50th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (September 1, 2021).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection nationwide has been decreasing, but it has reached a record-high level of approximately 116 per 100,000 population for the latest week of reporting dates. The unprecedented spread of infection has continued in almost all areas nationwide. The decreasing trend is observed mainly in the Tokyo metropolitan area, but there is still a high-level increasing trend in the Chukyo area. There are some areas where the number of infected patients has not decreased due to the effect of the Obon holiday. As for the number of infected persons per 100,000 population by age, the number of infected patients in their 20s is still the highest, and the number of those in their 10s is increasing to the same level as those in their 30s. Depending on the area, the number of infected patients in their 10s is higher than that of those in their 30s.
• With the rapid increase in the number of infections to date, the number of severe patients is rapidly increasing, making it the largest ever and the number of deaths is also on the rise. The public health/medical care provision systems are under extremely severe pressure nationwide, and a situation similar to that at the time of a disaster continues.

  Effective reproduction number: On a national basis, the most recent number remains above 1 at 1.06 (as of August 15). The figure is 0.97 in the Tokyo metropolitan area and 1.15 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 turns downward but remains extremely high at approximately 177. The number of inpatients continues to increase mainly among those in their 20s to 50s. The number of persons in their 60s or older is also increasing. The number of severe patients who need a mechanical ventilator or artificial heart and lung apparatus has stopped increasing mainly among those in their 40s to 60s, but continues to increase in their 70s and older. The numbers of inpatients and severe patients has reached record highs, and in some cases it is difficult to newly accept/arrange for hospitalization during the nighttime, etc. There are also restrictions on general medical services, such as acceptance at emergency medical care and intensive care units.

   In Saitama, Chiba, and Kanagawa the number of new cases of infection has also started to decrease, reaching approximately 136, 152, and 170, respectively. The cases are mainly among those in their 10s to 50s. The use rate of beds and the use rate of beds for severe patients both remain high. Particularly in Kanagawa, the use rate of beds for severe patients continuously exceeds 80%. The nighttime population remains at a low level in Saitama and Kanagawa, but the population in Tokyo and Chiba has turned upward after the Obon holiday. It is feared that infection will spread again in the Tokyo metropolitan area.

2. Okinawa

   The number of new cases of infection remains at a record high of approximately 287 in Japan, but the ratio of this week to last week has started to decease to 0.91. New cases are mainly seen among those in their 20s to 30s. The use rate of beds and the use rate of beds for severe patients remain around 90% and the situation continues to be severe. The nighttime population has recently started to increase and attention needs to be paid to the trend in the number of new cases of infection.

3. Kansai area

   In Osaka, the number of new cases of infection has been increasing to approximately 198, with a ratio of this week to last week of 1.09. New cases are mainly seen among 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 turned upward after the Obon holiday and the possibility that the infection will continue to spread remains. In Kyoto and Hyogo, the number of new cases of infection has stopped increasing and is approximately 134 and 120, respectively. The number of inpatients has rapidly increased in both prefectures. In Kyoto, the use rate of beds for severe patients remains high, and the situation is severe. In Shiga where the priority measures were shifted to emergency measures, the number of new cases of infection has deceased to approximately 88. In Kyoto, the nighttime population has started to increase, which requires close attention.

   As for other areas, the number of new cases of infection in Nara has been increasing to approximately 103. In Wakayama, the number of new cases of infection has decreased to approximately 47

4. Chukyo/Tokai

   In Aichi, where the priority measures were shifted to emergency measures, the number of new cases of infection continues to increase rapidly, and has reached approximately 168, with a ratio of this week to last week of 1.39. On the other hand, the number of new cases of infection in Gifu has stopped increasing at approximately 111. The number in Mie and Shizuoka has decreased to approximately 143 and 100, respectively. In both prefectures, an increasing trend in the numbers of inpatients and severe patients continue. The nighttime population remains at a low level in Gifu, Aichi, and Shizuoka. In Mie, the nighttime population has turned downward. Attention should be paid as to whether this will lead to a decrease in the number of new cases of infection.

5. Hokkaido

   The priority measures were shifted to emergency measures. The number of new cases of infection has started to decrease, reaching approximately 54 (approximately 79 in Sapporo City), with a ratio of this week to last week of 0.78. The use rate of beds for severe patients remains below 20%. The nighttime population has decreased but remains at a high level, and there is concern about the effect on the future situation of infection.

6. Kyushu

   In Fukuoka, the number of new cases of infection has started to decrease, but exceeds 100 at approximately 123, with a ratio of this week to last week of 0.83. The number of inpatients remains high and the situation is severe. The use rate of beds for severe patients is below 20%. The nighttime population has turned upward after the Obon holiday and there is concern about the effect on the future situation of infection. In Kumamoto and Kagoshima, the number of new cases of infection has started to decrease and is approximately 87 and 62, respectively. In Saga, Nagasaki, and Miyazaki, which have been newly designated as areas of priority measures, the number of new cases of infection turned downward reaching approximately 71, 31, and 62, respectively.

