therefore necessary to continue analysis.

Future outlook and measures to be taken

  • Although a downward trend in the number of new cases of infection may continue nationwide, attention should be paid to the increasing trend in the flow of people, since the existing strains were almost replaced by the variants of B.1.1.7 lineage (alpha variant) and the variants may be more infectious. There are some regions where the flow of people has already started to increase and there is a possibility that the number of new cases of infection may stop decreasing in these regions.
  • In regions under emergency measures and those under priority measures, such as for prevention of the spread of disease (priority measures), the number of infections has decreased owing to the cooperation of citizens and business operators, clearly showing the effect of these measures. In Okinawa and Hokkaido, however, the number of new cases of infection has remained at the level equivalent to the Stage IV. There are some regions where the medical care provision systems remain under severe pressure, although the burden has decreased alongside the decrease in the number of new cases of infection and patients who are receiving care. Therefore, it is necessary reduce the number of new cases of infection as much as possible to prevent a future rebound and to continue to control the increase even if the reduction stops. It is necessary to thoroughly implement the measures based on the "Measures to be taken after June during the declaration of the state of emergency" compiled by the government's Novel Coronavirus Response Headquarters on May 28.
  • Particularly in Tokyo, the flow of people continues to increase. If this trend continues, the number of infected patients will stop decreasing and rebound in future. Vaccinations have been performed mainly in the elderly, and therefore it is expected that severe cases may be suppressed in the elderly. However, if the number of infected patients continues to surge after a rebound, the number of severe patients may increase and the medical care provision systems will be overwhelmed. In addition, there is a burden associated with vaccination at medical institutions. Based on these points, efforts necessary to control the spread of infection should be continued in the future.
  • In other regions and regions where the priority measures are lifted, each local government has to analyze the flow of people, the status of infection and the medical care provision systems in a conference style with experts in the region, and implement the necessary measures in a timely manner, based on the possibility that infection will spread faster than before due to alpha variants and variants of B.1.617 lineage (including delta variants).
  • As for the spread of infection this time, the size, speed, and course of decrease differed among regions. These differences can be attributed to various factors including replacement by variants, contents and timing of the start/end of countermeasures, movement of people or gathering of persons who do not usually meet due to the turn of the start/end of fiscal year or Golden Week holidays, and the age group that became the center of infection, but further investigation is needed.
  • The number of vaccinations has already exceeded 19 million nationwide and approximately 14.5 million people have received the first vaccination. To suppress the spread of infection, it is necessary to promptly and smoothly carry out the vaccination of many people nationwide, including occupational vaccinations.
  • While it is estimated that the existing strains have been replaced by alpha variants as the predominant strain in most regions with some exceptions, it is necessary to take measures focused on an understanding of the actual situation using virus genomic surveillance in order to reinforce the measures against new mutant strains. It is particularly essential concerning mutants, including the delta variants, to suppress the spread of infection as much as possible by following the measures: nationwide monitoring through genomic surveillance and screening of L452R variants, strengthening of systems to conduct tests regionally and active epidemiological surveys. In addition, it is also necessary to continue to take the border control measures promptly.

Figures (Number of new infections reported etc.) (PDF)

38th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (June 9, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide has been declining with approximately 13 per 100,000 population for the latest week on the basis of reporting dates. There is generally a downward trend in regions where the infection has spread. However, there are areas where the decreasing speed has slowed due to an increase in the flow of people, and there is a possibility of a rebound in future.
  • Along with the decrease in the number of new cases of infection, the number of severe patients and deaths has started to decrease.

    The nationwide effective reproduction number has been declining and remains below 1 at 0.78 (as of May 16).

Analysis of infection status [local trends]

  *The value of new cases of infection is the number of people per 100,000 in the total number for the latest week on the basis of reporting dates.

