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49th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (August 25, 2021).  Material 1

 

Evaluation of the latest infection status, etc.

Infection status

  • Without stopping the spread of infection, the number of new cases of infection nationwide continues to reach record highs, at approximately 128 per 100,000 population for the latest week of reporting dates. Compared to the Tokyo metropolitan area, the ratio of this week to last week in other areas, particularly in the Chubu area, is high. The unprecedented spread of infection has continued in almost all areas nationwide.
  • With the rapid increase in the number of infections, the number of severe patients is rapidly increasing, making it the largest ever and the number of deaths is also on the rise. The number of those being arranged for hospitalization is rapidly rising with the increase in the number of patients receiving treatment. The public health systems/medical care provision systems are under very severe pressure not only in the Tokyo metropolitan area but in other areas, which continue to be close to disaster levels.

    Effective reproduction number: On a national basis, it remains above 1 at 1.10 most recently (as of August 8). The figure is 1.04 in the Tokyo metropolitan area and 1.13 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 speed of increase in the number of new cases of infection is somewhat slowing down, but the upward trend continues. The number of new cases of infection is approximately 234 and the unprecedented spread of infection has continued. The infection is spreading mainly in persons in their 20s to 40s, and the number of elderly persons and people under 20 years of age with infection is also on an increasing trend. The number of inpatients continues to increase mainly in those in their 20s to 50s. The number of persons in their 60s and older is also increasing. The number of severe patients using mechanical ventilators or artificial heart and lung apparatus has remained high, mainly in those in their 40s to 60s. The numbers of inpatients and severe patients reach record highs, and there are cases where it is difficult to newly accept/arrange for hospitalization during nighttime, etc. The numbers of people receiving home care or those being arranged for hospitalization continue to increase rapidly, and the record-high levels have been continuously updated. In addition, general medical services have been restricted, such as acceptance in emergency medical care and intensive care units. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has also been rapidly increasing, reaching approximately 159, 168, and 185, respectively. As in Tokyo, the speed of spread of infection is somewhat slowing down, but the infection expansion continues at an unprecedented level. The infection is spreading mainly in persons in their 20s to 50s, but infected patients in their teens or younger are also on an increasing trend. The use rate of beds and the use rate of beds for severe patients are rapidly increasing. Particularly in Kanagawa, the use rates exceed 80% and the situation is still difficult. The nighttime population in Tokyo and Chiba turned upward after the Obon holiday. On the other hand, the nighttime population in Saitama and Kanagawa remains at a low level. It is necessary to pay close attention to changes in the number of infected patients in the Tokyo metropolitan area in the days ahead.

  2. Okinawa

    The speed of increase in the number of new cases of infection is somewhat slowing down, but the upward trend continues. The number of new cases of infection is the highest in Japan at approximately 314, and the unprecedented spread of infection has continued, but the potential to stop this increase is there. New cases are mainly in those in their 20s to 30s. As the use rate of beds and the use rate of beds for severe patients are almost reaching 90%, the severe situations have remained and arrangements for hospitalization are increasing. The nighttime population turns downward after the Obon holiday. Attention should be paid as to whether it leads to a decrease in the number of new cases of infection.

  3. Kansai area

    In Osaka, the number of new cases of infection has rapidly increased to approximately 182, with a ratio of this week to last week of 1.44. New cases are mainly in those in their 20s to 30s. The number of inpatients continues to increase, and the number of severe patients has also increased. The nighttime population has stopped to decrease after the Obon holiday, and the spread of infection may continue. In Kyoto and Hyogo where the priority measures were shifted to emergency measures, the number of new cases of infection continues to increase to approximately 132 and 124, respectively. The number of inpatients has rapidly increased in both prefectures. The use rate of beds for severe patients is rising rapidly, and the situation is severe. In Shiga, the number of new cases of infection continues to surge to approximately 102. The nighttime population has continuously decreased in Shiga and gradually decreased in Kyoto. In Hyogo, the figure has stopped to decrease. Attention should be paid as to whether the decrease in the area leads to a decrease in the number of new cases of infection.

    As for other areas, the trend of rapid increase in the number of new cases of infection is continuing also in Nara with the figure reaching approximately 96. Also in Wakayama, the number of new cases of infection turns upward, reaching approximately 60.

  4. Hokkaido

    The number of new cases of infection has increased to approximately 69 (approximately 103 in Sapporo City), with a ratio of this week to last week of 1.26. The use rate of beds for severe patients remains below 20%. The nighttime population has decreased but remains at a high level, and the spread of infection may continue.

  5. North Kanto

    In Ibaraki, Tochigi, and Gunma where the priority measures were shifted to emergency measures, the number of new cases of infection continues to increase to approximately 78, 78, and 102, respectively. In each prefecture, the number of inpatients and the number of severe patients are increasing, which results in severe situations as to the use rate of beds. The nighttime population remains at a low level in each prefecture. Attention should be paid as to whether the trend leads to a decrease in new cases of infection.

  6. Chukyo/Tokai

    In Aichi, the number of new cases of infection continues to surge to approximately 121, with a ratio of this week to last week of 1.94. In Shizuoka, the number of new cases of infection has rapidly increased to approximately 106, with a ratio of this week to last week of 1.60. In each case, the numbers of inpatients and severe patients continue to increase. The nighttime population has increased again in Aichi after the Obon holiday and has stopped decreasing in Shizuoka, and there is concern that infection may continue to spread. The number of new cases of infection shows rapid increases also in Gifu and Mie, reaching approximately 108 and 137, respectively. Both prefectures were newly designated as areas of priority measures. The ratio of this week to last week exceeds 2 in the 2 prefectures.

