2022年7月23日(土) 16時～17時30分

兵庫県保険医協会・政策研究会

国の新型コロナウイルス対策における科学性の欠如

京都大学名誉教授
一般財団法人 LHS研究所

福島 雅典

Masanori FUKUSHIMA
www.lhsi.jp

代表理事

M.D., Ph.D.

論 点

1.

感染拡大防止対策は正しかったか？

2.

ワクチン戦略は正しいのか？

3.

COVID-19から何を学び，何をなすべきか？

2022/7/23

兵庫県保険医協会・政策研究会

2https://www3.nhk.or.jp/news/special/coronavirus/entire/
2022/7/23

兵庫県保険医協会・政策研究会

3https://www3.nhk.or.jp/news/special/coronavirus/vaccine/progress/#mokuji02022/7/23

兵庫県保険医協会・政策研究会

4https://www3.nhk.or.jp/news/special/coronavirus/entire/
2022/7/23

兵庫県保険医協会・政策研究会

5ワクチン接種後死亡症例

２０代男性

新型コロナワクチン（コミナティ）接種後一週間以内に死亡
急性うっ血性心不全（横紋筋融解）

厚労省：新型コロナワクチン接種後の死亡として報告された事例の概要(2022年7月8日付)
ワクチン接種後の死亡と薬剤疫学的評価の概要

2022/7/23

兵庫県保険医協会・政策研究会

6ワクチン接種後死亡と薬剤疫学的評価の概要
Then & Now：ワクチン接種後経過日数
厚生労働省：「新型コロナワクチン接種後の死亡として報告された事例の概要」
2021年5月26日～2021年7月21日の各時点報告の集計

厚生労働省：「新型コロナワクチン接種後の死亡として報告された事例の概要」
2021年8月4日～2022年3月18日の各時点報告の集計

2022/7/23

兵庫県保険医協会・政策研究会

7ワクチン接種後死亡と薬剤疫学的評価の概要
Then & Now：報告された死因の割合
厚生労働省：「新型コロナワクチン接種後の死亡として報告された事例の概要」
2021年5月26日～2021年7月21日の各時点報告の集計：単一死因のみ

厚生労働省：「新型コロナワクチン接種後の死亡として報告された事例の概要」
2021年8月4日～2022年3月18日の各時点報告の集計

厚生労働省：「新型コロナワクチン接種後の死亡として報告された事例の概要」
2021年5月26日～ 2022年3月18日の集計（ファイザーのみ，複数死因）
2022/7/23

兵庫県保険医協会・政策研究会

8コロナの研究論文数：日本14位 存在感薄く

2022/7/23

兵庫県保険医協会・政策研究会

9Email ｆrom Dr. Swinbanks ①

One thing that struck me, but, which wasn’t a focus of oursupplement, was the very weak level of research on infectious
disease in Japan and in particular on covid compared with otherdeveloped nations. Please see attached powerpoint.
Japan typically ranks 4th or 5th in the world in scientific/medical
research no matter what database you look at. But in infectious
disease Japan ranks below ten at 12th (see slide 2 of attached).
And whereas all developed countries of the world have shown adramatic rise in research output on covid, for Japan it is barely ablimp…
2022/7/23

兵庫県保険医協会・政策研究会

10Email ｆrom Dr. Swinbanks ②2022/7/23

兵庫県保険医協会・政策研究会

11Email ｆrom Dr. Swinbanks ③2022/7/23

兵庫県保険医協会・政策研究会

12Email to Dr. Swinbanks ①
Dear David ,Now I am sending you my comments and some data For your reference, below are the situations around COVID19 treatments here in Japan:
1. COVID19 patients are not concentrated in university hospitals with research capabilities, and the annual number of COVID19 patients atuniversity hospitals itself is small.
2. Patients admitted to university hospitals are referred from other hospitals, seriously ill, and typically emergency cases, making it difficult tofor university hospitals to establish a system for continuous research on them, together with the above situation.
3. COVID19 patients admitted to university hospitals are not treated by specialists in infectious diseases but by specialists in respiratory
medicine and cardiology, as respiratory management is the primary treatment for these patients. In addition, hematologists will be in chargeof treating patients with thrombosis; COVID-19 is out of the scope of the study due to their expertise (respiratory medicine, cardiology, andhematology).
4. According to the policy of the MHLW, patient samples and other data are to be concentrated at the National Institute of Infectious
Diseases, which is under the direct control of the MHLW. This makes it difficult for university hospitals with research capabilities to plan anddevelop virological studies.
5. Infectious diseases themselves, including but not limited to COVID-19, can be considered, in a sense, as special diseases here in Japan,
which is another reason for the difficulty for research facilities to collect cases. TB, as you pointed out in your email, is also a rare disease now,and our current concern is that the disease is so rare that doctors are sometimes unable to diagnose TB these days, in other words, doctors
cannot even suspect the diagnosis.
6. Nosocomial infection is a major risk management issue. Every hospital has its own infection control team, and university hospitals have awell-developed system and infectious disease specialists. There are 1,700 infectious disease specialists certified by the Japan Society ofInfectious Diseases nationwide.

