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The pace of growth in the number of coronavirus patients with severe symptoms in Tokyo is accelerating, an infectious disease expert said Thursday.

The number of severely ill COVID-19 patients who need a ventilator or an extracorporeal membrane oxygenation (ECMO) system in the capital rose to 36 as of Thursday, up from 21 on Aug. 13. Such cases had been hovering around 20 since late July.

“Severe cases increase about 14 days after a rise in infections,” said Norio Omagari, head of the Disease Control and Prevention Center at the National Center for Global Health and Medicine.

“If the current situation continues, the number of severely ill cases won’t decline,” Omagari said at a meeting of the metropolitan government.

The metropolitan government has secured 2,500 beds for coronavirus patients, including 150 for those with severe symptoms.

Transmissions from people living together made up the largest proportion of coronavirus cases confirmed in the seven days through Monday, at 40.9 percent of the total. The figure rose 11.8 percentage points from the previous week.

Tokyo Gov. Yuriko Koike told the meeting that residents should wash and sanitize their hands soon after returning home and refrain from sharing everyday items among family members.

Omagari’s remarks came after it emerged there is a gap in who the central and Tokyo governments deem to be seriously ill COVID-19 patients.

The metropolitan government said Wednesday that it does not regard COVID-19 patients in intensive care units as severe patients unless they are using a ventilator or other equipment. By contrast, the state government regards all infected people treated in ICUs as severe patients.

The metropolitan government wants to grasp the infection situation more accurately, as ICUs sometimes host patients who are not seriously ill, an official said.

On Wednesday, Koike called for understanding of her government’s definition of severe COVID-19 patients, saying that it is being employed strategically.

On April 26, the health ministry asked municipalities to report the number of people infected with the new coronavirus. It said severe COVID-19 patients are either in an ICU or using an artificial respirator or ECMO machine.

Tokyo Gov. Yuriko Koike speaks at the Tokyo Metropolitan Government's COVID-19 monitoring meeting on Thursday. | KYODO
Tokyo Gov. Yuriko Koike speaks at the Tokyo Metropolitan Government’s COVID-19 monitoring meeting on Thursday. | KYODO

But the metropolitan government started applying its own definition on April 27, partly following advice by experts.

The metropolitan government said Wednesday it plans to report the number of severely ill patients in accordance with the ministry’s definition, while continuing to also release the numbers under its own criteria and use them for its monitoring meetings.

On Wednesday, Tokyo reported 186 new cases, almost the same as 187 for Osaka Prefecture. But the number of patients with severe symptoms in Tokyo as of Wednesday was 32, much lower than the 60 in Osaka. The metropolitan government said the number would be around 40 if the ministry’s criteria is applied.

Meanwhile, Kazuhiro Tateda, head of the Japanese Association for Infectious Diseases, said Wednesday that Japan is in the midst of the second wave of coronavirus infections.

The pace of increase in the number of new cases in Tokyo and across the country has slowed and the peak appears to have passed, Tateda said at a three-day meeting of the association held in Tokyo.

“But we need to pay attention to whether the number will fall or rise again,” he said.

Tateda said there have been fewer deaths in the second wave than in the first in spring, apparently because of a smaller percentage of cases in elderly people and progress in treatment.

In a speech at the gathering Thursday, Tohoku University Professor Hitoshi Oshitani, a member of a health ministry panel of experts on COVID-19 measures, said the number of new coronavirus cases may have hit a peak in many parts of Japan between late July and early August.

An analysis by Oshitani and others on the number of COVID-19 patients according to the dates they developed the disease found that new infections tended to decrease after peaking between late July and early August in many regions across the country.

The trend is believed to have stemmed from people’s efforts to change their behaviors and infection prevention measures that were enhanced at locations with high infection risks, according to the professor.

But Oshitani also pointed to the possibility of a resurgence of new coronavirus cases in Japan in the future, saying, “We need to carefully watch developments.”

Noting that there are continuous reports of deaths of COVID-19 patients, the professor called on elderly people to stay especially alert, as their symptoms tend to become severe once they contract the disease.

In the long run, the country will likely see repeated waves of infections, Oshitani said.

Giving a speech at the same gathering, Shigeru Omi, head of a government subcommittee on COVID-19 measures, also said he thinks infection cases in Japan have reached a peak. At the same time, he said people should brace for a renewed spread of the virus.

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