60th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (November 25, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide (based on the date of reporting) has been decreasing, and the ratio of this week to last week is 0.68. The number per 100,000 population has been approximately 0.6 in the last week, the lowest since the summer last year. With the decrease in the number of new cases of infection, the numbers of patients receiving treatment, severe patients, and deaths have also been decreasing.
• The proportion of the number of new cases of infection by age group has been increasing to 20% for people in their 60s and older, while that in people in their 10s and younger has been leveling off at approximately 20%.

  Effective reproduction number:On a national basis, the most recent number remains below 1, at 0.88 (as of November 7), with values of 1.12 in the Tokyo metro area and 0.81 in the Kansai area.

Future outlook and measures to be taken

• The number of new cases of infection is very low across the country, but the infection is continuing to spread. The nighttime populations keep growing in some regions with temporary upward trends in the number of infections due to clusters at restaurants and facilities or sporadic untraceable cases. It should be watched whether this trend leads to continued upward trends of infection. Indoor activities will increase as it gets colder towards the end of the year, and the expected further increase in socioeconomic activities with annual events such as year-end parties and the Christmas and new year holidays. It is important to maintain the current low level of infection, and it is necessary to conduct a thorough active epidemiological survey.
• Approximately 76% of the country's population has been fully vaccinated with two doses, and approximately 74% of those aged 12 to 19 years have been vaccinated with one dose. To further increase vaccination rates, it is necessary to promote vaccination of unvaccinated people, and local governments must promote the communication of information to those who still have to be vaccinated. It is also necessary to prepare for additional vaccinations starting in December. On the other hand, some countries that started vaccination earlier have seen breakthrough infections due to waning neutralizing antibody titers and rebound of infections amid significantly eased restrictions; this should be kept in mind when considering to ease the measures. Close monitoring of emerging variants should also be continued.
• Given the current situation that the infection keeps spreading, although at low levels, it is important to continue requesting citizens and businesses, including those vaccinated, to cooperate with basic anti-infection measures such as correctly wearing masks, hand washing, avoiding the three Cs, and ventilation. In addition, people have to undergo tests and examinations in case their health condition deteriorates even slightly. Since there is an overlap of several high-risk situations while eating and drinking, which may lead to an outbreak, customers are advised to choose third-party certified establishments and to wear masks when not eating or drinking.
• Based on the "overall picture of measures to ensure that safety is security against the next spread of infection" recently determined, it is required to create a new normal where it is possible to continue economic and social activities while reducing the risk of infection. In response to the policy, by means of the third-party certification system, the vaccine and test package, the behavioral restrictions on such activities as eating and drinking, attendance at events, and human movement will be eased, even under emergency measures in the future. However, it should be kept in mind that even vaccinated people can become infected and that it has not been completely ruled out that vaccinated people may transmit infection to unvaccinated people.
• Local governments need to encourage people to take basic infection control measures when going out, and to avoid crowded places with a high infection risk, as well as to refrain from moving across prefectures, such as returning home or travelling, if they have symptoms including fever. Business operators must also make efforts, such as working from home, staggered working hours, and commuting by bicycle, to reduce contact with people.

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

59th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (November 17, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide (based on the date of reporting) has been decreasing, and the ratio of this week to last week is 0.87. The number per 100,000 population has been approximately 1 in the last week, the lowest since the summer last year. With the decrease in the number of new cases of infection, the numbers of patients receiving treatment, severe patients, and deaths have also been decreasing.
• The proportion of the number of new cases of infection by age group has been increasing for people in their 60s and older, which is a little under 20%, while that in people in their 10s and younger has been leveling off at approximately 20%.

  Effective reproduction number:On a national basis, the most recent number remains below 1, at 0.84 (as of October 31), with values of 0.96 in the Tokyo metro area and 0.80 in the Kansai area.

Future outlook and measures to be taken

• The number of new cases of infection is very low across the country, but the infection is continuing to spread. The nighttime populations keep growing in some regions with temporary upward trends in the number of infections due to clusters at restaurants and facilities or sporadic untraceable cases, but no regions have seen continued upward trends of infection. Indoor activities will increase as it gets colder towards the end of the year, and socioeconomic activities are expected to increase further with annual events such as year-end parties and the Christmas and new year holidays. In anticipation of a future resurgence of infections, it is important to maintain the current low levels of infection.
• Approximately 75% of the country's population have been fully vaccinated with two doses, and more than 70% of those aged 12 to 19 years have been vaccinated with one dose. To further increase vaccination rates, it is necessary to promote vaccination of unvaccinated people, and local governments are required to promote communication of information to those who still have to be vaccinated. It is also necessary to prepare for additional vaccinations starting in December. On the other hand, some countries that started vaccination earlier have seen breakthrough infections due to waning neutralizing antibody titers and rebound of infections amid significantly eased restrictions; this should be kept in mind when considering to ease the measures. Close monitoring of emerging variants should also be continued.
• Given the current situation that the infection keeps spreading, although at low levels, it is important to continue requesting citizens and businesses, including those vaccinated, to cooperate with basic anti-infection measures such as correctly wearing masks, hand washing, avoiding the three Cs, and ventilation. In addition, people have to undergo tests and examinations in case their health condition deteriorates even slightly. Since an overlap of several high-risk situations while eating and drinking may lead to an outbreak, customers are advised to choose third-party certified establishments and to wear masks when not eating or drinking.
• Given the new classification of levels proposed on November 8 by the Subcommittee on Novel Coronavirus Disease Control, each local government is required to determine the number of beds required in a projected period of time, which will be estimated based on prediction tools and other indices using data from previous waves of infection, etc.
• The “overall picture of measures to ensure safety against the next spread of infection” decided on November 12 requires reinforcement of the flow from prevention to discovery and early treatment through widespread availability of vaccines, tests, therapeutic agents, etc. and strengthening of the medical care and public health systems in preparation for the next spread of infection, in an attempt to create a new normal that allows socioeconomic activities to continue while reducing the risk of infection.
• In this regard, the vaccine and test package proposed on November 16 by the Subcommittee on Novel Coronavirus Disease Control can be utilized, even under emergency measures and primary measures to prevent the spread of disease, to ease the behavioral restrictions on such activities as eating and drinking, attendance at events, and human movement. However, it should be kept in mind that even vaccinated people can become infected and that it has not been completely ruled out that vaccinated people may transmit infection to unvaccinated people.

