Local gov'ts urged to prepare hospitals for peak of virus infections

Everyone should know that's not sustainable in the long run. Except for Abe is what you're saying?

Or another reason could be that the Abe government wants to keep the numbers artificially low. Much like the orange buffoon in the US.

And if most of the ill don't go to the hospitals, which is what most do in ordinary circumstances, then what capabilities the hospitals have will be preserved to accommodate the ones who are really in need.

Of course one of the reasons could also be that during the home quarantine most of the cases which should be mild will heal naturally without going to hospitals and mingling with the general population in the process

The government wants people to stay at home and self quarantine unless the probability of being covid19 afflicted is high. If the bar for being tested is lowered many people whose health are already compromised will flock to hospitals where they are sure to mingle with the infected that will also come.

COVID-19 testing by country

Japan: 76 tests per 1 million people (March 10)

UK: 347 per million (March 8)

Italy: 826 per million (March 8)

S. Korea: 3,690 per million (March 8)

Why is Japan testing so much less than other countries?

I have thought why PCR test continue to remain low even after the introduction of test being covered by medical insurance and the only logical conclusion I have arrived at is that the Government is not interested with increasing the test to find more infected people, they have adopted a completely opposite strategy from other countries that are doing or did massive testing. Why? is the big question. "Obsession with Image" is the problem, and what the government has going for it, is a passive population and a media that because of nationalism or potraying a bad image of the country refuses to be critical of the government even when it is glaringly clear that officials are wrong, a good example is the famous highlighting of the justice system or the present super low pcr test.

If a member of a government selected expert panel on this virus nationally lies with a straight face that the country is holding on well with the virus and the media doesn't ask him that very simple question how that is possible without increased testing you know we are at the mercy of a selected few.

What is the government counting on with the reduced testing? My guess is, though risky, that it is known that the corona virus is not serious with the young and in most cases heal without the affected not even knowing they were infected. The most vulnerable group, those with underlying illness and the aged. The death of the aged can easily be attributed to cold induced pneumonia rather than covid-19.

It is left to each and everyone to ask themselves why countries that had their first cases of this virus after Japan have seen their affected cases spike, Even the diamond princess cruise ship had a one day increase of 99 infected cases. While over 2 months the whole if Japan has never that number of new cases. Japan is the only country that has done or is not doing anything special yet the numbers continue to remain low and doesn't need to be an on virology or public health to know that the number of affected greatly depend on the number of tests.

You cannot go fishing with a hook and expect to catch more than someone with a fishing net.

Will Japan move to using a fishing net (mass testing) and will we see a spike in the numbers like in other countries ? it won't happen for the reasons I gave.

Taking precautions is our responsibility as it is crystal clear we can't rely on our policy makers as they are more concerned with covering up their ineptude or unwillingness to accept blame.

.

Hi noriahojanen, Stefania from Italy, Bologna, quite close to the red zone. I wanted to tell you that the Italian health system is not suffering at the moment, we have absolutely no patients in the corridors. Most people with coronavirus are in quarantine in their homes, there are some serious vessels that need intensive care, but everything is working. All the country has been declared a red zone to avoid congesting hospitals and to try to lower the epidemic peak so as not to overcrowd intensive care. We are trying to contain the virus in the outbreak areas so that it doesn't reach the rest of the country. I ask you not to talk about situations that you don't know, here we are fighting seriously.

Here is the real reason why Japan's infection rate is "only" 400 or so. Almost nobody is being tested! And you can bet no post-death testing is being done for suspicious deaths from pneumonia. Consequently, the infection rate here is likely massively underestimated. Why? You can guess.

