67th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (January 13, 2022).  Material 1

Evaluation of the latest infection status, etc.

Infection status

• The number of new cases of infection (by date of report) nationwide was approximately 41 per 100,000 in the last week, and the ratio of the number for this week to last week continued to increase rapidly, to 8.5. The number of newly infected people is increasing rapidly, mainly among people in their 20s. In addition to Okinawa, Yamaguchi, and Hiroshima, where priority measures to prevent the spread of disease are being applied, the number of new cases of infection is increasing rapidly at an unprecedented rate, not only in urban areas such as in the Kanto and Kansai regions (e.g., Tokyo and Osaka), but also in other regions, as well. With the rapid increase in the number of new cases of infection nationwide, the number of patients receiving treatment has surged, and the number of severe patients is also on the rise.
• So-called community-acquired infections of the Omicron variant have expanded in most prefectures, and in some regions, replacement of the epidemic strain by the Omicron variant is progressing rapidly. Considering the high transmissibility of the Omicron variant, it is necessary to pay attention to the possibility that the infection will spread rapidly in the future, that the numbers of patients who are receiving treatment at home and at accommodation facilities, as well as those who require inpatient treatment will increase rapidly, and that the medical care provision system for patients with mild/moderate symptoms will be placed under severe pressure.

  Effective reproduction number: On a national basis, the most recent number is above 2, at 2.29 (as of December 28). The figure is 2.27 in the Tokyo metropolitan area and 1.98 in the Kansai area.

Local trends

* The value for new cases of infection is the number of people per 100,000 among the total number for the latest week, based on reporting dates.

1. Areas subject to priority measures

   In Okinawa, Yamaguchi, and Hiroshima, where priority measures are being applied, the number of infected patients is continuing to increase rapidly. The number of new cases of infection in Okinawa is approximately 605, and the ratio of the number for this week to last week was 7.6, which is the highest in Japan. The infected individuals are mainly in their 20s or younger. The use rate of beds and the rate of beds for severe patients are each at slightly more than 40%. In Yamaguchi, the number of new cases of infection is approximately 81, and the ratio of this week to last week is 3.6. The use rate of beds is slightly more than 40%. In Hiroshima, the number of new cases of infection is approximately 135, and the ratio of this week to last week was 9.6. The use rate of beds is approximately 30%.

2. Hokkaido

   The number of new cases of infection is increasing rapidly, and has reached approximately 16 (approximately 19 in Sapporo City), with a ratio of this week to last week of 5.2. The use rate of beds is less than 10%.

3. North Kanto

   The number of new cases of infection has continued to increase in Ibaraki, Tochigi, and Gunma, reaching approximately 17, 25, and 36, respectively. In each of these prefectures, the ratio of new cases for this week to last week increased rapidly, to above 2. The use rate of beds is slightly less than 20% in both Tochigi and Gunma.

4. Tokyo metropolitan area (Tokyo and 3 neighboring prefectures)

   In Tokyo, the number of new cases of infection has increased rapidly to approximately 57, with a ratio of this week to last week of 8.5. The infected individuals are mainly in their 20s or younger. The use rate of beds is approximately 10%. In Saitama, Chiba, and Kanagawa, the number of new cases of infection has also been increasing, reaching approximately 29, 28, and 29, respectively. In each of these prefectures, the ratio of new cases for this week to last week increased rapidly, to above 2.

5. Chukyo/Tokai

   In Aichi, the number of new cases of infection has increased rapidly to approximately 31, with a ratio of this week to last week of 12.0. The infected individuals are mainly in their 20s or younger. The use rate of beds is less than 10%. In Gifu, the number of new cases of infection has increased rapidly to approximately 23, with a ratio of this week to last week of 6.8. In Shizuoka and Mie, the number of new cases of infection has increased to approximately 21 and 15, respectively. In each of these prefectures, the ratio of new cases for this week to last week increased rapidly, to above 2.