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

58th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (November 9, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide has been decreasing, and the ratio of numbers this week to last week is 0.76 (based on report date). This represents approximately 1 case per 100,000 of the population, which is the lowest level since the summer of last year. The numbers of patients receiving treatment, severe patients, and deaths have also been decreasing. The number of severe patients is at its lowest level since autumn of last year, while that of deaths has dropped below the levels prior to the latest spread of the infection.

  Effective reproduction number:On a national basis, the most recent number remains below 1, at 0.81 (as of October 24), with values of 0.72 in the Tokyo metro area and 0.89 in the Kansai area.

  (Note) The number of deaths is an aggregation of the numbers reported by individual local governments. Based on the date of publication.

Future outlook and measures to be taken

• Due to the cooperation of many citizens and businesses toward infection control and an improvement in the vaccination rate (persons who have completed the second vaccination account for more than 70% of all citizens, and approximately 70% of persons aged 12 to 19 years have already received one vaccination), etc., the number of new cases of infection has been decreasing nationwide since November, and has remained at substantially low levels. Nevertheless, transmission of the infection is still continuing. In some regions, the nighttime population has been growing. In addition, clusters in restaurants and facilities, as well as cases of infection with an unknown transmission route have occurred sporadically, indicating a tendency toward temporary increases. However, no regions have shown a continuous increase in the number of new infections. For the time being, it is also necessary to pay attention to an increase in indoor activities due to the decreasing temperature. A further activation of socioeconomic activities is expected toward the end of the year, due to annual events such as year-end parties, and the Christmas and New Year's holidays. Under these circumstances, in anticipation of a re-expansion of the infection in the future, it is important to maintain the current improving infection status and low infection levels.
• Accordingly, it is important to prevent any spread of infection via the continued thorough implementation of an active epidemiological investigation, as a measure against clusters. Provision of vaccination is also needed for unvaccinated persons. In foreign countries where vaccinations started earlier, breakthrough infections have occurred due to a decrease in neutralizing antibody titers, and infection rebounds have occurred during the course of significant relaxations of regulations. Therefore, care should be taken when implementing reductions in measures. At the same time, additional vaccination should be considered.
• Based on these circumstances, vaccination should be promoted continuously, and each person must take actions to prevent the spread of the infection. It is also important to continuously request citizens including those who are vaccinated and businesses to cooperate with basic anti-infection measures such as wearing a mask correctly, hand washing, avoiding the three Cs (avoid all three, namely closed spaces, crowded places, and close-contact settings), and ventilation. In addition, people are required to undergo tests and examinations in case of any poor health conditions. When customers eat and drink at restaurants, an overlap of several high-risk situations can lead to an outbreak. For this reason, dining customers are advised to choose third-party certified restaurants, and to wear masks when not eating or drinking.
• The national and local governments are required to raise public awareness to avoid crowded places and times and act in small groups when going out, while calling on businesses to implement flexible ways of applying such arrangements as working from home. In addition, local governments are required to provide information to persons who have not been vaccinated.
• The Government policy announced on October 15 requires that the flow from prevention through detection and early treatment be reinforced by disseminating vaccinations, tests, therapeutic agents, etc. and that the medical care provision and public health systems be strengthened in preparation for the next wave of spreading of the infection.
• A new concept of level classification was presented at the Subcommittee on Novel Coronavirus Disease Control held on November 8. Each local government is required to examine the number of beds needed after a certain period of time, which is estimated via prediction tools and other indicators, using data obtained from previous spreads of the infection.

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

57th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (October 26, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide has continuously decreased and the ratio of this week to last week is 0.57 on the basis of reporting dates; it was approximately 2 per 100,000 population, which is the lowest level since the summer last year. On the other hand, the number of new cases of infection in people in their 60s or older and in their teens or younger has been decreasing; of all the infected patients, however, the proportion of those in their 60s or older has increased to a little less than 20% from the lowest, which had been recorded in August, and the proportion of those in their teens or younger has remained at about 20% since September.
• The number of patients receiving treatment, severe patients, and deaths has also been decreasing with the decreasing number of new cases of infection. The number of severe patients has fallen below the level before the latest spread of infection or before the spread last spring. On the other hand, the number of deaths has exceeded the level before the latest spread of infection.
• After lifting of the emergency situation measures, the nighttime population has been growing in many regions, requiring continued careful monitoring of the number of new cases of infection.

  Effective reproduction number:On a national basis, the most recent number remains below 1 at 0.70 (as of October 9). The figure is 0.60 in the Tokyo metro area and 0.68 in the Kansai area.

  (Note) Aggregation of the number of deaths reported by individual local governments. Based on the date of publication.

