Sorry, I didn't mean to offend you, but the r0 of 1.05 is based on Japan as a whole. Individual prefectures have localized variance; the r0 in Okinawa as of August 10th is 1.53.
I live in Aichi, which has also seen it's infections skyrocket recently, so I understand. However, if you read my entire post, you will see I am advocating against the current strategy. If you choose to make enemies of those trying to ally with you, you will have a much harder time advocating for Okinawa.
3 ( +3 / -0 )
The good news is that there is a downward trend in Tokyo as of August 10th, and wider Japan is close to seeing a downward trend, with an r0 of 1.05 based on the last 7 days. Of course, PCR testing is also way down following August 5th, most likely as a result of the Obon holidays.
With regard to deaths, unfortunately its not good news. July's total deaths were 37 for all Japan, whereas August has already seen 41 deaths as of August 10th. This is the first monthly increase in deaths since the SoE. The week between Monday, August 3rd and Sunday, August 9th, is also the deadliest week for corona since the last week of May (25th - 31st).
Ultimately, it comes back to leadership. The central government has decided that it will continue with its current strategy of encouraging economic activity (or, at least, not actively discouraging risk behavior). This position translates down to how individuals conduct themselves, from schools and sports teams, to commuters, and so on. It appears to be counter-intuitive according to the data. We can take personal measures, of course, however there is enough evidence now from multiple countries that central leadership is prerequisite to the pandemic response. The situation has not escalated to the point prior to the previous SoE, and so without strong messaging and strategy to direct people, we can only continue as we are until such a time as the numbers do require strong executive action, or don't, in which case I suppose we continue in this half limbo where cases kind of float around, and economic activity remains suppressed. Worst of both worlds.
4 ( +7 / -3 )
Recent evidence does suggest long term herd immunity can be achieved without vaccination.
Thank you for providing those videos, which also included links to the relevant reporting and studies.
Both videos raise excellent points regarding immunity, particularly with regard to encouraging evidence of at least partial immunity with respect to T cell immunity from exposure to other beta-coronaviruses, and how this can account somewhat for the significant variance in infection severity for covid-19.
These videos do support the notion that recovery from covid-19 does confer long term individual immunity (at least partial).
Herd immunity is a different concept to individual immunity, however. Even assuming those studies are true in all cases, and there is lifelong immunity to covid-19, in order to achieve herd immunity around 60% (taking a low end estimate) needs to be infected and recovery. In Japan that would be around 75 million people. Even if measures were taken to direct that natural infection path to those at lowest risk, with the mortality rate of 0.2%, 151200 of those infected would die. Furthermore, as we other diseases which are suppressed by herd immunity, invariable flare ups would continue to occur were immunity levels dropped below 60%, in the same way measles outbreaks occur where vaccination levels drop. Without a vaccine, it would be necessary to isolate the elderly and vulnerable from new borns or those without immunity.
Its an option I guess...
-2 ( +0 / -2 )
Herd immunity is happening and will happen, again whether we like it or not.
Do you have any citations to back this up? Herd immunity for other viruses has been acheived primarily through vaccination. Furthermore, there is insufficient data as to the duration and quality of natural immunity to determine whether herd immunity is possible. Here are several articles which support this:
I accept many believe this virus is not a public health threat; that the mortality rate and health impacts do not justify any action. Freedom of opinion is important. However, it us important to realise that those opinions are not founded in objective research and consensus of expert opinion.
7 ( +8 / -1 )
Thank you for those links.
This study does observe excess mortality of between 50 - 60 cases for January through April 2020.
As the study further notes:
Roughly translated as:
If deaths due to causes other than new coronavirus (for example, death from traffic accident, suicide, death due to other infectious diseases such as influenza) decreased during this time, it is possible that deaths due to the new coronavirus are offset with regard to excess mortality.
