Regarding the position of the new corona under the Infectious Diseases Act, the government officially decided on May 8 this year to move to the same ``5'' category as seasonal influenza.
How does it change when it comes to "5 types"?
What about medical expenses?
What are the behavior restrictions for patients and close contacts?
Summarized in a Q&A format.
(* Updated with information as of January 27)
Q1. Why from May 8th?
Regarding the transition period, we have been narrowing down the period from "late April to the end of the long holidays".
When I interviewed an official of the Ministry of Health, Labor and Welfare about the reason why it was May 8, they gave the following reasons.
▼ There were voices from local governments and medical institutions that a “preparation period” was necessary.
Regarding this "preparation period", the Ministry of Health, Labor and Welfare's Infectious Diseases Subcommittee issued an opinion on January 27. It should be done after a preparation period of about a month."
And about "before or after the big holidays".
▼ There was a concern that if the transition was made before the long holidays, the number of people coming and going would increase and the infection would spread.
▼ Considering the burden on medical institutions during long holidays.
Q2. How will it change if it is reclassified as 5?
We will look at each point, such as movement restrictions, medical institution response, and public expenses.
[1 Action restrictions, etc.]
If you move to "Type 5", you will no longer be able to restrict your actions.
Action restrictions that will not be possible include declaring a state of emergency, recommending and ordering hospitalization, and requesting that infected people and those who have been in close contact refrain from going out.
[2 Response of medical institutions]
Until now, only some medical institutions, such as designated medical institutions for infectious diseases and fever outpatients, were able to accept hospitalizations and provide medical care.
After the transition to “Type 5”, we plan to shift in stages so that a wide range of medical institutions can handle it.
[3 Public expense]
Medical expenses for hospitalization and examinations are currently covered entirely by the public, and are not borne by the patient.
After transitioning to Category 5, in principle, you will be responsible for a portion of the cost.
However, there are concerns that people will refrain from receiving medical examinations, so for the time being, we will continue to pay public funds and review them in stages.
[4 Border measures]
Until now, the government has required people entering Japan from overseas to have a certificate of three vaccinations.
In "Type 5", in principle, such measures cannot be taken.
[5 Report
of infected people] Regarding reports of infected people, we have requested medical institutions and public health centers to report all cases.
In "Type 5", in principle, it will be changed to a fixed point report from the core hospital.
[6 Wearing a mask]
It is recommended to wear a mask indoors, except when you can keep your distance and rarely talk.
The Ministry of Health, Labor and Welfare is considering the transition of classification and entrusting it to individual judgment.
[7 Vaccination]
Vaccination has been promoted free of charge based on the Preventive Vaccination Law.
The Ministry of Health, Labor and Welfare is discussing how to bear the burden of vaccination costs in the future at a subcommittee made up of experts. to show you.
The government will continue to make it possible to receive necessary vaccinations at no cost.
Regarding points 2 to 7, the Ministry of Health, Labor and Welfare will proceed with full-scale discussions in the future and will indicate measures and schedules for review.
Q3. Is "type 5" equivalent to seasonal flu?
Experts who have been involved in countermeasures have said that ``it will take some time before the disease can be treated in the same way as seasonal influenza,'' and that infection control measures will continue to be required even if it becomes ``type 5''.
[Lethal rate]
The fatality rate, which is the percentage of those who die among those infected, exceeded 5% in the first wave around spring 2020, when the infection first spread.
Since then, the number has dropped to 0.20% in the 8th wave from the fall of last year (2022) to the present due to progress in treatment methods and vaccination.
On the other hand, the number of infected people increased by an order of magnitude due to the Omicron strain, which spreads more easily, and about 17,000 people died in the two months from December last year (as of January 26) ) and accounted for about one in four people who ever die.
[What is the seasonality of corona]
Experts say that unlike influenza, which is prevalent every winter, the infection spreads regardless of the season, and the scale and timing of the epidemic cannot be predicted, making it difficult to respond.
In addition, the new corona has a faster pace of mutation than influenza, and there is a risk that new mutant viruses will emerge.
[Therapeutic drugs]
Although oral drugs are used in the new corona, the procedure for using them is more complicated than antiviral drugs such as Tamiflu for influenza, and it is difficult for people with underlying diseases to use them. There is also, and it is said that it is not in a state that can be easily administered.
[Medical institutions where you can consult]
Currently, even general medical institutions are able to treat patients with the new coronavirus after taking infection control measures, and prefectures publish a list of medical institutions such as local clinics that can provide medical care. Although the number of medical institutions that can be examined is increasing, there are not as many medical institutions that deal with influenza.
[Countermeasures should be "individually selected"] Shifting to
"Category 5" does not change the infectiousness or pathogenicity of the novel coronavirus.
Experts continue to say that infection control measures are necessary, and members of the Ministry of Health, Labor and Welfare's expert meeting said on January 25, ``From uniform measures based on the government's request, individuals and groups will be epidemic. We will make a proactive choice according to the situation and risks," he said.