   As for other areas, in Oita, the number has decreased but remains high at approximately 90.

7. Other areas subject to emergency measures

   In Miyagi, Okayama, and Hiroshima, where the priority measures were shifted to emergency measures, the number of new cases of infection has decreased to approximately 54, 76, and 79, respectively. The use rate of beds exceeds 50% in the 3 prefectures, and the situation is severe. The nighttime population has turned downward in Miyagi and has stopped decreasing in Okayama and Hiroshima. Attention should be paid to whether the number of new cases of infection continues to decrease.

   In Ibaraki, Tochigi, and Gunma, the number of new cases of infection has decreased, reaching approximately 62, 61 and 83, respectively. Particularly in Gunma, the use rate of beds continues to exceed 70%, and the situation remains tough. The nighttime population in Ibaraki and Tochigi remains at a low level and attention should be paid to whether the number of new cases of infection continues to decrease. In contrast, the number in Gunma turns upward and there is concern about the effect on the future situation of infection.

8. Other areas subject to priority measures

   In Kochi, which was newly added as an area of priority measures, the number of new cases of infection has started to decrease, reaching approximately 83. In Fukushima and Ishikawa, the number of new cases of infection has been decreasing to approximately 30 and 33, respectively.

   In Toyama, Yamanashi, Kagawa, and Ehime, the number of new cases of infection has decreased to approximately 48, 59, 52, and 28, respectively.

9. Other than the above

   In Aomori, Fukui, Tottori, Shimane, and Tokushima, the number of new cases of infection exceeds 25 at approximately 52, 37, 31, 31, and 52, respectively, showing an increasing trend. The future situation needs to be monitored carefully.

    

   Regarding the number of newly infected people, 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 when analyzing the trends.

Analysis of mutant strains

• For the B.1.617.2 lineage variant (Delta variant), the positive rate among the screening tests (mechanical estimation, August 16 to August 22) is approximately 89%, exceeding 80% in almost all prefectures. Recently, it has been estimated that it has reached almost 100% in each region, and it is considered that the B.1.1.7 variant (Alpha variant) has almost been replaced.

Effects of vaccine

• Regarding the efficacy of vaccines (including the prophylactic effect) nationwide, there is a report that the efficacy rate is approximately 90% during the replacement period of the Delta variant from the Alpha variant, but the rate varies depending on age group, etc., and it is therefore necessary to continue analysis in consideration of the effect of the Delta variant and immune attenuation.

Future outlook and measures to be taken

• The number of infected patients has been decreasing mainly in the Tokyo metropolitan area. Decreasing factors include weakening of the effect of long weekends in July and August, the Obon and summer holidays, the future climate situation, as well as further progress of vaccinations. However, there are also increasing factors such as the start of schools including universities, re-activation of social activities, and an increase in the de facto population. It is feared that the factors may lead to an increase in the number of infected patients again. Due to the rapid spread of infections to date, the number of severe patients has been the largest. The number of deaths continues to increase, though it is at a low level compared to the previous expansion stage. The number of elderly patients with infection and clusters in facilities for elderly people are also increasing, and there is concern that the number of deaths will further increase in the future.

• The number of infected patients remains at a high level, and it is necessary to take actions based on the recognition that the situation is at an unprecedented disaster level.

  In particular, the medical and public health systems are under extremely tough conditions. It has become difficult to arrange hospitalization for moderate and severe patients, and in some cases there are restrictions on general medical care such as surgery while emergency transportation is difficult. It is continuously necessary to control the spread of the current infection and to strengthen the medical system, prioritize the operations of public health centers and strengthen support.

• The number of infected patients has decreased with the cooperation of many citizens. It is required to continue efforts to steadily control infection in the future.

1. ★ Actions required to protect your and your family’s lives

   Citizens including those who have already been vaccinated should refrain from going out (at least at a frequency of not more than half the previous frequency) and spend as much time at home as possible 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 a poor health condition.

2. ★ Thorough basic measures against infection

   In addition to basic practices for infection control such as wearing a mask, the following measures should be promoted: reconfirmation of thorough compliance with the guidelines for each industry, tightening of infection control in offices, offering an environment where employees can easily receive vaccines (such as a vaccine leave), 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 when they do not go to the office. Especially concerning masks, it is recommended to use non-woven face masks which are highly effective in preventing respiratory droplets.

3. ★ Take appropriate actions to resume school

   It is necessary to take appropriate measures for each childcare facility/educational institution based on the guidelines to prevent the spread of infection.

4. ★ Maximize effective use of medical resources

   It is required to use new neutralizing antibody drugs with fast-track approval and to promptly organize a system for quick responses to exacerbation, as well as to make full use of medical resources in each area to secure required medical care. In addition, based 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 establishment of temporary medical facilities.

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