50th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (September 1, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide has been decreasing, but it has reached a record-high level of approximately 116 per 100,000 population for the latest week of reporting dates. The unprecedented spread of infection has continued in almost all areas nationwide. The decreasing trend is observed mainly in the Tokyo metropolitan area, but there is still a high-level increasing trend in the Chukyo area. There are some areas where the number of infected patients has not decreased due to the effect of the Obon holiday. As for the number of infected persons per 100,000 population by age, the number of infected patients in their 20s is still the highest, and the number of those in their 10s is increasing to the same level as those in their 30s. Depending on the area, the number of infected patients in their 10s is higher than that of those in their 30s.
  • With the rapid increase in the number of infections to date, the number of severe patients is rapidly increasing, making it the largest ever and the number of deaths is also on the rise. The public health/medical care provision systems are under extremely severe pressure nationwide, and a situation similar to that at the time of a disaster continues.

    Effective reproduction number: On a national basis, the most recent number remains above 1 at 1.06 (as of August 15). The figure is 0.97 in the Tokyo metropolitan area and 1.15 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 turns downward but remains extremely high at approximately 177. The number of inpatients continues to increase mainly among those in their 20s to 50s. The number of persons in their 60s or older is also increasing. The number of severe patients who need a mechanical ventilator or artificial heart and lung apparatus has stopped increasing mainly among those in their 40s to 60s, but continues to increase in their 70s and older. The numbers of inpatients and severe patients has reached record highs, and in some cases it is difficult to newly accept/arrange for hospitalization during the nighttime, etc. There are also restrictions on general medical services, such as acceptance at emergency medical care and intensive care units.

    In Saitama, Chiba, and Kanagawa the number of new cases of infection has also started to decrease, reaching approximately 136, 152, and 170, 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 both remain high. Particularly in Kanagawa, the use rate of beds for severe patients continuously exceeds 80%. The nighttime population remains at a low level in Saitama and Kanagawa, but the population in Tokyo and Chiba has turned upward after the Obon holiday. It is feared that infection will spread again in the Tokyo metropolitan area.

  2. Okinawa

    The number of new cases of infection remains at a record high of approximately 287 in Japan, but the ratio of this week to last week has started to decease to 0.91. New cases are mainly seen among those in their 20s to 30s. The use rate of beds and the use rate of beds for severe patients remain around 90% and the situation continues to be severe. The nighttime population has recently started to increase and attention needs to be paid to the trend in the number of new cases of infection.

  3. Kansai area

    In Osaka, the number of new cases of infection has been increasing to approximately 198, with a ratio of this week to last week of 1.09. New cases are mainly seen among those in their 20s to 30s. The number of inpatients continues to increase, and the number of severe patients has also increased. The nighttime population has turned upward after the Obon holiday and the possibility that the infection will continue to spread remains. In Kyoto and Hyogo, the number of new cases of infection has stopped increasing and is approximately 134 and 120, respectively. The number of inpatients has rapidly increased in both prefectures. In Kyoto, the use rate of beds for severe patients remains high, and the situation is severe. In Shiga where the priority measures were shifted to emergency measures, the number of new cases of infection has deceased to approximately 88. In Kyoto, the nighttime population has started to increase, which requires close attention.

    As for other areas, the number of new cases of infection in Nara has been increasing to approximately 103. In Wakayama, the number of new cases of infection has decreased to approximately 47

  4. Chukyo/Tokai

    In Aichi, where the priority measures were shifted to emergency measures, the number of new cases of infection continues to increase rapidly, and has reached approximately 168, with a ratio of this week to last week of 1.39. On the other hand, the number of new cases of infection in Gifu has stopped increasing at approximately 111. The number in Mie and Shizuoka has decreased to approximately 143 and 100, respectively. In both prefectures, an increasing trend in the numbers of inpatients and severe patients continue. The nighttime population remains at a low level in Gifu, Aichi, and Shizuoka. In Mie, the nighttime population has turned downward. Attention should be paid as to whether this will lead to a decrease in the number of new cases of infection.

  5. Hokkaido

    The priority measures were shifted to emergency measures. The number of new cases of infection has started to decrease, reaching approximately 54 (approximately 79 in Sapporo City), with a ratio of this week to last week of 0.78. The use rate of beds for severe patients remains below 20%. The nighttime population has decreased but remains at a high level, and there is concern about the effect on the future situation of infection.

  6. Kyushu

    In Fukuoka, the number of new cases of infection has started to decrease, but exceeds 100 at approximately 123, with a ratio of this week to last week of 0.83. 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 upward after the Obon holiday and there is concern about the effect on the future situation of infection. In Kumamoto and Kagoshima, the number of new cases of infection has started to decrease and is approximately 87 and 62, respectively. In Saga, Nagasaki, and Miyazaki, which have been newly designated as areas of priority measures, the number of new cases of infection turned downward reaching approximately 71, 31, and 62, respectively.

    As for other areas, in Oita, the number has decreased but remains high at approximately 90.

  7. Other areas subject to emergency measures

    In Miyagi, Okayama, and Hiroshima, where the priority measures were shifted to emergency measures, the number of new cases of infection has decreased to approximately 54, 76, and 79, respectively. The use rate of beds exceeds 50% in the 3 prefectures, and the situation is severe. The nighttime population has turned downward in Miyagi and has stopped decreasing in Okayama and Hiroshima. Attention should be paid to whether the number of new cases of infection continues to decrease.

    In Ibaraki, Tochigi, and Gunma, the number of new cases of infection has decreased, reaching approximately 62, 61 and 83, respectively. Particularly in Gunma, the use rate of beds continues to exceed 70%, and the situation remains tough. The nighttime population in Ibaraki and Tochigi remains at a low level and attention should be paid to whether the number of new cases of infection continues to decrease. In contrast, the number in Gunma turns upward and there is concern about the effect on the future situation of infection.

  8. Other areas subject to priority measures

    In Kochi, which was newly added as an area of priority measures, the number of new cases of infection has started to decrease, reaching approximately 83. In Fukushima and Ishikawa, the number of new cases of infection has been decreasing to approximately 30 and 33, respectively.