  1. (1) Okinawa
    • Two weeks have passed since the start of emergency measures. In Naha City, the southern/middle regions, and the Miyako/Yaeyama areas, the number of new cases of infection continued to surge, mainly among the working generations in their 20s and 30s. The number has decreased since June, but remains above 100 at 103. The use rate of beds has remained at a high level and the hospitalization rate has decreased. Therefore, the number of patients who are receiving care at home has increased. Concern is rising regarding potential increase in the number of severe patients in future and the further burden this may impose on the medical care provision systems. There is concern that transmission of infection in the elderly could cause a further increase of severe patients.
    • The nighttime and daytime populations have decreased since the start of emergency measures. Although the number of new cases of infection may decrease in future, attention should be paid to whether these trends continue. For patients who are receiving care at home or at accommodation facilities, it is necessary to handle issues including preparation for sudden changes in the condition of these patients.
  2. (2) Hokkaido
    • The number of new cases of infection continues to decrease, but the level is above 25 at approximately 29. In Sapporo City, which is the center of infection spread, the number has decreased, but is still at a higher level of approximately 49. In addition, clusters continue to occur at welfare and other facilities. The nighttime population has decreased since the start of emergency measures. Although the number of new cases of infection may decrease in future, attention should be paid to whether these trends continue. The use rate of beds has remained high in Sapporo City. Clusters have also occurred in welfare facilities in other regions than Sapporo.
  3. (3) Kansai area
    • In Osaka, Hyogo, and Kyoto, the number of new cases of infection has been decreasing to approximately 14, 9, and 12, respectively. As the number of new cases of infection has decreased, there is some improvement such as the decrease in the number of inpatients and severe patients, but clusters in facilities for the elderly are continuing. In Osaka, the nighttime and daytime populations are increasing, but remain at a level approximately 10% lower than the minimum value during the second declaration of the state of emergency. In Hyogo, the nighttime population remains at a level lower than the minimum value during the second declaration of the state of emergency. While the number of new cases of infection is expected to continue to decrease, the nighttime population in Kyoto has begun to increase. Therefore, careful monitoring is necessary including the de facto population after improvement in the infection status.
    • In Shiga and Nara, the number of new cases of infection has been on a downward trend to approximately 14 and 8, respectively.
  4. (4) Metropolitan area (Tokyo and its 3 neighboring prefectures) 
    • In Tokyo, Saitama, Chiba, and Kanagawa, the number of new cases of infection has been decreasing to approximately 21, 9, 11, and 16, respectively. The ratio of this week to last week has been below 1 since mid-May, but the level remains higher and the decreasing speed is slower compared to the Kansai area. Particularly in Chiba and Kanagawa, it is almost flat. In addition, there is no apparent downward trend in the number of severe patients.
    • In Tokyo, both the nighttime and daytime populations have increased for 4 consecutive weeks. In particular, the increase from before and after the extension of the declaration of the state of emergency is remarkable. In Saitama, Chiba, and Kanagawa, the trend has remained flat. There is concern that it is becoming difficult to obtain cooperation with the measures. Particularly in Tokyo, if the upward trend continues, there is a possibility of a rebound and caution is therefore required.
  5. (5) Chukyo area
    • In Aichi, the number of new cases of infection has been decreasing to approximately 20. The burden on the healthcare systems continues in spite of the decrease in severe patients, and the use rates of beds are at high levels. The medical care provision systems have been under severe pressure. The number of new cases of infection is expected to decrease in future, but the nighttime and daytime populations have slightly increased. Attention should be paid to whether the downward trend in the number of new infections continues.
    • In Gifu, the number of new cases of infection has been decreasing to approximately 15. The nighttime and daytime populations remain at a low level, and the number of new cases of infection is expected to decrease in future. In Mie, the number has been decreasing to approximately 8. The nighttime population has been increasing, which leads to concern about a rebound. In Shizuoka, the number has also been decreasing to approximately 7.
  6. (6) Kyushu
    • In Fukuoka, the number of new cases of infection has been decreasing to approximately 11. Although the number of inpatients and severe patients has decreased, there is a great burden on the medical care provision systems. The nighttime population remains low. The number of new cases of infection is expected to decrease in future, but it is necessary to carefully watch whether these trends continue.
    • In Kumamoto, the number of new cases of infection has continued to decrease to approximately 5. As the number of new cases of infection has decreased, the use rate of both beds for inpatients and beds for severe patients is decreasing, which secures the hospitalization rate above 50%. In other Kyushu prefectures, the decreasing trend generally continues.
  7. (7) Other areas under emergency measures (Okayama and Hiroshima) and those under priority measures, such as for prevention of the spread of disease (Gunma and Ishikawa)
    • In Okayama and Hiroshima, the number of new cases of infection has been decreasing to approximately 7 and 12, respectively. In both prefectures, the number of severe patients has decreased, while the use rate of beds remains high. The nighttime population remains at a low level in both prefectures and the number of new cases of infection is expected to decrease in future, but attention should be paid to whether the downward trend in the number of new infections continues.
    • In Gunma and Ishikawa, the number of new cases of infection has been decreasing to approximately 5 and 7, respectively. As the number of new cases of infection has decreased in both prefectures, the use rate of both beds for inpatients and beds for severe patients is decreasing, which secures the hospitalization rate above 50%.
  8. (8) Areas other than those listed above
    • In Yamanashi and Kochi, the number of new cases of infection exceeds 15 at 21 and 18, respectively. While the number has started to decrease in Kochi, it has increased in Yamanashi due to the occurrence of clusters and should be watched carefully.

Future outlook and measures to be taken

  • Although a downward trend in the number of new cases of infection may continue nationwide, attention should be paid to the increasing trend in the flow of people, since the existing strains were almost replaced by the variants of B.1.1.7 lineage (alpha variant) and the variants may be more infectious. There are some regions where the flow of people has already started to increase and there is a possibility that the number of new cases of infection may stop decreasing in these regions.
  • In regions under emergency measures and those under priority measures, such as for prevention of the spread of disease (priority measures), the number of infections has decreased owing to the cooperation of citizens and business operators, clearly showing the effect of these measures. In Okinawa and Hokkaido, however, the number of new cases of infection has remained at the level equivalent to the Stage IV. There are some regions where the medical care provision systems remain under severe pressure, although the burden has decreased alongside the decrease in the number of new cases of infection and patients who are receiving care. Therefore, it is necessary reduce the number of new cases of infection as much as possible to prevent a future rebound and to continue to control the increase even if the reduction stops. It is necessary to thoroughly implement the measures based on the "Measures to be taken after June during the declaration of the state of emergency" compiled by the government's Novel Coronavirus Response Headquarters on May 28.
  • Particularly in Tokyo, the flow of people continues to increase. If this trend continues, the number of infected patients will stop decreasing and rebound in future. Vaccinations have been performed mainly in the elderly, and therefore it is expected that severe cases may be suppressed in the elderly. However, if the number of infected patients continues to surge after a rebound, the number of severe patients may increase and the medical care provision systems will be overwhelmed. In addition, there is a burden associated with vaccination at medical institutions. Based on these points, efforts necessary to control the spread of infection should be continued in the future.
  • In other regions and regions where the priority measures are lifted, each local government has to analyze the flow of people, the status of infection and the medical care provision systems in a conference style with experts in the region, and implement the necessary measures in a timely manner, based on the possibility that infection will spread faster than before due to alpha variants and variants of B.1.617 lineage (including delta variants).
  • As for the spread of infection this time, the size, speed, and course of decrease differed among regions. These differences can be attributed to various factors including replacement by variants, contents and timing of the start/end of countermeasures, movement of people or gathering of persons who do not usually meet due to the turn of the start/end of fiscal year or Golden Week holidays, and the age group that became the center of infection, but further investigation is needed.
  • The number of vaccinations has already exceeded 19 million nationwide and approximately 14.5 million people have received the first vaccination. To suppress the spread of infection, it is necessary to promptly and smoothly carry out the vaccination of many people nationwide, including occupational vaccinations.
  • While it is estimated that the existing strains have been replaced by alpha variants as the predominant strain in most regions with some exceptions, it is necessary to take measures focused on an understanding of the actual situation using virus genomic surveillance in order to reinforce the measures against new mutant strains. It is particularly essential concerning mutants, including the delta variants, to suppress the spread of infection as much as possible by following the measures: nationwide monitoring through genomic surveillance and screening of L452R variants, strengthening of systems to conduct tests regionally and active epidemiological surveys. In addition, it is also necessary to continue to take the border control measures promptly.

