The principal of Keio University hospital, one of the most famous hospital in Tokyo, has published about their strategy to deal with the COVID19 outbreak. In fact, they have had nosocomial infections among the staff and the patients. In the end of their statement, they have given the prevalence rate of COVID19 among the patients who visited the hospital for medical examination/care for the other diseases/symptoms than COVID19 and have been undergone PCR test. It was surprisingly high, that is, 5.9%. This prevalence rate may not be identical to that among "healthy" people but still roughly approximates the latter.
There have been a few reports which show the result of antibody testing among healthy groups. Most of them took data from large number of people. They vary from 2 to 15%. Some researchers criticize these data owing to the possible cross reactivity with the other common Corona virus. The antibody measurement system should be developed to be specific for the Sars Cov2. And I believe the data of 5 to 15% could be reliable so far. This means quite some portion of the people has experienced the infection in the past. It is another question if the antibody examinees have had could be protective to further infection of COVID19 or not.
In Tokyo, the outbreak is still going on with increasing number of those with test positive and of the victims due to COVID19. Both of them, increasing daily, are still fewer than those in Europe or the USA. But the low numbers should be due to limited testing. The infected people in Tokyo could be as many as several hundred thousands. Since the outbreak is still on the uphill phase, there could be a few hundred thousand severe cases and a ten thousand or two of fatal cases in Tokyo in the near future. This could be only the worst scenario.
Recently, Singapore, which was regarded an honor country in the battle against COVID19 virus in the beginning, has caused a bad mega cluster among the foreign workers. The foreign workers have been living in dormitories with high density of population and have not given the chance for the PCR test even if they have had symptoms suggestive of COVID19, as Bloomberg reported. This news reminded me of the people in Tokyo who were still commuting on crowded trains even if not like the usual canned sardines fashion. The authority won't question about the jam packed commuter trains which could cause clusters.
On the other hand, some doctors are optimistic for the characteristics of this infection and its course from now. The number of infected people in Tokyo according to the date of beginning of symptoms is graphed as below.
http://www009.upp.so-net.ne.jp/tatsuo/lkjhghj.jpg
They insist the infection has peaked out in the beginning of this month. If this is true, it could never be better. The problem is that it depends on the number of PCR test done by the administration. As well known, the number of the test has been strictly limited by them. I have heard some cases were denied to be tested by the authority even if the doctor on charge thought it quite necessary. And the administration has looked upon those closely contacted or those returning from foreign countries as the candidate for testing. These limitation of testing could cause certain bias for the result. I am free from judging this peak out theory so far.
The health care system is under jeopardy due to nosocomial infections and increased need for inpatients of COVID19. It is too sad the authority has not taken the larger scale of data from more people, which could have given us more reliable prospect for the future. The authority seems to finally change its attitude for more detailed and accurate epidemiological data. Without reliable data, we could not foresee the future nor decide what maneuver we should take.
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