    In Toyama, Yamanashi, Kagawa, and Ehime, the number of new cases of infection has decreased to approximately 48, 59, 52, and 28, respectively.

  9. Other than the above

    In Aomori, Fukui, Tottori, Shimane, and Tokushima, the number of new cases of infection exceeds 25 at approximately 52, 37, 31, 31, and 52, respectively, showing an increasing trend. The future situation needs to be monitored carefully.

     

    Regarding the number of newly infected people, it has been pointed out that the actual number of infected people is underestimated when the number of infected patients is rapidly increasing and the positive rate of tests is rising, so caution is required when analyzing the trends.

Analysis of mutant strains

  • For the B.1.617.2 lineage variant (Delta variant), the positive rate among the screening tests (mechanical estimation, August 16 to August 22) is approximately 89%, exceeding 80% in almost all prefectures. Recently, it has been estimated that it has reached almost 100% in each region, and it is considered that the B.1.1.7 variant (Alpha variant) has almost been replaced.

Effects of vaccine

  • Regarding the efficacy of vaccines (including the prophylactic effect) nationwide, there is a report that the efficacy rate is approximately 90% during the replacement period of the Delta variant from the Alpha variant, but the rate varies depending on age group, etc., and it is therefore necessary to continue analysis in consideration of the effect of the Delta variant and immune attenuation.

Future outlook and measures to be taken

  • The number of infected patients has been decreasing mainly in the Tokyo metropolitan area. Decreasing factors include weakening of the effect of long weekends in July and August, the Obon and summer holidays, the future climate situation, as well as further progress of vaccinations. However, there are also increasing factors such as the start of schools including universities, re-activation of social activities, and an increase in the de facto population. It is feared that the factors may lead to an increase in the number of infected patients again. Due to the rapid spread of infections to date, the number of severe patients has been the largest. The number of deaths continues to increase, though it is at a low level compared to the previous expansion stage. 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 an unprecedented disaster level.

    In particular, the medical and public health systems are under extremely tough conditions. It has become difficult to arrange hospitalization for moderate and severe patients, and in some cases there are restrictions on general medical care such as surgery while emergency transportation is difficult. It is continuously necessary to control the spread of the current infection and to strengthen the medical system, prioritize the operations of public health centers and strengthen support.

  • The number of infected patients has decreased with the cooperation of many citizens. It is required to continue efforts to steadily control infection in the future.
  1. Actions required to protect your and your family’s lives

    Citizens including those who have already been vaccinated should refrain from going out (at least at a frequency of not more than half the previous frequency) and spend as much time at home as possible to protect themselves and their families. In cases where 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 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 for infection control such as wearing a mask, 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. Especially concerning masks, it is recommended to use non-woven face masks which are highly effective in preventing respiratory droplets.

  3. Take appropriate actions to resume school

    It is necessary to take appropriate measures for each childcare facility/educational institution based on the guidelines to prevent the spread of infection.

  4. Maximize effective use of medical resources

    It is required to use new neutralizing antibody drugs with fast-track approval and to promptly organize a system for quick responses to exacerbation, as well as to make full use of medical resources in each area to secure required medical care. In addition, based on the premise that the severe infection situation will continue nationwide for at least the time being, it is necessary to take immediate measures, including the establishment of temporary medical facilities.

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

 

49th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (August 25, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • Without stopping the spread of infection, the number of new cases of infection nationwide continues to reach record highs, at approximately 128 per 100,000 population for the latest week of reporting dates. Compared to the Tokyo metropolitan area, the ratio of this week to last week in other areas, particularly in the Chubu area, is high. The unprecedented spread of infection has continued in almost all areas nationwide.
  • With the rapid increase in the number of infections, the number of severe patients is rapidly increasing, making it the largest ever and the number of deaths is also on the rise. The number of those being arranged for hospitalization is rapidly rising with the increase in the number of patients receiving treatment. The public health systems/medical care provision systems are under very severe pressure not only in the Tokyo metropolitan area but in other areas, which continue to be close to disaster levels.

    Effective reproduction number: On a national basis, it remains above 1 at 1.10 most recently (as of August 8). The figure is 1.04 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 speed of increase in the number of new cases of infection is somewhat slowing down, but the upward trend continues. The number of new cases of infection is approximately 234 and the unprecedented spread of infection has continued. The infection is spreading mainly in persons in their 20s to 40s, and the number of elderly persons and people under 20 years of age with infection is also on an increasing trend. The number of inpatients continues to increase mainly in those in their 20s to 50s. The number of persons in their 60s and older is also increasing. The number of severe patients using mechanical ventilators or artificial heart and lung apparatus has remained high, mainly in those in their 40s to 60s. The numbers of inpatients and severe patients reach record highs, and there are cases where it is difficult to newly accept/arrange for hospitalization during nighttime, etc. The numbers of people receiving home care or those being arranged for hospitalization continue to increase rapidly, and the record-high levels have been continuously updated. In addition, general medical services have been restricted, such as acceptance in emergency medical care and intensive care units. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has also been rapidly increasing, reaching approximately 159, 168, and 185, respectively. As in Tokyo, the speed of spread of infection is somewhat slowing down, but the infection expansion continues at an unprecedented level. The infection is spreading mainly in persons in their 20s to 50s, but infected patients in their teens or younger are also on an increasing trend. The use rate of beds and the use rate of beds for severe patients are rapidly increasing. Particularly in Kanagawa, the use rates exceed 80% and the situation is still difficult. The nighttime population in Tokyo and Chiba turned upward after the Obon holiday. On the other hand, the nighttime population in Saitama and Kanagawa remains at a low level. It is necessary to pay close attention to changes in the number of infected patients in the Tokyo metropolitan area in the days ahead.