Future outlook and measures to be taken

• Even after lifting of the emergency situation measures, etc., the number of new cases of infection has been decreasing nationwide and has reached a very low level, owing to the cooperation of many citizens and businesses with infection control measures, the improvement in the vaccination rate (about 70% of all citizens who have completed two vaccinations), etc. However, the nighttime population has been growing in many regions, and in some regions, clusters and infection cases with an unknown transmission route have sporadically occurred, showing a temporary tendency of increase. Consequently, there is concern about slowing or cessation of the decrease in the number of infected patients. It is also necessary to keep in mind that as temperatures fall, more activities will be conducted indoors for the time being and that this infection may be spread again in the future. On the other hand, it is important to maintain the current infection status, which has improved and reached these low levels.
• This makes it important to nip the bud of any spread of infection as far as possible through continued thorough implementation of an active epidemiological investigation as another measure against clusters. Vaccination also needs to be provided to unvaccinated people. In foreign countries where vaccination started earlier, breakthrough infection and infection rebounds have occurred in the course of a decrease in neutralizing antibody titers or significant relaxation of regulations, and therefore attention should be paid when mitigating the measures. At the same time, additional vaccination should be considered.
• Based on the above circumstances, vaccination should continuously be provided. In addition, each person is required to take actions to prevent the spread of infection because social and economic activities are expected to increase toward the end of the year. It is also important to continuously request citizens including those who are vaccinated and businesses to cooperate with basic anti-infection measures such as wearing a mask correctly, hand washing, avoiding the three Cs (avoid all three, namely closed spaces, crowded places, and close-contact settings), and ventilation. In addition, people are required to undergo tests and examinations in case of any poor health conditions. Except for some prefectures, the request to restaurants to keep shorter operating hours has been withdrawn, and other countermeasures against the infection have gradually been eased. Consequently, opportunities for eating, drinking in restaurants, sometimes in groups, are expected to increase from now on. However, there remains the concern that the accumulation of high-risk situations can lead to an outbreak. For this reason, dining customers are advised to choose third-party certified restaurants and wear masks when not eating or drinking.
• The national and local governments are required to raise public awareness to avoid crowded places and times and act in small groups when going out, while calling on businesses to implement flexible ways of applying such arrangements as working from home.
• The Government policy announced on October 15 requires that the flow from prevention through detection and early treatment be reinforced by disseminating vaccinations, tests, therapeutic agents, etc. and that the medical care provision and public health systems be strengthened in preparation for the next wave of spreading of the infection.

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

56th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (October 20, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide has continuously decreased with the ratio of this week to last week at 0.65 on the basis of reporting dates; it was approximately 3 per 100,000 population. It is still lower than the level before the latest spread of infection or before the spread at the time of the last spring.
• The numbers of patients receiving treatment, severe patients, and deaths have also been decreasing with the decreasing number of new cases of infection. The number of severe patients has fallen below the level before the latest spread of infection or before the spread at the time of the last spring. On the other hand, the number of deaths has exceeded the level before the latest spread of infection.
• After the lifting of the emergency measures and priority measures to prevent the spread of disease, the nighttime population has been growing in many regions, requiring continued careful monitoring of the number of new cases of infection.

  Effective reproduction number: On a national basis, the most recent number remains below 1 at 0.68 (as of October 3). The figure is 0.66 in the Tokyo metro area and 0.67 in the Kansai area.

  (Note) Aggregation of numbers reported by individual local governments. Based on the date of publication.

Future outlook and measures to be taken

• The number of new cases of infection keeps decreasing owing to the cooperation of many citizens and businesses so far and increased vaccination rates.
• On the other hand, after the lifting of the emergency measures etc., the nighttime population keeps growing in many regions, raising concern that the decrease in the number of infection cases will slow down or bottom out. It is important to look ahead to the future spread of infection, maintain the current improvement in the infection status, and further decrease the number of infection cases.
  Given the expected increase in socioeconomic activities and decrease in temperature toward the end of the year, it should also be kept in mind that people will become more active indoors. Considering that some countries leading in vaccinations have seen a resurgence after a massive easing of restrictions, a gradual easing of measures is desired.
• Some regions have seen clusters in restaurants and facilities for the elderly. This makes it important to nip the bud of any spread of infection as far as possible through thorough implementation of an active epidemiological investigation according to the local status of infection etc. as another measure against clusters. In a phase where the number of infection cases has decreased, it is important to adequately conduct a "retrospective active epidemiological investigation" to identify potential sources of infection and exploit the findings to develop countermeasures. For example, if the issue is spreading of infection in a population with fewer opportunities for vaccination, one conceivable countermeasure is to provide the population opportunities to be vaccinated.
• It is also important to continue requesting citizens and businesses to cooperate with basic anti-infection measures such as wearing a mask correctly, hand washing, avoiding the three Cs (avoid all three), and ventilation. After expiration of the request for restaurants to keep shorter operating hours, the measures will gradually be eased in some regions; however, there remains the concern that the accumulation of high-risk situations can lead to an outbreak. For this reason, dining customers are advised to choose third-party certified restaurants and wear masks when not eating or drinking. The national and local governments are required to raise public awareness to avoid crowded places and times and act in small groups when going out, while calling on businesses to implement flexible ways of working through such arrangements as working from home.
• The framework of the overall picture of measures to ensure that safety is security against the next spread of infection, announced on October 15, requires that the flow from prevention through detection and early treatment be reinforced by disseminating vaccinations, tests, therapeutic agents, etc. and that the medical care provision and public health systems be strengthened in preparation for the next spread of infection.

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

55th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (October 13, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The numbers of new cases of infection nationwide (based on the reporting dates) continue to decrease. The number for the latest week was approximately 4 per 100,000 of the population, not only lower than the levels before the latest spread of infection but also before the previous spread. The number per prefecture was less than approximately 10 per 100,000 of the population in all prefectures.
• Although the numbers of patients receiving treatment, severe patients, and deaths have also been decreasing with the decreasing number of new cases of infection, the numbers of severe patients and deaths have not reached the levels before the latest spread of infection.
• After lifting of the emergency measures and priority measures to prevent the spread of disease, the nighttime population has been growing in many regions, requiring continued careful monitoring of the number of new cases of infection.

  Effective reproduction number: On a national basis, the most recent number remains below 1 at 0.63 (as of September 26). The figure is 0.63 in the Tokyo metro area and 0.64 in the Kansai area.

  (Note) Aggregation of numbers reported by individual local governments. Based on the date of publication.

