46th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (August 8, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide is rapidly increasing with the ratio of this week to last week at 2.09 on the basis of reporting dates; it was approximately 59 per 100,000 population, which is the highest ever. The number of new cases of infection rapidly increased not only in the Tokyo metropolitan area, but also in various regions nationwide, and this unprecedented spread of infection continues. And with the rapid increase in the number of infections, the number of severe patients that has been kept low is increasing.

  Effective reproduction number: On a national basis, it remains above 1 at 1.35 most recently (as of July 18). The figure is 1.33 in the Tokyo metropolitan area and 1.30 in the Kansai area. It is expected to further rise based on the movement in the number of new cases of infection on the basis of reporting dates.

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)

   Emergency measures have been taken in Tokyo. The number of new cases of infection was approximately 168, with rapidly increasing ratio of this week to last week, 1.89. The largest-ever spread of infection exceeding the spread during the year-end and New Year holidays was observed. New cases are mainly in persons in their 20s to 40s. The number of inpatients continued to increase mainly in those in their 20s and 50s. The number of severe patients using mechanical ventilators or artificial heart and lung apparatus have been increasing, mainly in those in their 40s to 50s. Both levels exceed the level during the spread of infection in May. With rapid increase in the number of infections, patients who are forced to receive home care and those for whom hospitalization is being arranged rapidly increased. In addition, general medical services have been restricted. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has also been rapidly increasing mainly in those in their 20s and 30s, reaching approximately 86, 80, and 103, respectively. The ratio of this week to last week rapidly increased and exceeded 2 in all three prefectures. The nighttime population only slightly decreased in Tokyo, though started to increase late last week. On the other hand, the nighttime population did not significantly decrease in Saitama and Chiba, and the spread of infection cannot be avoided for a while in the Tokyo metropolitan area.

2. Okinawa

   Emergency measures have been taken. The number of new cases of infection was approximately 179, with rapidly increasing ratio of this week to last week, 2.17. New cases are mainly in those in their 20s to 30s. The number of inpatients is rapidly increasing. The use rate of beds and the use rate of beds for severe patients are in severe situations. The nighttime and daytime populations, which significantly decreased during the 4 consecutive holidays, started to increase again, making the spread of infection unavoidable.

3. Kansai area

   In Osaka, the number of new cases of infection was approximately 69, with a rapidly increasing ratio of this week to last week at 1.90. New cases are mainly in those in their 20s to 30s. The number of inpatients continued to increase, and the number of severe patients started to increase. The nighttime population still remains high and is in an increasing trend. It is expected that the spread of infection will continue.

   In Kyoto and Hyogo, the number of new cases of infection has been increasing to approximately 46 and 38, respectively. Across the 3 prefectures, the use rate of beds for severe patients continues to be below 20%, but the nighttime population remains high. It is highly likely that the spread of infection will continue.

   Also in Shiga, Nara, and Wakayama, the number of new cases of infection rapidly increased to approximately 26, 31, and 27, respectively.

    

4. Hokkaido/Ishikawa/Fukuoka

   The number of new cases of infection rapidly increased in Hokkaido, Ishikawa, and Fukuoka, where the priority measures such as for prevention of the spread of disease (priority measures) were applied, reaching approximately 33 (56 in Sapporo City), 56, and 60, respectively. The use rate of beds for severe patients remains below 20% across all prefectures. The nighttime population has decreased in these prefectures, but remains at a high level in Hokkaido, and it is highly likely that the spread of infection will continue.

5. Other than the above

   In Aichi where the priority measures were lifted, the number of new cases of infection was approximately 22, with a rapidly increasing ratio of this week to last week at 2.24. The use rate of beds for severe patients continues to remain below 20%.

   The number of new cases of infection rapidly increased in almost all other regions; especially in Fukushima, Ibaraki, Tochigi, Gunma, Fukui, Yamanashi, Tottori, Okayama and Kumamoto, the figure was 33, 46, 42, 36, 27, 31, 30, 25 and 29, respectively, which exceeded 25. And the ratio of this week to last week exceeded 2, indicating rapid spread of infection.

    

Analysis of mutant strains

• For the B.1.617.2 lineage variant (delta variant), the positive rate in the screening tests (mechanical estimation, July 19 to 25) is approximately 45%. The rate is increasing and the existing strains have been replaced by this variant. Especially in Tokyo, the rate exceeds 50% and is estimated to reach approximately 90% most recently.

Future outlook and measures to be taken

• While the existing strains have been replaced by the delta variant, the reduction in the de facto population is limited and the number of infections is increasing at an unprecedented rate; the number of severe patients is also rapidly increasing. Attention should be paid to the situation of absolute numbers of not only relatively young severe patients, but that of elderly patients is increasing. Although the number of deaths is still at a low level, the number of severe patients is increasing and the number of deaths lags behind the movement in severe patients. Therefore, the number of deaths may also increase in future. It is necessary to promptly contain the current rapid increase in infection. Again, it is necessary to address this situation by sharing a sense of crisis between the government and citizens, and investigating measures to further reduce opportunities of contact.

1. ★Necessity to effectively utilize medical resource to the maximum

   For the burden on the medical care system/public health system, inpatients mainly in their 20s to 50s are increasing especially in Tokyo where the infection is rapidly spreading, severe patients in their 40s to 50s is rapidly increasing unlike before, and general medical services have been restricted. 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. In other regions where the infection is spreading, it is strongly concerned that a similar situation may occur while the medical care system cannot provide sufficient care for this condition compared to Tokyo. On the other hand, with the progress of vaccination, the profile of patients is changing. Under these circumstances, promotion of doctor’s visits to patients who are forced to receive home care, input of medical care in accommodation facilities for recuperation, and health monitoring of patients who are receiving care at home or at accommodation facilities should be facilitated while securing systems to ensure hospitalization of severe patients and patients in moderate conditions at high risk of exacerbation in regions where the infection is rapidly increasing, based on the regional conditions. In addition, it is required to make full use of regional medical resources, such as doctor’s visits and home-visit nursing, and immediately organize a system for quick responses to exacerbation of the disease in order to secure required medical care.

2. ★Thorough implementation of basic measures for summer vacation

   The infection is rapidly spreading to workplaces and schools as well as commercial facilities in various regions. It is necessary to continue to take thorough measures for scenes of eating and drinking, and to thoroughly prevent transmission to home and workplaces due to eating and drinking behaviors. It should be reminded that guidelines for each industry should be thoroughly implemented again, the tightening of infection control in offices and the policy of working from home be promoted, and voluntary restraint of persons with symptoms on going to the office be thoroughly implemented, in addition to basic practices for infection control, such as wearing a mask, hand washing, and keeping social distances, and ventilation. Especially for masks, it is recommended to use non-woven face masks which are highly effective in prevention of respiratory droplets. Opportunities to meet people whom one does not usually meet during the three-day holiday, summer vacation and Obon holiday increase the risk of infection. One should be prudent regarding moving across prefectures. Furthermore, it is necessary to encourage people to visit a hospital early, receive tests proactively and recuperate appropriately, in case of feeling physically sick, even for mild cold symptoms. It is important to thoroughly communicate these efforts.

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