USA 5 tests per million people — worst in world

Japan 66 tests per million people — second worst in world

UK 347 tests per million people

Holland 350 tests per million people

Israel 401 tests per million people

Italy 826 tests per million people

sicksound:

I'm from Italy and I live in Sapporo, and I can tell you that Japanese people (at least here in Sapporo) were more aware of the coronavirus since it started in Wuhan (masks were already sold out the day after basically) when italians basically started to care just last Saturday. The way we behave is completely different, we touch people, we hug people, we kiss people, we shake hands we gather in bars after work with usually at least other 10/15 people and grandparents are the core of most of the families in Italy

Good point! Japan with its no-touch culture, small families, and general cleanliness probably has a huge advantage here.

Burning Bush...your referencing 3,400 deaths from influenza in 2018 without panic is good but not completely accurate. That is the number of deaths recorded on death certificates by doctors as resulting from influenza. The true figure is probably closer to 10,000.

Many deaths recorded as pneumonia are in fact the result of influenza.

I agree that its rather strange that with so many “hidden” infected the dead are not piled up in the streets.

China, and therefore our resident CCP mouthpiece, are pushing the lie that the Americans did this to China. Dictatorships don’t like the bad image that comes from being the source of something like this, so they try to cover it up with lies.

@Akie

Now it is still important to increase the scale of test to get real numbers,

Do not get why the "still" is needed but agree with the increasing of the scale of tests.

and to identify the real source of the virus.

You quite often come with something like that. You most likely know that the origin of the illness is from China, most likely the Wuhan market (or at least for the real outbreak) and Chinese official don't seems to disagree with it so perhaps you are trying to mean something else. Are you by any chance trying to pit point that confirmed case should be backtracked in order to find the patient(s) zero so that it is possible to track potential infected by following their track till now ?

If that is that I agree but that is most likely not going to be successful (kind of late). That still need to be done as to contain the epidemic one is to be faster than it meaning one have to identify all potential spreader and isolate them. The more spreader one "catch" the less new cases then the more time to "catch" new spreader and so on. That obviously involve testing people. As Germany and some others did (thanks for the one which gave the link, perhaps Tora, my id's memory is bad sorry) https://www.yahoo.com/news/experts-rapid-testing-helps-explain-172747085.html

This should have been done 2 weeks ago. Now it is still important to increase the scale of test to get real numbers, and to identify the real source of the virus.

10 out of the 12 thousand bed hospitals built are now closed in China. Apparently the numbers are dropping.

Are you back healthy ?

Yes! I had a...mystery illness. I’m much better now. Thanks for asking

Using the equations and the government's demographic estimate as of October 2018, Tokyo is estimated to see 45,400 outpatients and 20,500 inpatients per day, of whom 700 will be in severe condition.

Please anybody let me know where I can get and confirm this info in Japanese. Literally, unbelievable.

@Burning Bush

And you are SPECULATING that those who were not tested are COVID negative.

Burning bush: "We’re already 50 days into this ‘outbreak’ and still at an infection rate of 1 per 100,000 in Japan."

Given that the rate of testing is only for about that rate, it's understandable that 1 in 100,000 would be found. Where are you getting your numbers from? Not even close to 100,000 have been tested, so how can you say 1 out of 100,000 of the entire population is positive? If I never go to the hospital, even when sick, I can't say I'm not sick (only that nothing has been confirmed), but the government can site me as a statistic in people not showing up positive in the overall population -- doesn't mean I'm not... just means I haven't been tested.

That said, I agree with you that there's no need to panic about the virus (the economy is another matter).

But here's my big problem, and question. Since so much is being cancelled, and many schools and businesses closed, and yet they think the peak has yet to come, why the arbitrary restart dates of April 1st, or even March 19th? What are they going to do when next month proves worse than this, but have already slated the schools to restart after they just tried to pray the problem away for the end of March? Unless it is just a political move, which everyone knows it was, and is not actually for the safety of all, why not declare all schools closed indefinitely? And why not add nursery schools and kindergartens -- where the most germs are spread and the closest contact exists -- to the list of things closed?