6. Kansaia area

   In Osaka, the number of new cases of infection has increased rapidly to approximately 65, with a ratio of this week to last week of 8.2. The infected individuals are mainly in their 20s or younger. The use rate of beds is slightly less than 20%. In Shiga, Kyoto, Hyogo, and Nara, the number of new cases of infection has increased to approximately 46, 52, 27, and 44, respectively. In each of these prefectures, the ratio of new cases for this week to last week increased rapidly, to above 2. The use rate of beds is slightly less than 40% in Shiga, slightly less than 30% in Kyoto, and slightly more than 20% in Nara.

7. Kyushu

   In Fukuoka, the number of new cases of infection has increased rapidly to approximately 28, with a ratio of this week to last week of 13.4. The infected individuals are mainly in their 20s or younger. The use rate of beds is less than 10%. In Saga, Kumamoto, and Kagoshima, the number of new cases of infection has increased to approximately 48, 31, and 48, respectively. In each of these prefectures, the ratio of new cases for this week to last week increased rapidly, to above 2.

8. Areas other than the above

   The numbers of new cases of infection continued to increase rapidly in nearly all other regions, especially in Niigata, Fukui, Nagano, and Shimane. The number is approximately 25, 28, 36, and 32, respectively. The use rate of beds is slightly more than 20% in Nagano and approximately 40% in Shimane.

Future outlook and measures to be taken

• In addition to Okinawa, Yamaguchi, and Hiroshima, where priority measures to prevent the spread of the disease have been applied since January 9, there has been a rapid increase in the number of new cases of infection nationwide. Furthermore, the number of patients infected with the Omicron variant has also increased, and the Delta variant has already been replaced by the Omicron variant. On the other hand, people infected with the Delta variant have also been detected, and since infection by the Delta variant is more likely to become severe, caution is necessary. As for the nighttime population, although the number decreased at the beginning of the year as a nationwide trend, it has recently started to increase once again. The rapid expansion of infection may continue in the future, considering the fact that indoor activities have been increasing with the decrease in temperature, in addition to an increase in the movement of people due to homecoming visits during the year-end and new-year holidays, and the long weekend in January, as well as increasing interactions between persons who do not usually come into contact.
• Depending on the future increasing trend, there are concerns regarding strains on the medical care provision system and the spread of infection to people who are at a high risk of becoming severely ill. Tentative information on the Omicron variant is being obtained from reports from international organizations and foreign countries, as well as domestic cases of infection. There are concerns about high transmissibility, because the Delta variant has been rapidly replaced by the Omicron variant as the epidemic strain. In addition, compared with the Delta variant, it has been confirmed that the Omicron variant shortens the generation time, doubling time, and incubation period, and the risk of secondary infection and reinfection is increased. However, thus far in Japan, many cases of infection with the Omicron variant have occurred in the same situations (such as eating and drinking) as those that are characteristic of the conventional strains and the Delta variant. There have been no findings suggestive of changes in the route of infection (such as droplet/aerosol transmission, contact infection). As for vaccines, the preventive effect obtained via primary immunization on deterioration due to infection with the Omicron variant is maintained, to a certain degree. The fact that the preventive effect of vaccination against onset is markedly reduced, and also that a booster vaccination is effective against infection with the Omicron variant have also been reported overseas. It has been suggested that infection with the Omicron variant may be less likely to become severe than with the Delta variant. However, if the number of patients receiving treatment increases rapidly due to the rapid spread of infection, primarily in young people, it should be noted that the medical care provision system for mild and moderate cases may quickly become strained, and that the spread of infection among the elderly may lead to an increase in the number of severe patients. Attention should also be given to the occurrence of cases that are positive for the novel coronavirus among hospitalized patients in ICU and ward settings, in general medical care.
• Efforts against the spread of infection with the Omicron variant are required at border-control and domestic sites.
  • As measures against the Omicron variant at border control under the current circumstances, it is necessary to regard those who are positive in the immigration inspection as positive for the Omicron variant, and to continue whole-genome analysis for positives. It is necessary to continue to verify future border-control measures, while taking into account the prevalence of the Omicron variant in Japan and overseas.
  • While the spread of infection with the Omicron variant is progressing in Japan, it is necessary to continue the surveillance system according to the local infection status, including the situation of replacement with the Omicron variant. In areas where infection with the Omicron variant has not been observed, early detection by thorough implementation of the testing system, prompt and active epidemiological investigations, and implementation of measures to prevent the spread of infection are necessary. In regions experiencing a rapid spread of the infection, it is necessary to consider prioritizing tests and active epidemiological surveys based on the findings obtained thus far, and to change the treatment systems.
  • Based on the infection status of the region and forecasts of the numbers of infected cases and severe cases, local governments must work flexibly to secure the required number of beds and healthcare professionals, secure the functions of public health centers, which are indispensable for local communities, along with support for strengthening the healthcare center system, and establish home-visit and online medical care systems for home care recipients.

