日本在3月21 日的疫症總數為1046,總死亡人數50,新症36,新死亡人數1,平均死亡率3.44%。它的處理手法好壞有評(註1),主要針對其測試是足夠。特別在日本面對著奧運會和鑽石公主號遊輪的處理手法上(註2),日本在過去一周平均只做約900個測試,被指責政府處事不力。但在事實,日本的被一確診個案相對較少。
日本厚生勞動省回應,檢測較少和不採用流行的PCR檢測是因為PCR檢測不是為了「醫學程序」,無助遏制疫情的蔓延。PCR檢測是製藥巨頭羅氏公司的試劑盒,它在日本未通過確認。在未有治療方法,早期發現並不一定會導致早期治療。就嚴格的醫學術語而言,測試本身的價值不如人們想像的那樣。厚生勞動省的測試目的是進行「流行病學調查」,私營公司使用PCR試劑盒進行檢測,檢測質量的差異可能影響流行病學研究(註3)。
日本是少數國家為新型狀病毒交出官方的流行學報告之一(註4)。報告在3月10日發表,研究了2月24日前的114個日本確認案例。
報告的個案群的性別比為1.6:1,共有69位為男性和43位為女性。 中位年齡為66.5歲(年齡範圍為15-89歲), 10-19歲佔2%, 20-29歲佔6%, 30-39歲佔7%,40-49歲佔 8%,50-59 歲佔18%,60-69歲佔12%,70 -79歲佔29%, 80-89歲佔18%。 大約60%的病例是在60歲以上的人群中發現的。
研究發現:主要症狀為發燒81/112(72%),咳嗽69/112(62%),肺炎43/66(65%),喉嚨痛23/68(34%),全身不適 20/61(33%),流鼻涕或“鼻塞感覺”17/64(27%),頭痛17/62(27%),腹瀉11/64(17%),噁心和/或嘔吐5/60(8%) ,關節或肌肉疼痛4/58(7%),急性呼吸窘迫綜合徵(ARDS)3/41(7%)和眼球結膜充血0/53例(0%)。
在COVID-19病例診斷時,有21/112例病例(19%)為無症狀病例。
當中被安排進入深切治療室(ICU)入院率為8/52(15%),(氣管插管)為11/50(22%)。
5名患者需要動用更高級的體外膜氧合器(ECMO),其中包括40歲1人,60歲1人,70歲2人,80歲1人。 截至2月24日,已分析的112病例均無死亡。
鑽石公主號圖示
圖1顯示了從2020年1月20日至2月19日的90例的流行曲線。如圖所示,鑽石公主號遊輪引入的相關病例在2月7日達到峰值。
備註
註1:Japanese government under scrutiny for handling of coronavirus
註2:Coronavirus could see the Tokyo Olympics cancelled. Is Japan's handling of the outbreak to blame?
註3:Coronavirus: Why Japan tested so few people
註4:Based on data reported as of February 24, 2020 by both NESID and MHLW’s active epidemiologic investigations, there were 112 lab-confirmed COVID-19 cases. The gender ratio was 1.6:1, with 69 males and 43 females in total. The median age was 66.5 (age range 15-89), with age distribution of 2 cases in the 10-19 range (2%), 7 cases in the 20-29 range (6%), 8 cases in the 30-39 range (7%), 9 cases in the 40-49 range (8%), 20 cases in the 50-59 range (18%), 13 cases in the 60-69 range (12%), 33 cases in the 70-79 range (29%), and 20 cases in the 80-89 range (18%). Approximately 60% of cases were identified in those over 60 years of age.
At of case report day, the main symptoms identified were fever 81/112 (72%), cough 69/112 (62%), pneumonia 43/66 (65%), sore throat 23/68 (34 %), general malaise 20/61 (33%), nasal discharge or congestion 17/64 (27%), headache 17/62 (27%), diarrhea 11/64 (17%), nausea and/or vomiting 5/60 (8%), joint or muscle pain 4/58 (7%), acute respiratory distress syndrome (ARDS) 3/41 (7%), and conjunctival congestion 0/53 cases (0%)
At the time of COVID-19 case diagnosis, 21/112 cases (19%) were reported as asymptomatic cases.
Intensive care unit (ICU) admission was 8/52 (15%) and invasive ventilation (tracheal intubation) was 11/50 (22%). Other interventions used included extracorporeal membrane oxygenator (ECMO) in 5 patients, with 1 in their 40s, 1 in their 60s, 2 in their 70s, and 1 in their 80s. As of February 24, there were no deaths reported in the 112 cases analyzed