Future outlook and measures to be taken

• For more than a month since late August, the effective reproduction number has remained between approximately 0.6 and 0.9, owing to the cooperation of citizens and businesses with infection control measures, decreased nighttime populations, improved vaccination rates, and decreased number of infection clusters in medical institutions and facilities for the elderly, etc. The number of new cases of infection has been decreasing even after the lifting of the emergency measures and priority measures to prevent the spread of disease.
• On the other hand, the nighttime population is obviously growing after the lifting of emergency measures, etc., with some regions showing an increase in the effective reproduction number at some point, raising concern that the decrease in the number of infections will slow down or bottom out. Although further progress in vaccination promises positive outcomes, it is important to look ahead to the possible future spread of infection, maintain the current improvement in the infection status as long as possible, and decrease the number of infection cases further steps.
• For this purpose, it is necessary to keep requesting citizens and businesses to cooperate with basic anti-infection measures, such as how to correctly wear a mask, hand washing, avoid the three Cs (avoid all three), and ventilate. It is also necessary to eat and drink in small groups and for a short period of time and to wear a mask when not eating or drinking. Based on the revised basic policy, the national and local governments are required to raise public awareness to avoid crowded places and time frames, and act in small groups, while calling on businesses to promote flexible ways of working through such arrangements as working from home. It should be noted that the causes of and contributions to the latest rapid decline should be further analyzed to prepare for a future spread of infection, and we as an advisory board will continue to work on it.
• It is necessary to continue steady promotion of vaccination among groups who are less vaccinated, such as young people, while strengthening the medical care provision and public health systems in preparation for a future spread of infection. Although further progress in vaccination is expected to reduce the spread of infection and prevent more severe cases, the waning of vaccine effectiveness may lead to an increase in breakthrough infections; therefore, even vaccinated people are advised to see a doctor or take a test if suspected of having symptoms. Antigen test kits are available for use as a self-check tool for those concerned about their physical condition at home.

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

54th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (October 6, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide (based on the reporting dates) has decreased. The figure has been approximately 7 per 100,000 people over the last week, showing a decrease to the level before the spread of infection in this phase.
• With the decrease in the number of new cases of infection, the number of patients receiving treatment, the number of severe patients and the number of deaths (*) have also decreased. However, it should be noted that many severe patients are still receiving treatment, mainly in the metropolitan areas. The public health and medical care provision systems are still in showing an improving trend.

  Effective reproduction number: On a national basis, the most recent number remains below 1 at 0.61 (as of September 19). The figure is 0.58 in the Tokyo metro area and 0.62 in the Kansai area.

  (*) Aggregation of numbers reported by individual local governments. Based on the date of publication.

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 metro area (Tokyo and 3 neighboring prefectures)

   In Tokyo, the number of new cases of infection has been decreasing to approximately 9. The numbers of inpatients and severe patients have also been decreasing. Patients in their 60s and older account for 15% of new cases of infection, 34% of inpatients, and 40% of severe patients. Note that the percentage of patients in their 60s and older has been on an increasing trend among inpatients and severe patients since August. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has been decreasing to approximately 8, 7, and 7, respectively. The use rate of beds and the use rate of beds for severe patients have been decreasing. The nighttime population in the entire Tokyo metro area has remarkably increased since the declaration of the state of emergency has been lifted. The number of new cases of infection should be carefully monitored.

2. Okinawa

   The number of new cases of infection remains at a record high of approximately 20 in Japan, but the ratio of this week to last week has continued to decrease to 0.45. The use rate of beds and the use rate of beds for severe patients have been decreasing, and both are in the order of 10%. The number of patients in home care and arranged accommodation for care has also been decreasing to approximately 37.

3. Kansai area

   Osaka, the number of new cases of infection has been decreasing to approximately 17. The numbers of inpatients and severe patients have also been decreasing, and the use rate of beds is in the order of 20%. In Kyoto and Hyogo, the number of new cases of infection has been decreasing to approximately 8 and 10, respectively. The nighttime population increased in Osaka and Hyogo. The increase In is remarkable, especially after the declaration of the state of emergency has been lifted. The number of new cases of infection should be carefully monitored.

4. Aichi

   The number of new cases of infection has continued to decrease to approximately 8. The number of inpatients has also been decreasing, and the use rate of beds is in the order of 10%. The nighttime population has been increasing. Accordingly, the number of new cases of infection should be carefully monitored.

5. Hokkaido

   The number of new cases of infection has been decreasing to approximately 3 (approximately 5 in Sapporo City). The number of inpatients has been decreasing, and the use rate of beds for severe patients is below 10%. The nighttime population increased from around the time when the declaration of the state of emergency was lifted. The increase is remarkable especially after the declaration of the state of emergency was lifted. The number of new cases of infection should be carefully monitored.

6. Fukuoka

   The number of new cases of infection has continued to decrease to approximately 5. The number of inpatients has also been decreasing, and the use rate of beds for severe patients is in the order of 10%. The nighttime population increased slightly.

Future outlook and measures to be taken

• On October 1, the emergency measures and the priority measures, such as those for the prevention of the spread of disease, were all lifted. This shows that the nationwide number of infections has rapidly decreased owing to the cooperation of citizens and business operators with infection control measures, a decrease in the nighttime population, improvement in the vaccination rate, and decreases in cluster infections in medical institutions and facilities for elderly people, and the number of patients receiving treatment and that of severe patients have steadily decreased, resulting in a reduction in the burden on the medical care provision and public health systems.
• While it is expected that further promotion of vaccination will bear fruit, attention should be paid to the many severe patients receiving treatment mainly in metropolitan areas. There is also concern about increased opportunities of contact with people because people have become relieved about the reported decrease in cases of new infections and the restrictions are mitigated by the nationwide lifting of the state of emergency, but these factors may lead to a resurgence in new cases. It is therefore necessary to ask for the cooperation of citizens and business operators to maintain the decreasing trend in the number of infections with thorough basic measures against infection and to prevent a resurgence in new cases of infection.
• Vaccination should continually be promoted. However, given the accompanying changes in the epidemiological features and the pathological features of infected patients, and to become ready for a potential resurgence in infections, the medical care provision and public health systems should be reinforced. In this regard, while inhibition of the spread of infection and prevention of aggravation of the disease are expected with further promotion of vaccination, breakthrough infection due to attenuation of the effect of the vaccine is also predicted. Testing of vaccinated persons is still required if they have symptoms of the disease. The proportion of elderly persons that are infected may also increase again with the future spread of infection, and the trend in the number of patients in each age group should be carefully monitored.