  2. Okinawa

    The speed of increase in the number of new cases of infection is somewhat slowing down, but the upward trend continues. The number of new cases of infection is the highest in Japan at approximately 314, and the unprecedented spread of infection has continued, but the potential to stop this increase is there. New cases are mainly in those in their 20s to 30s. As the use rate of beds and the use rate of beds for severe patients are almost reaching 90%, the severe situations have remained and arrangements for hospitalization are increasing. The nighttime population turns downward after the Obon holiday. Attention should be paid as to whether it leads to a decrease in the number of new cases of infection.

  3. Kansai area

    In Osaka, the number of new cases of infection has rapidly increased to approximately 182, with a ratio of this week to last week of 1.44. New cases are mainly in those in their 20s to 30s. The number of inpatients continues to increase, and the number of severe patients has also increased. The nighttime population has stopped to decrease after the Obon holiday, and the spread of infection may continue. In Kyoto and Hyogo where the priority measures were shifted to emergency measures, the number of new cases of infection continues to increase to approximately 132 and 124, respectively. The number of inpatients has rapidly increased in both prefectures. The use rate of beds for severe patients is rising rapidly, and the situation is severe. In Shiga, the number of new cases of infection continues to surge to approximately 102. The nighttime population has continuously decreased in Shiga and gradually decreased in Kyoto. In Hyogo, the figure has stopped to decrease. Attention should be paid as to whether the decrease in the area leads to a decrease in the number of new cases of infection.

    As for other areas, the trend of rapid increase in the number of new cases of infection is continuing also in Nara with the figure reaching approximately 96. Also in Wakayama, the number of new cases of infection turns upward, reaching approximately 60.

  4. Hokkaido

    The number of new cases of infection has increased to approximately 69 (approximately 103 in Sapporo City), with a ratio of this week to last week of 1.26. The use rate of beds for severe patients remains below 20%. The nighttime population has decreased but remains at a high level, and the spread of infection may continue.

  5. North Kanto

    In Ibaraki, Tochigi, and Gunma where the priority measures were shifted to emergency measures, the number of new cases of infection continues to increase to approximately 78, 78, and 102, respectively. In each prefecture, the number of inpatients and the number of severe patients are increasing, which results in severe situations as to the use rate of beds. The nighttime population remains at a low level in each prefecture. Attention should be paid as to whether the trend leads to a decrease in new cases of infection.

  6. Chukyo/Tokai

    In Aichi, the number of new cases of infection continues to surge to approximately 121, with a ratio of this week to last week of 1.94. In Shizuoka, the number of new cases of infection has rapidly increased to approximately 106, with a ratio of this week to last week of 1.60. In each case, the numbers of inpatients and severe patients continue to increase. The nighttime population has increased again in Aichi after the Obon holiday and has stopped decreasing in Shizuoka, and there is concern that infection may continue to spread. The number of new cases of infection shows rapid increases also in Gifu and Mie, reaching approximately 108 and 137, respectively. Both prefectures were newly designated as areas of priority measures. The ratio of this week to last week exceeds 2 in the 2 prefectures.

  7. Kyushu

    In Fukuoka where the priority measures were shifted to emergency measures, the number of new cases of infection continues to increase to approximately 148, with a ratio of this week to last week of 1.33. The number of inpatients continues to increase and the situation is severe. The use rate of beds for severe patients is below 20%. The nighttime population turns upward after the Obon holiday and the spread of infection may continue. In Kumamoto, the number of new cases of infection has been increasing to approximately 97. In Kagoshima, which was newly designated as an area of priority measures, the number of cases has been increasing to approximately 89, with a ratio of this week to last week of 1.27. The use rate of beds exceeds 70%, and the situation is severe

    Rapid increase in the number of new cases of infection has been observed in other prefectures. In Saga, Nagasaki, Oita, and Miyazaki, the figure has exceeded 25, reaching approximately 108, 44, 115 and 78, respectively. Especially in Oita and Miyazaki, the ratio of this week to last week exceeds 1.5.

  8. Other areas subject to priority measures

    In Fukushima and Ishikawa, the number of new cases of infection has stopped increasing and is approximately 38 and 45, respectively. The nighttime population remains at a low level. Attention should be paid as to whether it leads to a decrease in the number of new cases of infection.

    In Miyagi, Toyama, Yamanashi, Okayama, Hiroshima, Kagawa, and Ehime, the number of new cases of infection continues to increase to approximately 69, 73, 74, 88, 83, 64, and 40, respectively. Particularly in Toyama and Hiroshima, the ratio of this week to last week has increased rapidly to over 1.5. The use rate of beds exceeds 80% in Miyagi and Yamanashi and 70% in Kagawa, resulting in severe situation.

  9. Other than the above

    The number of new cases of infection has rapidly increased in many other regions; especially Aomori, Yamagata, Niigata, Fukui, Nagano, Yamaguchi, Tokushima and Kochi which exceed 25 at approximately 37, 31, 34, 30, 43, 44, 44, and 75, respectively, indicating rapid spread of infection.

    * Regarding the number of newly infected people mainly in the Tokyo metropolitan area and Okinawa Prefecture, it has been pointed out that the actual number of infected people is underestimated when the number of infected patients is rapidly increasing and the positive rate of tests is rising, so caution is required in trend analysis.

Analysis of mutant strains

  • For the B.1.617.2 lineage variant (Delta variant), the positive rate in the screening tests (mechanical estimation, August 2 to August 8) is approximately 85%. Recently, it is estimated that it exceeds 90% in each region, and it is considered that the B.1.1.7 variant (Alpha variant) has almost been replaced, except in some regions.

