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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)

Copyright 1998 National Institute of Infectious Diseases, Japan