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Tokyo reports 391 new coronavirus cases; nationwide tally 2,165

45 Comments

The Tokyo metropolitan government on Sunday reported 391 new cases of the coronavirus, down 148 from Saturday. The number is the result of 7,409 tests conducted on Nov 19.

The tally brought Tokyo's cumulative total to 37,708.

By age group, the highest number of cases were people in their 20s (129), followed by 72 in their 30s, 52 in their 50s and 45 in their 40s.

The number of infected people in Tokyo with severe symptoms is 40, unchanged from Friday, health officials said.

Nationwide, the number of reported cases was 2,165 as of 6:30 p.m. Osaka had the most cases at 490, followed by Tokyo, Hokkaido (245), Kanagawa (163), Aichi (144), Hyogo (139), Saitama (115), Chiba (80), Ibaraki (45), Shizuoka (44), Okinbawa (32) and Fukuoka (30).

Six coronavirus-related deaths were reported.


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45 Comments
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Japan - The only country in the world that thinks it's a good idea to run a nationwide travel campaign in the middle of a 100 year pandemic.

16 ( +18 / -2 )

Cases (PCR positives) don't worry me at all.

Selfish attitude. Medical professionals - the people at the coal face - ARE worried.

13 ( +15 / -2 )

Very predictable, nothing new at all.

12 ( +12 / -0 )

Raw Beer - Cases (PCR positives) don't worry me at all.

Not until you are in hospital on a ventilator struggling to take your next breath, of course.

11 ( +14 / -3 )

The incompetent Japanese Government must not be made to lose face in front of a entire world for their complete lack of care as to what happens to the people who live in Japan. Money first and screw the people that is their motto. The Olympics must be staged because TV companies paid huge fees which would have to be repaid if it is not staged, but it does not mutter to JG that they are going to stage a Super Mega Corona cluster!!! Because politicians have no sense of responsibility and know public have very short memories and it will all be quickly forgotten....

11 ( +13 / -2 )

Saturday - Sunday.

Just saying.

9 ( +9 / -0 )

@garth

there have been quite a few quite heavily upvoted comments on Yahoo JP in recent days saying that the recent surge is due to the government allowing more foreigners in again

It is a good way to shift the attention and not blame the government for taking absolutely no action since the beginning of the pandemic.

9 ( +10 / -1 )

A case does not mean one is sick. It doesn't even mean one is infected.

Since when SARS-CoV-2 is classified as resident flora in Homo sapiens?

8 ( +9 / -1 )

Sadly, but all too predictably, there have been quite a few quite heavily upvoted comments on Yahoo JP in recent days saying that the recent surge is due to the government allowing more foreigners in again. One guy even demanded that the government release the nationalities of all infected people!

8 ( +9 / -1 )

It just means the person has some virus up their nose, it does not need to be viable virus. Depending on how many cycles they do, you don't need many particles to get a positive result.

There is no protocol that could report as positive virus that did not underwent replication in the person. That means the person is infected or has been until recently. To detect contamination instead of infection it would mean that every sample would turn up positive by inespecific amplification, which obviously is not happening.

Contamination is also part of the protocol and controls are in place for all reactions to search for it. In Japan is not a significant part of the reported positive results.

To say reported positive cases are not actual positives you need evidence that contradict the reported quality numbers of the test according to the National Institute of Infectious Diseases, badly understanding what are the tests and how they are performed is a terribly poor basis to interpret the results.

8 ( +10 / -2 )

Number of test in brackets performed on Nov 19 ( Pcr test and Antigen test combine)

Nationwide 2165 (33,876)

Osaka 490 (5,000)

Hokkaido 245 (2,847)

Kanagawa 163 (2,268)

Aichi 144 (1,111)

Hyogo 139 (1198),

Saitama 115 ( Difficult to find)

Chiba 80 (1,033)

Ibaraki 45 (434)

Shizuoka 44 (575)

Okinawa 32 (585)

Fukuoka 30 (1775)

6 ( +6 / -0 )

There are plenty of experts that have come out and stated that when you go above 35 cycles, you can detect very small quantities of RNA and cannot be considered proof of infection.

Again, that would report everything as positive, and it would be on a single primer aligment, negative controls would routinely turn up positive by the mentioned inespecific amplification.