With regard to death from traffic accident alone, there were 41 fewer deaths for the months January through April 2020 than the same period in 2019:
Furthermore, the peak in deaths for the corona virus occurred in May, which was not covered by this survey:
All that said, I agree that Japan had been successful at limited mortality and spread of the new coronavirus up until the end of June 2020. Looking at the statistics, it appears the biggest impact was the SoE. The situation now appears to be changing, and the current strategy is failing as cases, hospitalizations and deaths are all trending up. I understand we are not yet at the same level we were in April/May, however I believe it would prudent to act prior to reaching that level.
0 ( +0 / -0 )
So many posters rush to reject good news but believe every negative story irrespective of validity.
I agree, and vice versa. My take looking at the statistics and reporting to date is that Japan initially performed better than average at limiting the spread and impact of the virus through to mid-June, with mortality relatively average on a global scale, and slightly below average on an East Asia scale. Following policy and strategic changes from early May, late June saw the situation escalate in Japan to where it is now performing below average on controlling spread, while mortality and serious cases (icu) remain fairly average for the world generally. Basically its pretty average here, but appears to be heading in the wrong direction. It may or may not result in Japan moving toward the situations seen in the 'losing' countries. However, if Japan really wants to be an example to the world of 'winning' (i find the whole idea of winning and losing comparisons distasteful) then the current strategy is not working.
10 ( +11 / -1 )
Okay, sorry, the more I contribute here the more paranoid I become regarding posts it seems! But it is strangely addictive, and at least it motivates me to research more which, if nothing else, actually helps me feel more in control of my life.
I do wish these articles would link to the studies though... I have a bit more time, but I'd rather not spend it stalking Google...
3 ( +3 / -0 )
The study's findings are consistent with well known info regarding the most at risk part of population
i@n, do you have a link for the study? I would be interested to see the findings and the methodology.
But of course our imaginings and suppositions has more weight and far more credible, the result is clearly wrong and misleading, right?
As I point out in my post, I found the reporting to be unclear and incomplete, so I attempted to add context. I apologize if this appeared to be 'imaginings' or 'supposition', although I do give citations for the data, and preface my conclusion with 'In my opinion', meant to indicate that the proceeding is my own opinion.
3 ( +4 / -1 )
There is something called the "excess mortality rate", which compares mortality of the current year, current month with an average of all the recorded years.
Excess mortality is actually one of the best tools to calculate the extend of a pandemic.
Currently there is no out of normal excess mortality in Japan.
Luis, do you have a link for the excess mortality data for Japan for this year? I have seen reporting on this, but cannot find the data itself.
0 ( +0 / -0 )
This article makes a good point acknowledging the covid-19 death rate in Japan is not spiraling out of control.
However, as the article notes, criteria for hospitalization vary from country to country, which is an important factor. In Japan, all confirmed positive cases were required to be hospitalized until late-May, when asymptomatic and mild cases where moved to lodgings or allowed to return home:
This effectively means deaths per hospitalized case in Japan is more comparable with deaths per case in other countries. By this metric, Japan is somewhat average in comparison to other countries, sitting at 2.43%:
Furthermore, as of June 1, there were 889 confirmed deaths from covid-19 in Japan between March 1st and June 1st; https://toyokeizai.net/sp/visual/tko/covid19/en.html.
This article reports that the study found there was a 7.5% death rate amongst 2600 people hospitalized at around 230 facilities between March and June, which accounts for 195 deaths. So clearly 694 people died at hospitals not included in the study. Excluding the majority of deaths during the period in questions seems dubious. I have not read the study itself, however, so I can't comment on methodology.
