69th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare (January 26, 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 276 per 100,000 in the last week, and the ratio of the number for this week to last week continued to increase rapidly, to 2.2. The number of new cases of infection is increasing mainly in their 20s or younger, but the proportion by age group shows a decrease in patients in their 20s, while the proportion of patients under 10 years old has increased. Of 16 prefectures to where priority measures to prevent the spread of disease are applied, 15 prefectures other than Okinawa have been continuously showing a rapid increase. In Okinawa, the ratio of the number of new infections for this week to last week is below 1. It should be noted that the number of new infections is decreasing in young people mainly in their 20s, but increasing in people in their 60s and older. In addition, there continues to be rapid increase in the number of new infections in areas other than the areas subject to priority measures. 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 cases is also on the rise.
• So-called community-acquired infections of the Omicron variant have expanded, and in many regions, replacement of the epidemic strain by the Omicron variant is progressing rapidly, although the Delta variant continues to be detected.

  Effective reproduction number: On a national basis, the most recent number is above 1 at 1.37 (as of January 9). The figure is 1.45 in the Tokyo metropolitan area and 1.42 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.

< Area subject to priority measures >

1. Tokyo metroplitan area (Tokyo and 3 neighboring prefectures)

   In Tokyo, the number of new cases of infection has increased rapidly to approximately 482, with a ratio of this week to last week of 2.5. Most are in their 20s and 30s, but those in their teens or younger are also increasing. The use rate of beds is slightly more than 30%, and the use rate of beds for severe cases is about 30%. Also in Saitama, Chiba and Kanagawa, the number of new cases of infection continued to increase, reaching approximately 254, 256, and 278, 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 about 40% in Saitama, about 30% in Chiba and slightly more than 30% in Kanagawa.

2. Gunma and Niigata

   In Gunma, the number of new cases of infection has increased rapidly to approximately 230, with a ratio of this week to last week of 2.4. The infected individuals are mainly in their 20s or younger. The use rate of beds is slightly more than 50%. In Niigata, the number of new cases of infection has increased rapidly to approximately 141, with a ratio of this week to last week of 1.9. The infected individuals are mainly in their 20s or younger. The use rate of beds is slightly more than 20%.

3. Chukyo

   In Aichi, the number of new cases of infection continued to increase rapidly to approximately 295, with a ratio of this week to last week of 2.5. The infected individuals are mainly in their 20s or younger. The use rate of beds is slightly more than 20%. In Gifu and Mie, the number of new cases of infection has increased to approximately 188 and 142, respectively. In Gifu, the ratio of new cases for this week to last week increased rapidly, to above 2. The use rate of beds is slightly more than 50% in Gifu and slightly more than 30% in Mie.

4. Hiroshima,Yamaguchi and Kagawa

   In Hiroshima, the number of new cases of infection continued to increase to approximately 334, with a ratio of this week to last week of 1.4. The infected individuals are mainly in their 30s or younger. The use rate of beds is approximately 40%. In Yamaguchi and Kagawa, the number of new cases of infection continued to increase to approximately 171 and 124, respectively. In Kagawa, the ratio of new cases for this week to last week increased rapidly, to above 2. The use rate of beds is about 50% in Yamaguchi, about 40% in Kagawa.

5. Kumamoto, Nagasaki and Miyazaki

   In Kumamoto, the number of new cases of infection continued to increase to approximately 284, with a ratio of this week to last week of 1.8. The infected individuals are mainly in their 20s or younger. The use rate of beds is slightly less than 50%. In Nagasaki and Miyazaki, the number of new cases of infection continued to increase to approximately 249 and 192, 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 more than 30% in both.

6. Okinawa

   The number of new cases of infection for this week to last week is 0.8, which is below 1, but it must be noted that the number reported may not reflect the actual situation. At about 547 it was the highest in Japan. Newly infected patients are mainly in their 30s or younger, but those younger than 10 and those in their 60s and older are increasing. The use rate of beds is slightly more than 60%, and the use rate of beds for severe cases is slightly less than 70%.

< Other than areas subject to priority measures >

1. Hokkaido

   The number of new cases of infection is increasing rapidly and has reached approximately 202 (approximately 284 in Sapporo City), with a ratio of this week to last week of 2.8. The infected individuals are mainly in their 20s or younger. The use rate of beds is slightly more than 20%.