In Japan two different sets of primers are used for every reaction, and in some cases 3, with negative controls and duplicated or triplicated wells for every sample, it is not realistically possible that only a few samples would turn positive that way, on exactly the same cycle, for all sets of primers, in all the duplicates and without the negative controls being also routinely becoming positive. Error is part of the considerations, but the controls are there to keep it into an insignificant number (for the total of tests)

Your information is outdated and you have no understanding of how the test are actually done, that is why you are mistaken. Inespecific amplification is suspected when controls turn out different of what is expected and a lot of the samples turn out positive but only on one of the duplicates, etc. This is not happening in Japan by any report, and it would be illogical to expect it since positivity rates are so low compared with the total number of tests.

Yeah, that is if they contaminated a reagent used in all their reactions. That's not what I was referring to.

No, that is again your misunderstanding. Detecting the coronavirus on a person that has not been infected would mean the virus is contaminating the person (not the reagents, the person) that is realistically speaking impossible, it would need to detect less than one genome copy per reaction, which in a practical consideration would mean that routinely all samples would turn up positive. Even people that are still infected fail to be detected as positive, that is because the lower limit of detection is above the amount of virus collected from them. You really need to understand the testing before trying to incorrectly explain it.

In simple terms, a positive test means the person has the infection except for extremely rare false positive cases, testing thousands of people means the actual numbers are as reported with only very little variation.

5 ( +6 / -1 )

Still unrealistic numbers, they must be a 1,000 order of magnitude bigger to be at least credible.

4 ( +10 / -6 )

The covid death rate in Tokyo has not changed for months, with about one death daily.

What makes you think that we are getting the correct covid death rates information?

Do you trust your sources?

4 ( +8 / -4 )

I am very familiar with PCR and I acknowledge that you have used PCR related terms, but with all due respect, you are not making much sense in the first half of your post. It does not address any of my points.

No you are not, your assumptions are illogical and completely out of what a proper reaction is, you ignore the role of controls and think it would be easy to get a combination of extremely rare situations routinely in order for false positive results to be in any way common.

No, 40 cycles, 50 or 60 would not be enough, ever, for triplicate samples to become positive on the same cycle, all together, from an uninfected patient, for 5-10% of them, without the negative controls also becoming positive, and for the 2 or 3 combination of primers again all giving the same approximate titer.

First you need to understand the test, much more above the very faint details that you may be told on a video. Else your explanations will keep being wrong.

4 ( +5 / -1 )

Covid-19 data. From the Tokyo Metropolitan Government.

https://stopcovid19.metro.tokyo.lg.jp/en/

Number of people hospitalized by COVID. Reported yesterday: 1375.

Number of people hospitalized by COVID. Reported today: 1462.

Day-over-day change: +87 persons

Mild-moderate and Serious symptoms data. They are already included in the total number of people hospitalized. It should also be remembered that data on severe symptoms are already reflected in the Japan Today article. And there is no need to mention them again in the comments.

Patients hospitalized by COVID in Tokyo Prefecture, per 100,000 inhabitants. Yesterday's data: 9,87 points.

Patients hospitalized by COVID in Tokyo Prefecture, per 100,000 inhabitants. Today's data: 10,49 points.

Day-over-day change: +0,62 points.

Attention: There are already 1462 people admitted for coronavirus, in the hospitals of Tokyo Prefecture. 87 more people than yesterday.

And the rate of people hospitalized for coronavirus, per 100,000 inhabitants in this prefecture. It stands at 10,49 points.

These are very high figures. Very hard days are coming.

3 ( +6 / -3 )

Only 7,000 tests a day?

3 ( +4 / -1 )

So how many cycles are used in the Japanese tests? Since you pretend to know so much about it...

Again, you have so little knowledge on the topic that you keep insisting on a detail that actually don't have any importance. And also why you can't even make sense of a perfectly clear explanation (for anybody that actually have done at least once the technique) it is your career on biotechnology again.

Probably you think the reaction is done and the product loaded for electrophoresis to see positive bands or something. It is not. It is a real time PCR reaction and using specific probes instead of just fluorescent dye between the chains of DNA, so trendlines make perfectly clear the moment each sample becomes positive, giving a viral titer according to that moment.

Now, imagine you have 25 samples, run on triplicate on one plate, and the same 25 samples run on triplicate on another plate with another set of primers detecting a completely different region of the viral genome.

How likely do you think is that one single sample will give a false positive on all 6 wells? and it has to be on the same cycle so it would not be discarded immediately as a false positive. it is not something that could happen commonly. If the reagents were contaminated every sample would have some of the 6 wells becoming positive (or the whole plate would be positive, including the negative controls) that is a very clear sign for the test to be discarded.

