New coronavirus, how to tackle The case of Hokkaido, Japan (A)

Japan was suffered this crisis earlier than other countries besides China. Therefore I would like to share with you our experience and countermeasures to this virus. I hope they would help you to make strategies to cope with this problem.

Data source: Hokkaido government website: http://www.pref.hokkaido.lg.jp/hf/kth/kak/hasseijoukyou.htm

The case of Hokkaido

Hokkaido is the most infected prefecture in Japan. 157 people were infected, 6 people dead(3.8%) and 73 patients have already recovered (recover rate is 46%) as of Mar 19, 2020. One of the reasons is that there are a lot of tourists, especially from China. The graph above shows the daily number of patients infected with the virus.

The first patient was found in Sapporo, the capital of Hokkaido on Jan 28th. She was a tourist from Wuhan, China. After this case, there was a snow festival in Sapporo. This is the largest event in Hokkaido. There are more than 200, 000 visitors every year including foreign tourists. After the festival, the number of patients has increased and the Hokkaido government recognized some of them infected in the office of the snow festival. Around one week later, the patient number is dramatically increased. Therefore the governor of Hokkaido had an emergency meeting with experts. On the 28th of February, He did an “emergency declaration” of COVID-19. He asked the citizen of Hokkaido not to go out except for any emergency reasons. Also, he asked all schools to close temporarily to avoid the spread of the virus. After these measures, the trend of the patient increase was gradual. This declaration has good for around three weeks. During this time period, we could increase the number of hospitals can treat with the disease and also increase the number of beds from 100 to 200 for the patients in serious condition with this virus.

Learnings from the experience

From this experience, we learned how to tackle this epidemic. I want to share it with you at some points.

How to delay the peak of the outbreak

Due to the emergency declaration by the governor, the citizens tried to stay in their homes. As a result, hospitals could have some time to prepare the system and the capacity to deal with this case. Therefore we can avoid the panic situation in medical institutions.

Adapt the triage system

If you do not have a sufficient number of hospitals to deal with this new virus, it better to do the triage system. It is better to prioritize the patients depend on the severity of their condition. The hospitals accept only emergency patients. The waiting time in the hospital will be the risk of the spread infection.

Three conditions to emerge corona cluster

One of the factors to increase the number of patients is the cluster formation. The following is the three conditions to make the cluster of patients;

Source: Ministry of health and welfare Japan https://www.mhlw.go.jp/content/10900000/000608425.pdf

In Sapporo, there was a cluster case that occurred in a live bar. 19 people were infected there. The cluster means that one infected person transmitted multiple persons. Besides Hokkaido, in other prefectures also there are some cluster cases in live houses. Therefore the point of avoiding the rapid increase in the number of patients is how to minimize basic reproduction number, the average number of secondary infections generated by one infectious individual. So the ministry of health recommend to take the following actions;

  • Do not go to the places which satisfy the above three conditions such as live houses, sports gyms, exhibitions and so on.
  • Ensure adequate ventilation
  • Reduce the density of people
  • Avoid conversations and vocalization in the close proximity (use face mask)

How to make masks

Waring mask is good etiquette and avoids the spread, however, I imagine you can not obtain them easily in this situation. I found some information to make masks by your self.

The link of DIY mask (in English)

Enhance your immune system

Also, probiotics and prebiotics are effective to enhance your immune system. So eat vegetables which will be feeds of good microorganisms and eat yogurt after the meals (take good microorganisms such as lactic acid bacterias)

Reliable online learning source of COVID-19

Imperial College of London is providing an online course with updated information about this virus on Coursera, one of the learning platforms by leading universities all over the world.

Science Matters: Let’s Talk About COVID-19

Regarding the recent data and analysis, we do not have enough samples date statistically significant in Japan. Let us share with you the website of CDC(Center for Disease Control and Prevention) of the US. It is better to check periodically to obtain the latest information.

18 thoughts on “New coronavirus, how to tackle The case of Hokkaido, Japan (A)”

  1. Hello Mr Tsuboi
    It’s great to hear from you again. I hope you are well protected and that all our colleagues at JICA Obihiro and the Insight Mangement team are safe from this Covid Pandemic19.

    Thank you very much for sharing and the precious advice. Currently there are 58 cases of coronavirus in Morocco, including 2 cases of death.

    As with Hokkaido, Morocco’s proximity to Europe and the large flow of tourist and trade exchanges with this continent meant that the first cases of covid19 were imported from Europe to our country.

    May God assist us all to thwart this pandemic and to remain constantly cautious.
    Greetings

    Abdelhadi SBIA/Morocco

    1. Hi Sbia-san,

      Thank you for your comment and information in your country.
      This is a real management issue. We are managing effectively so far.
      Let’s manage external factors with creativity and get resilience.
      May God be with you,

  2. Thank you so much. We thank God you are doing well and safe. So did most people recover in your country?

    1. Hi, Thank you for your comment.
      73 patients have already recovered. The death rate is around 3% in our case.
      I revised my article to add the above information.

  3. Hi,

    It is great pleasure to hear from you and do belief that you are all doing well.

    I wish to sincerely appreciate for sharing your Japanese experience and advice to us on the Corona virus COVID-19 pandemic. In Kenya we have 7 confirmed cases all imported.

    Our Government is doing whatever possible to management the pandemic. We are praying for God’s protection from it.

    Thank you . Be blessed

  4. Thank you very much Mr.Shin for your valuable advises.

    Here in Ethiopia, 4 people are infected and death is not recorded yet. The triage system is very crucial and the community is attempting to act accordingly.

    May God Bless the whole world!