Something is wrong here. May I know, if the japanese gov't is reporting the truth ???. Covering up this time will not help. Mo shiwake gozaimasen will not help to cover the lies if there is any this time. Lives are at stake here.

Panic is uncalled for.

The Japanese government isn't panicking. Its doing this thing called "preparing".

Its the responsible thing to do. It only looks like panicking if you are using the Trump approach of trying to pretend the epidemic out of existence as a basis for comparison.

Typical Japanese government behavior! Pass the responsibility onto someone else! No leadership at the top unless it is to take advantage of the general people or backstab company CEOs.

@sicksound

Ok, so that is what I guessed : you take the number of confirmed case as basis. Not the number of people in ICU over the country.

So you should understand that as the number of death it can not be used as a criteria to establish if the illness is spreading or not as long as you do not cast out all others people in your reference group as non infected.

For example, imagine as of today there is nationwide, 1000 person in ICU you get out the 61 you mentioned, as long as the 939 others are not tested they are to be taken as a kind of Schrodinger cat : they infected and non-infected at the same time.

There are things we know, things we do not. Nothing to fret about.

don't see how understaffed overcrowded hospitals can just magically be prepared in Japan or anywhere in the world either. Also the burnout rate is generally very high. This is why it's important to self quarantine to save the system from being overwhelmed. Provide a basic stipend to people to stay home is cheaper. UBI helps here

@Burning Bush

12 deaths is statistically improbable. And the argument that Japan's better health care system is a reason for low infection is a male cow excrement. How can the hospitals take care of the sick if they the infected aren't tested?

ministry has also asked local governments to decide...

Ministry passing the buck again, oh man

@Flute

NHK said this yesterday.

"The health ministry said that as of last Friday, 61 patients were in serious condition and either on respirators or being treated in intensive care units. Thirty-one of them came from the Diamond Princess cruise ship."

In Italy there are 700 people in ICU, this a baffling number, but very easy explainable as the virus lingered for about one month in the hospitals around Milan (not only), and obviously if you are already unwell for other healthy reasons is more easily to end in ICU if you get coronavirus.

There's a weird case about this old lady in Rome who was admitted on the 15th of January who died for an heart problem few days ago and she was tested positive for Sars Cov 2.

Just to be clear, I'm not trying to downplay this, actually I'm taking as much precautions as I can and I'm really worried about my relatives in Bologna, but for now, I feel a lot safer here in Japan than back home.

Sorry to rain on their parade, but hospitals here (large majority of them) are under-staffed and overly-crowded. There is a high probability of perishing before reaching a medical institution - they commonly practiced to refuse patients for much minor matters, just imagine the outcome with COVID-19 knocking their doors.

This is not ebola, or even sars.

You are right. It's already proven far more deadly than SARS and is on track to quickly surpass Ebola. You can't compare these things by an individual's % risk of death if infected. You need to start thinking of the population impact of total infections, death, and even more importantly for covid, severe disease requiring hospitalization. Covid is not SARS, it's not Ebola and it's not the flu. It's covid. It requires it's own set of unique strategies.

@Strangerland

"This work provides additional evidence for a median incubation period for COVID-19 of approximately 5 days, similar to SARS"

https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported

Key Factors which cause people to significantly overestimate risk:

Catastrophic potential: Lots of people affected at once, rather than in small numbers over time.

Familiarity: A risk that isn't common knowledge.

Understanding: A sense that something isn't well understood by experts.

Personal control: A sense that danger is outside your control.

Voluntariness: Something can do harm even when you don't voluntarily put yourself in danger.

Children: Mention the word children, and panic multiplies.

Victim identity: As Joseph Stalin said: "One death is a tragedy; one million deaths is a statistic."

Paul Slovic  professor of psychology at the University of Oregon and the president of Decision Research Council

@sicksound

Italy has around 400 people in ICU, Japan (without counting the cruise) just around 40 or something.

Where did you get that ?

