What are the conditions for canceling the emergency declaration? May 1: 12:34

How long can we stay "stay home"?
Many people may be overwhelmed by the number of new infections announced each day.
Declaration of an emergency with a deadline of May 6th. The government is making adjustments in the direction of extending it by about one month while keeping the target area nationwide.
Then, what can we do to "cancel"? I heard that the point of the judgment was uncertain.
(Kazuma Ando)

Three key indicators

According to the expert meeting, there are three major indicators.
(1) Infection status (2) Behavioral changes (3) The Medical System
Experts' Committee will analyze these three and make a comprehensive evaluation.

Points of cancellation (1) Infection status

There are several notable figures regarding the infection status.
▽ Number of new infected persons, ▽ Total number of infected persons, ▽ Doubled time, ▽ Ratio of unknown infection route, ▽ Number of effective reproductions, etc.

● Point (1) -1: Number of
new infections The number of new infections is announced daily by the national and local governments.

(Click here for the summarized site)

In the case of Tokyo, 79 people were announced on April 7, when the declaration was issued. The number increased to 201 on the 17th, but after this peak, the number did not exceed 200, and some days below 100.

"Tokyo has begun to decline," said Hiroshi Nishiura, a member of the expert meeting and a professor at the Graduate School of Hokkaido University. On the other hand, he said, "The rate of decline is not as high as I expected. I was expecting to see more dramatic changes," he said, recognizing that the rate of decline was slower than expected.

The number of new infections nationwide was 360 on April 7, but peaked at 719 on the 11th, and remained at the 200 level in late April.

By prefecture, most prefectures are on the decline, but some prefectures, such as Hokkaido, have seen an increasing trend toward the second half of April, so it is difficult to say that the trend is decreasing.

Experts say that not only the number is decreasing, but whether it is decreasing gradually or sharply, how the curve descends is also an important point. In addition, some experts say that the number of new infections per day in Japan is less than 100, and the number should be double digits.

The change in the number of deaths is also an important indicator.
The number of deaths in Japan was one on April 7, when the declaration was issued, for a cumulative total of 109 (including cruise ships). On April 29th, there were 22 people, for a total of 448 people (including cruise ships).
The number of deaths is increasing, although it is smaller than overseas.

● Point (1) -2: Doubled time (* Doubled time)
"Doubled time" is a translation of English "doubling time".
It refers to the number of days until the total number of infected persons doubles.

The “overshoot” (explosive infection) that experts fear most is that the number of infected people doubles, doubles, and even doubles, increasing exponentially. Currently, there is no overshoot in Japan, but if this "doubling time" reaches 2-3 days, it is judged as an overshoot.

The expert meeting said that the "doubling time" in early April in Tokyo was 5 days.

The official method of calculating the "doubling time" has not been clarified, but the cumulative number of infected people in Tokyo reached 500 on March 31st. Five days later, on April 5, the number of people exceeded 1,000. On the 12th, seven days after that, the number of people exceeded 2000. The number of people reached 4000 on the 28th, 16 days later.
It can be seen that the pace of infection spread slows down as the number of infected people doubles.

● Point (1) -3: Percentage of who does not
know the infection route “Patients who do not know the infection route” are called “sporadic cases (Kohatsurei)”.
Until March, I was able to track to some extent where I was infected and who I contacted. However, in April, more than 60% of the patients in Tokyo had no known route of infection, and even more than 80% of the days passed.
It is about 40% in late April.

The more cases where the route of infection is unknown, the more the infection spreads without even knowing it. If this rate is lowered and the route of infection can be tracked, it is possible to suppress the spread of infection by waiting at home for concentrated contacts.
(Whether should it much lowered, see Nishiura interview of Professor in the second half of article)

● Point (1) -4: The effective reproduction number
"effective reproduction number" is, of whether the Transfer there is one of the infected person to many people Average value.
According to Professor Nishiura, the estimated value for Tokyo in late March is 1.7. If this number falls below 1.0, the number of new infections will start to decline.

