Novel Coronavirus Expert Meeting

Novel Coronavirus Expert Meeting (新型コロナウイルス感染症対策専門家会議, Shingata Korona Uirusu Kansenshō Taisaku Senmonka Kaigi) is a Japanese advisory body established in the New Coronavirus Infectious Diseases Control Headquarters of the Japanese Cabinet.

Background

It was established on February 14 to advise the Cabinet of Japan from a medical point of view, following the first confirmed Covid-19 death in Japan.

Takaji Wakita, Director of the National Institute of Infectious Diseases, chairs the Expert Meeting and Shigeru Omi who was instrumental in SARS measures as director of WHO Regional Office for the Western Pacific and later worked to respond to the 2009 swine flu pandemic in Japan is a vice chairman. The members are composed of Prof. Hitoshi Oshitani, who is the leader of the Cluster Measures Team and remedied the situation in the SARS outbreak as an infectious disease advisor at WHO Regional Office for the Western Pacific, and others.

Japan's Strategy for Covid-19

The aim of the Expert Meeting is to curb the pandemic while maintaining socio-economic activities. If countries around the world repeatedly block the city and lift the blockade every time an outbreak occurs, the global economy and society will collapse. They think that urban blockade is a 19th-century measure, and that there is a 21st-century-type measure to curb the spread of infection by controlling the behavior of people.

Vaccine development takes time, and we don't know if we can actually make a vaccine. Herd immunity cannot be achieved unless a large number of victims are killed and about 70% of the population is infected.

There were three pillars of basic strategy that they chose. (1) Early detection of clusters (a group of infected people). (2) Strengthening the medical system. (3) Changing people's behavior.

Three C's

The Expert Meeting analyzed the outbreak from Wuhan, which became the first wave of COVID-19 in Japan, and discovered the conditions under which clusters occur, "Three C's (3密, San Mitsu)." The first strategy they hammered out was to avoid places of "Three C's (Closed spaces, Crowded spaces and Close-contact settings)." A small partThe main routes of infection were considered to be "contact infection", which is transmitted by touching a substance to which the virus is attached, and "droplet infection", which is transmitted by inhaling droplets from a sneeze or cough. However, it has been pointed out that the possibility of "micro droplet infection" is pointed out as a new infection route.icle of less than 10 micrometers in diameter containing the virus, a micro-spray floats in the air for 20 minutes, and the infection spreads by people nearby sucking it in.

Cluster surveillance

One of the features of the measures for the new coronavirus in Japan is the strategy of cluster surveillance. Japan has deterred outbreaks through epidemiological surveys centered on cluster surveillance.

In early February, Oshitani and Hiroshi Nishiura, a members of the Cluster Measures Team, found that 80% of patients did not infect others with the coronavirus, but certain patients infected many people, by analyzing the data of the first wave from China. The Expert Meeting set their eyes on that, they decided to prevent outbreaks by tracking infected people and testing those who were in close contact with them. If the number of positives is small, it is possible to suppress the spread of infection by tracking the cluster, and it is possible to continue the infectious disease measures while maintaining a constant economic activity.

When the infection rate is very low, the infection will not spread by testing only high-risk people. PCR tests cause false positives, so many tests at low infection rates can even cause false positives to outnumber true positives. They took that strategy with that in mind.

Behind that was the fact that the medical resources in Japan were vulnerable. Unlike other Asian countries, Japan was not well prepared to test for infectious diseases because SARS did not land. The new coronavirus became a designated infectious disease, so those who tested positive were required to be hospitalized even for mild cases, and there were few sickbeds.

However, they also thought that it was a big problem that the number of PCR tests did not increase in the rapid increase of the infected person, and they have gradually increased the number of PCR tests since mid-March.

The strategy worked well until mid-March, and it succeeded in preventing the first wave from China, but the second wave via returnees from Europe and the US could not be stopped, and the outbreak occuared in April. That was revealed in May by a genomic molecular epidemiology survey of the new coronavirus (SARS-CoV-2).

Changing people's behavior

The outbreak occurred in April, and the government declared a "statement of emergency" and asked people to quarantine themselves. The Expert Meeting asked people to “reduce contact between people by 80% more than usual” in order to reduce the rate of increase in the number of infected people and allow cluster surveillance again. When the government lifted the state of emergency in May, they then proposed "new lifestyle" for people.

The composition of the Expert Meeting

The Expert Meeting is composed of experts in infectious diseases, public health and virology, and lawyer. The standing members are as follows. However, the chairman may request the attendance of other parties as necessary.

The chairman

• Takaji Wakita (Director, National Institute of Infectious Diseases)

The deputy chairman

• Shigeru Omi (Chairman of the Japan Community Health care Organization,　 and President of the Advisory Committee on the Basic Action Policy)

Members

• Satoshi Kamayachi (Executive Director, Japan Medical Association)
• Akihiko Kawana (Professor, Department of Medical Education, National Defense Medical College)
• Yoshihiro Kawaoka (Director, International Research Center for Infectious Diseases, The Institute of Medical Science, University of Tokyo)
• Kaori Muto (Professor, Institute of Medical Science, University of Tokyo)
• Hitomi Nakayama (Lawyer, Kasumigaseki-Sogo Law Office)
• Nobuhiko Okabe (Director, Kawasaki City Institute of Health and Safety)
• Hitoshi Oshitani (Professor, Graduate School of Medicine, Tohoku University)
• Motoi Suzuki (Director, Center for Infectious Disease Epidemiology, National Institute of Infectious Diseases)
• Kazuhiro Tateda (Professor, School of Medicine, Toho University)
• Masaki Yoshida (Professor, Jikei University School of Medicine)