- COVID-19 uproar and its cause
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- The uproar started by a coronavirus in Wuhan, China. RNA enveloped virus like
flu virus, probably derived from bat. Killed by surfactants. 5 days incubation,
8 days symptoms. Causes pneumonia, fever, taste/olfactory disturbance, dyspnoea.
The elderly, hypertensive and diabetic patients are more likely to become serious.
80% are asymptomatic and mild, 20% are infection symptoms, and about its 10% are
serious. Fatality rate from 1% in Germany to about 9% in Italy. The basic
reproduction number is around 2.5 in Europe and America. Infection is mainly by
droplet infection and contact infection. Crisis of medical collapse in New York
and Italy. No medicine nor vaccine, just cured by patient's immunity. PCR examination
possible to detect infection.
- In Japan, the basic reproduction number is around 1.5 to 1.7. Japanese lifestyle is
helpful, such as no shaking hands, encouraging hand washing and masking, and no loud
conversation. He lives in a self-restraining manner, thanks to the national character of
the Japanese.
- Until now the infection has been low. Take only the two-sided operation of cluster busting
and self-restraint. In other countries, a wide inspection system is realized through such as
walk-throughs. Only Japan narrows down the examination.
According to the policy of the medical community in Japan, different from the policy
in Germany, emphasis has been placed on the severely sick patients, not the mildly
sick, which may have produced the strict inspection requirements of the Ministry of
Health, Labor and Welfare such as fever for more than 4 days. This can exclude
mildly sick any patients. Therefore, it is speculated that the fact that the
examination can be consulted only through the Returnee Consultation Center and
is usually rejected is the cause of this uproar.
Because people with mild fever cannot be screened, then go out and spread the infection,
if infected. For this reason, the number of basic reproductions will not be reduced to 1 or
less only with the two-sided operation of cluster crushing and loose self-control. Perhaps
self-restraint at the level of city blockade (lock-down) could achieve the enough reduction.
But it gives us a big damage socio-economically. In addition, mildly infected persons become
soon serious and suffer from the disease.
These stringent inspection requirements should be removed immediately, but still maintained.
Moreover, it has not been identified as the cause of the failure to proceed wide and thorough
examination in Japan. I'm sorry that nobody cares of this defect.
Since foreign countries can understand the status of infection by their wide examination,
it is easy to obtain public cooperation and they cooperate even under city blockade. In
Japan, the status of infection is unknown, and people are worrying about where they are.
- Actions to be taken by government administration and prospects at that time.
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- A patient with a designated infectious disease shall enter under the restriction
of hospitalization at any designated medical institutions. But MHLW removed such a
rule and allowed home medical treatment for mildly sick patients. (3.1 Notification
of MHLW. 3.19 Expert Meeting. But MHLW has refused practically and finally
accepted on 4.2) Therefore, the problem of lack of beds has been solved for the time being.
- Cluster crushing was quite successful at first. However, the labor and staff of
the health center and others were divided as needed to track the route. In addition,
self-restraint starting on 2.26 for 3 weeks was really just only self-restraint,
during which the administration did nothing.
- What was to be done was to abolish the strict inspection requirements from the
beginning, and establish wide-ranging and early inspection systems with the cooperation
of the private sector through such as walk-throughs. Then the government could
have obtained the information of the infection status, and shared it with
the public to ask cooperation for a self-restraint life.
This is the government's failure. The number of basic reproductions could have
been reduced to 1 or less.
- If the examinations were sufficient, the infection could have been reduced. The
sooner the better. And even if it is late, we have to do it early.
Then, as described in 3.16,
only mild self-control should have been required, and the health and
socio-economic damage to the people could have been minimized. There should
have been no medical collapse, no hardships for healthcare workers, and the
lives of businesses and citizens could have been as usual, and
financial support should have been unnecessary. I am sorry that we wasted
life, money, labor and time.
- Irresponsible failure of government administration.
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- As I wrote above, government still keeps strict inspection requirements and the Returnee
Consultation Center for consult, where they refuse the acceptance of inspection mostly.
People with mild fever may or may not be infected, and if not infected, it may take
longer to identify other diseases and may become more serious. If they are infected,
they will go out and contribute to the spread of the infection, because they do not
know that they themselves are infected due to the rejection of examination by the
strict inspection requirements (= examination leakage = accelaration of infection).
Concomitantly, they feel guilty when they transfer the infection elsewhere. In addition,
they don't know if they are going from mild to serious, and they may finally suffer
from heavy pain.
- Without expanding the examination, the number of basic reproductions will be
about 1.5 or more, that is, the infection will continue to spread. Therefore, with
this two-sided operation, it is necessary to repeat self-restraint many times and
continue for a long time until achieving mass immunity. Or much worse is that this
accelaration may lead us to an overshoot of infection as many countries abroad
are suffering now.
