38th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (June 9, 2021). Material 1
Evaluation of the latest infection status, etc.
Infection status
- The number of new cases of infection nationwide has been declining with approximately 13 per 100,000 population for the latest week on the basis of reporting dates. There is generally a downward trend in regions where the infection has spread. However, there are areas where the decreasing speed has slowed due to an increase in the flow of people, and there is a possibility of a rebound in future.
- Along with the decrease in the number of new cases of infection, the number of severe patients and deaths has started to decrease.
The nationwide effective reproduction number has been declining and remains below 1 at 0.78 (as of May 16).
Analysis of infection status [local trends]
*The value of new cases of infection is the number of people per 100,000 in the total number for the latest week on the basis of reporting dates.
- (1) Okinawa
- Two weeks have passed since the start of emergency measures. In Naha City, the southern/middle regions, and the Miyako/Yaeyama areas, the number of new cases of infection continued to surge, mainly among the working generations in their 20s and 30s. The number has decreased since June, but remains above 100 at 103. The use rate of beds has remained at a high level and the hospitalization rate has decreased. Therefore, the number of patients who are receiving care at home has increased. Concern is rising regarding potential increase in the number of severe patients in future and the further burden this may impose on the medical care provision systems. There is concern that transmission of infection in the elderly could cause a further increase of severe patients.
- The nighttime and daytime populations have decreased since the start of emergency measures. Although the number of new cases of infection may decrease in future, attention should be paid to whether these trends continue. For patients who are receiving care at home or at accommodation facilities, it is necessary to handle issues including preparation for sudden changes in the condition of these patients.
- (2) Hokkaido
- The number of new cases of infection continues to decrease, but the level is above 25 at approximately 29. In Sapporo City, which is the center of infection spread, the number has decreased, but is still at a higher level of approximately 49. In addition, clusters continue to occur at welfare and other facilities. The nighttime population has decreased since the start of emergency measures. Although the number of new cases of infection may decrease in future, attention should be paid to whether these trends continue. The use rate of beds has remained high in Sapporo City. Clusters have also occurred in welfare facilities in other regions than Sapporo.
- (3) Kansai area
- In Osaka, Hyogo, and Kyoto, the number of new cases of infection has been decreasing to approximately 14, 9, and 12, respectively. As the number of new cases of infection has decreased, there is some improvement such as the decrease in the number of inpatients and severe patients, but clusters in facilities for the elderly are continuing. In Osaka, the nighttime and daytime populations are increasing, but remain at a level approximately 10% lower than the minimum value during the second declaration of the state of emergency. In Hyogo, the nighttime population remains at a level lower than the minimum value during the second declaration of the state of emergency. While the number of new cases of infection is expected to continue to decrease, the nighttime population in Kyoto has begun to increase. Therefore, careful monitoring is necessary including the de facto population after improvement in the infection status.
- In Shiga and Nara, the number of new cases of infection has been on a downward trend to approximately 14 and 8, respectively.
- (4) Metropolitan area (Tokyo and its 3 neighboring prefectures)
- In Tokyo, Saitama, Chiba, and Kanagawa, the number of new cases of infection has been decreasing to approximately 21, 9, 11, and 16, respectively. The ratio of this week to last week has been below 1 since mid-May, but the level remains higher and the decreasing speed is slower compared to the Kansai area. Particularly in Chiba and Kanagawa, it is almost flat. In addition, there is no apparent downward trend in the number of severe patients.
- In Tokyo, both the nighttime and daytime populations have increased for 4 consecutive weeks. In particular, the increase from before and after the extension of the declaration of the state of emergency is remarkable. In Saitama, Chiba, and Kanagawa, the trend has remained flat. There is concern that it is becoming difficult to obtain cooperation with the measures. Particularly in Tokyo, if the upward trend continues, there is a possibility of a rebound and caution is therefore required.
- (5) Chukyo area
- In Aichi, the number of new cases of infection has been decreasing to approximately 20. The burden on the healthcare systems continues in spite of the decrease in severe patients, and the use rates of beds are at high levels. The medical care provision systems have been under severe pressure. The number of new cases of infection is expected to decrease in future, but the nighttime and daytime populations have slightly increased. Attention should be paid to whether the downward trend in the number of new infections continues.
- In Gifu, the number of new cases of infection has been decreasing to approximately 15. The nighttime and daytime populations remain at a low level, and the number of new cases of infection is expected to decrease in future. In Mie, the number has been decreasing to approximately 8. The nighttime population has been increasing, which leads to concern about a rebound. In Shizuoka, the number has also been decreasing to approximately 7.