1. ★ Thorough basic measures against infection

   Basic anti-infection measures include the proper wearing of a mask, washing of hands, avoidance of the three Cs (avoidance of all three), and ventilation by individuals, while people should immediately contact a doctor, even if they feel only slightly unwell. People should continue to eat and drink in small groups for a short period of time, and a mask should be worn when not eating or drinking. The national and local governments should also call attention for people to avoid crowded places and times and to act in small groups of people when going out, and to promote flexible workstyles in view of the state of promoting teleworking by companies according to the revised basic policy.

2. ★ Reinforcement of medical care provision and public health systems in preparation for re-spreading of infection

   Based on “Future Actions for Novel Coronavirus Infection” summarized on September 28, assuming that similar dimension or speed of infection spread to those observed in various regions in this phase of infection spread may occur in the future, measures should be promptly taken such as organizing of temporary medical facilities/facilities for patients waiting to be hospitalized, strengthening of the systems for home and accommodation medical care, enhancement of the system of administering therapeutic drugs including neutralizing antibody drugs in inpatient and outpatient settings and during doctor’s visits, and of establishing systems to secure medical human resources and a testing system. Local governments should actively promote vaccination.

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

53th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (September 27, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide was approximately 14 per 100,000 population for the latest week of reporting dates. The number of new cases of infection per 100,000 population by age group is predominant in people in their 50s and younger.
• With decreasing number of new cases of infection, the numbers of patients receiving treatment and severe patients have been decreasing. The number of deaths(*) has turned to a gradually decreasing trend. The public health and medical care provision systems are showing an improving trend.

  Effective reproduction number: The most recent number remains below 1 at 0.64 nationwide (as of Sep. 9) and is 0.65 both in the Tokyo metro and Kansai areas.

  (*) Aggregation of numbers reported by individual local governments. Based on the date of publication.

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 metro area (Tokyo and 3 neighboring prefectures)

   In Tokyo, the number of new cases of infection has been decreasing to approximately 18. The numbers of inpatients and severe patients have also been decreasing. The use rate of beds remains below 30%, and the use rate of beds for severe patients, below 50%. Patients in their 60s and older account for 11% of new cases of infection, 32% of inpatients, and 38% of severe patients. Note that the percentage of patients in their 60s and older among inpatients and severe patients has been on an increasing trend since August. The number of patients in home care and arranging accommodation for care has also been decreasing to approximately 18. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has been decreasing to approximately 16, 15, and 16, respectively. The use rate of beds and of beds for severe patients have been decreasing; the use rate of beds is approximately 30% for all prefectures.

2. Okinawa

   The number of new cases of infection is approximately 47, the highest in Japan; however, it has been decreasing, and the ratio of this week to last week is 0.50. On the other hand, the proportion of minors who have been newly infected has increased. The use rate of beds and the use rate of beds for severe patients have been decreasing, and both are in the order of 30%. The number of patients in home care and arranging accommodation for care has also been decreasing to approximately 58.

3. Kansai area

   In Osaka, the number of new cases of infection has been decreasing to approximately 31. The number of inpatients has also been decreasing, and the use rate of beds is in the order of 30%. The number of severe patients has also been decreasing to slightly lower than the peak in May. The number of patients in home care and arranging accommodation for care has also been decreasing to approximately 38. In Shiga, Kyoto, and Hyogo, the number of new cases of infection has been decreasing to approximately 10, 15, and 21, respectively. The use rate of beds is approximately 30% in all prefectures. The nighttime population has turned to increase in Osaka, Kyoto, Hyogo, and Shiga. There has particularly been a recent increase in Hyogo and Shiga. Accordingly, the number of new cases of infection should be carefully monitored. In Nara and Wakayama, the number of new cases of infection has been decreasing to approximately 15 and 7, respectively.

4. Chukyo/Tokai

   In Aichi, the number of new cases of infection has been decreasing to approximately 20. The number of inpatients has also been decreasing, and the use rate of beds is in the order of 30%. The number of patients in home care and arranging accommodation for care has also been decreasing to approximately 42. Also in Gifu, Shizuoka, and Mie, the number of patients in home care and arranging accommodation for care has been decreasing to approximately 13, 8, and 8, respectively. The use rate of beds is in the order of 20% in Gifu and Mie, and in the order of 10% in Shizuoka. The nighttime population has turned to increase in Aichi and continued to increase in Mie. The number of new cases of infection should be carefully monitored.

5. Hokkaido

   The number of new cases of infection has been decreasing to approximately 8 (approximately 12 in Sapporo City). The number of inpatients has been decreasing, and the use rate of beds for severe patients remains below 20%.

6. Kyushu

   In Fukuoka, the number of new cases of infection has been decreasing to approximately 13. The number of inpatients has been decreasing, and the use rate of beds for severe patients remains below 20%. The nighttime population has started to increase. Accordingly, the number of new cases of infection should be carefully monitored. In the other prefectures in Kyushu, the number of new cases of infection has been decreasing.

7. Other regions

   • Regions under emergency situation measures: In Ibaragi, Tochigi, Gunma, and Hiroshima, the number of new cases of infection has been decreasing to approximately 11, 12, 9, and 10, respectively. The use rate of beds is in the order of 20% in Ibaraki, Tochigi, and Gunma, and in the order of 10% in Hiroshima. The nighttime population has turned to increase in Gunma and continued to increase in Tochigi. The number of new cases of infection should be carefully monitored.