The article also makes a point of comparison to Britain and New York, which are widely known to be the worst affected pandemic hotspots in the world. It would be more apt to compare Japan to it's East Asian neighbors or countries of similar size or geography:
China CFR 5.48%
Japan CFR 2.43%
South Korea CFR 2.08%
Philippines CFR 1.80%
Taiwan CFR 1.47%
New Zealand CFR 1.40%
The inevitable reply to these statistics is that CFR is a poor metric, because it favors countries that do wide testing and thereby have a high number of asymptomatic or mild cases which push down the CFR. For example, the U.S. is widely accepted to have one of the worst death rates in the world, however it only has a CFR of 3.24% thanks to 5 million cases having been identified in over 63 million PCR tests. In this case, many point to deaths per million population as a preferable metric:
Philippines DPM 20.2
Japan DPM 8.1
South Korea DPM 5.8
New Zealand DPM 4.5
China DPM 3.3
Taiwan DPM 0.3
Swedes also remove shoes, and they are also doing relatively well.
Sweden CFR 7.03% DPM 566.2
In my opinion, Japan had a low incidence of cases through to July 2020, due to strong contact tracing, pre-existing behaviors around personal prevention, and the SoE. In terms of mortality, Japan has been pretty average in terms of the global situation, and one of the worse in terms of the East Asia region. The previous strategy has now begun to fail, due to a false sense of security based on early success and rapid reopening. As a result cases are increasing more rapidly and more widely throughout Japan. There is a real possibility that the situation regarding mortality could worsen, based on has happened in countries that faced similar situations. The government has chosen to take a reactive approach regarding a further SoE; essentially wait and see. That is clearly its job to decide. I am just hoping we don't become one of those countries other places compare themselves to in an effort to seem like they are fine.
15 ( +15 / -0 )
This was the original post, which gives raw new case data for six consecutive [Tuesdays], and notes that the is an upward trend.
2 ( +2 / -0 )
Trending up. Here are the past six Tuesdays: 31, 54, 106, 143, 237, 266. And today: 309.
This was the original post, which gives raw new case data for six consecutive Sundays, and notes that the is an upward trend.
Is it? Here are the week-to-week increases based on your numbers...
This is the response, which clearly refutes the claim of an upward trend in the number of cases by use of rhetoric question proceeded by demonstrating a downward trend in the rate of increase in case numbers, an entirely different metric.
I was pointing out, that even if the rate of increase is on a downward trend, it is still increasing. Of course, both metrics have value. As you point out, rate of infection (r0) is an important metric when considering whether measures are effective. However, raw data on the number of cases is also important to put that in context. For example, cases rose 96% when comparing data for weeks 2 and 3, however that only translates to 52 cases. Whereas, the 16% increase between weeks 5 and 6 translates to 43 cases.
Most importantly, I believe it is not helpful to, at best, omit, or, at worst, misrepresent data to try to indicate that the virus is not increasing in Tokyo and wider Japan, or vice versa. Both 'teams' here frequently cherry pick data, especially when trying to prove the other wrong. It's intellectually dishonest. I'm just fact checking what people actually submit.
3 ( +4 / -1 )
The r0 is itself a numerical representation of the trend in number of cases. For example, if the r0 is 1.5 it means for every current active case, there will be 1.5 new cases, i.e. cases will increase in number. So while it is correct to say the r0 is trending down, as long as it is above one it only represents a slowing upward trend in actual cases, not a downward trend in cases.
3 ( +5 / -2 )
Sorry, html issue. Should read an upward trend is indicated by a r0 greater than 1.
2 ( +4 / -2 )
Is it? Here are the week-to-week increases based on your numbers...
74% Week 1-2
96% Week 2-3
35% Week 3-4
65% Week 4-5
12% Week 5-6
16% Week 6 - NOW
A positive percentage increase (or r0 1) is still an upward trend. A flat trend, or plateau, would be indicated by 0% increase (r0 of 1). So while your post presents the data in a different form, it doesn't invalidate the claim of an upward trend. Nice try though.
4 ( +8 / -4 )
To fair Larr Flint, you are comparing Japan's first quarter GDP (Jan to Mar) to the U.S and worlds second quarter reporting (April to June).
5 ( +5 / -0 )
The remarks came as the government struggles to balance the need to reopen the economy while keeping the spread of the coronavirus in check.
