Japan rolls out policies aimed at containing mass infection

The health ministry on Tuesday rolled out a basic set of policies on handling COVID-19 infections as the government tries desperately to curb the spread of the disease within the limited window available.

The move came amid apprehension over the growing spike in domestic cases and their deepening severity, with reports emerging Tuesday of the fourth fatality among those previously aboard the Diamond Princess cruise ship.

The nation’s total tally of infected people has risen day by day, widening as of Tuesday to 17 prefectures.

By the evening, a host of cities had reported cases, including five in Hokkaido, three in Nagoya and one each in Kumamoto, Sapporo and Nagano — the first in Nagano Prefecture.

A Japanese man in his 80s died at a hospital due to the new coronavirus, according to a government source, marking the fourth death linked to the Diamond Princess.

Tuesday’s developments brought the total number of confirmed cases in Japan to 861, of which 709 are related to the quarantined cruise ship.

The professional soccer J-League on Tuesday postponed all matches until March 15 due to fears over the outbreak.

Advertising giant Dentsu Inc. said a male employee in his 50s working at its headquarters in Tokyo was infected with the virus and told all of the roughly 5,000 employees there to work from home in principle.

“At this point, we are at a crucial moment in preventing the escalation of mass infection,” Chief Cabinet Secretary Yoshihide Suga said. “To have absolute and effective infection prevention measures and to curtail the speed of any increase in patients are critically important for containing prevalence (of the disease).”

In principle, the policies officially unveiled Tuesday follow the health ministry’s previous guidelines for stopping the virus from spreading: avoid overwhelming hospitals and prioritize treatment for those who are at risk of developing serious pneumonia.

Those with mild cold-like symptoms are pressed to stay in their homes and refrain from visiting hospitals, to stamp out a possibility of mass infection and protect those who are most vulnerable — the elderly and people with pre-existing conditions.

If the elderly and people with pre-existing conditions don’t have cold-like symptoms but need a prescription, they will be able to get one by talking to a doctor over the phone, according to the guidelines.

Kazuhiro Tateda, director of the Japanese Association for Infectious Diseases, believes the government’s instructions incorporate the lessons learned from the H1N1 influenza outbreak in 2009, which prompted clinics and hospitals to prepare for treating patients with infectious diseases.

Under the basic set of policies, the government will also advise all people to stay away from large gatherings, and tell those in areas where there has been an uptick in cases to stay inside their homes. In those places, hospitals that are not designated as accommodating patients with infectious diseases will, nonetheless, be asked to take in possible COVID-19 cases.

Koji Wada, a professor of public health at the International University of Health and Welfare in Tokyo, said calls for the public to self-quarantine are necessary in areas with a sizable cluster of coronavirus infections, such as Hokkaido or Aichi Prefecture.

The government has already encouraged people to wash their hands and cover their mouth as well as their nose when sneezing. The elderly and people with pre-existing conditions had already been advised to avoid crowded areas.

Even though it is not thought that the virus can be transmitted through the air, there is a risk of infection if many people are talking in close proximity within a confined space, even without coughs or sneezes.

The government has not issued a nationwide standard for canceling events, but has asked event sponsors to consider whether they are necessary. In areas with an increasing number of patients, though, health minister Katsunobu Kato said the government would urge them to exercise restraint.

The policy reflects a rapidly evolving situation in which a growing number of people in Japan with no travel history to China, where the recent strain is thought to have originated, have become infected with the virus and experienced respiratory illnesses. It also comes after the central government was rebuked by some for what they described as its slow and inept initial responses to the virus outbreak.

Kato said the public health insurance system will cover the cost of carrying out COVID-19 testing and that 28 people who disembarked the Diamond Princess were showing symptoms such as fever.

“We are trying to stop one group of patients from creating another group of patients,” Kato said at a news conference Tuesday afternoon.

Pointing out there are “clusters of coronavirus patients” appearing in the country with no apparent infection routes, Prime Minister Shinzo Abe stressed that the government will step up its support to those areas in order to contain the virus and prevent it from spreading further.

The government, Abe added, will promote the adoption of telecommuting, encourage staggering commuting hours and ensure that workers with cold-like symptoms can take sick leave.

On Monday, the government convened its third meeting of infectious disease experts. The experts warned that the response in the next one to two weeks will determine whether the novel virus will spread further in Japan — possibly on a mass scale — or be contained.

But some experts are worried that the threat will remain.

“Even if Japan gets through the next two weeks without a major epidemic, that does not necessarily mean the threat will have passed. The following two weeks may be just as critical,” Paul Hunter, a professor of health protection at the University of East Anglia in Norwich, England, said in an email to The Japan Times.

“I do not think we will get on top of this epidemic any time soon and I suspect the epidemic will continue through most of this year and possible into the next.”

Countries elsewhere that have been hit by the pneumonia-causing strain, such as Italy and South Korea, have taken drastic measures, including shutting down schools, businesses and large conferences.

In the United States, the Centers for Disease Control and Prevention reported that 18 more Americans who had been aboard the Diamond Princess and returned there have since tested positive.

Also Tuesday, Suga doubled down on comments by the health ministry that it would not conduct COVID-19 tests on quarantine officers that had been aboard the Diamond Princess, with the justification that they “have sufficient knowledge regarding infection prevention” to prevent themselves from exposure. Two quarantine officers that had boarded the vessel are known to have become infected.

There is worldwide unease over the virus, particularly following jumps in the number of cases in South Korea, Italy and Iran and a global stock market rout. The government is ready to mobilize any necessary economic measures “without hesitation,” Suga said.

The Foreign Ministry has issued an advisory for the South Korean city of Daegu and North Gyeongsang province, advising would-be travelers to call off nonurgent and nonessential trips.

Staff writer Magdalena Osumi, Kyodo and Enzo DeGregorio contributed to this report