   • Regions under priority measures: In Miyagi, Fukushima, Ishikawa, Okayama, and Kagawa, the number of new cases of infection has been decreasing to approximately 7, 3, 6, 5, and 4, respectively.

Future outlook and measures to be taken

• The latest spread of infection, which was attributable to the delta variant and summer vacation, has been followed by a sharp and continuous decrease in infection cases nationwide, including the areas under emergency measures and priority measures, such as for prevention of the spread of disease, thanks to the cooperation of citizens and businesses with infection control measures, decreased nighttime populations, increased vaccination rates, decreased number of infection clusters in medical institutions and facilities for the elderly, etc. The numbers of patients receiving treatment and severe patients are steadily decreasing, and the medical care provision and public health systems are showing an improving trend.
• Further progress in vaccination promises positive outcomes, but raises concerns about increased movement during consecutive holidays in September and re-opening of schools such as universities, which will increase opportunities of contact between people who do not usually meet, and concern about people who are relieved about the reported decrease in cases of new infection and then change their behavior to increase opportunities for contact. These factors can lead to a resurgence of new cases and therefore require careful monitoring.
• The nationwide spread of infection so far has put a heavy burden on the medical care provision and public health systems. Given that some regions still have many severe patients and limited access to general healthcare services, it is crucial to thoroughly take the necessary measures to lower infection cases as far as possible. When considering relaxing measures, a step-by-step approach should be taken to meet the conditions in individual regions. Areas with a high infection risk can cause circulation and lingering of the infection, and therefore require thorough implementation of the relevant measures.
• Vaccination should continually be promoted. However, given the accompanying changes in the pathological features of infected patients, and to become ready for a potential resurgence in infections, the medical care provision and public health systems should be reinforced. Attention should also be paid to overseas countries that have taken a lead in the implementation of vaccinations, yet are suffering a resurgence in infections. It is also necessary to get ready for the upcoming fall and winter influenza season.

1. ★ Thorough basic measures against infection

   For those who have already been vaccinated, people should not go far from home or gather in large groups when it cannot be helped but to go out, and should stay away from settings with a high risk of infection such as crowded places and times of crowding. Reinforce awareness of basic anti-infection measures, such as how to correctly wear a mask and clean one’s hands, avoid the three Cs (avoid all three), and ventilate. Also make sure to promote full compliance with the guidelines for different businesses, continue workplace measures against infection, provide an environment that encourages employees to get vaccinated, establish online meetings as a general rule, and promote working from home. Vaccination should continually be actively encouraged and people should undergo testing or see a doctor, even if they feel only slightly unwell.

2. ★ Maximize the effective use of medical resources

   Maximize the use of local medical resources to ensure the medical care required for COVID-19 patients while minimizing the impact on the general medical care. Assuming that the infection status will become more severe as winter approaches, take the following measures urgently: sort out the ideal medical care provision system for the entire region; organize temporary medical facilities and facilities for patients waiting for hospitalization; strengthen the systems for home and accommodation medical care; and establish systems to secure medical human resources.

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

52th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (September 16, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide has decreased over the past 3 weeks by approximately 63% with approximately 42 per 100,000 population for the latest week of reporting dates. The newly infected patients consist mainly of those in their 50s or younger.
• With the decrease in the number of new cases of infection, the number of patients under medical care is showing a downward trend. The number of severe patients has started to decrease, but remains at a record high. On the other hand, the number of deaths has shown an upward trend. Although an improving trend is noted, in many regions, the public health system and the medical care provision system have been under extremely severe pressure.

  Effective reproduction number: On a national basis, the most recent number remains below 1 at 0.71 (as of August 30). The figure is 0.68 in the Tokyo metropolitan area and 0.79 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 the 3 neighboring prefectures)

   In Tokyo, the number of new cases of infection has been decreasing, but it remains high at pproximately 57. The number of inpatients in their 20s or older has started to decrease; however, the number of those in their 10s remains unchanged. Severe patients using a mechanical ventilator or an artificial heart and lung apparatus consist mainly of those in their 50s to 60s; however, the number of these patients is showing a decreasing tendency. The number of inpatients has also started to decrease, and the number of patients under home medical care and under coordination with medical care, etc. have been decreasing. On the other hand, general medical services have been restricted, including the acceptance of emergency medical care. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has started to decrease, but it remains high at approximately 52, 46, and 51, respectively. The use rate of beds and the use rate of beds for severe patients have both started to decrease. In Tokyo, Saitama, and Chiba, the nighttime population has slightly increased.

2. Okinawa

   The number of new cases of infection remains the highest in Japan at approximately 128; however, it has been decreasing, and the ratio of this week to last week is 0.63. On the other hand, the proportion of minors who have been newly infected has increased. The number of severe patients has also started to decrease, and the use rate of beds for severe patients has also decreased to approximately 60%. However, the hospitalization rate is low at approximately 10%, and the number of patients under home medical care and under coordinated medical care, etc. remains high at approximately 252 per 100,000 population.

3. Kansai area

   In Osaka, the number of new cases of infection has been decreasing, but it remains high at approximately 88. The number of inpatients has been increasing. In Shiga, Kyoto, and Hyogo, the number of new cases of infection has been decreasing to approximately 24, 48, and 57, respectively. The number of inpatients has started to decrease in any of these prefectures. In Nara and Wakayama, the number of new cases of infection has been decreasing to approximately 38 and 14, respectively.

4. Chukyo/Tokai

   In Aichi, the number of new cases of infection has started to decrease; however, it remains high at approximately 77. In Gifu, Shizuoka, and Mie, the number of new cases of infection has been decreasing to approximately 33, 26, and 30, respectively. In all of these prefectures, the use rate of beds for severe patients remains below 50%. In Mie, the nighttime population has slightly increased.

5. Hokkaido

   The number of new cases of infection is approximately 15 (approximately 23 in Sapporo). It has been decreasing, and the ratio of this week to last week is 0.55. The number of inpatients has been decreasing, and the use rate of beds for severe patients remains below 20%. The nighttime population has started to increase. Accordingly, the number of new cases of infection should be carefully monitored.

