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Updates onCOVID-19 in Japan

June 25th, 2020

Ministry of Health, Labour and Welfare

Today’s points

1. Epidemiological Update

2. Future policy for COVID-19 control

3. COVID-19 Contact-Confirming Application (COCOA)

4. Antibody Test Results

5. Pharmaceutical Approval for Reagents for Novel Coronavirus Antigen Testing (quantitative)

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1. Epidemiological Update

• The cumulative number of infections is 18,110. (0AM, June 25th )

• The trend in the number of new infections is certainly slowing down.

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Confirmed cases in JapanAs of 0AM, Jun 25, 2020

The number in parentheses indicates the change from the previous day.

PCR testedPCR tested

Positive

Need Inpatienttreatment

Dischargeor

end ofmedical

treatment

DeathUnder

Confirmation

Critically lll

Domestic cases

(excludingreturnees by

Charteredflights)

365,927（+4,979）

17,802 （+89）

713（+15）

58（-2）

16,116（＋58）

967（＋4）

10（+2）

Airportquarantine

68,739（+1,035）

293(+7)

103(+7)

0 1891

(+1)0

Returnees by chartered

flights829 15 0 0 15 0 0

Total435,495 （+6,014）

18,110（+96）

816（+22）

58（-2）

16,320（＋58）

968（＋5）

10（+2）

4

224

253

337

370

386

270

377

550572

708

676

571

333

511

511

596575

590

372

365

374

450445

451

374

221

189

284

227

199

266

302

204

177

120106

96

89

108

6850

80

54

100

5257

3030

3138

4331

2940

20

2737

61 64463236

51

2645

414532

223036

40

57

43

6260

4243

68

54

65

49

4053

89

0

100

200

300

400

500

600

700

800

23-Jan 30-Jan 6-Feb 13-Feb 20-Feb 27-Feb 5-Mar 12-Mar 19-Mar 26-Mar 2-Apr 9-Apr 16-Apr 23-Apr 30-Apr 7-May 14-May 21-May 28-May 4-Jun 11-Jun 18-Jun5

The trend of No. of confirmed cases

As of ０AM, June 25, 2020

Cumulative No. of confirmed cases: 18,110Cumulative No. of death cases: 968

1022762

744

16031147

655

50589213691373

14891016

6291143

1587

1411

1551

1970

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5661266

2021

1870

1746

1575

1565

643

11161811

1786

18141462

882

845

14372278

1915

2145

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2191

32394073

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512057985966

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5330

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8029

8184

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4621

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6978

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6669

7628

7502

7192

7255

6022

2509

4383

5261

0

5000

10000

15000

20000

25000

30000

35000

2/18 2/25 3/3 3/10 3/17 3/24 3/31 4/7 4/14 4/21 4/28 5/5 5/12 5/19 5/26 6/2 6/9 6/16 6/23

Teste

d c

ases／

per

day

Test capacity Tested cases

〇 Capacity to conduct PCR tests for novel corona virus has been increasing.〇 As of now, more PCR test capacity is secured than the actual number of conducted tests.

Total number of tested cases: 632,744 (2/18-6/23)

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Novel Corona Virus Test: Capacity and the number of cases tested per day

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PCR Test Positive Rate and Number of PCR Tests Conducted in Tokyo

PCR Test Positive Rate: 2.1% (as of June 23).

PCR Test Positive RateTotal number of people testing positiveTotal number of people testing negative

Source: “Tokyo COVID-19 Information（As of June 24), prepared by Tokyo Metropolitan Government

2,500

2,000

1,500

1,000

500

0

2. Future policy for COVID-19 control

• For behavior modification, switch to a "new lifestyle“

• For efficient counter-cluster measures, enhance the capacity of counter-cluster measures

• For medical system, increase the capacity

• For development of treatment, expedite the research and process

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- In regions where the number of new infections is limited, the "request for thorough behavior modification" will be

relaxed, and a "new lifestyle" will be popularized and continued. If another outbreak does occur, a "request for

thorough behavior modification" will be made (while considering the following points).

The following points are required in the "new lifestyle"

- Securing the 3Cs, physical distance and basic measures to prevent infection (e.g. wearing masks, washing hands).

- Establishing guidelines for business operation based on the framework presented by the expert meeting.

for behavior modification

- Full support for public health centers.

- Early implementation of contact tracing by utilizing ICT.

for efficient counter-cluster measures

- Develop systems for better coordination to share functions among medical institutions and secure lodging facilities,

etc.

- Establish a system that can respond to a sudden increase in infections.

- Visualize the situations of delivering medical care in each prefecture.

- Expand the capacity of PCR and other tests.

for medical system

- Treatment methods, medications, vaccines, and severity markers.

- Early diagnosis and treatments by rapid diagnostic test kits to prevent severe symptoms.

for development of treatment, etc.

Switch to a "new lifestyle"

Increase the capacity

Enhance the capacity of

counter-cluster measures

Expedite the process

- Schools:, it is important to secure learning opportunities by restarting school activities while reducing risks. - Parks： it is also necessary to consider how to manage parks.