In China, Taiwan, South Korea, etc., the examinations were enhanced, and before
reaching mass immunization, they succeeded in suppression of this disease. But our
government did not try to learn about such successes. The government keeps its
medical policy and has been exerting much and long time damage to the health/life
and socio-economics of the people. (Additionally, it's scary that the people seem
to follow it gracefully.)
- In the ideal case described above, the damage to the people would have been
minimal. On the other hand, it has been and will continue to reach a great deal of
damage. Do they have that awareness? I have repeatedly criticized the government's
inaction for "unnecessary intention". I think criminal, civil, and liability should be
questioned.
- Irresponsibility of media.
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- No news report addresses this strict inspection requirement. Wouldn't they even
read it on the MHLW site? They just commented that it was strange why the examination
did not proceed properly. The role of media should be to investigate that kind of
question by themselves.
- In addition, when this emergency was declared, they appealed to the citizens to
refrain from going out. They even state that people who act in violation of this
should be punished. They say that it would be better to have a forced city blockade
(lock-down) as seen in other countries. This is not democracy but a dictatorship,
I am afraid. There are many such outrageous commentators at this time.
(They are similar as many war co-operators who drove the nation to war during
the World War II. It is a kind of a fox borrowing the power of a tiger, by flattering
the power. I would like to cry out who they are!)
- An extreme example is as follow: He claims that this time is a kind of typical
democracy, where the hope of the people and municipalities has forced the government
to declare the emergency even if with a delay. I am afraid that there is a BIG
DIFFERENCE. The problem was that the government did not try to
examine the current infection status, did not open the data out to people, forced
people into deep anxiety about the spread of infection, and finally took advantage
of the anxieties to declare and to apply this special law having the power to
restrict private rights. This is the same trick as Nazi Germany used. The
difference from other countries is that the governments work hard to keep track of
the infection status, open those data, and then ask the cooperation of the people.
Japan is not giving out any information, but only fostering anxiety. It is
incitement politics itself coming out from populism.
Watching these commentators comment on the press shows, I became worried that
Japan will revert to wartime militarism.
Now it seems that we are suffering from big socio-economic damages. We did not have
to suffer; by simply removing the strict inspection requirements of the Ministry of
Health, Labor and Welfare and expanding examinations through walk-throughs, etc.,
we could have eliminated examination leakages, changed this accelaration to a
strong brake thanks to Japanese nationality, and stopped the spread of
infection, which should have lead to the reduction of the infection in Japan with a
mild self-restraint.
If self-restraint is near perfect, infection will be reduced. The people may
even cooperate toward this perfect self-restraint. But the damage should be enormous.
So far both governmental and metropolitan governmental parts who are in charge of
COVID-19 have not worked efficientlly and intelligently, which gave us such big
pains. With a little bit of more work and a little more effort, they could have
expanded the examination range. I am not saying that self-restraint is
not necessary. I think that the public and private sectors must do their best to
overcome the spread of the disease. But the public health has been left unchecked
due to the public sector's sabotage, and the life/health and socio-economic damage
of the people have become enormous. Is it tolerable? (Still prime minister and
metropolitan governor both insist on the self-restraint of Tokyo without paying
any effort to expand the examination range!)
Foreign media criticized the declaration of Japan's emergency situation as too
slow or too mild. But they do not know that the spread of infection is slow here
due to the fact that the number of basic reproductions is not so bad as 2.5
owing to the Japanese nature.
They claim that the infection status becomes similar as that in New York, but
it is merely a speculation because they do not understand well Japan's
circumstances. They should get such proper true information and then worry about
our situation. Please help us by claims based on the real true facts/situation of
us, not of your own.
The examination leakages now really seem to accelarate the speed of infection
spreading: Basic reproduction number is coming up from 1.2 to 2 to 2.3 thesedays,
inspite of the Japanese self-restraining nationality. This may be due to the
inevitable short distance contacts during works, traffics, or meetings even under
the emergency declaration; now many people avoid crowded places such as bars,
live houses, etc., but they still work and use crowded traffics. Therefore, we
may not be able to avoid the rise of the basic reproduction number to 2.5 as
observed in Italy when the real number of infected people increases more than
certain level, which may mean that we also have to experience an overshoot
like as in Wuhan, Italy, England, etc. And finally Tokyo lock-down?
But I am sorry specifically here in Japan that we do not have enough examination
system to know the infection status because our government has not yet established
the wide and early examination system (insisting on the medical policy in Japan).
The situation is on one hand an accelaration of infection spreading by the
examination leakage and on the other hand a strong brake by the emergency
declaration at the same time. Again I would cry "STUPID"! Please help us by
knowing this situation.