You could run the test for 100 cycles and you would never increase this exceptional situation. You would already know this if you knew about the technique enough to talk about it.

3 ( +4 / -1 )

So you don't know how many cycles...

Again, it does NOT matter how many cycles, if I told you they are doing 60 cycles or 200 the rate of false positivity would not increase, there is no real possibility that any significant number of reported positive cases are false. And specially that the virus can be detected from uninfected people.

I can explain it to you, but I cannot make you understand it.

3 ( +4 / -1 )

Wolfpack asked "Only 7,000 tests a day?"

The answer is "yes", with Japanese quality.

0 ( +2 / -2 )

I am aware that the qPCR results are not analyzed by agarose gel electrophoresis.

It does matter how many cycles are considered positive. If the signal shoots up after 60 or 200 cycles, then the amount of RNA detected is too low to be considered an infected person.

There are experts in several countries who are complaining that the PCR cycles that are considered positive are way too high, for example if the product shoots up after 45 cycles they will consider it a positive (in some countries). What the Japanese testers consider a positive, I don't know.

Also, when you talk about doing PCRs in triplicate. Are you suggesting they shove 3 Qtips up the person's nose?

-1 ( +0 / -1 )

It does matter how many cycles are considered positive. If the signal shoots up after 60 or 200 cycles, then the amount of RNA detected is too low to be considered an infected person.

No, you still do not understand why it does not matter, your primitive criticism depends completely on not having any of the multiple controls for inespecific amplification. Which I already explained to you several times. The main purpose of doing a qRT-PCR is that the result do not depends on the final result to be interpreted.

Even with hundreds of cycles qRT-PCR still can have a proper limit of detection because any of the samples that have evidence of inespecific amplification can easily be discarded as negative.

Now, try to read a little bit more about what you are trying to talk about about, what step of the qRT-PCR do you misunderstood to involve qtips?

-1 ( +0 / -1 )

Are you Italian? You keep on bringing up "inespecific" amplification. In my decades of research, I have never come across "inespecific", but googling it brings up some Italian and Spanish researchers using that term.

Anyways, I am not talking about nonspecific amplification. From the start I was talking about the detection of very small amounts of virus, so small that they are not indicative of infection. When you do qPCR, samples with high levels of virus (indicative of infection) will produce a signal within 25-35 signals. This is the recommended number of cycles.

Some countries consider positive cases when the signal shoots up after 40 or 45 cycles, which represent extremely low levels of RNA (virus). Many experts are complaining about this as they do not indicate infection. Nothing in what you wrote addresses this. You're just pasting a bunch of statements from some PCR document you found or was handed to you without actually understanding it. It looks impressive and sophisticated, but it doesn't really make much sense. I don't think I'm the one that should be doing more reading...

what step of the qRT-PCR do you misunderstood to involve qtips?

Yeah, I know they don't really call them Qtips, but I am referring to that thing they shove up your nose when they collect the sample.

When you talk about triplicates, is it from the same swab, that was reverse transcribed and simply aliquoted into three separate PCR reaction tubes? Based on what you wrote, it sounds like you're suggesting three separate swabs were taken. Unless you're only referring to testing the reproducibility of the PCR reaction, which I don't see how that is relevant to what we are talking about...

-1 ( +0 / -1 )

Anyways, I am not talking about nonspecific amplification.

Which is exactly your problem, you keep thinking that just by doing more cycles you can detect smaller amounts of virus, that is not true, and betray your lack of experience. Every technique has something called limit of detection, below which anything detected has the same probability of being inespecific amplification.

There is NO protocol of qRT-PCR that can detect virus at levels compatible with contamination of the patient instead of infection. The limit of detection is above the levels only found on patients that have viral replication ocurring in the body.

If you cannot make sense of something being told to you, and at the same time you cannot even say what is what is wrong, just that you cannot understand it, it is quite obvious who is the one that has never done it. Specially because you don't even know any of the protocols followed by the NIID. It is a little bit late to make an appeal to any supposed "research" when you already demonstrated not having any experience.

And no, the name of the swab tool is not the problem. I am asking you what part of the qRT-PCR do you ever think the swab belongs to. That makes no sense, find the list of steps, then you will understand it.