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Future policy for novel coronavirus disease control

Regions where the number

of new infections is limited

Regions where the

infection situation

is severe

- Until (i) there is a prospect for preventing severe symptoms with early diagnosis and development of treatment

methods, or (ii) effective vaccination is developed, it is necessary to prioritize preventing the spread of infections

while balancing this with socio-economic activities.

- In regions where infections are limited and necessary medical care is secured, counter-infection measures can be

relaxed to a certain degree, transition to a "new lifestyle" designed to prevent the spread of infections will be

promoted, and the appearance of new infections will be controlled to a certain level with efficient counter-

cluster measures. At the same time, it will be pursued to enhance the capacity of medical care systems. If

infections begin to spread once again, a "request for thorough behavior modification" will be made.

Num

ber o

f new

infe

ctio

ns

"New lifestyle"

Prevent spread of infections

by popularizing and continuing a "new lifestyle"

Regions where the infection

situation is severeRegions where the number of new infections is limited

：Number of future infections (projection)Time

Request for

thorough behavior

modificationDevelopment of

treatment methods

from early diagnosis,

to prevention of

severe symptoms

Development of

vaccines

"New lifestyle"

Rapidly reduce the number of new

infections by request for thorough

behavior modification

Strict measures

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Outlook for novel coronavirus disease control (projection)

：Number of infections if no measures are taken (projection)

Ministry of Health, Labour and Welfare

COVID-19 Contact-Confirming Application

MHLW website

Install the contact-confirming application to protect yourself, your loved ones, your community and society as a whole.

The contact-confirming application is a smartphone app that enables you to receive notifications about the possibility of contact with someone infected with the novel coronavirus.

○This app uses the short-range communication

function (Bluetooth) on smartphones upon user approval to receive notifications about the possibility of contact with a person who has tested positive for the novel coronavirus, while ensuring anonymity for your privacy.

○Users can receive support, such as testing from a

public health center, sooner, by knowing that they might have been in contact with someone who has tested positive. The more users, the more effective it will be in preventing the spread of infection.

Possibility of contact within 1 meter for 15 minutes or more

・Contact records will be managed in the device only and do not leave

the device.

・Where, when, and with whom there was contact will not be known by

either side.

*Information about the contact (random codes) is recorded within the device only.

*Records are disabled after 14 days.

*Contact information, location information and other information that could identify the individual are not recorded.

*Information is not recorded when Bluetooth is turned off.

Request to install the COVID-19 Contact-Confirming Application

*screen image

Office for Novel Coronavirus Disease ControlNational Strategy Office of Information and Communication Technology

CabinetSecretariat

iPhone users Android users For details:

（Abbreviation: COCOA）

3. COVID-19

Contact-Confirming

Application

(COCOA)

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Q1 What is a contact-confirming application?

It is an application using the short-range communication function (Bluetooth) on smartphones, upon userapproval, to receive notifications about the possibility of contact with a person who has tested positive for thenovel coronavirus, while ensuring anonymity for privacy. This app has been developed based on applicationprogramming interfaces (APIs) offered by Apple and Google.

Q2 What are the benefits of using the app?

Users can receive support, such as testing from a public health center, sooner, by knowing they might have beenin contact with someone who has tested positive. The more users, the more effective it will be in preventing thespread of infection.

Q3 How is contact with other users recorded?

The short-range communication function (Bluetooth) on smartphones is used to detect proximity to other smartphones (within approximately 1 meter for 15 minutes or more) as contact. Information on close contact is encrypted and recorded only in the user's smartphone, and is automatically disabled after 14 days. The record does not leave the device and the user can delete the record at will any time by deleting the app.

When the smartphone you are using is close to someone else's, within approximately 1 meter for 15 minutes ormore, it is highly likely to be detected as close contact. Depending on conditions such as the performance of yourdevice, the surrounding environment (glass windows, thin walls, etc.), or the direction in which the device is held,distance and time might be measured differently. Accuracy is not guaranteed.

Q4 Is it possible that personal information may be collected?

You are not asked to enter your name, phone number, e-mail address or other information that could identify you.Information on close contact with other smartphones is encrypted and recorded only in your smartphone, and isautomatically disabled after 14 days. Administrative agencies or third parties will not use or collect contact recordsor personal information.

Q5 Is location information used?

Location information such as GPS is neither used nor recorded.

Q6 Is there criteria for detecting contact with other users?

Q8 What kind of notifications will I receive with the app?

When a person who has tested positive for the novel coronavirus, upon agreement, registers that he/she testedpositive, you will be notified if there is a possibility that you were in close contact—within approximately 1 meterfor 15 minutes or more—with that person in the last 14 days. Once you receive the notice, if you select your owncondition, contact information for the Outpatient Services for Returnees and Contact Persons, etc. will appear,providing guidance for care such as testing.