Future outlook and measures to be taken

  • Despite the continuation and expansion of emergency measures and priority measures, the de facto population has increased after the Obon holiday and the replacement with the Delta variant is progressing. Furthermore, the number of infected people is increasing nationwide on an unprecedented scale. The number of infected people may increase further due to the effects of the Obon holiday and the increase of social activities after this holiday. Under these circumstances, the number of severe patients has reached a record high and the number of deaths is on the rise. Furthermore, as the number of elderly infected people and the clusters at facilities for elderly people also rises, there is concern that the number of deaths will further increase in future. It is necessary to take action based on the recognition that the situation is at an unprecedented disaster level. The number of infected patients under 20 years of age has been increasing. The school will resume after the summer holiday in the days ahead and it is necessary to take measures to prevent the spread of infection. However, it should be noted that the impact and measures vary depending on educational institutions such as primary schools, junior high schools, high schools, and universities.
  • It has become difficult to arrange hospitalization for moderate and severe patients, and there are cases where general medical care, such as surgery, is restricted and transportation in emergencies is difficult. Additional restrictions are expected as a result of further strengthening of measures against COVID-19 in future. It is immediately necessary to promptly control the spread of current infection and to strengthen the medical system, prioritize the operations of public health centers and strengthen support.
  • The government and citizens share a sense of crisis that the highly infectious Delta variant is a virus of a different level than before, and further efforts are now needed. The government and municipalities will further strengthen the measures that have been taken so far and make detailed calls.
  1. Actions required to protect your life

    Opportunities to meet people who one does not usually meet have been shown to increase the risk of infection, and it is necessary to reduce such chances of infection as much as possible.

    Citizens, including those who have already been vaccinated, should refrain from going out (at least at a frequency not more than half the previous frequency) and spend time at home as much as possible in order to protect themselves and their families. In cases where 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 infection risk. Vaccination should be continuously promoted and citizens should undergo tests/examinations in case of any poor health condition.

  2. Thorough implementation of infection control measures at school, etc.

    After the epidemic of the Delta variant, the number of infected people in their teens or younger is on an increasing trend. At welfare facilities such as day-care centers and educational institutions such as primary schools, junior high schools, high schools, and universities, measures for infection control should be strengthened with reference to proposals on measures indicated by the Center for Field Epidemic Intelligence, Research and Professional Development in the National Institute of Infectious Diseases.

  3. Thorough basic measures against infection

    In addition to basic practices for infection control, the following measures should be promoted: reconfirmation of thorough compliance of guidelines for each industry, tightening of infection control in offices, 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 without going to the office.

  4. Maximize effective use of medical resources

    Prefectures should lead in making full use of medical resources to use new neutralizing antibody drugs with fast-track approval and promptly organize a system for quick responses to exacerbation in order to secure required medical care. In addition, on the premise that the severe infection situation will continue nationwide for at least the time being, it is necessary to take immediate measures, including the use of Article 16-2 of the revised Infectious Diseases Control Law and the establishment of temporary medical facilities.

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

 

48th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (August 18, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide continues to reach record highs, with approximately 101 per 100,000 population for the latest week of reporting dates. The spread of infection has not stopped, and the number of new cases of infection is rapidly increasing across almost all regions nationwide, resulting in an unprecedented spread of infection.
  • With the rapid increase in the number of infections, the number of severe patients is rapidly increasing, making it the largest ever. And the number of patients for whom adjustment is made for hospitalization, etc. is rapidly increasing with the increase in the number of patients receiving treatment. The public health systems/medical care provision systems are under very severe pressure mainly in the Tokyo metropolitan area, which continues to be close to disaster levels.

    Effective reproduction number: On a national basis, it remains above 1 at 1.15 most recently (as of August 1). The figure is 1.11 in the Tokyo metropolitan area and 1.16 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)

    Emergency measures continue in Tokyo. The number of new cases of infection is still increasing and has become approximately 228, with the ratio of this week to last week of 1.14.* The largest-ever spread of infection is continuing. The infection is spreading mainly in persons in their 20s to 40s, and the number of elderly persons and people in their teens and under with infection is also on an increasing trend. The number of inpatients continued to increase mainly in those in their 20s to 50s. The number of persons in their 60s and older is also increasing. The number of severe patients using mechanical ventilators or artificial heart and lung apparatus have been increasing, mainly in those in their 40s to 60s. The numbers of inpatients and severe patients continue to reach record highs, and there are cases where it is difficult to accept/arrange for hospitalization for some cases during nighttime, etc. With the rapid increase in infections, patients receiving medical care at home and those for whom arrangement is being made rapidly increased. In addition, general medical services have been restricted, such as care in intensive care unit, etc. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has also been rapidly increasing mainly in those in their 20s and 30s, reaching approximately 149, 138, and 160, respectively. As in Tokyo, the use rate of beds and the use rate of beds for severe patients are rapidly increasing. Although the nighttime population has steadily decreased in Tokyo, it has not reached the level during the period under the previous declaration. The nighttime population has continued to decrease in Saitama, Chiba, and Kanagawa. Attention should be paid as to whether decrease in the de facto population leads to a decrease in the number of new cases of infection.

  2. Okinawa

    Emergency measures continue to be taken. The number of new cases of infection continues to increase and has become approximately 312, which is the highest nationwide and at an unprecedentedly high level, with a rate of this week to last week of 1.26.* New cases are mainly in those in their 20s to 30s. The use rate of beds and the use rate of beds for severe patients are in severe situations at more than 80%, those for whom arrangement is being made are increasing. The nighttime population tends to increase again after the start of the Obon holidays, and the spread of infection may continue.

  3. Kansai area

    In Osaka, the number of new cases of infection was approximately 126, with a rapidly increasing ratio of this week to last week at 1.46. New cases are mainly in those in their 20s to 30s. The number of inpatients continued to increase, and the number of severe patients also increased. The nighttime population tended to decrease. Attention should be paid as to whether it leads to a decrease in the number of new cases of infection.

    In Shiga, Kyoto and Hyogo, the number of new cases of infection is still in an increasing trend, reaching approximately 76, 104, and 81, respectively. The number of inpatients rapidly increased across all prefectures. In Kyoto, the use rate of beds fore severe patients is rising rapidly, and the situation is severe. The nighttime population is slightly decreasing in Shiga and staying flat in Kyoto. In Hyogo, there is a sharp decrease. Attention should be paid as to whether the decrease in the area leads to a decrease in the number of new cases of infection.

    The trend of rapid increase in the number of new cases of infection is also continuing in Nara with the figure reaching approximately 63. In Wakayama also, the number of new cases of infection turns upward, reaching approximately 34.

