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23th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (February 11, 2021).  Material 1

 

Evaluation of the latest infection status, etc

Infection status

  • The number of new infections reached approximately 36 per 100,000 population in the week ending 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 11 per 100,000 population. (Based on the date of onset, the number is keeping a decreasing trend from the beginning of January.)

    Effective reproduction number: The effective reproduction number has fallen below 1 from the beginning of January nationwide and has been 0.76 recently (as of January 25). In Tokyo and its 3 neighboring prefectures, Osaka/Hyogo/Kyoto, Aichi/Gifu, and Fukuoka, the levels remain below 1. (as of January 25)

  • The number of hospitalized patients continues to decrease. In addition, the number of severe patients is clearly showing a decreasing trend while the number of deaths has also decreased. Since the proportion of newly infected patients aged 60 years or older is increasing, it may take time to decrease the number of severe patients. Although the number of cases under adjustment of hospitalization and medical care has decreased, staff members of public healthcare centers and medical facilities who continue to respond remain under a lot of strain, thus resulting in concern about the impact on their work. While the number of infected patients continues to increase mainly in urban areas, 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. On top of this, clusters in elderly facilities continue to occur.
[Local trends]

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

  1. (1) Metropolitan area:
    In Tokyo, the number of new infections has decreased and reached below one-third of the peak in the period under the Declaration of the State of Emergency, but it is still approximately 26. The medical care provision systems remain under very severe pressure. It also remains difficult for local governments to make arrangements for hospitalization. In Kanagawa, Saitama, and Chiba, the number of new infections continues to decrease, approximately 14, 18, and 19, 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 6. The use rate of beds is on a general decline.
  2. (2) Kansai Area:
    In Osaka, the number of new infections continues to decrease and has reached approximately 13, which is lower than the index for stage III, 15. In contrast, the situation in the medical care provision system and arrangements including admission by local governments remain difficult. Clusters in places such as elderly facilities continue to occur and the number of severe patients remains high. In Hyogo and Kyoto, the number of new infections is on a declining trend and has reached approximately 10 and 8, respectively, but the situation in the medical care provision system remains tough. 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.
  3. (3) Chukyo Area:
    In Aichi, the number of new infections continues to decrease, falling below approximately 8, which is lower than the 15. In Gifu, the number of new infections has decreased continuously, reaching approximately 9. In both cases, The use rate of beds decreasing, but the medical care provision systems are under tough conditions. 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. (4) Kyushu Area:
    In Fukuoka, the number of new infections continues to decrease, reaching approximately 12, which is lower than the 15. However, the number of severe patients is showing a general increase. The medical care provision systems are 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. (5) Areas other than those listed above:
    The number of new infections continues to decrease. In Okinawa, the medical care provision system remains under extremely tough conditions, but the number of new infections has decreased to approximately 17. In Okinawa, since the proportion of people aged 65 years or older is high, caution is required.
[Mutant strain]
  • The new mutations, which have been increasingly found in the UK, South Africa and other countries, have been spreading worldwide. These strains were also detected in Japan from people who did not travel overseas and might have been affected by domestic infection. In addition, diffuse outbreaks, which are clusters including infected patients across prefectures, have occurred. The mutations may have higher infectivity than the original strains. In case the mutations 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 effective reproduction numbers have been decreasing from the beginning of the year in Tokyo and its 3 neighboring prefectures, as well as Aichi/Gifu, and Osaka/Hyogo/Kyoto. Under the Declaration of the State of Emergency, the effective reproduction numbers are maintained at around just below 0.8, and the number of new infections has been decreasing, but attention needs to be paid to the slowdown of the decline in the number of people coming and going. The number of cluster occurrences in restaurants has been decreasing, partly due to cooperation with the efforts following the recent Declaration of the State of Emergency focusing on restaurants. However, clusters have occurred mainly in medical facilities, welfare facilities, and homes, and also continues to occur in restaurants. The number of infected patients in their 20s to 50s has decreased nationwide, but the decreasing trend has been weak in those 80 and older, and the proportion of those aged 60 or older in the total number of infected patients has been increasing. Since this trend may delay the decrease of severe patients and deaths, attention should be paid to it.
  • Considering the spread of infection from urban areas to surrounding areas during the year-end and New Year holidays, it is indispensable to maintain infection control strictly and prevent re-expansion 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 over one-quarter of the entire country. Tokyo and its 3 neighboring prefectures account for just under 55%. The 10 prefectures which are subject to the Declaration of the State of Emergency account for just under 80% of new infections.

Measures to be taken

  • Thorough measures are required to ensure the decreasing trend of new infections and reduce the number of severe patients and deaths in future, as well as to reduce the burden on medical facilities for allow for future vaccinations. Also, these measures are necessary to prevent reoccurrences and to enable accurate detection of mutant strains.
  • The Declaration of the State of Emergency issued in 11 prefectures was decided to be extended, excluding Tochigi Prefecture, on February 2. Although the number of new infections has fallen below 15 and the use rate of hospital beds is declining in some regions, the impact on the burden of the medical care provision system and the public health system needs to be carefully watched. Assuming a situation where there will be a large number of hospitalized and severe patients continuously, the necessary medical care provision system should be continuously secured.
  • Even in regions where the Declaration of the State of Emergency has been removed, it is necessary to continue efforts to reduce the number of infected patients so that it will not lead to a renewed increase. For that purpose, it is required to establish a system that can reinforce active tests and active epidemiological studies again according to the infection risk. In addition, it is necessary to evaluate and analyze the core places for spread of infection and changes in the impact, and to consider new measures to be taken.
  • “Protect the elderly.” Efforts to prevent the spread of infection are required at welfare facilities and medical facilities where clusters have continued to occur. Moreover, measures to protect staff members of the facilities are needed. Periodic examinations of staff members of the facilities should be conducted while support is required for infectious disease control measures through dispatch of experts to facilities in cooperation between the welfare division for the elderly and the infectious disease control division within each local government. In addition, if even one case of infection is confirmed in an elderly facility, local healthcare resources should be utilized to expedite medical support to the facility.
[Mutant strain]
  • To monitor the influx of mutant strains into Japan, it is necessary to strengthen the quarantine system based on risk assessment. Furthermore, by strengthening the domestic screening test system for mutant strains, it is required to conduct early detection of mutant infected people and to carry out active epidemiological survey and measures to promptly prevent the spread of the mutant strains, as well as to support dealing with diffuse outbreaks. Avoidance of the 3 Cs, wearing of a mask and hand washing, etc. are also recommended as basic preventive measures for individuals.

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

Copyright 1998 National Institute of Infectious Diseases, Japan