  5. Hi, Mr Tsuboi san,
    I hope you and all your familly are fine. Even the family of JICA.
    Thank you for all information you have shared with us. It is very important to take all précautions you have sent to limit propagation of covid 19 in our country. Thank you a lot.
    God bless you all.
    Nesrine Charef San.
    From ALGERIA.

    1. The algerian government obsrved that some people don’t respect the lockdown measures and they don’t stay home, the raison of the raise of death and affected persons .
      Implementing taxes to people outside home does not work much.
      Recently, We have spent one month fasting called month of Ramadhan. Normally in this month, people pray in mosque and then they meet at night for soiree to eat cakes and help poor persons .After this month fasting , precisely, before yesterday, it was religious holidays when people , normally finish fasting and go visiting familly, neihbours to demand pardon if they made mistakes for them and share with them cakes. They give also money and clothes for poor persons.
      In this situation, governement imposed some measures such as:
      – wearing masks became mondatory.
      – take the vehicules circulating during the lockdown hours to the pound with payement of taxes.
      -imposing taxes for people walking on streets during lockdown hours.
      – sensitization of people throught the IMAM of mosque who says that when people don’t respect the lockdown , they are considered as killers and killing innocent persons is not accepted in Islam, because these people can transfer virus to other people and cause intentionally, their death.

  6. Hello Mr. Tsuboi, it is a pleasure to have news from you. Thanks for your advices that will help us to tackle this sickness, Here in Perú, there are 263 infected people and 4 people dead, fortunately in the Region I live there are not infected people at the moment, the government ordered not to go out from our houses. I hope to pass this situation as soon as it’s posible and without complications.

    God bless you all
    Javier Perinango Gaitán
    Cajamarca – Perú

    1. Hola, Javier-san,
      Gracias por su commentario.
      We relieved you and your family are safe.
      Please collaborate with the community and manage this situation.

      Cheers,

  7. Good evening Shinichi-san from Bosnia!!!

    Even if its not so good evening.

    First, I would like to say thank you very much once again on your kindly advice, even this is not so nice topic.

    Anyway, here in Europe is very very hard situation. In my country, Bosnia, also. As you already know in Italy is so bad situation, that Europe didn’t see for decades.
    Bosnia is so closely connected with Italy, Slovenia and Croatia, like borders as don’t even exists, and lot of our people working in these countries, as well as in Austria and Germany.
    So our governments didn’t pay attention so much on travelling and now we have situation that we are all in lockdown.
    Because, when this starts in Europe, lot of people start return to their homes. Already sick. Lot of them, like in Italy went by themselves in hospitals, with lot of old people. And virus enter in hospitals. That was biggest problem. Bosnia today have 90 cases.
    Here in my region, we have 5 cases and lot of self-isolation.
    And unfortunatly, today one woman died in my city. Her son bring virus from Germany 3 weeks ago.
    Bosnia is now in State of Emergency , everything is closed, schools, gyms, cinemas, caffe bars, restaurants, playgrounds, parks, everything which represents normal life. We have campaign “Stay home”. From today we have police hours from 6 pm till 5 am, we have Army on borders for carantine.
    But as you already know, Bosnia is poor, so we don’t have enough tests for virus. So lot of our people are in self isolation on 14 days, and only if you show symptoms and was with known transmitter, hospital will do the test. Further problem is lack of respirators in hospital, or on a beginning lack of face masks. Lot of bad people tried to make profit on masks. Now, we also have people who made this kind of mask from cotton. But, I must say that this mask on video is much prettier.
    I want everybody who read this to know that despite all this measures, specially because our countries are poor, if people don’t figure that this virus is serious problem to society and future economy, and that only if they make social distance and wear protection, soon their environment will face this like in Europe. EU didn’t take this serious on time.
    Please dear friends be careful and stay safe!!!
    Doviđenja from Bihac!

    1. Hi Mirela-san,
      Thank you for your information and sorry about the situation.
      The suburb areas in Japan also do not have enough hospital and test equipment including Hokkaido.
      “Problem is solution”. Management is how to allocate limited resources effectively.
      Let’s use our creativity and tackle this case. The triage system is helpful.
      According to the case in the US, the fatality age range is roughly more than 65 years old.
      https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm#F2_down
      Therefore, It better to prioritize the elderly people to check in hospitals.
      CDC(Center for Disease Control and Prevention) is offering reliable information. I revise my article and put that link.
      Let’s stay determined.
      Better management for a better world.

  8. Greetings from Mongolia,

    As of Mongolia, we have now 10 confirmed cases of this virus, all imported from Europe. The government of Mongolia is taking all measures no to spread it. All patients were isolated straight from the plane, that arrived from Europe. We were under the quarantine from the end of January up until now, and the quarantine is prolonged until April 30.
    I’m wishing you and all JICA alumni to stay safe at your homes, wear your masks if you go out for some good reason outside, wash your hands properly, eat quality food to support your immune system and be always positive!!!!

  9. Hi Shinichi San
    Thank you for sharing precise information to avoid Covid 19. Now Nepal is in lockdown stage. we are in home. we follow yours suggestions and experience to cope COVID 19. Stay safe and take care.

  10. Tsuboi san,
    I aware about your country but I did not think the situation of Hokaido, but COVID attacked your area you can recovered in very soon and thriplle gems (budda, damma, sanga) with you.
    In Sri Lanka situation, it is growing smoothly now 102 infected fortunately no any deaths. at present day temperature of the country more than 30 hence spreading is low. but we could not expect so in next days. how ever, quarantine practices we implemented, airport closed, some districts were closed, essential goods are dilevering to doorsteps, etc…
    thankyou about your information,
    stay and safe and take care.

    1. Hi Kanchana-san,
      Thank you for your kind words.
      We are managing it well in Hokkaido.
      But the situation in Tokyo is getting worse.
      We hope you, your family and your country would manage this situation well.

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