Aren't you mistaking the number of critical confirmed patients with the number of people in ICU ? And do not remember seeing any data about it.

Once will also be interested about deaths number by months for an extended period of time. Usually it is how the death impact of "events" are estimated if for some reason that can not be counted at the time of death. By comparing the difference in between the estimated number of deaths and the real number (taking in account a margin error) then browsing death they can make a estimate of the death related to the event thought it can be direct and indirect and that still will only be an estimate.

@Burning Bush

As of yesterday evening, that is 9 deaths for Japan and 7 for the cruise.

https://www3.nhk.or.jp/news/special/coronavirus/

https://covid19japan.com/

If you want to compare influenza 2018 (season 2017-2018 or 2018-2019) and covid-19 you can but you have to compare it fully. You are currently comparing a number established according to some rule concerning something which is finished with a something which is in process and could be following different rules of calculation. You need to tend to something like ceteris paribus sic stantibus.

@ jojobird

Are you back healthy ?

This is not ebola, or even sars.

The difference is that due to the lengthy incubation time, it is likely to spread more than SARS, so that even with a lower death rate, it will result in more deaths.

This is why they are concerned and trying to halt/slow it.

if you don't test people in icu, you cant have covid 19 in icu!

@Fuzzy

I am not arguing for a total lack of measures but a measure of calm as the death rate is 1~3% and even lower for healthy/young people.

This is not ebola, or even sars.

The current closure of schools, people not going out, cancelation of even small gatherings is unsuitable and is already causing dire problems for many people.

Sick, only the Chinese know the real death rate, their 5000 patient in critical condition from the and their are 15000 other Coronavurus the Chinese have 50000 doctors in Wuhan and 10 of thousands of nurses, specially for Wuhan regions, they have 2.5 doctors per patient in Wuhan

@sicksound

So in the end it's mostly on us and how we behave.

I couldn't agree more with this statement. And you raise some good points about cultural influence on behaviors. Japan may well have some advantages over other nations in dealing with this. But we are certainly not immune (literally or figuratively). As you say, it's mostly down to how we behave. Treating the virus with respect and taking necessary precautions leads to one outcome. Pretending it's nothing to worry about and ignoring basic prevention measures leads to a different outcome.

I'm from Italy and I live in Sapporo, and I can tell you that Japanese people (at least here in Sapporo) were more aware of the coronavirus since it started in Wuhan (masks were already sold out the day after basically) when italians basically started to care just last Saturday. The way we behave is completely different, we touch people, we hug people, we kiss people, we shake hands we gather in bars after work with usually at least other 10/15 people and grandparents are the core of most of the families in Italy (young people spread the infections to the olders who are most likely to end in hospital), we have friends.

In Hokkaido the community spread started in mid-late January (as in Italy), and now there are 108 people infected (50 recovered, obviously the toll is much more high), and I think how people behave is making a difference. Just one more info, in the two weeks after the Wuhan lockdown influenza infections in Japan dropped by 60% from the same week the year before.

I read two paper stating that death rate for Sars Cov 2 is around 0,8 to 1,8% so this not obviously a death penalty, the problem is how fast is spreading and the risk of sending ICU and hospital completely in tilt, if it's coming like a tsunami wave(that's what happening in Lumbardy). Just one more info, Japan has the highest hospital curative (ICU) bed count compared to the population in the world. https://twitter.com/ThManfredi/status/1234881154056171520/photo/1

What are you reading about Italy lockdown is misleading, people are still going to work, while obviously doing teleworking where they can. Schools are off, as in Japan, big gatherings are off, as in Japan, supermarket are open, restaurant and bar are open until 6pm (here in Sapporo a lot of business are closed because a drop in business), the only thing they clearly asked is to stop to go out for non essential things like work, doing groceries and health reason. So in the end it's mostly on us and how we behave.