  4. Hokkaido

    The number of new cases of infection is increasing and has become approximately 55 (approximately 85 in Sapporo City), with a ratio of this week to last week at 1.26. The use rate of beds for severe patients remains below 20%. The nighttime population has decreased but remains at a high level, and the spread of infection may continue.

    * Regarding the number of newly infected people in the Tokyo metropolitan area and Okinawa prefecture, it has been pointed out that the actual number of infected people is underestimated when the positive rate of tests is rising, so caution is required in trend analysis.

  5. North Kanto

    The number of new cases of infection is still in a trend of increase in Ibaraki, Tochigi and Gunma, reaching approximately 65, 55 and 69, respectively. In each case, the number of inpatients and the number of severe patients are increasing, and the use rate of beds is in a severe situation. The nighttime population has been flat recently in Ibaraki, but the others tended to decrease. Attention should be paid as to whether the trend leads to a decrease in new cases of infection.

  6. Chukyo/Tokai

    In Aichi, the number of new cases of infection continued to increase at a rapid rate and reached approximately 62, with the ratio of this week to last week at 1.90. In Shizuoka, the number of new cases of infection was approximately 66, with a rapidly increasing ratio of this week to last week at 1.74. In each case, the numbers of inpatients and severe patients continue to increase. In each case, the nighttime population decreased. Attention should be paid as to whether it leads to a decrease in new cases of infection.

    The number of new cases of infection shows rapid increases also in Gifu and Mie, reaching approximately 54 and 56, respectively. In particular, in Gifu, ratio of this week to last week continued to exceed 2.

  7. Kyushu

    In Fukuoka, the number of new cases of infection has shown an increasing trend and reached approximately 112, with the ratio of this week to last week at 1.18. The number of inpatients continues to increase and the situation is severe. The use rate of beds for severe patients is below 20%. The nighttime population is decreasing rapidly. Attention should be paid as to whether it leads to a decrease in the number of new cases of infection.

    In Kumamoto and Kagoshima, the number of new cases of infection has been increasing to approximately 77 and 70, respectively. Especially in Kagoshima, the ratio of this week to last week rapidly increased and exceeded 2. In Kagoshima, the use rate of beds exceeds 50%, and the situation is severe.

    Rapid increase in the number of new cases of infection is observed in other prefectures. In Saga, Nagasaki, Oita, and Miyazaki, the figure has exceeded 25, reaching approximately 76, 33, 58 and 37, respectively, and the spread of infection is especially rapid in Saga and Oita.

  8. Other areas subject to priority measures

    In Fukushima, the number of new cases of infection has been increasing at a rapid rate and reached approximately 45, with the ratio of this week to last week at 1.40. The use rate of beds has exceeded 50%; the situations is severe. The nighttime population decreased. Attention should be paid as to whether it leads to a decrease in new cases of infection. In Ishikawa, the number of new cases of infection has stopped decreasing and was approximately 47. The nighttime population has decreased but the movement is slow, and there is concern that infection may spread again.

    In addition, in Miyagi, Toyama, Yamanashi, Okayama, Hiroshima, Kagawa, and Ehime, which were newly designated as areas of priority measures, the number of new cases of infection continues to rapidly increase, at approximately 51, 45, 60, 63, 42, 51, and 38, respectively. In particular, in Miyagi, Toyama, Okayama, Hiroshima, Kagawa, and Ehime, the ratio of this week to last week has increased rapidly to over 1.5. In Miyagi, Yamanashi, and Kagawa, the use rate of beds exceeds 50%, and the situation is severe.

  9. Other than the above

    The number of new cases of infection rapidly increased in many other regions; especially in Aomori, Niigata, Nagano, Yamaguchi, and Kochi, the figure was approximately 27, 27, 30, 29, 26, and 25, respectively, which exceeded 25, indicating rapid spread of infection.

Analysis of mutant strains

  • For the B.1.617.2 lineage variant (Delta variant), the positive rate in the screening tests (mechanical estimation, August 2 to August 8) is approximately 79%. Recently, it is estimated that it exceeds 90% in each region, and it is considered that the B.1.1.7 variant (Alpha variant) has almost been replaced, except in some regions.

Future outlook and measures to be taken

  • Despite the continuation and expansion of emergency measures and priority measures taken so far, the reduction in the de facto population is limited, the replacement with the Delta variant is progressing, the number of infected people is increasing nationwide on an unprecedented scale, and it is expected that the number of infected people will increase further due to the effects of Obon holidays. Under these circumstances, the number of severe patients has reached a record high, and the number of deaths is beginning to increase, but the number of elderly infected people is also increasing, and there is concern that the number of deaths will further increase in the future. It is necessary to take action based on the recognition that the situation is at a disaster level nationwide.
  • However, there are limits to the expansion of the medical care system and public health system. It has become difficult to arrange hospitalization for moderate and severe patients, and there are cases where general medical care such as surgery is restricted and transportation in emergencies is difficult. If the situation is left as it is, there is fear of a critical situation in which lives that could be saved will not be, and it is necessary to promptly suppress the spread of the current infection as soon as possible. In order to promptly reduce the number of new infections, it is necessary to further reduce the opportunities for contact, strengthen the medical care system, prioritize public health center operations, and strengthen support.
  • Although the daytime and nighttime populations tend to decrease, it has not reached 50% of the population immediately before the declaration of emergency, and there are many people in the 40 to 64 years old group. In many areas, the PCR positive rate is 20% or more, and it is considered that the number of infected persons is not adequately grasped by the test. The government and citizens share a sense of crisis that the highly infectious Delta variant is a virus of a different level than before, and further efforts are now needed.
  • For this reason, based on the revised basic treatment policy and the proposal of the new coronavirus infectious disease countermeasures subcommittee on August 12, the national and local governments must further strengthen the countermeasures thus far and make detailed calls, and reduce contact opportunities by reducing the number of outings in the lives of citizens to less than half and avoiding crowded places.
  1. [Measures required in citizens' lives] Refrain from traveling or going out across prefectural borders, and avoid meeting people you do not normally meet

    Opportunities to meet people who do not usually meet have been shown to increase the risk of infection, and it is necessary to reduce such chances of infection as much as possible.