- (6) Kyushu
- In Fukuoka, the number of new cases of infection has been decreasing to approximately 11. Although the number of inpatients and severe patients has decreased, there is a great burden on the medical care provision systems. The nighttime population remains low. The number of new cases of infection is expected to decrease in future, but it is necessary to carefully watch whether these trends continue.
- In Kumamoto, the number of new cases of infection has continued to decrease to approximately 5. As the number of new cases of infection has decreased, the use rate of both beds for inpatients and beds for severe patients is decreasing, which secures the hospitalization rate above 50%. In other Kyushu prefectures, the decreasing trend generally continues.
- (7) Other areas under emergency measures (Okayama and Hiroshima) and those under priority measures, such as for prevention of the spread of disease (Gunma and Ishikawa)
- In Okayama and Hiroshima, the number of new cases of infection has been decreasing to approximately 7 and 12, respectively. In both prefectures, the number of severe patients has decreased, while the use rate of beds remains high. The nighttime population remains at a low level in both prefectures and the number of new cases of infection is expected to decrease in future, but attention should be paid to whether the downward trend in the number of new infections continues.
- In Gunma and Ishikawa, the number of new cases of infection has been decreasing to approximately 5 and 7, respectively. As the number of new cases of infection has decreased in both prefectures, the use rate of both beds for inpatients and beds for severe patients is decreasing, which secures the hospitalization rate above 50%.
- (8) Areas other than those listed above
- In Yamanashi and Kochi, the number of new cases of infection exceeds 15 at 21 and 18, respectively. While the number has started to decrease in Kochi, it has increased in Yamanashi due to the occurrence of clusters and should be watched carefully.
Future outlook and measures to be taken
- Although a downward trend in the number of new cases of infection may continue nationwide, attention should be paid to the increasing trend in the flow of people, since the existing strains were almost replaced by the variants of B.1.1.7 lineage (alpha variant) and the variants may be more infectious. There are some regions where the flow of people has already started to increase and there is a possibility that the number of new cases of infection may stop decreasing in these regions.
- In regions under emergency measures and those under priority measures, such as for prevention of the spread of disease (priority measures), the number of infections has decreased owing to the cooperation of citizens and business operators, clearly showing the effect of these measures. In Okinawa and Hokkaido, however, the number of new cases of infection has remained at the level equivalent to the Stage IV. There are some regions where the medical care provision systems remain under severe pressure, although the burden has decreased alongside the decrease in the number of new cases of infection and patients who are receiving care. Therefore, it is necessary reduce the number of new cases of infection as much as possible to prevent a future rebound and to continue to control the increase even if the reduction stops. It is necessary to thoroughly implement the measures based on the "Measures to be taken after June during the declaration of the state of emergency" compiled by the government's Novel Coronavirus Response Headquarters on May 28.
- Particularly in Tokyo, the flow of people continues to increase. If this trend continues, the number of infected patients will stop decreasing and rebound in future. Vaccinations have been performed mainly in the elderly, and therefore it is expected that severe cases may be suppressed in the elderly. However, if the number of infected patients continues to surge after a rebound, the number of severe patients may increase and the medical care provision systems will be overwhelmed. In addition, there is a burden associated with vaccination at medical institutions. Based on these points, efforts necessary to control the spread of infection should be continued in the future.
- In other regions and regions where the priority measures are lifted, each local government has to analyze the flow of people, the status of infection and the medical care provision systems in a conference style with experts in the region, and implement the necessary measures in a timely manner, based on the possibility that infection will spread faster than before due to alpha variants and variants of B.1.617 lineage (including delta variants).
- As for the spread of infection this time, the size, speed, and course of decrease differed among regions. These differences can be attributed to various factors including replacement by variants, contents and timing of the start/end of countermeasures, movement of people or gathering of persons who do not usually meet due to the turn of the start/end of fiscal year or Golden Week holidays, and the age group that became the center of infection, but further investigation is needed.
- The number of vaccinations has already exceeded 19 million nationwide and approximately 14.5 million people have received the first vaccination. To suppress the spread of infection, it is necessary to promptly and smoothly carry out the vaccination of many people nationwide, including occupational vaccinations.
- While it is estimated that the existing strains have been replaced by alpha variants as the predominant strain in most regions with some exceptions, it is necessary to take measures focused on an understanding of the actual situation using virus genomic surveillance in order to reinforce the measures against new mutant strains. It is particularly essential concerning mutants, including the delta variants, to suppress the spread of infection as much as possible by following the measures: nationwide monitoring through genomic surveillance and screening of L452R variants, strengthening of systems to conduct tests regionally and active epidemiological surveys. In addition, it is also necessary to continue to take the border control measures promptly.