6. Kyushu

   In Fukuoka, the number of new cases of infection has been decreasing to approximately 42. The number of inpatients has started to decrease. The use rate of beds for severe patients remains below 20%. In the other prefectures in Kyushu, the number of new cases of infection has been decreasing.

7. Other regions

   • Regions subject to emergency situation measures: In Ibaragi, Tochigi, Gunma, and Hiroshima, the number of new cases of infection has been decreasing to approximately 33, 28, 19, and 26, respectively. In Gunma, the use rate of beds has started to decrease and remains below 50%. In Tochigi, the nighttime population has recently started to increase. Accordingly, the number of new cases of infection should be carefully monitored.

   • Regions subject to priority measures: In Miyagi, Fukushima, Ishikawa, Okayama, and Kagawa, the number of new cases of infection has been decreasing to approximately 17, 12, 16, 20, and 8, respectively.

Future outlook and measures to be taken

• In this expansion phase of the epidemic, the existing strains are being replaced by the delta variant, which has higher transmissibility. Under these circumstances, people in their 20s to 50s, of whom only half have been vaccinated, may have been active over the 4-day holidays in July and the summer vacations with increased opportunities to have face-to-face contact with people whom they do not usually meet. Indoor activities may also have increased during this period due to the hot outdoor temperatures.
• On the other hand, the following may be considered as reasons for the subsequent decreasing phase: the effects of long weekends and summer holidays decreased; a long spell of rain, etc. may have decreased the opportunities to go out; the media may have exerted an effect on people, i.e. people’s behavior has changed owing to the information about the surging number of infected patients and the tight medical situations reported through the media; and vaccination has been progressing in people including those of working age. The occurrence of clusters at hospitals and facilities for the elderly, which is usually seen in the latter half of an epidemic, has been suppressed by the vaccination, and a prolonged epidemic has not been observed among elderly people.
• Based on the above, for the future, although the progressing vaccination is expected to produce positive effects, there is concernsince the Silver Week holidays and the resumption of school at universities, etc. will again provide increased opportunities for people to have face-to-face contact with others whom they do not usually meet, and the downward trend of infections may slow down at a stage when it has still not reached a sufficiently low level, and infections may increase again. The necessary measures should therefore continuously be taken to reduce the number of infections as much as possible and prevent rebound. In the future, the infection may also circulate and persist in places with a high risk of infection. It is accordingly necessary to identify such places and take even stronger countermeasures.
• When considering to relax measures according to the local situation, it is necessary to move stepwise to avoid early rebound. It is also necessary to make efforts toward normalization in the regions that were the focus of the targets of active epidemiological surveys in association with the rapid expansion of the infection.

1. ★ Actions required to protect you and your family’s lives

   People including those who have already been vaccinated need to refrain from going out and stay with their family members or usual companions as much as possible to protect themselves and their families. Even if one has to go out, it is essential to avoid going far from home and gathering in large groups. In addition, one should keep away from places with a high infection risk by refraining from going to crowded places or a place at a time when it is crowded with people. Vaccination should be continuously promoted and citizens should undergo tests/examinations in case of a poor health condition.

2. ★ Thorough basic measures against infection

   In addition to basic practices for infection control, the following measures should thoroughly be implemented: reconfirmation of thorough compliance of guidelines for each industry; tightening of infection control in offices; providing an environment where employees find it easy to receive vaccination; conducting meetings online; promotion of working from home; and making sure that persons with symptoms take a rest without coming to the office. The local government should improve the environment to make it easier for people to receive vaccination and promote the provision of information to those who have not yet received vaccination.

3. ★ Maximize the effective use of medical resources

   It is required that the use of local medical resources be maximized to ensure the necessary medical care for COVID-19 while minimizing the impact on the general medical care. Based on the premise that the infection status will become more severe as winter approaches, it is necessary to urgently take the following measures: sorting out the ideal medical care system for the entire region; organizing temporary medical facilities/facilities for patients waiting to be hospitalized; strengthening the systems for home and accommodation medical care; and establishing systems to secure medical human resources.

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

51th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (September 8, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide has been decreasing in almost all regions, but it remains high at approximately 81 per 100,000 population for the latest week of reporting dates. The unprecedented spread of infection is still continuing in almost all areas nationwide. As for the number of infected patients per 100,000 population by age, the rate of decrease is high among people in their 10s to 40s, especially those in their 20s. In contrast, attention should be paid to a small decrease in the rate of elderly infected patients.
• With the decrease in the number of new cases of infection, the number of patients receiving treatment has decreased. However, the number of severe patients has remained high and continues to be at a record high. In addition, the number of deaths is continuing to increase. In many regions, the public health/medical care provision systems continue to be under extremely severe pressure.

  Effective reproduction number: On a national basis, the most recent number remains below 1 at 0.87 (as of August 22). The figure is 0.83 in the Tokyo metropolitan area and 0.97 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 the 3 neighboring prefectures)

   In Tokyo, the number of new cases of infection continues to decrease, but it remains high at approximately 112, exceeding 100. The number of inpatients remains high mainly among those in their 20s to 50s and the proportion of those in their70s and older has increased. Severe patients using mechanical ventilators or artificial heart and lung apparatus are mainly those in their 50s to 60s, but the number of those patients in their 70s or older has been increasing. The numbers of inpatients and severe patients are at the highest level, but have started to decrease. The number of those for whom hospitalization is being arranged has also decreased. On the other hand, general medical services have been restricted, including acceptance for emergency medical care.

   Also in Saitama, Chiba, and Kanagawa, the number of new cases of infection has started to decrease, but it remains high at approximately 85, 112, and 110, respectively. The cases are mainly among those in their 10s to 50s. The use rate of beds and the use rate of beds for severe patients remain high, and the situation continues to be severe. The nighttime population has recently turned upward in Kanagawa, but has started to decrease in Tokyo, Saitama, and Chiba.