Figures (Number of new infections reported etc.) (PDF)

37th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (June 6, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide has been declining since mid-May and results in approximately 18 per 100,000 population for the latest week on the basis of reporting dates. The number on the basis of onset dates also tends to decrease since early May. There is generally a downward trend in regions where the infection has spread. In some regions, however, the number remains flat or increases. Under such circumstances, flow of people has recently increased in various regions and there is a possibility of a rebound in the future. Along with the decline in the number of new cases of infection, the number of severe patients, which had been increasing, has recently declined, while the number of deaths has remained high.  

    The nationwide effective reproduction number has been declining and remains below 1 at 0.82 (as of May 16).  

Analysis of infection status [local trends]

  *The value of new cases of infection is the number of people per 100,000 in the total number for the latest week on the basis of reporting dates. The effective reproduction number represents the mean value of the most recent week (as of May 17)

  1. (1) Okinawa
    • In Okinawa, 1 week has passed since the start of emergency measures. In Naha City, the southern/middle regions, and the Miyako/Yaeyama areas, the number of new cases of infection continues to surge, mainly among the working generations in their 20s and 30s, and the number has remained at an unprecedentedly high level of approximately 126. The use rate of beds has remained at a high level, the hospitalization rate has decreased, and the number of patients who are receiving care at home and cases in the process of arranging hospitalization has increased. The number of severe patients has increased and a further burden may be imposed on the medical care provision systems. Although the number of patients in their 70s has flattened for the latest week, there is particular concern that transmission of infection among elderly people could cause a further increase in severe patients.
    • The nighttime and daytime populations have decreased since the start of emergency measures; however, the ratio of this week to last week has remained above 1 and the number of infected patients may increase for the time being. As the number of patients who are receiving care at home or at accommodation facilities is increasing, it is necessary to handle issues including the preparation for sudden changes in the condition of these patients.
  2. (2) Hokkaido
    • Two weeks have passed since the start of emergency measures. The number of new cases of infection has decreased since late May, but is very high at approximately 53. The number of severe patients has not decreased. In Sapporo City, which is the center of infection spread, the number has decreased, but is still at a higher level of approximately 92. In addition, clusters continue to occur at hospitals and welfare facilities. The nighttime and daytime populations have decreased since the start of emergency measures and have remained at a low level. Although the number of new cases of infection may decrease in the future, attention should be paid to whether these trends continue. The medical care provision systems in Sapporo have been under severe pressure and the use rate of beds remains at a high level. There have also been cases of wide-area medical evacuations transported outside the city. Clusters have also occurred in welfare facilities in other regions than Sapporo. Actions to prevent expansion are required.
  3. (3) Kansai area
    • In Osaka, Hyogo, and Kyoto, 5 weeks have passed since the start of emergency measures. The number of new cases of infection has decreased to approximately 19, 13, and 13, respectively.
    • In Osaka, the nighttime and daytime populations are increasing, but remain at a level approximately 20% lower than the minimum value during the second declaration of the state of emergency. In Hyogo and Kyoto, the nighttime population remains at a level lower than the minimum value during the second declaration of the state of emergency. The effective reproduction number in Osaka, Hyogo, and Kyoto is below 1, respectively. While the number of new cases of infection is expected to continue to decrease, careful monitoring is necessary including the de facto population after improvement in the infection status.
    • The situation has improved according to the decrease in the number of new cases of infection. However, the healthcare provision systems remain under severe pressure, mainly in Osaka and Hyogo, as the number of severe patients is decreasing in Osaka but remains at a high level in Hyogo. Clusters continue to occur in places such as elderly facilities.
    • In Shiga, the number of new cases of infection has increased again, reaching approximately 20. In Nara and Wakayama, the number of new cases of infection has been on a downward trend to approximately 11 and 5, respectively.
  4. (4) Metropolitan area (Tokyo and its 3 neighboring prefectures) 
    • In Tokyo, 5 weeks have passed since the start of emergency measures. In Saitama, Chiba and Kanagawa, 6 weeks have passed since the start of priority measures. The number of new cases of infection has been decreasing since mid-May, to approximately 27, 12, 11 and 16, respectively. The ratio of this week to last week has been below 1 since mid-May, but the level remains higher and the decreasing speed is slower compared to the Kansai area. There was also no apparent decreasing trend in severe patients in Tokyo and Kanagawa.
    • In Tokyo, both the nighttime and daytime populations have clearly increased. In Saitama, Chiba, and Kanagawa, the trend has been from flat to slightly increasing. The nighttime population in Tokyo is gradually reaching the level in March. There is concern that it is becoming difficult to obtain cooperation with the measures. If the upward trend continues, there is a possibility of rebound, and caution is therefore required.
  5. (5) Chukyo area
    • In Aichi, 3 weeks have passed since the start of emergency measures. Although the number of new cases of infection started to decrease in late May, it remains at a high level of approximately 31. The burden on the healthcare systems has continuously increased due to an increase in severe patients, and the use rates of beds are at high levels. The medical care provision systems have been under severe pressure. The nighttime population has fluctuated around the lowest level during the second declaration of the state of emergency. The daytime population has increased slightly. The number of new cases of infection is expected to decrease in the future, but it is necessary to carefully monitor whether these trends will continue.
    • In Gifu and Mie, 3 weeks have passed since the start of priority measures. In Gifu, the number of new cases of infection has been decreasing to approximately 22. The nighttime population remains at a low level, and the number of new cases of infection is expected to decrease in the future. In Mie, the number has been decreasing since late May, to approximately 11. The nighttime population has clearly been increasing, which leads to concern about rebound. In Shizuoka, the number has also been decreasing to approximately 11.
  6. (6) Kyushu
    • In Fukuoka, 3 weeks have passed since the start of emergency measures. The number of new cases of infection continues to decrease to approximately 21. As the number of new cases of infection has decreased followed by a drop in the number of inpatients, the number of severe patients may peak out. The use rate of beds, however, remains high and there continues to be a heavy burden on the medical care provision systems. The nighttime population has not reached the lowest level during the second declaration of the state of emergency, but remains at a low level. The number of new cases of infection is expected to decrease in the future, but it is necessary to carefully watch whether these trends continue.
    • In Kumamoto, 2 weeks have passed since the start of priority measures. The number of new cases of infection has continued to decrease to approximately 14. In other prefectures in Kyushu, the number of new cases of infection is on a downward trend. The ratio of this week to last week has been decreasing below 1 and the number of new cases of infection may continue to decrease. However, it needs to be monitored continuously.
  7. (7) Other areas under emergency measures (Okayama and Hiroshima) and those under priority measures (Gunma and Ishikawa)
    • In Okayama and Hiroshima, 2 weeks have passed since the start of emergency measures. Although the number of new cases of infection has continued to decrease to approximately 18 and 26, respectively, the number in Hiroshima remains above 25. In Hiroshima, the number of severe patients is on an upward trend and the use rate of beds is at a high level in both Okayama and Hiroshima. In both prefectures, the nighttime and daytime populations have decreased since the start of emergency measures, and the number of new cases of infection may continue to decrease in the future. However, in Okayama, the nighttime population starts to increase following the decrease in the number of infected patients. Therefore, it is necessary to carefully watch whether the downward trend in the number of new cases of infection will continue.
    • In Gunma and Ishikawa, 2 weeks have passed since the start of priority measures. In both prefectures, the number of new cases of infection has been decreasing to approximately 10 and 15, respectively. The nighttime population is on a decreasing trend and is expected to decrease in the future, but it is necessary to watch carefully whether this trend continues.
  8. (8) Areas other than those listed above
    • In Kochi, the number of new cases of infection is approximately 26. The number stays at a high level exceeding 25 and attention is also required hereafter.