Q9 Will I receive a notification immediately when a person who has tested positive for thenovel coronavirus registers on the app?

Notifications to users are sent about once a day. Depending on when the app registered the contact, you may notreceive a notification immediately. By selecting "Turn notifications ON" in the app's settings, a notification messagewill appear on the screen if and when one arrives.

Q10 What happens if I do not register on the app despite testing positive for the novelcoronavirus?

If you test positive, registration on the app is voluntary, based on the user's consent. By registering, people who may have been in contact with you can receive support, such as testing from a public health center, sooner.

Q11 What should I do if I receive a notification that I may have been in contact with aperson who tested positive?

Follow the instructions displayed on the app screen and select your condition. Contact information for the Outpatient Services for Returnees and Contact Persons, etc. will appear, and guidance for care such as testing will be provided.

Q12 What will the Ministry of Health, Labour and Welfare use the information obtainedfrom the app for?

The Ministry of Health, Labour and Welfare will not use or collect user data from the app. We also do not ask users to enter their name, phone number or other personal information.

Q7 Can I stop using it at any time?

You can stop using the app at will any time. All records from the last 14 days can be removed by deleting the app.

COVID-19 Contact-Confirming Application: Q&A for users

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4. Antibody Test Results

Test results

Abbott (+) Abbott (-) Total

Roche (+) 2 (0.10%) 4 (0.20%) 6 (0.30%)

Roche (-) 2 (0.10%) 1,963 (99.59%) 1,965 (99.70%)

Total 4 (0.20%) 1,967 (99.80%) 1,971

Abbott (+) Abbott (-) Total

Roche (+) 5 (0.17%) 5 (0.17%) 10 (0.34%)

Roche (-) 11 (0.37%) 2,949 (99.3%) 2,960 (99.66%)

Total 16 (0.54%) 2,954 (99.46%) 2,970

Abbott (+) Abbott (-) Total

Roche (+) 1 (0.03%) 6 (0.20%) 7 (0.23%)

Roche (-) 2 (0.066%) 3,000 (99.7%) 3,002 (99.76%)

Total 3 (0.11%) 3,006 (99.9%) 3,009

Cumulative cases(infection rate) as

of May 31

5,236(0.038%)

1,783(0.02%)

88(0.004%)

To

kyo

Osa

ka

Miy

ag

i

Overview

■ Antibody tests were conducted from June 1 to 7 in Tokyo, Osaka, and Miyagi prefectures on randomly selected residents who agreed to

participate in this study (Tokyo 1,971; Osaka 2,970; Miyagi 3,009; Total 7,950).

■ For a more accurate positive judgment, results deemed "positive" in this study were those testing positive with two test reagents.

Mokobio(reference

value)

21(1.07%)

37(1.25%)

36(1.20%)

The antibody retention ratio for each municipality was 0.10% in Tokyo, 0.17% in Osaka, and 0.03% in Miyagi.

The number of people with antibodies in each municipality is greater than the number of cumulative cases; however, the results

indicate that majority of people do not have the antibodies yet.

This study estimates the ratio of people nationwide who have been infected with the novel coronavirus in the past, and is not a study

to assess current infections individually.

At this time, the nature of the antibodies (how long they last in the body, whether they provide protection from a second

infection) has not been confirmed.13

Test target

PCR test(including LAMP

method)

Antigen test (quantitative)

(June 19–)

Antigen test(rapid kit)

Nasopharyngeal

SalivaNasophary

ngealSaliva

Nasopharyngeal

Saliva

Symptomatic cases(including those whose symptoms have disappeared)

Within 9 days after onset of symptoms

○ ○(June 2–)

○ ○ ○ (*1)

(June 16–)×

10 days or more after onset of symptoms

○ × ○ × △ ×

Asymptomatic cases ○ × (*2) ○ × (*2) × ×

*1: From the 2nd to 9th day after onset of symptoms for the antigen test (rapid kit).*2: The degree of coincidence is being studied for the saliva PCR test and nasopharyngeal PCR test inasymptomatic cases."△" Can be used, but a nasopharyngeal PCR test must be conducted if the result is negative.

<Target of each test>

○In addition to a rapid antigen test kit, Fujirebio has developed a test reagent that can measure antigens quantitatively with high sensitivity, and applied for manufacturing and sales approval with PMDA. Approval was granted today (June 19).

〇This quantitative test is similar to the LAMP method in terms of sensitivity and can be used in the same way as PCR tests(*1, 2). For symptomatic cases, samples can be taken from saliva.

○Testing requires test equipment from the company, but testing time is short (around 30 minutes) and 60 to 120 tests can be conducted per hour.

5. Pharmaceutical Approval for Reagents for Novel Coronavirus Antigen Testing (quantitative)

(*1) Approximate amount of virus needed for testing --- RT-PCR: 10 copies; LAMP method; 100 copies; Rapidantigen kit: 500 to 1,000 copies

(*2) In cases with small quantity of antigens (1 to 10 pg/ml), consider using it together with PCR tests as needed.

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