  7. Kyushu

    In Fukuoka where the priority measures were shifted to emergency measures, the number of new cases of infection continues to increase to approximately 148, with a ratio of this week to last week of 1.33. The number of inpatients continues to increase and the situation is severe. The use rate of beds for severe patients is below 20%. The nighttime population turns upward after the Obon holiday and the spread of infection may continue. In Kumamoto, the number of new cases of infection has been increasing to approximately 97. In Kagoshima, which was newly designated as an area of priority measures, the number of cases has been increasing to approximately 89, with a ratio of this week to last week of 1.27. The use rate of beds exceeds 70%, and the situation is severe

    Rapid increase in the number of new cases of infection has been observed in other prefectures. In Saga, Nagasaki, Oita, and Miyazaki, the figure has exceeded 25, reaching approximately 108, 44, 115 and 78, respectively. Especially in Oita and Miyazaki, the ratio of this week to last week exceeds 1.5.

  8. Other areas subject to priority measures

    In Fukushima and Ishikawa, the number of new cases of infection has stopped increasing and is approximately 38 and 45, respectively. The nighttime population remains at a low level. Attention should be paid as to whether it leads to a decrease in the number of new cases of infection.

    In Miyagi, Toyama, Yamanashi, Okayama, Hiroshima, Kagawa, and Ehime, the number of new cases of infection continues to increase to approximately 69, 73, 74, 88, 83, 64, and 40, respectively. Particularly in Toyama and Hiroshima, the ratio of this week to last week has increased rapidly to over 1.5. The use rate of beds exceeds 80% in Miyagi and Yamanashi and 70% in Kagawa, resulting in severe situation.

  9. Other than the above

    The number of new cases of infection has rapidly increased in many other regions; especially Aomori, Yamagata, Niigata, Fukui, Nagano, Yamaguchi, Tokushima and Kochi which exceed 25 at approximately 37, 31, 34, 30, 43, 44, 44, and 75, respectively, indicating rapid spread of infection.

    * Regarding the number of newly infected people mainly in the Tokyo metropolitan area and Okinawa Prefecture, it has been pointed out that the actual number of infected people is underestimated when the number of infected patients is rapidly increasing and the positive rate of tests is rising, so caution is required in trend analysis.

Analysis of mutant strains

  • For the B.1.617.2 lineage variant (Delta variant), the positive rate in the screening tests (mechanical estimation, August 2 to August 8) is approximately 85%. Recently, it is estimated that it exceeds 90% in each region, and it is considered that the B.1.1.7 variant (Alpha variant) has almost been replaced, except in some regions.

Future outlook and measures to be taken

  • Despite the continuation and expansion of emergency measures and priority measures, the de facto population has increased after the Obon holiday and the replacement with the Delta variant is progressing. Furthermore, the number of infected people is increasing nationwide on an unprecedented scale. The number of infected people may increase further due to the effects of the Obon holiday and the increase of social activities after this holiday. Under these circumstances, the number of severe patients has reached a record high and the number of deaths is on the rise. Furthermore, as the number of elderly infected people and the clusters at facilities for elderly people also rises, there is concern that the number of deaths will further increase in future. It is necessary to take action based on the recognition that the situation is at an unprecedented disaster level. The number of infected patients under 20 years of age has been increasing. The school will resume after the summer holiday in the days ahead and it is necessary to take measures to prevent the spread of infection. However, it should be noted that the impact and measures vary depending on educational institutions such as primary schools, junior high schools, high schools, and universities.
  • It has become difficult to arrange hospitalization for moderate and severe patients, and there are cases where general medical care, such as surgery, is restricted and transportation in emergencies is difficult. Additional restrictions are expected as a result of further strengthening of measures against COVID-19 in future. It is immediately necessary to promptly control the spread of current infection and to strengthen the medical system, prioritize the operations of public health centers and strengthen support.
  • The government and citizens share a sense of crisis that the highly infectious Delta variant is a virus of a different level than before, and further efforts are now needed. The government and municipalities will further strengthen the measures that have been taken so far and make detailed calls.
  1. Actions required to protect your life

    Opportunities to meet people who one does not usually meet have been shown to increase the risk of infection, and it is necessary to reduce such chances of infection as much as possible.

    Citizens, including those who have already been vaccinated, should refrain from going out (at least at a frequency not more than half the previous frequency) and spend time at home as much as possible in order to protect themselves and their families. In cases where it is really necessary to go out, it is essential to avoid going far from home and to keep away from crowded places and events with infection risk. Vaccination should be continuously promoted and citizens should undergo tests/examinations in case of any poor health condition.

  2. Thorough implementation of infection control measures at school, etc.

    After the epidemic of the Delta variant, the number of infected people in their teens or younger is on an increasing trend. At welfare facilities such as day-care centers and educational institutions such as primary schools, junior high schools, high schools, and universities, measures for infection control should be strengthened with reference to proposals on measures indicated by the Center for Field Epidemic Intelligence, Research and Professional Development in the National Institute of Infectious Diseases.

  3. Thorough basic measures against infection

    In addition to basic practices for infection control, the following measures should be promoted: reconfirmation of thorough compliance of guidelines for each industry, tightening of infection control in offices, conducting meetings online, promoting working from home (especially for persons with underlying diseases and pregnant women), and making sure that persons with symptoms take leave without going to the office.

  4. Maximize effective use of medical resources

    Prefectures should lead in making full use of medical resources to use new neutralizing antibody drugs with fast-track approval and promptly organize a system for quick responses to exacerbation in order to secure required medical care. In addition, on the premise that the severe infection situation will continue nationwide for at least the time being, it is necessary to take immediate measures, including the use of Article 16-2 of the revised Infectious Diseases Control Law and the establishment of temporary medical facilities.

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

 

Copyright 1998 National Institute of Infectious Diseases, Japan