Please. The governments current strategy is minimalist intervention on both fronts. The virus is spreading relatively unhindered apart from personal prevention measures. The economy is open in every regard apart from international tourism. Perhaps that is the best strategy; many commentators here seem to think so. I admit, the fact that there has been minimal economic contraction in Japan surprised me, although thanks to both luck and the short SOE, Japan has largely avoided significant impact from the virus.
I personally still believe that the spread of the virus will drive down consumer confidence, delay resumption of tourism and in turn damage the economy. I also maintain that the function of the government is to balance the free market economy by imposing regulation for public health and welfare, not to protect the economy at the cost of its citizens. However, I will admit, if Japans luck holds and the virus does not spiral out of control, maybe it will get away with this current strategy. Lets hope the lessons learnt dont color the response when the next threat looms.
8 ( +8 / -0 )
Ok, so lets have some follow-up. How many of those that tested positive were showing symptoms!? How many were randomly tested? How many are in ICU? No? Too much to ask?
I am not sure if is true in every municipality, but both my city of residency and that I work in offer this information on the city website. I wont link either, for privacy reasons.
For example, here is a extract from information available for a recent patient in the city in which I work (translated via Chrome translate):
Overseas travel history Within 14 days None
Onset date July 18
Positive confirmation date July 22
Main symptoms such as fever, cough, sore throat, headache, malaise, diarrhea
no special instruction
My home city offers less information, for example no 'onset date', but is mostly the same. One thing I have noted is that while some patients identified via contract tracing (indicated under special instruction) are listed as having no symptoms, the majority are listed as mild symptoms, a few of which have further descriptions like the patient above.
The information is readily available with a fairly simple google search; there is no great conspiracy to portray the virus as worse or better than it really is.
5 ( +5 / -0 )
Realistically, the debate here is purely academic, and rather repetitive. Leaving aside speculation and projections about mortality and possible ongoing medical effects (and their related costs), I think there are three broad possible scenarios going forward:
The government changes course and declares a SOE, or, more extremely, legislates changes to the constitution to permit a lockdown. Testing and tracing remains in place, but due to restrictions, cases can be properly isolated and the virus is contained and managed, possibly eliminated. This likely takes 2 - 3 months given the currently spread of the virus. The economy is severely hobbled, requiring extreme government investment post restrictions to restart the economy, however recovery is relatively fast given that consumer confidence is unimpeded by concern over the virus. Tourism resumes after 4 to 6 months with countries in similar positions (e.g NZ)
The government abandons limited testing and pursues widespread, public testing. Testing is continually increased to the point where 80% of the population can be tested with a 2 -3 month period. The virus is removed from the designated infectious disease list and those with minor infections are told to self quarantine. Hospital capacity is boosted to accommodate those with more severe symptoms. The cost to the government is astronomical. Economic activity remains depressed for 6 to 8 weeks minimum, until consumer confidence slowly begins to increase as testing is more readily available and infections are visible controlled and isolated. Tourism resume after 6 to 9 months with countries in similar positions (e.g. S.Korea)The government continues to pursue its current half baked strategy, and the virus naturally attenuates, reaches a point.of herd immunity, or a viable vaccine is developed and distributed. Timeframe is around 6-8 months minimum, if ever for any of those outcomes. The economy bottoms out due to decreasing consumer confidence, impact on trade and tourism, and the necessity of the public taking its own measures to avoid infection. By far the most costly, both in terms in public health and the economy.
0 ( +2 / -2 )
Even though, infections (many other too) have been recognized as significant causes of cardiac diseases for many decades now, this particular study results recommend further research needed.
I agree. In fact, given, as you state, that 'infections have been recognised as significant causes of cardiac diseases for many decades', I propose that while further research is being conducted into the long-term effects of a highly infectious, novel strain of virus, it would be a prudent public health and economic position to limit is spread amongst the population.