Analysis of mutant strains

  • The proportion of variants of B.1.1.7 lineage (alpha variant) has become approximately 80% of the national total in screening tests, suggesting that the existing strains have almost completely been replaced by mutant strains, except for some regions. In addition, the number of reports of variants of B.1.617 lineage (including delta variants) is increasing.
  • It is also necessary to establish a medical care system and provide treatment assuming the possibility of an increased risk of the disease becoming more severe due to alpha variants.
  • It has also been reported that the existing strains have being replaced by delta variants overseas, and that this strain may be more infectious and transmissible than alpha variants. Therefore, it is necessary to continue analyses.

Measures to be taken

  • Although the decreasing trend may continue nationwide except in some regions, attention should be paid to the increasing trend in the flow of people. The increase is expected to continue in Okinawa. The existing strains have almost been replaced by alpha variants nationwide, and the expansion speed of the variants is faster than before. It tends to take longer than before for the decrease in the flow of people to lead to a reduction in the number of new cases of infection. In addition, even in regions where the number of new cases of infection is decreasing, the number of severe patients continues to increase or remains high. Therefore, the number of infected patients needs to be reduced continuously.
  • On the other hand, in other regions under emergency measures than Okinawa and those under priority measures, the number of infections has decreased owing to the cooperation of citizens and business operators, clearly showing the effect of these measures. However, the number of new cases of infection has remained at a level equivalent to Stage IV in several regions, and the medical care provision systems continues to be under severe pressure in many regions. There are also some regions where the flow of people has already started to increase, and there is a possibility that the number of new cases of infection may stop decreasing. It is required to reduce the number of new cases of infection as far as possible to prevent future rebound, and to continue to control the increase even if the reduction stops. For this reason, it is necessary to thoroughly implement the measures based on the "Measures to be taken after June during the declaration of the state of emergency" compiled by the government's Novel Coronavirus Response Headquarters on May 28.
  • The number of vaccinations has already exceeded 13 million nationwide, and approximately 9.8 million people have received the first vaccination. To suppress the spread of infection, it is necessary to promptly and smoothly carry out vaccination of many people nationwide, including occupational vaccination. • Based on the results of past efforts, the current infection status, the status of medical care provision systems, and the possibility that infection will spread faster than before due to alpha and delta variants, each local government has to analyze the flow of people, the status of infection and the medical care provision systems in a conference style with experts in the region, and implement the necessary measures in a timely manner.
  • While it is estimated that the existing strains have been replaced by alpha variants as the predominant strain in most regions with some exceptions, it is necessary to take measures focused on an understanding of the actual situation using virus genomic surveillance in order to reinforce the measures against new mutant strains. Particularly concerning mutants including the delta variants, it is essential to suppress the spread of infection as far as possible by following the measures: nationwide monitoring through genomic surveillance, strengthening of systems to conduct tests regionally and active epidemiological surveys. In addition, while the border control measures have been strengthened several times, it is continuously required to deal with issues promptly.

Figures (Number of new infections reported etc.) (PDF)

36th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (May 26, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide has decreased since mid-May on the basis of reporting dates, and the number in the most recent week is approximately 26 per 100,000 population. There may be a decreasing trend in the epi-curve on the basis of onset dates. While a levelling-off trend or a decreasing trend has been shown in some regions, other regions still face an increasing trend. The situation continues to require caution. The trend in the number of severe patients or deaths shifted from increasing to flat, but the latest level has remained high.
  • In particular, in the metropolitan areas such as the Tokyo, Kansai, and Aichi areas, the flow of people decreased by various measures, but as the predominant strains are being replaced by mutants first detected in the UK (B.1.1.7), it has taken longer than before until the number of new cases of infection decreases. Under such circumstances, the flow of people has recently increased in various regions. Attention should be paid to the situation including changes in the number of new cases of infection.

