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Novel Coronavirus (COVID-19) Infectious Disease

Information for citizens of Tokushima Prefecture

o The novel coronavirus infectious disease is reportedly a type of viral cold, and its incubation period, the period between exposure to an infection and the appearance of the first symptom, is estimated from 1 to 12.5 days.
o The novel coronavirus spreads mainly by droplet transmission and contact transmission, and it is believed that airborne transmission has not occurred.

Droplet transmission: The virus comes out with the cough, sneeze and saliva of an infected person. Other people then catch the virus by inhaling it.
Contact transmission: After a person covers his/her hands when sneezing or coughing and touches objects, the virus lands on the surfaces. If other people touch these objects, the virus attaches to their hands. People then catch the virus by touching their mouths and nose with their hands.
According to the Novel Coronavirus Infectious Disease Control Measures Expert Panel Meeting:
• Most people infected by the novel coronavirus have either no symptoms or mild symptoms, and some have already recovered.
• Many people have a fever and respiratory problems for about a week and complain of severe tiredness.
• However, some develop serious pneumonia and need intensive care such as the use of a respirator. At this time, elderly people and those with underlying medical problems are reportedly more likely to develop severe illness.

To prevent infection “carry out cough etiquette and handwashing”

The same as with colds and seasonal influenzas, it is essential that every single person covers their mouth when coughing and sneezing, and washes their hands. Please take precautions to prevent infection.

When to seek medical advice

If you have the following symptoms, please seek medical advice from the Consultation Centers for Returnees and People in Contact with Those Infected:
• Cold-like symptom or fever 37.5℃ or above lasting for four days and more (including in the case that you have to keep taking antipyretic/fever medicines).
• Severe tiredness and breathing problems
For elderly people and those with underlying medical problems, please contact the Center if the above symptoms last for two days.

If the Consultation Center suspects that you have the novel coronavirus infection, they will refer you to the outpatient unit exclusive to the returnees and people in contact with those infected. In that case, please wear a mask and avoid using public transportation to go there.

If you suspect that you have influenza, etc., please seek medical advice from your home doctor as usual, as the vast majority of patients have different medical problems (non-novel-coronavirus infectious disease) at the moment.

Notes on when you go to a medical institution after seeking advice

o Please go to the medical institution recommended by the Consultation Centers for the Returnees and People in Contact with Those Infected. Please do not go to other medical institutes.
o Please make sure that you wear a mask, thoroughly wash hands, and cover your mouth and nose with your mask, tissue, handkerchief or sleeve when you cough and sneeze (cough etiquette).

Holding or joining events where a large number of people gather

o When you join an event where a large number of people gather, please make sure that every single one of you follow cough etiquette and frequent handwashing. For event organizers, please consider taking some precautions to the maximum extent possible such as placing hand sanitizer (with alcohol for disinfection) at the entrance of the venue.

The Ministry of Health, Labour and Welfare has issued the guideline to prevent a mass infection

(March 1, 2020)

So far, 80% of people who had been confirmed as having an infection in Japan have not passed the virus to other people. On the other hand, there are some reports that in places such as sports gyms, houseboats, buffet-style events, mah-jong parlors, ski resort guesthouses, and sealed temporary tents, the virus spread from a single infected person to multiple people.

To prevent a mass infection, please avoid gathering in a group in a place that is less well ventilated, people gather closely for a certain amount of time, and a large number of people are more likely to be in close contact with each other. For event organizers, please rethink whether holding an event is necessary. If you still hold the event, please consider precautions such as creating better ventilation.

The national expert panel meeting summarized their opinions regarding the precautions

(March 2, 2020)

At the Novel Coronavirus Infectious Disease Control Measures Expert Panel Meeting of the Ministry of Health, Labour and Welfare summarized their opinions regarding the precautions. The outline is as follows:

(1) Spreading infection from people with mild symptoms

  • People with mild symptoms appear to be spreading the virus without noticing.
  • In particular, young adults have a very low chance to develop severe symptoms, which prevents them from grasping the scale of infection. As a result, many middle-aged and senior adults appear to have been infected.