@carpslidy

You raise an important point. There is more to consider here than death and mortality directly related to covid. There are significant and far reaching knock on implications and impacts. However, you seem to be arguing that this is caused by the various policies being put in place. While it's true that the actions that are being taken now have negative consequences, if these actions were not taken, the negative consequences could be far far greater.

Economic impacts are the obvious ones. But even coming back to health, the costs for young and old will be high. When ICUs are beyond capacity, it won't just be people with severe covid that die. People who have a heart attack, stroke, car accident or any number of other things will also not be able to get the care they normally would. These people will not be counted as covid deaths. Hospitals will be forced to triage and makes decisions on who dies and who lives.

Unfortunatly, far more people especially young and middle aged people are going to die from corona related stresses caused by the economic effects of government and medical policies than from the actual virus.

it is irresponsible to treat this as fact.

And it's also irresponsible to treat any hypothetical infection count or scenario as fact as well.

I agree. Both are irresponsible.

Best not be irresponsible either way in cases like this.

The rest is speculation by internet experts.

Correction, the rest is speculation by medical experts.

Italy has around 400 people in ICU, Japan (without counting the cruise) just around 40 or something

And yet in this article, the government is predicting at the peak there will be 700 severe patients admitted to hospital per day, just in Tokyo. It wasn't long ago that Italy had only 40 or so. It all in the understanding of linear vs exponential. If it's a 3 month period from initial community spread to it peak (for example), the vast majority of cases and deaths will occur in the final week or two of that 3 month period. That's why looking at today's number of deaths tells us nothing about what happens next.

There are currently 12 confirmed fatalities due to Covid in Japan.

If the infection rate is much higher than reported, where are the associated fatalities? Or are they be somehow "underreported" as well.

Burningbush,

Tell us, what has japan has done or is doing better than other countries with high counts such as China, S.Korea, Italy, iran etc

As of march 7, Tokyo a metropolis of 38 million people has done a hefty 1990 pcr test since jan 30 and discover 68 affected cases despite the trains running with people packed like sardine and poor ventilated places like pachinko palors with people in close proximity still operating.

Does it mean we should conclude from the low counts that this virus is not transmitted in trains and pachinko?

Well, continue to stay in denial.

 Do you believe the Japanese are somehow immune or better able to fight off the virus? 

Seems like alot of people really believe this. Truly shocking!!

Leo is right, the virus spreads easier in winter (low humidity and cool temperatures). As humidity and temperatures rise in Spring and Summer, the virus becomes far less contagious.

Read around a little and you’ll find that this scenario is not being pushed as inevitable by most experts. While there is some optimism it will become less contagious, it is irresponsible to treat this as fact.

There is just one little piece here that seems missing though. Italy has around 400 people in ICU, Japan (without counting the cruise) just around 40 or something. This is not related to how many test you do, if you test them post mortem and things like that, this is an objective fact, and probably even the hardest to hide.

if you dont test after death they can't have died of covid 19, right?

Leo, countries where it is already hot and dry have the virus. Look at the Middle East, Australia, South America.

Unless you are very sick you should not be going anywhere near a hospital or clinic.

For all those downplaying based on current reported deaths, what is your case for why this won't become a problem in Japan? Community spread is confirmed. What makes you think Japan is so special that we won't see a repeat of Hubei, Iran, Italy, South Korea? Do you believe the Japanese are somehow immune or better able to fight off the virus? Or do you believe the health system is so good that we can simply deal with it? What is your argument?

The government calling on hospitals to prepare for the peak is a clear indication they now understand they can't contain this. They are now focusing on mitigation. Although, I suspect we may see a renewed emphasis on containment once the new law kicks in.

Bush,you are i

Leo !

what planet are you on ?

Testing will do know good, you can test negative and get infected again for real

Amazing. They're asking local medical authorities, not public figures. I guess they got burnt enough. Anyway, we'll see the graph go up as they start testing a greater part of the population.

