2/14/2020

COVID-19 epidemic seems to start here

Here are a few patients of COVID-19 infection who have been infected without any prior contacts with the patients in Japan now. One of them is a medical doctor in Wakayama Prefecture. The tertiary infection has been started.

As for this epidemic or even pandemic, I am not very pessimistic for the outcome right now. Even more virulent SARS than this virus infection could be stabilized in several months. Hopefully, it could be controlled very soon.

But the government won't take this impending crisis very seriously. Their strategy in urgency for this pandemic is stressed on, at first, pretending to have smaller number of patients in our country and then alleviation of the impact on the economy. It is not the time for them to do with economy yet. I believe the impact firstly would be loaded on the local medical care system.

The local medical facilities are not equipped with the proper diagnostic tests nor proper staff. The government has determined to force the patients to be hospitalized at the peculiar facilities assigned for infectious diseases. Surprisingly, the number of beds for infectious diseases is only 113 nationwide. It is as plain as daylight that those beds will be full when the pandemic goes on. To treat respiratory failure due to pneumonia, they should be equipped with respirators or NPPV, which is less plausible.

The diagnostic test kit will be, as the news says, available by the end of March. It is still RT PCR method, which turns out to be only 40% of sensitivity at present while pretty accurate in specificity. This means the current estimates for the infectivity is lower and the fatality or severe case rate is higher. Together with the long incubation period, this means the prevalence is subtly going on in the society. The presence of tertiary infection cases could not be explained without this subtle prevalence. The border quarantine is impossible at present. The diagnostic kit with improved sensitivity should be provided at the local medical facilities as soon as possible.

The local medical system could be collapsed if most of the personnel is infected or even goes on ominous course of the disease. It means the other patients than this COVID-19 infection cases would suffer much from the process. The local medical system is fragile to such a crisis. The government should support it by finance or the other ways.

In some time, this virus should prevail all around. We should stay home if we have only common cold like symptoms. It would lessen the burden on the local medical system.

Our government is very eager to get more armaments from overseas or to attract investment for casino. But unwilling are they to provide proper measures against such pandemic going on now or the natural disasters we had in the recent years.

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