    The nationwide effective reproduction number stayed at around 1 and has recently become 0.95 (as of May 9), marking the drop below 1.

Analysis of infection status [local trends]

 *The value of new cases of infections is the number of people per 100,000 in the total number for the latest week on the basis of reporting dates. The effective reproduction number represents the mean value of the most recent week (as of May 10)

  1. (1) Kansai area
    • In Osaka, Hyogo, and Kyoto, 4 weeks have passed since the start of emergency measures. The number of new cases of infection is approximately 30, 22, and 24, respectively. In Osaka and Hyogo, the number of new cases of infection continues to decrease, and a decreasing trend has been also shown in Kyoto. The number in Osaka, however, is still at a high level above 25.
    • In Osaka, the nighttime and daytime populations keep at a level approximately 30% lower than the minimum value during the second declaration of the state of emergency. In Hyogo and Kyoto, the nighttime population remains at a level lower than the minimum value during the second declaration of the state of emergency. The effective reproduction number is 0.69, 0.64, and 0.85 in Osaka, Hyogo, and Kyoto, respectively. While the number of new cases of infection is expected to continue to decrease, careful monitoring is necessary including the de facto population after the improvement of the infection status.
    • Mainly in Osaka and Hyogo, the medical care provision systems and public health systems are under very severe pressure. In Osaka, the number of patients receiving care at accommodation facilities, the number of inpatients and the use rate of beds for severe patients are decreasing as is the number of patients receiving care at accommodation facilities in Hyogo, but the other numbers remain at the same level. Although the situation is expected to improve alongside the decrease in the number of new cases of infection, general medical care still remains restricted. Clusters in places such as elderly facilities continue to occur.
    • In Shiga, Nara, and Wakayama, the number of new cases of infection is on a downward trend to approximately 19, 18, and 8, respectively.
  2. (2) Metropolitan area (Tokyo and its 3 neighboring prefectures) 
    • In Tokyo, 4 weeks have passed since the start of emergency measures. In Saitama, Chiba and Kanagawa, 5 weeks have passed since the start of priority measures. The number of new cases of infection has been flat or declining since mid-May, to approximately 31, 16, 13 and 20, respectively. Many people are in their 20s to 50s. The ratio of this week to last week is recently below 1. On the other hand, there may be effects by fluctuations in the number of infected patients during the Golden Week holidays (GW). Considering this point, we cannot be over-optimistic about the future.
    • In Tokyo, the nighttime and daytime populations have been increasing to the lowest level during the second declaration of the state of emergency. In Saitama, Chiba, and Kanagawa, the trend has remained flat. If the flow of people continues to be on an upward trend in Tokyo, there is a possibility of a rebound, and therefore, caution is required.
  3. (3) Chukyo area
    • In Aichi, 2 weeks has passed since the start of emergency measures. The number of new cases of infection increased rapidly, but has been flat since mid-May, at a high level of approximately 48. Many people are in their 20s to 30s. The burden on medical institutions and public health centers has continuously increased, and the use rates of beds are at high levels. The medical care provision systems have been under severe pressure.
    • The nighttime population has slightly decreased and has fluctuated around the lowest level during the second declaration of the state of emergency. The daytime population has decreased since the declaration of the state of emergency. Five weeks or more have passed since the de facto population decreased, and it is necessary to carefully watch whether the number of new cases of infection decreases.
    • In Gifu and Mie, 2 weeks have passed since the start of priority measures. In Gifu, the number of new cases of infection has decreased since mid-May, to approximately 30. As the nighttime and daytime populations are decreasing, it is expected to decrease in the number of new cases of infection. In Mie, the number of new cases of infection has also decreased to approximately 12. In Shizuoka, the number of new cases of infection continued to increase, but has decreased after mid-May, to approximately 13. Attention should be paid to future trends.
  4. (4) Kyushu/Okinawa
    • In Okinawa, 6 weeks have passed since the start of priority measures. Emergency measures have been applied since May 23. In the metropolitan areas including Naha City and the Yaeyama area, the number of new cases of infection has surged mainly in the working generations in their 20s and 30s, and the number has remained at a high level of approximately 93. There have been infections in persons coming from outside the prefecture. The use rate of beds has increased and further burden may be imposed on the medical care provision systems due to increase in the number of infected patients. Although the percentage of patients in their 60s is low at present, there is particular concern that transmission of infection in the elderly could cause an increase of severe patients.
    • The nighttime population, which decreased after the priority measures, has increased during GW. As there was only a slight decrease after GW, the number of infected patients is expected to continue to increase in the future.
    • In Fukuoka, 2 week has passed since the start of emergency measures. The number of new cases of infection continued to surge mainly among people in their 20s to 30s, but has decreased since mid-May, to approximately 44. The ratio of this week to last week has recently been 1 or less. However, the number of infected patients remains at a very high level. The use rate of beds is also increasing, and there continues to be a heavy burden on the medical care provision systems.
    • The effective reproduction number is 1 or less, and it is expected that the number of new cases of infection will decrease. However, after emergency measures, there was only a slight decrease in the nighttime population, which has not decreased to the minimum level at the time of the second declaration of the state of emergency. Therefore, it is necessary to watch carefully.
    • In Kumamoto, 1 week has passed since the start of priority measures. The number of new cases of infection has decreased since mid-May, to approximately 26.
    • There is a downward trend in other prefectures in the Kyushu area, but the number of infected patients in Saga and Oita exceeds 15, reaching approximately 20 and 24, respectively. The ratio of this week to last week has been decreasing below 1 and may continue to decrease. However, it needs to be monitored continuously.
  5. (5) Hokkaido
    • In Hokkaido, 2 weeks and 1 week have passed since the start of priority measures and emergency measures, respectively. The number of new cases of infection is increasing to a high level of approximately 78. The number in Sapporo City is at a higher level of approximately 127. In addition, clusters have occurred at hospitals and welfare facilities. The nighttime and daytime populations have decreased since emergency measures. However, the ratio of this week to last week remains above 1, though there is a decreasing trend, and the increase may continue in future. The medical care provision systems in Sapporo have been under severe pressure and the use rate of beds remains at a high level. In addition, there have been cases of wide-area medical evacuations transported outside the city.
  6. (6) Other areas under emergency measures (Okayama and Hiroshima)
    • In Okayama and Hiroshima, 1 week has passed since the start of emergency measures. The number of new cases of infection has decreased in Okayama since mid-May and has started to decrease in Hiroshima as well, but it is still at a high level of approximately 35 and 43, respectively. The use rate of beds is at a high level in both prefectures. In both prefectures, the nighttime and daytime populations are continuously decreasing and the ratio of this week to last week has recently been 1 or less. It is necessary to carefully monitor whether the decreasing trend continues.
  7. (7) Other areas under priority measures, such as for prevention of the spread of disease (Gunma and Ishikawa)
    • In Gunma and Ishikawa, 1 week has passed since the start of priority measures. In both prefectures, the number of new cases of infection has been decreasing since mid-May, to approximately 17 and 27, respectively (in Ishikawa, the number has currently increased in clusters in school settings). The effective reproduction number was below 1 in both prefectures and the ratio of this week to last week has been below 1. The number is expected to decrease in the future, but attention should be paid to whether the trend continues.
  8. (8) Areas other than those listed above
    • The number of new cases of infection in Aomori, Toyama, Yamaguchi and Kochi exceeds 15, reaching approximately 16, 22, 21 and 20, respectively. There is a downward trend in Yamaguchi, and a levelling-off trend in Aomori, while an upward trend continues in Toyama and Kochi. It is necessary to pay close attention in future.