"The ministry has also asked local governments to decide which medical institutions will deal with those who need to be hospitalized, receive intensive care or be put on a respirator. The municipalities are also asked to prepare the necessary medical equipment and supplies"

....no words

Tora ,he is the third stage of denial,

@BurningBush

I admire your eternal optimism, I do.

The numbers are manipulated. Everybody sees it apart from you.

If not bad, why is Abe planning to declare a state of emergency?

I suggest you watch the latest Peak Prosperity, where he covers exponential growth.

Also go and watch "Arithmetic, Population and Energy" by Dr. Albert Bartlett. It's on YouTube.

To quote Bartlett: "The greatest shortcoming of the human race is our inability to understand the exponential function."

In the spring and summer the virus will die. It likes low humidity and low temperatures.

Or are they be somehow "underreported" as well.

If they aren’t even willing to test people who are alive with the disease what are the chances they are going to test people who have passed away already?

Japan do not have enough support staff or ventilator or nurses and doctors

let s make it clear:

no doctors available, no space available, no virus solution. the hospital is a virus nest.

you want to kill us or what?

With an R0 of between 2.2-2.6 the infection rate we are seeing in Japan is statistically impossible. It is not some miracle of the Japanese health care system that is keeping the infection rate so low, it’s a manipulation of the testing procedures.

People with mild symptoms should stay home and self-quarantine for about a week, which would be able to prioritize and save other life-threatening members of the public.

In Italy as an Europe's hotspot, local healthcare services seem overwhelmed and near-paralyzed with many outpatients waiting on hospital corridors according to media reports. Some other European states such as UK are already taking a recourse from containment to delay of the outbreak to relieve rapidly mounting stresses on local healthcare systems.

Story after story of people who went to the hospital/doc with SYMPTOMS and were not tested. These symptoms get worse and then they are tested, sometimes weeks later, after spreading the virus.

We NEED more testing!! Stop refusing people!!

But, excluding the Princess, just 500 or so are infected in the whole of Japan! Compared to other countries, this number is amazingly low, especially considering the numbers of tourists that had been coming from China and the population size and density here. Japan was also one of the first places outside of China for the virus to be detected.

The Japanese government is very proud of the exceptionally low number of infected people and just stated last night that asking schools to close and people to refrain from mass gatherings has worked. Japan is a very safety country!

However, as things have spiralling out of control around the world and governments have been introduing draconian measures to deal with the outbreak, Japan is now going to getting serious and following suit.

They have held off testing large numbers and downplaying the seriousness of the situation so as to look good on the world stage in an attempt to save the Olympics.

I think they are finally realising that continuing to manipulate the situation can't go on and it might be time to sacrifice the Olympics for public health after all.

Finally the market has had a chance to vote and the market has said “We’re vey concerned”

No, only panic where people in the markets are creating fire where there is no smoke. If calm, then no panic, just have to grit and take the best care possible of oneself.

For past corona-type viruses, the infection chart trend line goes essentially vertical at the 9 week mark. This isn’t a hoax or undue panic. This is called science.

And it’s not panic in an aging country when a virus that is highly contagious kills at a very high (although the final rate is as yet undetermined) rate.

In addition, 15% of infected patients will need some form of medical treatment including hospitalization. In addition to the already sick, this could easily overwhelm the public health system.

Finally the market has had a chance to vote and the market has said “We’re vey concerned”

Long story short, this is a real thing both from a public health perspective and from an economic perspective. If you’re not worried, you aren’t paying attention.

They are unwilling to increase pcr test yet estimating skyhigh numbers of infections. How on earth are they going to discover those affected.

Are the projection so high to get money from the central government.

This type of ridiculous projection may pass here but the rest of the world is not that stupid.

Using the equations and the government's demographic estimate as of October 2018, Tokyo is estimated to see 45,400 outpatients and 20,500 inpatients per day, of whom 700 will be in severe condition.

So, this has all been worked from October 2018?

Whatever they are estimating is going to be wrong....