Point (2) Behavior change

The government has set a goal of reducing contact with people by 80% and is calling for us to change our behavior.
According to Professor Nishiura, who made a trial calculation, if 80% reduction is possible, the decrease in the number of confirmed patients can be clearly seen in the data one month after the declaration. The effect will be visible around May 6.

On the other hand, if the reduction rate does not reach 80%, it will take more time to reduce the number of infected people.
Some experts said that "if the reduction rate is 70%, it will take more than two months to control the infection."

So how do you prove 80% reduction?
The ruler was presented in a recommendation of the expert meeting on the 22nd.
It is said that two indicators are used: "people flow", which represents the flow of movement of people, and "contact rate," which represents the number of contacts.

● Point (2) -1 ： People's flow

"People's flow" is the flow of people at major stations and downtown areas.
The data provided by the mobile phone companies are available on the special website of the Cabinet Secretariat and on the NHK homepage, so we can check it every day.

(Click here for the site)

For example, as of the 29th, the area around the south exit of Shinjuku Station was “81.7% less” than before the infection spread, but in many other cities, it has not reached “80% reduction”.

● Point (2) -2: Contact rate The

other "contact rate" is a numerical value that indicates "contact" per hour using the location information data of the mobile phone.
According to the data around Shibuya Station shown on the 22nd, the contact rate on April 17 was 80% less at night than on January 17th. However, during the daytime, the decrease was only about 60%.

The number of contact reductions with people reached nearly 80% at night, but the results of the daytime efforts were "not enough". Professor Nishiura said, "I am confident that there are places where the flow of people is sufficiently reduced during the night on weekdays but not necessarily during the daytime on weekdays or in rural areas." Professor Nishiura and his colleagues will proceed with the analysis and publish data on contact rates in other cities.

"80% reduction in contact with people" is an index that measures "personal flow" and "contact rate" in total. If this can be achieved, it will be a material for lifting the declaration.

Point (3) Medical system

Experts attach great importance to the medical system.
Especially in rural areas, the medical system is weaker than in urban areas. I am worried that medical care could suddenly collapse if I'm careless.

The medical system does not have quantified indicators like the number of infected persons and the contact rate mentioned above.
▽ The tightness of the bed, ▽ While the severely ill are admitted to the hospital, ▽ Minor illness is moving to the accommodation facility, ▽ Is the examination being performed smoothly, ▽ Masks, gowns, ventilators, etc. are available? It is said that the decision is made by looking at the situation in each region.

NHK examines the number of hospital beds and inpatients corresponding to the new coronavirus for each prefecture, and publishes it on its website.

(Click here for the site)

At the time of the April 28, hospitalization number of patients, and it is beyond the 80% of the number of beds that are preparing, Hokkaido, Tokyo, has become a three prefectures of Ishikawa Prefecture

expert meeting members Nobuhiko Okabe, director of the Kawasaki Health and Safety Research Institute, said, “I think the medical system is the most important consideration. If medical care collapses, it will lead to overshoot. There were few deaths at most, and the medical system managed to stay normal, but this time it is not likely to be in time with the normal medical system. In the area where the bed is approaching saturation, It is possible to continue the declaration. "

How experts look

Based on these points, we asked the members of the expert meeting about their thoughts at the present time.

● Prof. Hiroshi Nishiura, Graduate School of Hokkaido University

Q: What is the prospect of cancellation?
A: In addition to 80% reduction in contact, the number of infected people and the medical care provision system are important points. Reduce the number of infected people and return to a place where the source of infection can be traced.
Q: How much can you chase?
A: When the number of confirmed patients per day was about 10, we were able to adequately track contacts even in Tokyo, so I would like to lower it to that level. In addition, we will consider whether or not to lift the action restriction, considering that the acceptance system of medical institutions is in place.
Q: What is the image of cancellation?
A: Schools and companies will be phased. Returning to work will be reduced to 50%, 30%, and so on, step by step. The same life as before will not come back soon. Over the next year, I will have to deal more or less.