You still have no idea about the difference between normal PCR and qRT-PCR, that is why you don't understand why triplicate wells over two different primer sets make impossible to detect anything below the limit of detection. Once again, try reading more about it, with a little effort you will be able to understand the importance of the CT and why it is not possible to detect contamination without inespecific amplification (which is eliminated by the controls).

-1 ( +0 / -1 )

I am aware of the limit of detection, it is extremely low. You can still detect small quantities that are above that level but too low to be indicative of infection (if you accept the signal after 45 cycles). It's not just me saying this, there are many experts complaining about this. But I realize you want people to accept these exagerated results and panic over the casedemic so that they all rush to get your vaccine.

If the swab is contaminated, you can still get a positive signal in all triplicate samples, if they are derived from the same swab.

-1 ( +0 / -1 )

I am aware of the limit of detection, it is extremely low. You can still detect small quantities that are above that level but too low to be indicative of infection

False, that is not possible, there is not a single report for reliable detection of contaminated but not infected patients. not even one.

Even if you go above 100 cycles you cannot do it, because the limit of detection of every single protocol for detection of coronavirus in patients is well above the amount of virus present before infection has been established.

There is no need to accept imaginary results that do not exist, bring the report that proves what you say is easy to do or accept it is not a realistic possibility.

And no, swabbing a contaminated patient collects orders of magnitude less viruses than the limit of detection of any published and validated protocol, which means that even if by extremely small chance all triplicates of the sample would give amplification the CT would be wildly different and thus easily eliminated from the true positives by this extremely obvious control of the reaction.

Patient contamination instead of infection is not a realistic possibility, much less to represent any kind of significative percentage of the reported positive cases.

-1 ( +0 / -1 )

Even if you go above 100 cycles you cannot do it, because the limit of detection of every single protocol for detection of coronavirus in patients is well above the amount of virus present before infection has been established.

You mean by limiting the number of cycles, right? If not how?

Do you even know how PCR works?

-1 ( +0 / -1 )

You mean by limiting the number of cycles, right? If not how?

No, that is not what the described control works. Limiting the number of cycles is irrelevant for it.

Once again, there is no protocol published anywhere in the world that can reliably detect patient contamination in the absence of infection. You describe something that do not exist.

That means that there is no possibility that any significant portion of the test reported as positive come from people that have not been infected only because they were contaminated by the virus.

-1 ( +0 / -1 )

He probably meant it doesn't mean sarscov2 is present in said homo sapien

-4 ( +2 / -6 )

Osaka had the most cases at 490

Osaka wins !!

-4 ( +2 / -6 )

So you don't know how many cycles...

-6 ( +0 / -6 )

So how many cycles are used in the Japanese tests? Since you pretend to know so much about it...

-7 ( +0 / -7 )

There is no protocol that could report as positive virus that did not underwent replication in the person. That means the person is infected or has been until recently.

There are plenty of experts that have come out and stated that when you go above 35 cycles, you can detect very small quantities of RNA and cannot be considered proof of infection. Many countries use 40 or more cycles, resulting in many false positives. I don't know about Japan...

To detect contamination instead of infection it would mean that every sample would turn up positive by inespecific amplification, which obviously is not happening.

Yeah, that is if they contaminated a reagent used in all their reactions. That's not what I was referring to.

-8 ( +2 / -10 )

Still very low.

-9 ( +5 / -14 )

Virusrex

I am very familiar with PCR and I acknowledge that you have used PCR related terms, but with all due respect, you are not making much sense in the first half of your post. It does not address any of my points.

The second half would be valid only if they are doing the acceptable 25-30 cycles, at most 35. Is that the case? No word salads are needed to address this point.

-9 ( +1 / -10 )

*A case does not mean one is sick**.*

It absolutely does in Japan. They don't test you otherwise.

Don't they also test those who came in contact with those who tested positive?

*A case does not mean one is sick. It doesn't even mean one is infected.*

Since when SARS-CoV-2 is classified as resident flora in Homo sapiens?

It just means the person has some virus up their nose, it does not need to be viable virus. Depending on how many cycles they do, you don't need many particles to get a positive result.

Or perhaps a sloppy technician contaminating the sample.

-11 ( +1 / -12 )

@raw beer

agree.

but...old people stay home.

-13 ( +2 / -15 )

A case does not mean one is sick. It doesn't even mean one is infected. The case number is meaningless, mainly used to scare people.

-14 ( +4 / -18 )

The covid death rate in Tokyo has not changed for months, with about one death daily.

Cases (PCR positives) don't worry me at all.

-19 ( +3 / -22 )

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