    Citizens, including those who have already been vaccinated, should refrain from moving or going out across prefectures and spend at home as much as possible in order to protect themselves and their families.

  2. [Social measures] Thorough basic measures against infection

    In particular, working age groups are in the process of vaccination, and even for those who have already been vaccinated, it should be reminded that guidelines for each industry should be thoroughly implemented once more. This includes the tightening of infection control in offices, conducting meetings online, promoting telework (especially for persons with underlying diseases and pregnant women), and encouraging voluntary restraint of persons with symptoms on going to the office; in addition to basic practices for infection control. Furthermore, it is necessary to encourage people to visit a hospital early, receive tests proactively and recuperate appropriately, in case of feeling physically sick, even for mild cold symptoms. Proactive vaccination should also be continued.

  3. [Measures for the medical system] Maximize the efficient use of medical resources in the face of the ongoing crisis

    In regions where the infection is rapidly spreading, prefectures should lead in making full use of medical resources to use new neutralizing antibody drugs with fast-track approval and promptly organize a system for quick responses to exacerbation according to each regional situation in order to secure required medical care. In addition, on the premise that the severe infection situation will continue nationwide for at least the time being, it is necessary to take immediate measures, including the use of Article 16-2 of the revised Infectious Diseases Control Law and the establishment of temporary medical facilities.

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

 

47th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (August 11, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide has been increasing at a rapid rate on the basis of reporting dates with the ratio of this week to last week of 1.33. The record-high levels have been updated, reaching approximately 78 per 100,000 population in the most recent week. The spread of infection is remarkable in the Tokyo metropolitan area and Okinawa. The number of new cases of infection is rapidly increasing across almost all regions nationwide, resulting in an unprecedented spread of infection.
  • With the rapid increase in the number of infections, the number of severe patients that had been kept low is rapidly increasing. And the number of patients for whom adjustment is made for hospitalization, etc. is rapidly increasing with the increase in the number of patients receiving treatment. The public health systems/medical care provision systems are under very severe pressure mainly in the Tokyo metropolitan area, which is already close to disaster levels.
  • It should be noted that the most recent figure of infected persons may continuously increase following 3-day weekend, etc.

    Effective reproduction number: On a national basis, it remains above 1 at 1.39 most recently (as of July 25). The figure is 1.37 in the Tokyo metropolitan area and 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)

    Emergency measures have been taken in Tokyo. The number of new cases of infection is still on an increasing trend and has become approximately 200, with the ratio of this week to last week of 1.19. The largest-ever spread of infection exceeding the spread during the year-end and New Year holidays is continuing. The infection is spreading mainly in persons in their 20s to 40s, and the number of elderly persons with infection is also on an increasing trend. The number of inpatients continued to increase mainly in those in their 20s to 50s. The number of persons in their 60s and older is also increasing. The number of severe patients using mechanical ventilators or artificial heart and lung apparatus have been increasing, mainly in those in their 40s to 50s. The numbers of inpatients and severe patients reached a record high, and it is difficult to accept/arrange for hospitalization for some cases during nighttime, etc. With the rapid increase in infections, patients receiving medical care at home and those for whom arrangement is being made rapidly increased. In addition, general medical services have been restricted, such as care in intensive care unit, etc. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has also been rapidly increasing mainly in those in their 20s and 30s, reaching approximately 120, 107, and 140, respectively. As in Tokyo, the use rate of beds and the use rate of beds for severe patients are rapidly increasing. Although the nighttime population is decreasing in Tokyo, it has not reached the level during the period under the previous declaration. And not only persons in their 20s and 30s, but also 40s and 50s, account for high proportions of the nighttime population. The nighttime population started to decrease in Saitama and Chiba, but remains flat in Kanagawa. The infection is expected to spread for the time being in the Tokyo metropolitan area.

  2. Okinawa

    Emergency measures have been continuously taken. The number of new cases of infection is still in a trend of rapid increase and has become approximately 248, which is the highest nationwide and at an unprecedentedly high level, with a rate of this week to last week of 1.38. New cases are mainly in those in their 20s to 30s. Rapid increase in the number of inpatients is continuing. The use rate of beds and the use rate of beds for severe patients are in severe situations. The nighttime population started to decrease again to below the level during the first declaration of the state of emergency. Attention should be paid as to whether the trend leads to a decrease in the number of new cases of infection.

  3. Kansai area

    In Osaka, the number of new cases of infection has been increasing at a rapid rate and reached approximately 86, with the ratio of this week to last week at 1.25. New cases are mainly in those in their 20s to 30s. The number of inpatients continued to increase, and the number of severe patients also increased. The nighttime population turned downward but remains at a high level, and it is expected that the spread of infection will continue.

    In Shiga, Kyoto and Hyogo, the number of new cases of infection is still in an increasing trend, reaching approximately 45, 71, and 51, respectively. The number of inpatients rapidly increased across all prefectures. In Kyoto and Hyogo, the nighttime population decreased. Attention should be paid as to whether it leads to a decrease in the number of new cases of infection.

    he trend of rapid increase in the number of new cases of infection is also continuing in Nara with the figure reaching approximately 44.

  4. Hokkaido

    The number of new cases of infection is rapidly increasing and has become approximately 44 (approximately 80 in Sapporo City), with a ratio of this week to last week at 1.34. The use rate of beds remains below 20%, but is in an increasing trend most recently. The nighttime population has decreased but remains at a high level, and the spread of infection may continue.

  5. Chukyo area

    In Aichi, the number of new cases of infection has been increasing at a rapid rate and reached approximately 33, with the ratio of this week to last week at 1.48. In Shizuoka, the number of new cases of infection is rapidly increasing and has become approximately 38 with the ratio of this week to last week at 1.65. In any case, the number of inpatients continues to increase. The use rate of beds for severe patients is below 20%. In Aichi, the nighttime population turned upward most recently and the spread of infection may continue.

    The number of new cases of infection shows a trend of rapid increase also in Mie, reaching approximately 28.

