22th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (February 1, 2021). Material 1
Evaluation of the latest infection status, etc
Infection status
- The number of new infections nationwide reached approximately 36 per 100,000 population in the week ending on January 11 based on the reporting date, but has shown a downward trend since the middle of January, and the number in the most recent week is approximately 19 per 100,000 population. (Based on the date of onset, the number shows a decreasing trend from the beginning of January.)
Effective reproduction number: The effective reproduction number has fallen below 1 from the middle of January nationwide and has been 0.80 recently (as of January 15). In Tokyo and its 3 neighboring prefectures, Osaka, Hyogo and Kyoto, Aichi and Gifu, Fukuoka, and Tochigi, the levels generally remain below 1. (as of January 16)
- The number of inpatients has decreased, but the numbers of severe patients and deaths continue to reach record highs. It will take a certain time before the decrease in new infections is reflected in a decrease in inpatients and severe patients. The staff of public health centers and medical facilities who are continuously handling the situation are extremely exhausted and there is concern about the impact on the way they perform their tasks. While the number of infected patients continues to increase, it remains difficult to maintain both medical care for novel coronavirus cases as well as usual medical care, and there are also cases in which the situation affects the emergency response. There are also still many cases in which hospitalizations and recuperating patients need to be coordinated due to a shortage of beds. The occurrence of clusters in elderly facilities has also increased.
[Local trends]
- (1) Metropolitan area:
the number of new infections has decreased and has fallen below half the peak in the period under the Declaration of the State of Emergency, reaching approximately 43 per 100,000 population in the most recent week. The continuously tough situation in the medical care provision system affects the emergency response. It also remains difficult for local governments to make arrangements for hospitalization. In Kanagawa, Saitama, and Chiba, the number of new infections has also decreased and the number was approximately 30, 25, and 33 per 100,000 population, respectively. The situation in the medical care provision system remains harsh in all three prefectures.
In Tochigi, the number of new infections has decreased, reaching approximately 11 per 100,000 population in the most recent week. The use rate of hospital beds has been on a declining trend, but attention should be paid to the impact on the burden of the medical care provision system. - (2) Kansai area:
In Osaka, the number of new infections continues to decrease, and has reached approximately 26 per 100,000 population in the most recent week, which is close to 25, the index of stage IV. In contrast, the situation in the medical care provision system and the admission arrangements by local governments remain serious. Clusters in places such as elderly facilities continue to occur. In Hyogo and Kyoto, the number of new infections is on a declining trend, and has reached approximately 20 and 27 per 100,000 population, respectively, but the situation in the medical care provision system remains tough. - (3) Chukyo area:
In Aichi, the number of new infections continues to decrease, reaching approximately 16 per 100,000 population in the most recent week. In Gifu, the number of new infections has decreased continuously, and has reached approximately 14 per 100,000 population in the most recent week. The medical care provision system in both prefectures are in a serious situation. It is necessary to pay attention to the impact on the burden of the medical care provision system associated with the decrease in the number of new infections. - (4) Kyushu:
In Fukuoka, the number of new infections continues to decrease, and has reached approximately 22 per 100,000 population in the most recent week. The medical care provision system is under severe pressure. It is necessary to pay attention to the impact on the burden of the medical care provision system associated with the decrease in the number of new infections. - (5) Areas other than the above:
In Ibaraki, the number of new infections continues to decrease, but it has exceeded 15 per 100,000 population in the most recent week. In Okinawa, there is a decreasing trend, but the infection is spreading in Miyakojima. The number of new infections exceeds 35 per 100,000 population and the situation in the medical care provision system is extremely serious.
[Mutant strain]
- In Japan, the new mutants that are increasingly found in the UK, South Africa and other countries, were detected from people who had travelled overseas and their contacts. The mutants have also been detected from those who did not travel overseas but might have experienced secondary infection. The mutants may have higher infectivity than the original strains. In case the mutants continue to spread across the country, there is a risk of more rapid spreading than before. Concerning the UK strains, attention should also be also paid to the impact of the mutations on the seriousness of the infection.
Analysis of infection status
- The number of infected patients is on a downward trend after the steep proliferation during the year-end and New Year holidays. Although infections in restaurants have decreased, infection and clusters at medical facilities and welfare facilities have occurred across the country. The nationwide sharp increase in infected patients by the date of onset from the beginning of the year, which was mostly observed among people in their 20s to 50s, decreased thereafter. However, patients in their 80s and 90s have not decreased and severe patients and deaths may increase, and it is therefore necessary to pay attention to the trend. The trends in the number of infected patients and the positive rates during the year-end and New Year holidays may have been affected by infections at such locations as year-end parties, intergenerational transmission through homecoming visits, and an increase in the number of examinations performed before homecoming visits or the first working day of the year. The tendency should be analyzed continuously.
- Considering the geographical spread of infection from urban areas to surrounding areas during the year-end and New Year holidays, it is effective to maintain infection control in large cities to reduce infection in rural areas.
- *As for the number of new infections in the most recent week, Tokyo accounts for just under one-quarter of the entire country. Tokyo and its 3 neighboring prefectures account for just over half. The 11 prefectures under the Declaration of the State of Emergency account just under 80% of new infections.
Measures to be taken
- The Declaration of the State of Emergency was issued in the metropolitan area (Tokyo and its 3 neighboring prefectures) on January 7, and in 7 prefectures including the Kansai area, the Chukyo area, Fukuoka, and Tochigi on January 13. The number of new infections in these areas is on a downward trend through cooperation with recent efforts focused on restaurants. Especially in Tochigi, the number has declined to under 15 per 100,000 population and the use rate of beds is also on a declining trend, although the impact on the burden of the medical care provision system and the public health system needs to be carefully watched. Measures to decrease new infections need to be taken continuously to prevent an increase in the number of severe patients and deaths. Measures corresponding to locations as the core of infection spreading and changes in the impact should also be examined.
- To ensure a downward trend, the measures under the Declaration of the State of Emergency should be thoroughly implemented. It is also necessary to continue trying to decrease infected patients, because it is important to prevent an immediate rapid resurgence when people are no longer subject to measures in the future. Since hospitalized and severe patients are assumed to be observed continuously, the necessary medical care provision system should be secured. It is also necessary to improve the environment for home care such as efficient use of accommodation care, outsourcing of follow-up to medical associations and efficient monitoring, and to ensure strengthening of the inspection system.
- Efforts to prevent spreading of infection at welfare facilities and medical facilities are required. Efforts for facilities should be made for infection control, prevention of infection spread, early detection of infection by tests, actions at the time of occurrence, and strengthening of actions to be taken at the time of occurrence, and support to actually take actions at the site should be sought. It is required to utilize self-check by guidance and videos, various government support measures, and to establish a system for dispatching specialists.
- To monitor the influx of mutant strains into Japan, it is necessary to strengthen the quarantine system based on risk assessment. The mutation testing system should also be strengthened inside the country. If infected patients are found, an aggressive epidemiological survey should be conducted. In addition, genomic analysis needs to be continued. Avoidance of 3 Cs, wearing of a mask and hand washing, etc. are also recommended as basic preventive measures for individuals.