Among them, ``There are cases where excessive infection control measures and infection control measures whose effectiveness are questionable are being continued, and the problem is that they are greatly restricting socioeconomic activities, educational activities, and the lives of children. "Individuals will make their own value judgments based on information about how effective infection control measures are."
It also states, ``It is desirable to reach an agreement through discussions at workplaces and gatherings, and consideration should be given to respecting individual choices so that they are not forced to take measures or, conversely, to stop taking measures.''
In addition, "Since there are people who are likely to become seriously ill in crowded public places, and there are people who want to avoid infection even if they are healthy, there is a need for measures that do not make them feel uneasy, and in hospitals and facilities for the elderly, It continues to be important to prevent infections from being brought in because the infection spreads easily and the impact if it spreads is large."
In the future, we will show you the infection countermeasures that are required in specific situations.
Q4. What about masks?
Regarding the wearing of masks, members of the Ministry of Health, Labor and Welfare's expert meeting said, ``Even if the status of the Infectious Diseases Act changes, people who have had opportunities to be at high risk of infection should continue to wear masks to prevent them from infecting others. It is said that
The new coronavirus spreads mainly through coughs and sneezes of infected people, droplets emitted during conversation, and very small droplets called "aerosols" and "micro droplets."
Even if you are unaware that you have been infected with symptoms or are asymptomatic, you may shed the virus and spread the infection. has been recommended to wear a mask.
In the opinion of experts,
▼ those who are infected or have symptoms, and ▼ those
who have had a high risk of infection such as those who have been in close contact should refrain from going out with others and wear a mask.
▼ For other people, infection prevention measures, including adequate ventilation, are required depending on the epidemic situation and scene, such as wearing a mask at facilities for the elderly.
Q5. What are the effects of the change in "Category 5"?
The members of the expert meeting pointed out the following points as concerns if it is changed to "class 5".
▼ When the number of patients increases, hospitalization adjustment is not carried out by the government, making it difficult to coordinate across regions.
▼ Treatment costs will no longer be borne by public funds, and infected people may not or may not receive tests and treatment.
In addition, when it becomes "class 5", it is no longer subject to the special measures law, but he pointed out the following points as concerns in that case.
▼ There is a possibility that the legal basis for the prefectural governor's call for infection control will be lost, and the necessary infection control measures will not be taken as the "new corona is over".
▼There is a possibility that the abolition of the task force will make it impossible to take prompt measures in the event that a new mutated virus with significantly increased infectivity and pathogenicity appears.
▼ Vaccine measures may be reduced, and if self-pay is incurred at the time of vaccination, the vaccination rate may decrease.
Shigeru Omi, chairman of the government subcommittee, said in an NHK program on January 24, ``The number of infected people and the number of deaths will not automatically decrease if we shift to ``type 5'', and we will participate in corona medical treatment. It is not that the number of medical institutions will increase.It is very important to ``restore society, economy, and education to normal as much as possible'' and ``to be able to provide the necessary medical care''. We need to take a step-by-step approach with a period of preparation.”
Also, when asked if the society will become more accepting of infections, he said, "'Tolerance of infection' leads to the discussion of 'whether or not a certain number of deaths are tolerable.' However, it is known that if the measures were to be abruptly relaxed, the number of deaths would increase rapidly. I think it is necessary to create a national consensus little by little by discussing the issues of values in the discussion of the 5th category,” he said.
Q6. What are "Type 2" and "Type 5" in the first place?
The Infectious Diseases Control Law categorizes viruses and bacteria into categories 1 to 5, in principle, according to the risk of aggravation and infectivity, and stipulates the measures that can be taken by national and local governments.
"Type 1" is classified as Ebola hemorrhagic fever, plague, etc. as infectious diseases with extremely high risk of life-threatening if caught.
"Type 2" includes "tuberculosis" and "severe acute respiratory syndrome = SARS", which have a high risk of becoming severe and are highly contagious. All costs will be covered by public funds.
In principle, hospitalized patients are accepted by designated medical institutions for infectious diseases, and doctors are required to report the outbreak of all infected patients to the public health center.
On the other hand, "type 5" includes "seasonal influenza" and "syphilis", and local governments cannot take measures to restrict employment or recommend hospitalization, and some medical expenses will be borne by the patient.
General medical institutions also accept hospitalized patients, and for seasonal influenza, doctors are required to report within 7 days, and all patients are not required to be reported.
The new coronavirus was initially classified as "type 2" because its characteristics were unknown.
After that, in February 2020, the law was revised to classify it as a "new strain of influenza and other infectious diseases" that does not fall into the five categories, and stricter measures than "Type 2" can be taken, such as requesting people to refrain from going out, and a state of emergency has been declared. I was able to do a strong movement limit.
After that, the Omicron strain, which expanded in the "6th wave" and "7th wave", tended to have a lower rate of severe disease compared to the conventional strain, and in response to the start of vaccination against Omicron, measures were taken. progressed in mitigation.
This includes revising the period of medical treatment for patients (10 days → 7 days), simplifying the tracking of all infected people, and relaxing border measures.
Under these circumstances, the government has been in full swing since December last year, including a reduction to class 5, and has been seeking the necessary verification from experts.