2. Kansai areas

   In Osaka, the number of new cases of infection continued to increase rapidly to approximately 513, with a ratio of this week to last week of 2.0. The infected individuals are mainly in their 20s or younger. The use rate of beds is about 50%, and the use rate of beds for severe cases is about 20%. In Shiga, Kyoto, Hyogo, Nara, and Wakayama, the number of new cases of infection continued to increase, reaching approximately 246, 374, 340, 248, and 213, respectively. In Kyoto, Hyogo, and Nara, the ratio of new cases for this week to last week increased rapidly, to above 2. The use rate of beds is slightly more than 40% in Shiga, slightly more than 30% in Kyoto, approximately 60% in Nara, slightly more than 40% in Hyogo, and slightly more than 70% in Wakayama. The use rate of beds for severe cases is slightly more than 20% in Kyoto and Wakayama, and slightly less than 30% in Nara.

3. Kyushu

   In Fukuoka, the number of new cases of infection continued to increase rapidly to approximately 350, with a ratio of this week to last week of 2.7. The infected individuals are mainly in their 20s or younger. The use rate of beds is slightly more than 20%. In Saga, Oita, and Kagoshima, the number of new cases of infection continued to increase, reaching approximately 224, 192, and 153, respectively. In Oita and Kagoshima, the ratio of new cases for this week to last week increased rapidly, to above 2. The use rate of beds is slightly more than 30% in Saga, about 40% in Oita and slightly less than 40% in Kagoshima.

4. Areas other than the above

   Aomori, Iwate, Miyagi, Akita, Yamagata, Fukushima, Ibaraki, Tochigi, Toyama, Ishikawa, Fukui, Yamanashi, Nagano, Shizuoka, Tottori, Shimane, Okayama, Tokushima, Ehime, and Kochi were approximately 112, 29, 71, 73, 58, 51, 142, 161, 59, 143, 100, 164, 153, 206, 114, 161, 199, 64, 135, and 90, respectively. The use rate of beds is about 20% in Aomori, and about 30% in Iwate. It is slightly less than 30% in Yamagata and Okayama, slightly less than 40% in Fukushima, Nagano and Kochi, slightly more than 20% in Ibaraki, Toyama, Shizuoka, Tottori, Tokushima and Ehime, slightly more than 30% in Tochigi, Ishikawa and Shimane, and slightly more than 50% in Yamanashi.

Future outlook and measures to be taken

• The number of new cases of infection nationwide is rapidly increasing with replacement by the Omicron variant. In addition to the 16 prefectures that have already been designated as areas subject to priority measures, priority measures will be newly applied to 18 prefectures from January 27. The rapid increase in the number of infected people was largely influenced by the increase in contact opportunities due to year-end parties, Christmas and New Year holidays, and the long weekend in January, but the sites of infection are thought to be spreading to homes, workplaces, schools, medical facilities, and long-term care facilities. The nighttime population is generally decreasing in the areas subject to priority measures, although it is increasing in some areas. From the ratio of this week to last week and the effective reproduction number, the rate of increase is slowing down, but based on the characteristics of the Omicron variant and the positive rate of PCR tests, etc., the spread of infection is expected to continue nationwide, at least in the short term, and measures based on the characteristics of the Omicron variant must be taken promptly.
• In schools, kindergartens, nursery schools, etc., the numbers of people positive for COVID-19 infection and in close contact are increasing in many areas. In areas where infection has spread, it is necessary to strengthen and thoroughly implement basic infection control measures and also to secure educational opportunities and maintain social functions at these facilities.
• Although it is being replaced by the Omicron variant, individuals infected with the Delta variant are also detected. Infection with the Delta variant is more likely to become severe, and in fact severe cases have occurred. In Okinawa, which had earlier prevalence of infection by the Omicron variant, the number of infected cases is decreasing among young people, but the number of infected cases continues to increase at the age of 60 and over, and the number of hospitalized patients continues to increase. Similar trends may be seen in other regions in the future. The rapid spread of infection mainly in young people may cause the medical care provision system for mild and moderate cases to quickly become strained, including the response to a rapid increase in health observers and home care recipients. Thereafter, the spread of infection in the elderly may lead to increase in the number of severely ill patients. Attention should also be given to increases in the number of infected patients requiring hospitalization due to an underlying disease exacerbated by the infection, even if the positive person with the underlying disease does not have pneumonia due to COVID-19 infection. Many cases of emergency transport normally occur during this period, and according to the status survey on cases of difficulty in emergency transport, not only cases of suspected COVID-19 but also cases of suspected non-COVID-19 are increasing. With a rapid increase in the number of cases of suspected COVID-19, cases of emergency transport difficulties have exceeded those during the same period last year or the spread of infection in last summer. There is already a significant burden on regular medical care, especially emergency medical care.
• Findings on the characteristics of the Omicron variant
  • [Infectivity/transmissibility]

    It has been confirmed that compared to the Delta variant, the generation time has shortened to approximately 2 days (approximately 5 days for Delta). The doubling time and incubation period have also shortened, the risk of re-infection and secondary infection after infection has increased, and the speed of infection spread is very fast.