• An immediate review of the business continuity plan of each business in the region is necessary.

  Due to the rapid spread of infection in the region, infections among employees and their families, or withdrawal from the workplace due to close contact is highly likely, especially at medical institutions and nursing welfare facilities. In some regions, many healthcare professionals, such as physicians and nurses, are infected or become close contacts and are absent from work, which may result in reduced hospital functions. For this reason, it is necessary to ensure that healthcare professionals can work every day through tests, etc. even if they are close contacts with people infected with the Omicron variant. In addition, it is necessary to appropriately review the recuperation period of infected persons and the health observation period of close contacts, based on scientific knowledge. Furthermore, the same situation can occur at all workplaces that are involved in maintaining social functions, such as local governments, including healthcare centers and transportation facilities. In order to prepare for such a situation, the business continuity plan should be inspected, while taking into account the recently revised Basic Policies for Novel Coronavirus Disease Control. In addition, working from home should be encouraged in the workplace.

• The provision of information to unvaccinated people and those receiving booster vaccinations must be strengthened.

  Amidst concerns about the rapid spread of the Omicron variant, it is particularly necessary to promote the vaccination of unvaccinated people, and local governments must enhance the communication of information to those who have not yet been vaccinated. At the same time, booster vaccinations, which have already been started, must also be implemented steadily. In doing so, it is necessary to smoothly carry out an acceleration of the schedule for healthcare professionals and the elderly, who are at a high risk of becoming severely ill. In addition, the oral therapeutic drug that was approved by the fast-track system is expected to have a certain effect on preventing deterioration. Medical institutions that perform follow-up observation of patients at home are required to accelerate registration, as the institution that prescribes the oral therapeutic drug. In addition, in regions where the infection is spreading, it is necessary to actively perform tests for employees at facilities for the elderly, based on the Basic Policies for Novel Coronavirus Disease Control.

• It is necessary to widely share the assumption of the rapid spread of infection by the Omicron variant.
  • Governments, businesses, and citizens need to act with the recognition that the replacement of the Delta variant with the Omicron variant is progressing in Japan, and that the spread of the infection is expected to continue.
  • Based on the findings obtained thus far, basic anti-infection measures are also important for the Omicron variant, and it is necessary to continue to ensure the proper wearing of masks, hand washing, ventilation, etc., including among vaccinated people. Although the risk of infection is highest when the three Cs (crowded places, closed spaces, and close contact) overlap, even one C should be avoided as much as possible, due to the high transmissibility of the Omicron variant.
  • In regions where infection with the Omicron variant has been confirmed, it has become possible to receive free tests for those who are worried about infection and wish to receive such tests. However, in regions where the infection is increasing rapidly, attention needs to be paid to the rapid increase in the demand for these tests as well as the ability of the tests, and a system to ensure prioritized testing should be secured.

• The cooperation of citizens and businesses is crucial to prevent the spread of the infection.

  In order to protect the lives of both yourself and your family, and at the same time prevent the spread of infection by the Omicron variant, it is recommended to refrain from going out if you feel a little unwell, such as a mild fever or fatigue, and to proactively be examined and receive tests. Particularly in areas where the rapid spread of infection is causing concern regarding a strain on the medical care provision system, more careful judgment and actions are required. Crowded places and places with a high risk of infection must be avoided when going out. When it is necessary to use restaurants, it is necessary to select a third party-certified restaurant that implements infection control measures such as good ventilation, with as few people as possible, to avoid loud noises and long hours, and to wear a mask when not eating or drinking.

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