Analysis of mutant strains

  • The proportion of B.1.1.7 variants has become approximately 80% of the national total in screening tests, suggesting that the existing strains were almost all replaced by the mutant strains, except for some regions. As for B.1.617 (the mutant strain first detected in India) in Japan, there are cases where infection has been confirmed from people who have not traveled abroad.
  • It is necessary to establish medical care systems and provide treatments assuming the possibility of increased risk of disease becoming severer due to B.1.1.7.
  • In addition, it has been reported that B.1.617 is being replaced with the existing ones overseas, and it has been also suggested that this strain may be more infectious and transmissible than B.1.1.7. Therefore, it is necessary to continue analyses.

Measures to be taken

  • Although the downward trends may continue in the Tokyo metropolitan and Kansai areas, attention should be paid as there are fluctuations in the flow of people. In Aichi, it is necessary to keep a close watch on whether the number of infected patients will clearly decrease. The increase is expected to continue in Okinawa. The B.1.1.7 variants have almost replaced the existing ones nationwide. The variants are expected to be faster in expansion and it may take longer to curb the spread of the variants. In addition, the number of severe patients is increasing or remains at a high level in many regions, and therefore the increase of infected patients should be continuously reduced.
  • It takes longer than before until a decrease in the flow of people leads to a reduction in the number of new cases of infection. On the other hand, in some regions under emergency measures and those under priority measures, the number of infections has decreased or stopped increasing owing to cooperation of citizens and business operators, which indicates the effect of these measures. However, in regions where the number of infected patients continues to increase or has not decreased, the effect of these measures is still limited due to the influence of GW. In many regions, the number of new cases of infection has reached the level equivalent to the Stage IV, and the medical care provision systems continues to be under severe pressure. Therefore, continuation of necessary measures is required.
  • Based on the results of past efforts, the current infection status, the status of medical care provision systems, and the possibility that infection spread will progress faster than before due to B.1.1.7 and B.1.167, each local government needs to analyze the status of infection and the medical care provision systems at a conference body with experts in the regions and implement necessary measures in a timely manner.
  • It is essential to analyze and evaluate the timing of the priority measures and the emergency measures, their contents, and their effects during the expansion of the current epidemic, and to utilize the results for future operations. In addition, in each region, testing strategies utilizing the antigen qualitative tests and strengthening of the medical care provision systems should be carried forward based on the materials of the 33th ADB meeting and the discussions in the 5th Advisory Committee on the Basic Action Policy.
  • The effectiveness of vaccines has been reported. It is expected that vaccinations in wider populations can reduce severe cases and then inhibit infection of the virus. Vaccination in the large-scale vaccination centers has been initiated, and it is necessary for the national and local governments to work together to offer vaccinations for many people as quickly and efficiently as possible.
  • In some regions, the effects of masks are being analyzed. Taking into account these results, it is important to thoroughly wear a mask when conversing with others, including mealtimes. With the efforts in each region, it is indispensable to continue to communicate the importance of taking basic measures for infection control, such as proper wearing of masks, at various occasions in daily life, including workplaces and school settings. On the other hand, it is necessary ensure people understand that wearing a mask does not give complete immunity, and it should be also noted that compliance is difficult to ensure.
  • While it is estimated that the existing strains have been replaced with B.1.1.7 as the predominant strains in most regions with some exceptions, it is necessary to take measures focusing on understanding the actual situation using virus genomic surveillance in order to reinforce the measures against new mutant strains. Particularly for B.1.617, which has been positioned as VOC, it is essential to suppress the spread of infection in Japan as much as possible by following measures: nationwide monitoring through genomic surveillance, and active epidemiological surveys. In addition, while the border control measures have been strengthened, past measures need to be verified. Prompt actions will be required based on the occurrence status outside Japan and at quarantine stations in Japan, as well as the effects of the previous measures.