It would probably be both more ethical and ultimately less expensive than dealing with a generation shouldered with cardiac, respiratory or vascular complications from a pandemic event in their 20s.
0 ( +0 / -0 )
To date Hokkaido has seen only a hundred deaths in spite of not closing themselves off from the rest of the country, not having a month plus lockdown, and not living in fear
Just tonight 5000 went to see nippon ham play.
“On Sunday [June 14], 40,000-plus New Zealanders filled in the stands at Auckland's Eden Park for a game between the Auckland Blues and Wellington Hurricanes in the Super Rugby Aotearoa”:
So congratulations to NZ for having no cases but you have to ask if their draconian measures were needed and have achieved much beyond what your low population density woul have already achieved.
The population density in New Zealand is 18 per sq.Km (47 people per sq.mi). Roughly 86.9 % of the population is urban (4,191,405 people in 2020).
The population density in Brazil is 25 per sq.Km (66 people per sq.mi). 87.6 % of the population is urban (186,217,070 people in 2020).
I think that population density is clearly not sufficient to eliminate the virus without additional government intervention.
and by having zero cases you have locked yourself into and out of the rest of the world waiting for a vaccine. Which as a small country you aren't going to get in the first roll out .
Again, I am not sure how this differs from every other country with closed borders at this point? It is more likely that those countries without cases will resume trade and tourism with each other before those with cases. With regard to the distribution of the vaccine, you may be right. But at least they wont be burying grandparents while they wait.
0 ( +0 / -0 )
Did you manage to figure out who from Germany did the studies ? Seems to me they just threw the country name there to improve credibility but forgot the details ..
Both the studies are linked in the article itself:
1 ( +1 / -0 )
To be honest, I don't think New Zealand is so fundamentally different to Japan. Sure there is a vast population difference, but almost half of New Zealand's population lives in a single city. Its not as dense as Tokyo, but its certainly more dense than the circumstances the majority of Japanese live in outside the super cities. Furthermore, both are island nations with the capacity to secure their borders. Both economies are primarily consumption and service based, with a large tourism sectors (proportionally) and export industries largely centered around a major product (cars and dairy constitute around 20% of the economy for Japan and New Zealand, respectively). Both have relatively moderate populations which are generally amenable to government.
Furthermore, in terms of economic impact of these countries covid19 responses, both are looking at around the same effect on GDP:
New Zealand's estimated economic impact is a 7.2% shrink in GDP.
Japan's estimated economic impact is a 7% shrink in GDP.
Personally, I feel that Japan could have followed a New Zealand model successfully. The previous state of emergency did help to suppress the virus, and although New Zealand was capable of enforcing a lockdown, I feel that had the government here advocated for a succint and focussed plan, people would have complied and we may very well be another success story.
Some might say "Japan is a success story, look at the death rate". However a low death rate is only positive if the is some gain. Given that it doesnt appear that Japan is making any real economic gain from this strategy, largely because consumer confidence and consumption has bottomed out. New Zealand may not be better off economically (although it is already predicted to have a quick turn around), but it has no deaths now, and no cases. And they aren't closing bars early. So I dunno, its all academic now, but I cant sit here and argue its all sunshine
-1 ( +3 / -4 )
Some conflicting data
131 number of new patients
252 number who tested positive
My understanding is that Number of people new tested positive (モニタリング項目(1) 新規陽性者数) refers to total positive results, including retests of previous positive results.
Actually, someone did die from covid19 in Japan yesterday. A 60 year man was diagnosed as being corona positive on July 11th and hospitalized. He was asymptomatic for 10 days (from the 11th to the 21st) , and then his health deteriorated quickly. He died yesterday.
Hi Mirai, do you have a link to reporting for this? I would interested in reading more (English preferable if possible).