2. Okinawa

   The number of new cases of infection remains at a record high of approximately 212 in Japan, but the ratio of this week to last week has continued to decease to 0.74. New cases are mainly among those in their 20s to 30s and the proportion of minors is also increasing. The use rate of beds for severe patients remains at around 90% and the situation continues to be severe. The nighttime population has been turning downward.

3. Kansai area

   In Osaka, the number of new cases of infection continues to decrease but remains high at approximately 165, exceeding 100. New cases are mainly those in their 20s to 30s. The numbers of inpatients and severe patients continue to increase. The nighttime population continues to increase after the Obon holidays and attention should be paid to the re-expansion of infection. In Shiga, Kyoto, and Hyogo, the number of new cases of infection has been decreasing to approximately 63, 104, and 96, respectively. In Kyoto and Hyogo, the number of inpatients has rapidly increased. In Kyoto, there is not a decrease in the nighttime population, which requires close attention.

   As for other areas, the number of new cases of infection in Nara has started to decrease to approximately 83. In Wakayama, the number has been decreasing to approximately 39.

4. Chukyo/Tokai

   In Aichi, the number of new cases of infection has turned downward, but remains high at approximately 144, exceeding 100. On the other hand, the number in Gifu, Shizuoka, and Mie has continued to decrease to approximately 71, 60, and 71, respectively. In Aichi and Mie, the use rate of beds for severe patients is exceeding 50%. The nighttime population remains at a low level in Aichi, Gifu, and Shizuoka. In Mie, the figure has started to decrease.

5. Hokkaido

   The number of new cases of infection has decreased to approximately 31 (approximately 46 in Sapporo City), and the ratio of this week to last week is 0.57. The number of inpatients is on a declining trend and the use rate of beds for severe patients remains below 20%. The nighttime population is continuing to decrease.

6. Kyushu

   In Fukuoka, the number of new cases of infection has been decreasing to approximately 91. The number of inpatients remains high and the situation is severe. The use rate of beds for severe patients is below 20%. The nighttime population has turned downward. In other prefectures in Kyushu, the number of new cases of infection continues to decrease, and the use rate of beds for severe patients in Saga and Nagasaki is below 20%.

7. Other areas subject to emergency measures

   In Miyagi, the number of new cases of infection has been decreasing to approximately 30. In Ibaraki, Tochigi, and Gunma, the number of new cases of infection has been decreasing to approximately 53, 41 and 42, respectively.

   In Okayama and Hiroshima, the number of new cases of infection has started to decrease and is approximately 51 and 50, respectively. In Okayama, the use rate of beds is below 50%.

8. Other areas subject to priority measures

   In Fukushima, Toyama, Ishikawa, Yamanashi, Kagawa, Ehime, and Kochi, the number of new cases of infection has decreased to approximately 19, 23, 20, 34, 28, 13, and 51, respectively. Particularly in Ishikawa, Yamanashi, Ehime, and Kochi, the use rate of beds for severe patients is below 20%.

Future outlook and measures to be taken

• The number of infected patients continues to decrease in almost all regions nationwide. As places where the infection spreads, the proportion of restaurants and schools has decreased but that of homes and offices has increased. The reasons for the decrease in the number of infected patients include cooperation of many citizens with infection control measures, seasonal factors such as a decrease in the effect of consecutive holidays during summer vacation and the Obon holidays, further progress of vaccination of people including the working generation, reduction in personnel flow in areas under the declaration of the state of emergency and priority measures, and behavior change as an effect of the provision of information.
• While the vaccination rate is expected to further increase in the future, several factors such as long-weekends in September, the start of schools including universities, activation of social activities, and an increase in the de facto population also play a role. Therefore, attention should be paid to the infection situation. For this reason, it is necessary for the government and local governments to continue the necessary efforts in addition to infection control measures at places including the home, workplace, and school in order to steadily control infection.
• Thanks in part to the effect of vaccines, the number of deaths is at a low level compared to the previous infection expansion phase, but it continues to increase. The number of elderly patients with infection and clusters in facilities for elderly people are also increasing, and there is concern that the number of deaths will further increase in the future.

• The number of infected patients remains at a high level, and it is necessary to take actions based on the recognition that the situation is at a disaster level.

  In most regions, the medical/public health systems are continuously under tough conditions. It is necessary to continue measures required to improve the infection status at least to a level where general medical care is not restricted, and to strengthen the medical system, prioritize the operations of public health centers and strengthen support.

• When considering the relaxation of measures according to the local situation, it is required to move stepwise to avoid early rebound. In the mid- to long-term, a relatively serious situation of infections may continue toward the winter, and it is therefore necessary to comprehensively take various approaches such as the promotion of vaccination, proactive implementation of tests, and the utilization of neutralizing antibody drugs.

1. ★ Actions required to protect you and your family’s lives

   Citizens including those who have already been vaccinated should refrain from going out and spend as much time at home as possible to protect themselves and their families. In cases it is really necessary to go out, it is essential to avoid going far from home and to keep away from crowded places and events with an infection risk. Vaccination should be continuously promoted and citizens should undergo tests/examinations in case of a poor health condition.

2. ★ Thorough basic measures against infection

   In addition to basic practices of infection control, the following measures should be promoted: reconfirmation of thorough compliance with the guidelines for each industry, tightening of infection control in offices, offering an environment where employees can easily receive vaccines (such as a vaccine leave), conducting meetings online, promoting working from home (especially for persons with underlying diseases and pregnant women), and making sure that persons with symptoms take leave when they do not go to the office.

3. ★ Maximize effective use of medical resources

   It is necessary to use new neutralizing antibody drugs and to promptly organize a system of quick responses to exacerbation, as well as to make full use of medical resources in each area to secure the required medical care. In addition, based on the premise that the more difficult situation of infection will continue toward winter, it is necessary to take immediate measures, including the establishment of temporary medical facilities.

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