  6. Kyushu

    In Fukuoka and Kumamoto, the number of new cases of infection is rapidly increasing and has become approximately 95 and 44, respectively, with the ratio of this week to last week exceeding 1.5. The number of inpatients continues to increase. The use rate of beds for severe patients is below 20%. The nighttime population decreased. Attention should be paid as to whether it leads to a decrease in the number of new cases of infection. Rapid increase in the number of new cases of infection is observed in other prefectures. Especially in Saga, Oita and Kagoshima, the figure has exceeded 25, reaching approximately 32, 25 and 32, respectively, indicating rapid spread of infection.

  7. Other areas subject to priority measures

    The number of new cases of infection is still in a trend of rapid increase in Ibaraki, Tochigi and Gunma, reaching approximately 61, 47 and 50, respectively. In Fukushima and Ishikawa, it is approximately 32 and 45, respectively, at high levels or shows a decreasing trend. In all the prefectures, the use rate of beds exceeds 50%. The nighttime population decreased. Attention should be paid as to whether it leads to a decrease in the number of new cases of infection.

  8. Other than the above

    The number of new cases of infection rapidly increased in almost all other regions; especially in Miyagi, Toyama, Fukui, Yamanashi, Tottori, Okayama and Kagawa, the figure was approximately 28, 30, 25, 48, 31, 36 and 29, respectively, which exceeded 25, indicating rapid spread of infection and the infection staying at a high level.

Analysis of mutant strains

  • For the B.1.617.2 lineage variant (Delta variant), the positive rate in the screening tests (mechanical estimation, July 26 to August 1) is approximately 67%. The rate is increasing and the existing strains have been replaced by this variant. Especially in Tokyo, the figure is around 80%, and is estimated to be around 95% most recently, indicating that almost all of the existing variants have been replaced by the Delta variant. It is considered to be a major factor of the current spread of infection.

Future outlook and measures to be taken

  • Emergency measures and priority measures have been taken. While the existing strains have been replaced by the Delta variant, the reduction in the de facto population is limited and the number of infections is increasing on an unprecedented scale; the number of severe patients is also rapidly increasing. Attention should be paid to the increase in absolute numbers of not only relatively young severe patients, but of patients in their 60s as well.
  • The spread of infection has entered a hitherto unseen phase. Enhancement of medical care provision systems and public health systems provides only limited care to adequately respond to the recent situations of infection, and there are cases where general medical services, such as care in intensive care units or emergency transportation, become difficult to perform. There is concern that a critical situation where many lives cannot be saved will occur and it is necessary to contain the current spread of infection as promptly as possible. Again, it is necessary to address this situation by sharing a sense of crisis between the government and citizens, and to promptly further reduce situations of contact.
  1. ★ Please refrain from moving across prefectures and outings in the Obon holiday: consider postponement of visit your hometown during this holiday

    It is necessary to reduce the opportunities for infection as much as possible. Opportunities to meet with people to whom one does not usually meet increase the risk of infection. To protect ourselves and families, it is necessary to refrain from moving across prefectures and outings as much as possible, and to stay with our own families during the Obon holiday, which starts this week, as well as during summer vacation.

  2. ★ Thorough basic measures against infection

    The infection is rapidly spreading to workplaces and schools as well as commercial facilities in various regions. It is necessary to continue to take thorough measures for scenes of eating and drinking, and to thoroughly prevent transmission to home and workplaces due to eating and drinking behaviors. Even for those who have already been vaccinated, it should be reminded that guidelines for each industry should be thoroughly implemented once more. This includes the tightening of infection control in offices, conducting meetings online, promoting telework (especially for persons with underlying diseases and pregnant women), and encouraging voluntary restraint of persons with symptoms on going to the office; in addition to basic practices for infection control, such as wearing a mask, hand washing, and keeping social distances, and ventilation. Furthermore, it is necessary to encourage people to visit a hospital early, receive tests proactively and recuperate appropriately, in case of feeling physically sick, even for mild cold symptoms. Proactive vaccination should be continued in addition to these basic measures.

  3. ★ Maximize effective use of medical resources

    In regions where the infection is rapidly spreading, prefectures should lead in making full use of medical resources to use new neutralizing antibody drugs with fast-track approval and promptly organize a system for quick responses to exacerbation based on the newly presented “Concept of Treatments for Patients” according to each reginal situation in order to secure required medical care. Furthermore, it is necessary to promote measures including a system of nighttime emergency services on the assumption that rapid increase of infection will continue nationwide. In addition, it is necessary to promptly organize and take action regarding handling persons who have close contact with infected persons through healthcare workers.

  4. ★ Promotion of testing

    When an individual receives a positive PCR test or antigen test, it is considered that doctors and medical institutions should urge persons who may have close contact with the pertinent person to undergo a test even without a determination by public health center.

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

 

46th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (August 8, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • The number of new cases of infection nationwide is rapidly increasing with the ratio of this week to last week at 2.09 on the basis of reporting dates; it was approximately 59 per 100,000 population, which is the highest ever. The number of new cases of infection rapidly increased not only in the Tokyo metropolitan area, but also in various regions nationwide, and this unprecedented spread of infection continues. And with the rapid increase in the number of infections, the number of severe patients that has been kept low is increasing.

    Effective reproduction number: On a national basis, it remains above 1 at 1.35 most recently (as of July 18). The figure is 1.33 in the Tokyo metropolitan area and 1.30 in the Kansai area. It is expected to further rise based on the movement in the number of new cases of infection on the basis of reporting dates.

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)

    Emergency measures have been taken in Tokyo. The number of new cases of infection was approximately 168, with rapidly increasing ratio of this week to last week, 1.89. The largest-ever spread of infection exceeding the spread during the year-end and New Year holidays was observed. New cases are mainly in persons in their 20s to 40s. The number of inpatients continued to increase mainly in those in their 20s and 50s. The number of severe patients using mechanical ventilators or artificial heart and lung apparatus have been increasing, mainly in those in their 40s to 50s. Both levels exceed the level during the spread of infection in May. With rapid increase in the number of infections, patients who are forced to receive home care and those for whom hospitalization is being arranged rapidly increased. In addition, general medical services have been restricted. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has also been rapidly increasing mainly in those in their 20s and 30s, reaching approximately 86, 80, and 103, respectively. The ratio of this week to last week rapidly increased and exceeded 2 in all three prefectures. The nighttime population only slightly decreased in Tokyo, though started to increase late last week. On the other hand, the nighttime population did not significantly decrease in Saitama and Chiba, and the spread of infection cannot be avoided for a while in the Tokyo metropolitan area.

