Pneumonia epidemic: lessons from Japan’s epidemic prevention model to return to blockade-BBC News



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A woman wearing a face mask watches from a yakitori restaurant in a traditional dining room on March 19, 2020 in Tokyo, Japan.Image copyright
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Japan’s Hokkaido was once seen as a successful example of fighting the epidemic, and efforts in the region to contain, track and isolate the virus have caused a significant drop in the number of infected people. But Hokkaido once again became the focus of attention, but due to the fight to deal with the second wave of infection.

In late February, Hokkaido became the first region in Japan to declare a state of emergency due to the new crown epidemic.

Schools are closed, large gatherings are canceled, and people are encouraged to stay home. The local government is determined to actively combat the epidemic and aggressively track and isolate those who have had contact with victims.

This policy worked, and by mid-March the number of new cases had dropped to one or two per day. On March 19, the state of emergency was lifted and the school reopened in early April.

However, just 26 days after the emergency was lifted, it had to be implemented again.

When the Japanese government put Tokyo, Osaka and five other counties in a state of emergency, Hokkaido did not follow up once, but acted independently. But a few days later, all of Japan, including Hokkaido, went into a state of emergency.

A story of almost success

In the first week of mid-April, Hokkaido recorded 135 confirmed cases of new coronavirus. Unlike the first outbreak in February, there is no evidence that this round of infection was imported from outside Japan.

There are no foreigners in the newly diagnosed cases and no infected person has traveled outside of Japan in the past month.

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The containment measures taken by Hokkaido at first seemed to have been successful.

What does this mean? How did Hokkaido respond to the outbreak?

First, if early detection and early treatment can be achieved, the epidemic can be controlled.

“Relatively speaking, group management, contact tracking and isolation is relatively easy,” said Kenji Shibuya, a professor at King’s College London.

“The government has been quite successful in controlling the groups. At that time, in the early stages of the outbreak in Japan, the outbreak was localized. This is a success story.”

In this regard, Hokkaido has some similarities to the city of Daegu in South Korea. In Daegu, a large-scale outbreak that started in a cult organization was actively tracked. Infected people were quarantined and the epidemic was contained.

However, Hokkaido’s second experience is not so reassuring.

After the Daegu outbreak, the South Korean government launched a large-scale test program to try to track the outbreak. The Japanese approach is just the opposite.

Even today, more than three months after the first recorded case in Japan, only a small part of the population has been analyzed.

Initially, the government said this was because the large-scale tests were “a waste of resources.” Now, he has to change his tone, saying that he will increase testing efforts, but there are several reasons that seem to drag the government down.

First, the Japanese health department is concerned that the hospital is overloaded with patients with positive tests but only mild cases. On a larger scale, the local health center is responsible for the tests, not the national government.

Some of these local centers simply do not have staff or equipment to conduct large-scale testing. The local hotline is already overwhelmed, and even finding a doctor is very difficult.

Professor Shibuya said that the combination of these reasons means that the Japanese authorities are unclear about the spread of the virus among people.

“We are in the intermediate stage of the outbreak,” he said.

“The main lesson learned from Hokkaido is that even if you successfully control the virus from the beginning, it is difficult to isolate and maintain control for a long time. Unless detection capacity is expanded, it is difficult to determine community transmission and transmission hospitable. “

The way to go is long

The third lesson is that this “new state” will be much longer than most people think.

Hokkaido now has to re-implement restrictions, even if the Japanese version of the new corona virus “crash” is much less restrictive than elsewhere.

Most people still go to work. The school may be closed, but the shops and even the bars are still open.

Professor Shibuya believes that if stronger measures are not taken, Japan has little hope of controlling the spread of the so-called “second wave”, and not just in Hokkaido, but across the country.

“The key lesson,” he said, “even if it is successfully controlled locally, it still spreads to other areas. As long as people move, it will be difficult to maintain a virus-free state.”

Still, Hokkaido’s economy has been seriously hurt. This island relies heavily on tourism, and Japan has banned travelers from most countries in Europe, America, and Asia.

A friend who opened a bar in Chitose City has now been forced to close and fire employees. In the northernmost city of Asahikawa, Naoki Tamura told us that his bar is still open, but that there are now almost no customers.

“Every night one or two people come,” he said.

“There used to be a lot of tourists from China and Southeast Asia. Now they have completely disappeared. Now we cannot hear any foreign language on the street. The smallest family homes are closed and closed. Tourism is really struggling.”

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Hokkaido is highly dependent on tourism.

The new state of emergency will end at the end of the Japanese “Golden Week” vacation on May 6.

But a local government official dedicated to epidemic prevention in Hokkaido told us that the restrictions may have to last longer.

“We feel that we should continue to do the same,” he said. “Our goal is to minimize contact between people to prevent the spread of the virus.”

So how long does it take?

“Until we find the vaccine,” he said. “We must continue our efforts to stop the spread of the virus.”

Miho Tanaka also contributed to the report.

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