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)