  • [Place/route of infection]

    In Japan, many infections occur from the same opportunities as before (indoors with insufficient ventilation, opportunities of eating and drinking, etc.), and the routes of infection are considered to be via droplets, aerosol inhalation, contact infection, etc. as before.

  • [Severity]

    It has been suggested that infection with the Omicron variant may have a relatively lower risk of hospitalization and aggravation than the Delta variant, but in some areas, hospitalizations due to the Omicron variant infection have already increased.

  • [Duration of viral shedding]

    Viral shedding in patients infected with the Omicron variant decreased over time regardless of vaccination status, showing that the possibility of viral shedding is low from 10days after onset or diagnosis, as with the conventional strain.

  • [Vaccine effect]

    The preventive effect against infection with the Omicron variant by primary immunization is markedly reduced, but the preventive effect on aggravation is maintained at a certain level. It has also been reported that booster shot improves the infection-preventing effect and hospitalization-preventing effect for infection by the Omicron variant.

• Efforts based on the spread of infection by Omicron variant
  • [Test/diagnosis and surveillance in areas where infection is rapidly spreading]

    The test/diagnosis system and process of notification to public health centers are becoming strained, and there is concern that the published data may differ from the actual situation. Effective and appropriate surveillance must be considered in order to understand the trends of occurrence. Tests and active epidemiological surveys should be prioritized based on the findings so far. It is necessary to actively perform tests for employees at facilities for the elderly, based on the Basic Policies for Novel Coronavirus Disease Control. In addition, it has become possible to receive free tests for those who are worried about infection and wish to receive such tests. However, 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 needs to be secured.

  • [Monitoring system for mutant strains in Japan]

    While the spread of infection is progressing nationwide, it is necessary to continue the surveillance system according to the local infection status, including the situation of replacement with the Omicron variant. In severe cases and cluster cases, confirmation by genome analysis, including the Delta variant, is also required. In some areas overseas, infection by the BA.2 lineage is increasing. Currently, the mainstream of the Omicron variant in Japan is the BA.1 lineage, but the BA.2 lineage has also been detected in quarantine and in Japan. Monitoring must be continued by a certain number of genome analyses. In comparison between the BA.1 and BA.2 lineages, differences in hospitalization rates are not clear at this time.

  • [Measures taken by local governments]

    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. At that time, it is necessary to secure a system for prompt administration of oral therapeutic drugs and neutralizing antibody drugs for patients at risk of developing severe disease, such as elderly patients and patients with underlying diseases. At the same time, attention should be paid to the balance with ordinary medical care. If the infection spreads rapidly, it is necessary to promptly take concrete action for consultations and health observation according to the infection situation in the area, and prevent dysfunction in outpatient care.

  • [Reinforcement of information provision to non-vaccinated and booster vaccinated people]

    It is particularly important to promote the vaccination of unvaccinated people. Local governments are required to provide information to persons who have not 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 accelerated vaccination of healthcare professionals and the elderly.

  • [Border control measures]

    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, in order to monitor strains circulating overseas. The waiting period after entering Japan has been shortened to 10 days, but it is necessary to continue to verify future border control measures, including the waiting period, while taking into account the prevalence of the Omicron variant in Japan and overseas.

• 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, are increasing, especially at medical institutions and nursing welfare facilities. Since the same thing can happen in other workplaces needed for social maintenance, their business continuity plans must urgently be inspected. In addition, based on the newly obtained scientific findings on the Omicron variant, it is possible to shorten the period of health observation for healthcare professionals and close contacts, and to further shorten the period by combining tests for people needed for the maintenance of social functions, at the discretion of the region. The period of recuperation for unvaccinated people was determined to be the same as that for vaccinated individuals. The period of health observation and the period of recuperation must be continuously reviewed appropriately.
  • In order to maintain social functions, the number of workers and the opportunities for contact must be reduced by using telework and promoting the taking of time off.
• It is essential to share the current infection situation widely with citizens and businesses, and cooperate to prevent the spread of infection.
  • Governments, businesses, and citizens need to act with the awareness that infection, mainly with the Omicron variant, is spreading not only in areas subject to priority measures, but throughout the country.
  • Basic anti-infection measures are also important for the Omicron variant, and it is necessary to continue to ensure proper wearing of nonwoven 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 must be avoided as much as possible, due to the high transmissibility of the Omicron variant.
  • In areas where infection has spread, it is necessary to strengthen and thoroughly implement basic infection control measures in school activities, but also to secure educational opportunities and maintain social functions.
  • Crowded places and places with a high risk of infection must be avoided when going out. Activities with small numbers of people. 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.
  • 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 necessary to refrain from going out if you feel a little unwell, such as a mild fever or fatigue, and to be examined and receive tests according to government policy.

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