Figures (Number of new infections reported etc.) (PDF)

35th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (May 19, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide has stopped increasing based on the reporting date, and the number in the most recent week is approximately 32 per 100,000 population. As in the previous week, the figure does not indicate nationwide spread of infection, and the trends are different between regions; some are in an increasing trend, some remains the same, and some are in a decreasing trend. The numbers of severe patients and deaths are continuing to increase.
  • The number of infections has not clearly decreased at present. The effects of the movement of people during GW and the effects of mutant strains are intricately intertwined with the effects of various measures to control the infection, and it is difficult to evaluate the statuses and estimate the future. Attention should be paid to future movements.

    The nationwide effective reproduction number remains stable around 1, most recently 1.01 (as of May 2).

Analysis of infection status [local trends]

 *The value of new cases of infections is the number of people per 100,000 in the total number for the latest week on the basis of reporting dates. The effective reproduction number represents the mean value of the most recent week (as of May 3)

  1. (1) Kansai area
    • In Osaka, 6 weeks have passed since the start of priority measures, such as for prevention of the spread of disease (hereinafter referred to as “priority measures”), and 3 weeks since the start of emergency measures. The ratio of this week to last week has been 1 or lower for the most recent 2 weeks and the number of new cases of infection is decreasing, but remains extremely high. The nighttime and daytime populations rapidly decreased to the previous lowest level, and then increased. It took approximately 5 weeks from the decrease in the de facto population to the resulting decrease in the number of new cases of infection. The effective reproduction number is 0.87, 0.99, and 0.98 in Osaka, Hyogo, and Kyoto, respectively. While the number of new cases of infection is expected to continue to decrease, careful monitoring is necessary including the de facto population.
    • The number of new cases of infection is about 51, 36, 37 and 34 in Osaka, Hyogo, Kyoto and Nara, respectively. A decreasing trend has been generally observed, except for Kyoto whose figure is almost flat, but the number of new cases of infection is high in all age groups.
    • Mainly in Osaka and Hyogo, the medical care provision systems and public health systems are under very severe pressure. General medical care has been inevitably restricted. Efforts have been made to secure beds. It is essential to keep a downward trend in the number of new cases of infection to protect the system for necessary and timely care.
    • In Wakayama, the number of new cases of infection is in a decreasing trend, about 12. The figure remains almost stable, about 23, in Shiga.
  2. (2) Metropolitan area (Tokyo and its 3 neighboring prefectures)  
    • In Tokyo, 5 weeks and 3 weeks have passed since the start of priority measures and emergency measures, respectively. In Saitama, Chiba and Kanagawa, 4 weeks have passed since the start of priority measures. The number of new cases of infection remains almost stable in Tokyo (though the status is difficult to assess), and it remains stable or slightly increased in Saitama, Chiba and Kanagawa; the figure is about 38, 22, 16 and 22, respectively in these prefectures. Many people are in their 20s to 50s. The ratio of this week to last week increased after GW and is generally in a decreasing trend most recently.
    • In Tokyo, the nighttime and daytime populations reached a level 25% lower than the lowest value during the second Declaration, showed an increasing trend after GW, and then has become the same level of the lowest during the second Declaration. Three weeks have passed since the decrease in nighttime population was observed, but the number of new cases of infection has not been past the peak. The nighttime population remains stable or is increasing after GW also in Saitama, Chiba and Kanagawa, and the daytime population increased in Chiba and Saitama. The effective reproduction number is 1.03, 1.57, 1.08 and 1.14, respectively, and the number of cases of infection may increase or decrease. It is necessary to carefully follow movements in the de facto population and the number of new cases of infection.
  3. (3) Chukyo area
    • In Aichi, 4 weeks and 1 week have passed since the start of priority measures and emergency measures, respectively. The trend of rapid increase in the number of new cases of infection is continuing and the figure has reached about 52. The ratio of this week to last week has remained 1 or higher over about 8 weeks since late March. The cases of infection are mainly of those in their 20s to 30s, but the number of new cases of infection tends to increase in almost all generations. The burden on medical institutions and public health centers is increasing, the use rates of beds are at high levels, and the medical care provision systems are under severe pressure.
    • The nighttime population remains stable after issuance of the Declaration of State of Emergency, and has fluctuated around the lowest level during the second Declaration of Emergency State. In contrast, the daytime population started to increase from the latter half of GW and slightly decreased after issuance of the Declaration of State of Emergency. More than 4 weeks have passed since a decrease in the de facto population was observed, but the effective reproduction number has been 1 or higher, and the number of new cases of infection may continue to increase.
    • One week has passed since the start of priority measures in Gifu and Mie. The trend of increase in the number of new cases of infection is continuing in Gifu with the figure reaching about 44. Although the nighttime and daytime populations are decreasing, it is necessary to watch carefully whether the number of new cases of infection will decrease. The figure remains stable, about 18, in Mie. The ratio of this week to last week has rapidly increased since mid-May in Shizuoka and has been 1 or higher for about 3 weeks. The number of new cases of infection is about 17, and should receive close attention.
  4. (4) Kyushu/Okinawa
    • One week has passed since the start of emergency measures in Fukuoka. The number of new cases of infection has rapidly increased mainly in persons in their 20s and 30s since mid-April. The rate of increase slightly slowed down most recently, but the number is still very high, about 64. The ratio of this week to last week has remained 1 or higher over 6 weeks since early April. The bed occupancy rate is rapidly increasing and the burden on the medical care provision systems is still large.
    • The nighttime population was decreasing but did not reach the lowest level during the second Declaration of State of Emergency; it has remained stable after issuance of the Declaration of State of Emergency, and the daytime population increased before issuance of the Declaration of State of Emergency but slightly decreased afterwards. The effective reproduction number has remained 1 or higher, and the number of new cases of infection may continue to increase.
    • Priority measures have been taken since May 16 in Kumamoto. The number of new cases of infection had rapidly increased; the rate of increase slowed down most recently, but the figure is high, about 39.
    • A turn to decline has been observed in other prefectures in the Kyushu area, but the figures are still high, about 29 and 38 in Saga and Oita, respectively. The effective reproduction number is 1.35 in both prefectures; the ratio of this week to last week is in a decreasing trend which may continue and should be carefully monitored.
    • In Okinawa, 5 weeks have passed since the start of priority measures. Despite the priority measures, the number of new cases of infection has increased since GW, mainly in the working generations, 20s and 30s, in the metropolitan areas including Naha City and the Yaeyama area, with figures as high as about 57. There have been infections in persons coming from outside the prefecture. Medical care is expected to be in an impending situation if the number of cases of infection increases. There is particular concern that transmission of infection in the elderly could cause an increase of severe patients.
  5. (5) Other areas under emergency measures (Hokkaido, Okayama and Hiroshima)
    • In Hokkaido, priority measures and emergency measures were applied on May 9 and May 16, respectively. Rapid increase in the number of new cases of infection is continuing; the figure is very high, about 72. The ratio of this week to last week has been 1 or higher for about 6 weeks. The figure is at a high level, about 125, in Sapporo City, and many cases with an unknown link have occurred in the community. Clusters also occurred at hospitals and welfare facilities. The effective reproduction number is high, 1.57, and may continue to increase. The medical care provision systems in Sapporo have been under severe pressure, the use rate of beds is at a high level, and there have been cases of wide-area medical evacuations transported outside the city.
    • Emergency measures were applied to Okayama and Hiroshima on May 16. The figures are high, about 59 and 53, respectively. The ratio of this week to last week has been 1 or higher for 7 weeks in Okayama, and 5 weeks in Hiroshima. The use rate of beds is at a high level in both prefectures. In Okayama, the nighttime and daytime populations are decreasing. The effective reproduction numbers are high, i.e., 1.30 and 1.76, respectively. The infection may further spread from now on.
  6. (6) Other areas under priority measures, such as for prevention of the spread of disease (Gunma, Ishikawa, and Ehime)
    • Priority measures have been implemented since May 16 in Gunma and Ishikawa. The number of infections have been in a decreasing trend from mid-May in Gunma, and it stopped increasing most recently in Ishikawa; the figures are about 24 and 29, respectively. The effective reproduction number is 1 or higher in both prefectures, and it is necessary to carefully monitor the changes in the number of cases of infection.
    • In Ehime, 3 weeks have passed since the start of priority measures. The number of new cases of infection has decreased since late April, reaching approximately 6.
  7. (7) Areas other than those listed above
    • The number of new cases of infection in Fukushima, Ibaraki, Yamaguchi and Kagawa exceeded 15, i.e., about 17, 16, 25 and 21 , respectively. A decreasing trend has been observed in Fukushima and Kagawa, and an increasing trend in Ibaraki. The effective reproduction number is 1 or higher, including Yamaguchi, and the situation should be carefully monitored.