(2) A spread of infection from the places that fulfill certain conditions

  • So far, regardless of the level of the severeness of symptoms, approximately 80% of people who have been confirmed as having the infection have not passed the virus to other people.
  • On the other hand, there are some reports that in the places that fulfill certain conditions, the virus spread from a single infected person to multiple people.
  • Those places include live music clubs (“live house” in Japanese), sports gyms, houseboats, buffet-style events, mah-jong parlors, ski resort guesthouses, and sealed temporary tents.
  • These facts show that there is a possibility that staying or mingling closely for a certain period in a closed indoor place results in mass infection (cluster of patients).
  • The spread of infection from such a cluster to the next cluster leads to a rapid spread of infection.

(3) Patients who develop severe illness

  • Approximately 80% of people having symptoms whose infection was confirmed have/had mild symptoms, 14% of those have/had severe symptoms and 6% of those are/were seriously ill.
  • However, approximately half of the patients with severe symptoms have recovered.
  • Severe/serious-case patients had similar symptoms as ordinary colds (slight temperature, sore throat, coughs, etc.) at the beginning, and at that stage, it is difficult to judge whether it will develop severely or not.
  • Symptoms of the severe/serious-case patients rapidly deteriorated about 5 to 7 days after the first cold-like symptoms, and they developed pneumonia.

A message from the governor to the citizens of Tokushima Prefecture regarding novel coronavirus infectious disease

February 25, 2020

It is regrettable to inform you that a carrier of novel coronavirus without symptoms has been confirmed in Tokushima Prefecture today.

In Tokushima Prefecture, we set up the Risk Management and Vigilance Headquarters and were on the alert for the infection from the outbreak of the mass infection in China; however, upon the confirmation of the first infected person in the prefecture, we have just set up the Risk Management Measures Headquarters today, assigning myself as the chief.

Following the Basic Policy for Novel Coronavirus Infectious Disease Control Measures issued by the government today, the National Governors’ Association also has just set up the control headquarters for the National Governors’ Association immediately.

Regarding the novel coronavirus, we gradually came to understand that many infected people have either no symptoms or mild symptoms. Thus, the government’s basic policy has focused on endeavoring to minimize the number of patients with severe and serious conditions.

I would like to ask you, the citizens of Tokushima Prefecture, to call the Consultation Centers for the Returnees and People in Contact with Those Infected and seek advice first when you suspect that you might have novel coronavirus infectious disease, for instance, if you have had a temperature of 37.5℃ or above for four days or longer, or feel severe tiredness or tightness in the chest. I would also like elderly people and those with underlying medical problems to call a Consultation Center if they have such symptoms for two days. One of the Consultation Centers operates 24 hours.

General advice such as how to prevent infection is provided at a call center. For the telephone numbers, please refer to the prefecture’s website. The call charges for the call center are free; therefore, please do not hesitate to contact them.

As precautions to prevent infection, handwashing with soap and hand sanitizer (with alcohol for disinfection), and cough etiquette in a place where many people gather are important. Cough etiquette means, for instance, when you are about to cough, cover your mouth with your handkerchief, not your hands, or if you don’t have a handkerchief, cover your mouth with your sleeves, instead. In particular, people with underlying medical problems are advised to be more cautious and avoid public transport and busy places as much as possible.

I would like to ask you, the citizens of Tokushima Prefecture, to avoid places vulnerableto infection. Even if you need to participate in events where many people gather, I would like to remind every single person to carry out the precautions to prevent infection.

I would also like to ask event organizers to take some precautions to the maximum extent possible such as placing hand sanitizer (with alcohol for disinfection) at the entrance of the venue.

To suppress the spread of infection, it is essential that every single person carries out the precautions to prevent infection. We, the prefecture, will endeavor to understand the situation concerning the infected person who has been confirmed this time; therefore, please act calmly.

Let us work together to prevent the spread of infection thoroughly.

Thank you for your cooperation in advance.