  2. Okinawa

    Emergency measures have been taken. The number of new cases of infection was approximately 179, with rapidly increasing ratio of this week to last week, 2.17. New cases are mainly in those in their 20s to 30s. The number of inpatients is rapidly increasing. The use rate of beds and the use rate of beds for severe patients are in severe situations. The nighttime and daytime populations, which significantly decreased during the 4 consecutive holidays, started to increase again, making the spread of infection unavoidable.

  3. Kansai area

    In Osaka, the number of new cases of infection was approximately 69, with a rapidly increasing ratio of this week to last week at 1.90. New cases are mainly in those in their 20s to 30s. The number of inpatients continued to increase, and the number of severe patients started to increase. The nighttime population still remains high and is in an increasing trend. It is expected that the spread of infection will continue.

    In Kyoto and Hyogo, the number of new cases of infection has been increasing to approximately 46 and 38, respectively. Across the 3 prefectures, the use rate of beds for severe patients continues to be below 20%, but the nighttime population remains high. It is highly likely that the spread of infection will continue.

    Also in Shiga, Nara, and Wakayama, the number of new cases of infection rapidly increased to approximately 26, 31, and 27, respectively.

     

  4. Hokkaido/Ishikawa/Fukuoka

    The number of new cases of infection rapidly increased in Hokkaido, Ishikawa, and Fukuoka, where the priority measures such as for prevention of the spread of disease (priority measures) were applied, reaching approximately 33 (56 in Sapporo City), 56, and 60, respectively. The use rate of beds for severe patients remains below 20% across all prefectures. The nighttime population has decreased in these prefectures, but remains at a high level in Hokkaido, and it is highly likely that the spread of infection will continue.

  5. Other than the above

    In Aichi where the priority measures were lifted, the number of new cases of infection was approximately 22, with a rapidly increasing ratio of this week to last week at 2.24. The use rate of beds for severe patients continues to remain below 20%.

    The number of new cases of infection rapidly increased in almost all other regions; especially in Fukushima, Ibaraki, Tochigi, Gunma, Fukui, Yamanashi, Tottori, Okayama and Kumamoto, the figure was 33, 46, 42, 36, 27, 31, 30, 25 and 29, respectively, which exceeded 25. And the ratio of this week to last week exceeded 2, indicating rapid spread of infection.

     

Analysis of mutant strains

  • For the B.1.617.2 lineage variant (delta variant), the positive rate in the screening tests (mechanical estimation, July 19 to 25) is approximately 45%. The rate is increasing and the existing strains have been replaced by this variant. Especially in Tokyo, the rate exceeds 50% and is estimated to reach approximately 90% most recently.

Future outlook and measures to be taken

  • While the existing strains have been replaced by the delta variant, the reduction in the de facto population is limited and the number of infections is increasing at an unprecedented rate; the number of severe patients is also rapidly increasing. Attention should be paid to the situation of absolute numbers of not only relatively young severe patients, but that of elderly patients is increasing. Although the number of deaths is still at a low level, the number of severe patients is increasing and the number of deaths lags behind the movement in severe patients. Therefore, the number of deaths may also increase in future. It is necessary to promptly contain the current rapid increase in infection. Again, it is necessary to address this situation by sharing a sense of crisis between the government and citizens, and investigating measures to further reduce opportunities of contact.
  1. ★Necessity to effectively utilize medical resource to the maximum

    For the burden on the medical care system/public health system, inpatients mainly in their 20s to 50s are increasing especially in Tokyo where the infection is rapidly spreading, severe patients in their 40s to 50s is rapidly increasing unlike before, and general medical services have been restricted. 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. In other regions where the infection is spreading, it is strongly concerned that a similar situation may occur while the medical care system cannot provide sufficient care for this condition compared to Tokyo. On the other hand, with the progress of vaccination, the profile of patients is changing. Under these circumstances, promotion of doctor’s visits to patients who are forced to receive home care, input of medical care in accommodation facilities for recuperation, and health monitoring of patients who are receiving care at home or at accommodation facilities should be facilitated while securing systems to ensure hospitalization of severe patients and patients in moderate conditions at high risk of exacerbation in regions where the infection is rapidly increasing, based on the regional conditions. In addition, it is required to make full use of regional medical resources, such as doctor’s visits and home-visit nursing, and immediately organize a system for quick responses to exacerbation of the disease in order to secure required medical care.

  2. ★Thorough implementation of basic measures for summer vacation

    The infection is rapidly spreading to workplaces and schools as well as commercial facilities in various regions. It is necessary to continue to take thorough measures for scenes of eating and drinking, and to thoroughly prevent transmission to home and workplaces due to eating and drinking behaviors. It should be reminded that guidelines for each industry should be thoroughly implemented again, the tightening of infection control in offices and the policy of working from home be promoted, and voluntary restraint of persons with symptoms on going to the office be thoroughly implemented, in addition to basic practices for infection control, such as wearing a mask, hand washing, and keeping social distances, and ventilation. Especially for masks, it is recommended to use non-woven face masks which are highly effective in prevention of respiratory droplets. Opportunities to meet people whom one does not usually meet during the three-day holiday, summer vacation and Obon holiday increase the risk of infection. One should be prudent regarding moving across prefectures. Furthermore, it is necessary to encourage people to visit a hospital early, receive tests proactively and recuperate appropriately, in case of feeling physically sick, even for mild cold symptoms. It is important to thoroughly communicate these efforts.

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

 

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)

Copyright 1998 National Institute of Infectious Diseases, Japan