Analysis of mutant strains

  • The proportion of the mutant strain first detected in the UK (B1.1.7) became about 80% in national total in screening test, suggesting that the existing strains were almost all replaced by the mutant strains, except for some regions. In addition, analysis of screening at private testing institutions by the National Institute of Infectious Diseases also demonstrates that the existing strains have already been replaced by the mutant strains in many regions.
  • It is necessary to establish medical care systems and provide treatments assuming the possibility of increased risk of disease becoming severer due to B.1.1.7.
  • In addition, it has been reported that B.1.617 (mutant strain detected first in India) is being replaced with the existing ones overseas, and it has been suggested that this strain may be more infectious than B.1.1.7. Therefore, it is necessary to continue analyses.

Measures to be taken

  • In some areas designated to be controlled under emergency measures and those under priority measures such as for prevention of the spread of disease, the number of infections seem to decrease or stop increasing owing to cooperation of citizens and business operators. On the other hand, there are some regions where the number of infections has not clearly decreased. In the spread of infection mainly of mutant strain (VOC) this time, it takes a longer time before a decrease in the flow of people results in a decrease in the number of new cases of infection. Currently, the effective reproduction number has not decreased to much lower than 1 with the previous efforts. It is required to discuss necessary measures based on the infection status and the high infectivity of mutant strains and to implement them in a timely manner.
  • In other regions, if the number of new cases of infection is at a high level and then increases/remains, the speed of infection will increase more than before and the burden on medical care provision systems will become larger. Therefore, necessary actions should be promptly taken.
  • It is crucial to proceed with measures in the early stages of the epidemic. Each local government is required to conduct measures promptly to establish a meeting structure to utilize advice of experts on public health and infectious diseases for countermeasures and to act from an early stage and establish a cooperative system to secure medical care provision systems based on future prospects by using various data, including the flow of people.
  • While it is estimated that the existing strains have been replaced with B.1.1.7 as the predominant strains in most regions with some exceptions, it is necessary to take measures focusing on understanding the actual situation using virus genomic surveillance in order to reinforce the measures against new mutant strains. Particularly for B.1.617, which has been positioned as VOC, it is essential to suppress the spread of infection in Japan as much as possible by following measures: nationwide monitoring through genomic surveillance, and active epidemiological surveys. In addition, the border control measures against infection from India, Pakistan, and Nepal have been strengthened. Prompt action will be required based on the occurrence status in other countries and quarantine.
  • In addition to the effect of vaccines to prevent onset of the disease, there have been reports suggesting effectiveness in the prevention of aggravation and infection. It is expected that vaccinations in wider populations can reduce severe cases and then inhibit infection of the virus. Vaccinations in the elderly has begun. It is expected that the vaccination both residents and workers in elderly facilities, etc. can suppress clusters. It is necessary for the national and local governments, with the cooperation of local medical associations, to work together to offer vaccinations for many people as quickly and efficiently as possible.

Figures (Number of new infections reported etc.) (PDF)

Copyright 1998 National Institute of Infectious Diseases, Japan

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