0 ( +0 / -0 )
Personally, to add to the above, I would be happy with the government removing the virus from the designated infectious disease list, and allowing individuals to recover at home where appropriate, if there was widely available testing. Given the lack of preventative options in the form of a vaccine, and the evidence of asymptomatic spread, this testing should be available to anyone who wants it on a fortnightly basis. This does not mean entire populations need to be tested immediately, however there should be capacity for upwards of 70% to be tested on a monthly basis.
Alternatively, where this kind testing is not available, I believe the responsible thing is to limit social activity by way of a state of emergency. Either scenario would require massive government investment, however I personally view this as exactly the function of government.
Finally, I reject the notion that the economic reality is the majority of workers simply have to live with risk of infection. If that is the case, we should be reexamining our priorities, not trying to save said economy.
1 ( +4 / -3 )
For those advocating for personal responsibility and 'learning to live with it', I think that the majority of those contributing here are taking precautions and attempting to navigate the situation as responsibly as possible. In fact, I would argue challenging the government response is part of learning to live with the virus.
Given so many posit the flu as analogous (and ignoring any evidence that the coronavirus is not analogous with the flu), lets use that as an example. If I suspect I have the flu, I can go to any local clinic and get a flu test. I will receive my results before leaving the clinic. If I am positive I will be advised to isolate for 7 days. I maybe prescribed medication to alleviate my symptoms. This is not possible with coronavirus. Furthermore, if I am concerned about the flu, i can obtain a vaccine to lower my risk of infection. These vaccines are widely utilised to protect vulnerable populations. This is not possible with the coronavirus.
Learning to live with this virus may mean increased risk in day to day life, but it does not mean the government can abdicate any responsibility to minimise that risk, particularly where our ability to do so as individuals is limited. Those of us seeking increased testing and greater efforts to prevent the spread, including but not limited to a resumption of a state of emergency, are not necessarily claiming we shouldn't take responsibility. We are simply stating that limiting and managing societal risks is part of the governments function, and that it too needs to take responsibility and take actions to reduce the risk in the face of data that clearly shows the risk increasing.
2 ( +8 / -6 )
If these tests are from 3 days ago, it may be relevant to note that 864 tests were conducted on 7/24:
15 ( +20 / -5 )
Worldometer says the known active cases are only 6226. And its worth noting that deaths so far are only 993 with recent deaths per day being 1 or 0 for weeks.
Worldometer list deaths per day for the previous 7 days as:
July 26 - 3
July 25 - 1
July 24 - 2
July 23 - 1
July 22 - 1
July 21 - 3
That’s 11 deaths in the last week, or 1.57 per day. I understand your overarching point, but it is undermined by misrepresenting your own cited source.
0 ( +0 / -0 )
Given this is the most recent 'daily positives for Tokyo' thread, I thought it the best place to share a recent clarification I have found regarding statistics reported at:
The table at the top lists hospitalized (入院) and Hospitalization / Medical treatment, etc. (入院・療養等調整中). I noted on another article that I was unclear as to the difference. After reading another article which referred to people awaiting hospitalization, and consulting with a Japanese friend, I have learnt that the second figure is cases currently awaiting hospitalization. While this doesn't necessarily mean they are all in need of hospitalization, it does show that while reported hospitalizations are only 1165, there are an additional 966 potential hospitalizations. I don't proffer this as evidence one way or the other with regard to the severity of the virus, it is good to know in the interest of getting the accurate data.
0 ( +0 / -0 )
Where can a foreigner who lives here alone and feels scared turn for help?
I would go for embassy first.
Of course if you feel ready to trust the Japanese medical professionals this is a good choice too. Any local hospital will give you the referral letter.
Excellent advice. I live in a relatively rural part of Aichi (by Japanese standards it is 田舎) and I personally took a PCR test at a local hospital following several days of low-grade fever in early June. I received a negative result via phone call around 24 hours later from the local cities public health office, and in perfect English I might add. The process was very easy, although I would recommend asking a Japanese speaking friend to accompany you if your ability isn't great.
5 ( +6 / -1 )
Posted in: No wind in the sail