Something is happening with the corona virus numbers, most notably in Tokyo but also nationally. There are big jumps in the numbers and, it seems, some long-overdue changes to testing. Unfortunately there's still not a lot of transparency so everything is deduced from random quotes and reports here and there and then trying to read meaning into that. If you want to know what real transparency looks like, check out the Korean CDC[1], they have an FAQ and their daily reports describe all of the active clusters and tell you which clusters are still producing cases. I don't believe there is a Japanese equivalent to either for Japan (in Japanese or in English).
Things that have changed recently:
- Testing is largely being done by private labs now (the beige), with the public health centres being a fairly small portion now (the reddish). Graph [8]
- For Tokyo, the percentage of infections from unknown sources has been over 40% and even over 50% for weeks, although the 7-day avg is dropping rapidly, presumably a result of a small number of clubs providing a large number of cases. Graph [5]
- After 2-3 weeks of flatness, PCR positive numbers have started to spike up. The 7 day avg [2] is currently 165, up from 75 a week ago and 62 a week before that.
- Testing numbers are up having almost doubled from 3 weeks ago, to 5000-6000/day and apparently a desire for many more.
- Governor Koike says the spike is due to testing[9].
- There are several reports [3] that the contact tracers are now testing all contacts whereas before they would only test and isolate people with symptoms (anecdote from months ago, 2 bar staff test positive, one lives with the bar owner, they didn't test the owner because they had no symptoms).
- Shinjuku-ku will give you 100,000JPY (~1000USD) if you are found to be positive in recognition that you will need to stop working etc.[10]
- In Tokyo they are aggressively testing host bars and finding a ton of young male hosts who are positive. It's unclear if/why they are not testing hostesses. I've heard their clubs are not cooperating. Apparently the customers of host clubs are often hostesses whereas the customers of hostess clubs are businessmen[10]. On some days, I think, more than half of the cases announced were from clubs.
- The age profile of the positive cases is way younger than before. Consistent with detection of mild and asymptomatic cases and also hosts.
- The number of people hospitalised [4] had been dropping rapidly since early May. The number in ICU was also dropping. They started dropping around the same time. Hospitalised has been rising for about 2 weeks and ICU was still dropping until today.
- The head of the LDP's corona virus panel laid out some good stuff on what needs to be done, a refreshing change from the self-congratulation and mission accomplished nonsense. Including saying that previously testing was rationed due to lack of resources.
- They have started issuing alerts through the contact tracing app [6]
- The expert panel has been disbanded and will be replaced by a new panel. This is a mixed bag. It seems they conflicted with the politicians. It's very hard to know who was to blame for the previous bad testing policies. The new panel retains some of the old panel. It's also got Shinya Yamanaka a Nobel laureate who has been vocally critical about the lack of testing. This is a great sign but might also just be a good way to shut him up. Who knows...
As well as the links to the spreadsheet of the national stats, the Tokyo site [5] has a lot of the same numbers with nice graphs but Tokyo-specific.
So what does this all add up to?
It does seem pretty clear that testing policy has changed and we are finally looking for the asymptomatic cases and Shinjuku-ku are even offering a bounty. That bounty should be national policy, not something we have to wait for 23 wards and 47 other kens to implement. Maybe 40% of cases have no symptoms but can still spread. Catching them with contact tracing could be the difference between growing and shrinking case numbers. Wakayama did exactly that back in March [7] but at the time it had to defy policy. Maybe finally policy has caught up to them.
I have read recent stories in forums from people who are properly sick and still cannot get tested but if you are willing to pay for it, I believe testing is quite available. It's extremely short-sighted to put any barriers to testing people who have symptoms or are backed up by a request from a doctor. Hopefully the enthusiasm for more testing will spread. It would be really nice to see a strong, clear national policy that allowed any doctor get someone tested without charge. I suspect that the free testing at the public health centres is going to remain slow, manual and tightly rationed.
This part is total speculation. The spike in positives seems likely to be a mix of aggressive testing and some real growth. I feel like the jump is so sudden and large that it is more about testing than growth but that I might be doing some wishful thinking. The continued unlockdowning might also be a significant factor.
If my hope is correct, then we have a few weeks of continued rising numbers as we find more and more of the clusters that are already out there. The number of cases out there will not be growing rapidly, just the number that we are confirming. Now, for every cluster, we will find twice or three times as many infected people as before. Keep an eye on the number of people in ICUs and deaths. That lags by a few weeks but is much less impacted by PCR testing policy. If it stays low then the spike in numbers is coming from better testing.
Even if the new testing policy leads to control instead of growth, it would be great to kick-start the clean-up by mass-testing a few other at-risk industries, hostesses, massage, nail & hair, health, retail.
The alternative is that not that much has changed, Koike is demonising the night-entertainment industry because it's convenient [10] and we are all due for a another cycle of growth and lockdown (maybe locking down over Obon in August but I doubt we'll make it that far if it's really happening again).
I think both scenarios fit with the information and it's too early to tell which one is real. It would be awesome if Tokyo followed through on the poop studies [8]. It seems like waste water is able to give us almost real-time information on the infection levels in a city but until then I'll keep reading the tea-leaves - apparently floaters are good luck :)
1 https://www.cdc.go.kr/board/board.es?mid=&bid=0030
2 https://docs.google.com/spreadsheets/d/1t-EDGaXP5ehDgvPLOyLlESONMzFTFlZ-y5vrOs9nvVk/edit#gid=162562862
3 https://twitter.com/fergal_whatever/status/1278979040213262336
4 https://docs.google.com/spreadsheets/d/1t-EDGaXP5ehDgvPLOyLlESONMzFTFlZ-y5vrOs9nvVk/edit#gid=38005457
5 https://stopcovid19.metro.tokyo.lg.jp/en/
6 https://www.japantimes.co.jp/news/2020/07/03/national/japan-infection-codes-coronavirus-app/#.XwAPWnUzZhE
7 https://www.washingtonpost.com/world/asia_pacific/japan-coronavirus-wakayama/2020/03/22/02da83bc-65f5-11ea-8a8e-5c5336b32760_story.html
8 https://www.mhlw.go.jp/stf/covid-19/kokunainohasseijoukyou.html
9 https://www.japantimes.co.jp/news/2020/06/15/national/tokyo-47-covid-19-cases/
10 https://asiatimes.com/2020/07/tokyo-host-bars-take-the-heat-for-covid-revival/
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