● Nobuhiko Okabe, Director, Kawasaki City Institute of Health and Safety

Q: What is the prospect of lifting the declaration of emergency?
A: I wonder if it would be impossible under the current circumstances to return to normal life at the end of the long holiday season. Perhaps they will seek self-restraint where they are needed, in the form of gradual reduction.
Q: Is cancellation / extension preferable for each region rather than nationwide?
A: The target of the emergency declaration was initially seven prefectures, but I think that the opposite may be true, as the number of regions increased later. I think it's better to divide by region.
Q: Is it possible to extend the place designated as a specific vigilance prefecture and cancel the rest?
A: There may be that. But it's only after evaluating the situation, so I don't know if that will happen.
Q: Do I have to deal with this virus for about a year?
A: It's possible that you'll be dating for a longer period than one year. However, instead of repeating the same every time the trend comes, it will be necessary for the administration, experts, and the general public to think wisely about how to interact and make the most of it.

● Advisory Committee Shigeru Omi (Deputy Chairman of the Expert Meeting)

Q: Is it inevitable to extend the declaration?
A: I can't say now whether or not it will be extended, but the point is, after all, how far the infection situation has fallen, and whether it can be said on the basis of that.
Q: Do you sometimes divide cases between prefectures with a large number of infected people and those with a small number?
A: I think there is such an idea. It must be easy to understand when releasing. There is no 100% solution, but we must be able to explain it scientifically and sociologically by showing the basis that "I see, that's the case, then I knew it". It is possible that a declaration that has been canceled once will be applied again. At that time, I don't know if we will make the 80% reduction like we do now. If it ends in a month, nothing can happen. This doesn't end once, so please prepare yourself.
Q: When canceling, do you refer to examples from overseas?
A: In China and Singapore, even after the restrictions on behavior were lifted, live houses and restaurants with entertainment continued to be closed. Refer to this. Even after the cancellation, high-risk places and events involving inter-regional movement may continue to request self-restraint.
Q: 80% reduction is a strict target.
A: The purpose is to reduce the number of infected people, and the means and conditions for that. It is important that the entire Japanese learn what to do and what to do. "Controlling infections without overshooting and without locking down," Japan could do. If I could, I would be confident.

Figures such as the number of people infected each day reflect our actions two weeks ago. For this reason, Mr. Omi repeatedly called on him to continue to refrain from going out during the long holidays, saying, "If it gets loose, it may increase immediately."
I would like you to refer to "10 points to reduce contact with people".

Whether to extend or cancel, or to summarize the conclusions ...

Here is a summary of the expert's views that came to light during this interview.

● Current situation
・ 80% reduction in contact with people has not been achieved yet.
・ The number of infected people has started to decrease in Tokyo, Osaka, Fukuoka, etc., but the rate of decrease is slower than expected.

● Toward judgment
・ Analyze three areas such as "80% reduction in contact with people" and evaluate each area.
・ It is difficult to cancel all over the country.
・ There is a possibility that the correspondence may be divided between the specific caution prefectures and other areas.
(Specific warning prefectures = Areas where intensive efforts are made to prevent infections: Currently 13 prefectures)

● In the future
・ Even if it is canceled, not all activities can be resumed, such as restaurants at night and large-scale events. The request for self-restraint continues.
・ Resumption of economic activities will be carried out in stages.
・ We must be prepared for a long-term battle in the next year. Even if it is canceled once, if the trend of fashion comes again, it is possible to take strict measures such as issuing a declaration again.

The expert meeting is based on the scientific knowledge and numerical values. On the other hand, the impact on the economy and society is outside the scope of the expert meeting.
In addition to scientific evaluations by experts, the government will ultimately make political decisions by considering economic and social impacts.
Many people are required to explain why their area is extended and how it can be canceled.

Kazuma Ando, Reporter of the Ministry of Political Affairs
Joined the company in 2004. Also worked at Yamaguchi and Sendai stations. A club cap from the Ministry of Health, Labor and Welfare since last August. Continue coverage of the new coronavirus.