2022/7/23

兵庫県保険医協会・政策研究会

13

Email to Dr. Swinbanks ②7, As already answered in a previous email, research papers that are critical to the care of COVID-19 patients have been published already. Here aresome examples:
Hirose R，et al．Survival of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) and influenza virus on human skin: Importance ofhand hygiene in coronavirus disease 2019 (COVID-19)．Clinical Infectious Disease． https://academic.oup.com/cid/advancearticle/doi/10.1093/cid/ciaa1517/5917611
Yokota I，et al．Mass screening of asymptomatic persons for SARS-CoV-2 using saliva．Clinical Infectious Diseases．
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1388/5911780
Sakurai A，et al．Natural History of Asymptomatic SARS-COV-2 Infection．New England Journal of Medicine． 2020；383：885-6
https://www.nejm.org/doi/full/10.1056/NEJMc2013020
Yamamoto K，et al．Health Observation App for COVID-19 Symptom Tracking Integrated With Personal Health Records: Proof of Concept
and Practical Use Study．JMIR Mhealth Uhealth．2020；8（7）：e19902．doi: 10.2196/19902. https://mhealth.jmir.org/2020/7/e19902/
Abe K，et al．Severity of COVID-19 is inversely correlated with increased number counts of non-synonymous mutations in Tokyo.
https://www.medrxiv.org/content/10.1101/2020.11.24.20235952v1
Goto A，et al．Sustained neutralizing antibodies 6 months following infection in 3762 Japanese COVID-19 survivors．Frontiers in
Microbiology．Forthcoming 2021 https://www.frontiersin.org/articles/10.3389/fmicb.2021.661187/full
8, We have a well-organized, very thorough guideline essential for the care of COVID -19 patients and it has been constantly updated (currently inits 7th edition), and in each hospital, physicians diagnose and treat COVID-19 patients in accordance with the guideline. One of the reasons why themortality rate due to COVID-19 is significantly lower in Japan than in other countries may be attributed to the fact that the guideline are strictly andconsistently followed in the treatment of patients. Another reason for the low mortality rate is that access to hospitals is better than those in othercountries.

9. COVID-19 has been categorized in class 2 by Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases
enacted in 1998 (originated in the law enacted in 1897), and the first interventions by public health centers under the supervision of local
governments under the leadership of the Ministry of Health, Labor, and Welfare resulted in inadequate Medical services by physicians from thetime the infection began to spread. This is one of the reasons why mortality was high in the early stages of COVID- 19 pandemic.
10 Last spring, I published a paper with the title "Recommendations from Clinical Practice," in which I proposed that all strategic and practicalmeasures against this disease be left to medical associations and university hospitals, and that specialized hospitals be created or designated andpatients be concentrated there. Together with Dr Yokokura, the former president of Japan Medical Association, I submitted the report to thegovernment, the heads of local governments, and the media, but there has been little response so far.
2022/7/23

兵庫県保険医協会・政策研究会

14Email to Dr. Swinbanks ③2022/7/23

兵庫県保険医協会・政策研究会

15

Email to Dr. Swinbanks ④2022/7/23

兵庫県保険医協会・政策研究会

16

Email to Dr. Swinbanks ⑤❗️Following attached figures shows the facts that there is negative relation between the mortality rate versus infectious
disease experts number per million population, And also there is positive relationship between mortality rate and natureindex score2022/7/23

兵庫県保険医協会・政策研究会

17

新型コロナウィルス感染症関連論文シリーズ• 新型コロナウイルス関連肺炎に罹らないために• 新型コロナウイルス関連肺炎重症化への対処について• 【緊急提言】新型コロナ感染対策の抜本的改革~臨床からの提言• 【提言】新型コロナウイルス感染対策を問う~臨床からの提言• 巻頭言（COVID19ワクチンに関連して）• COVID-19ワクチン接種後の死亡と薬剤疫学的評価の概要：
全国民ベースの概観と提案• 論説：COVID-19ワクチンブースター接種でパンデミックを防止できるのか？

2022/7/23

兵庫県保険医協会・政策研究会

18

新型コロナウイルス感染対策を問う～臨床からの提言
ダイジェストバージョン

フルバージョン

さらに！
http://cont.o.oo7.jp/49_1/p53-66.pdf
2022/7/23

兵庫県保険医協会・政策研究会

重要研究成果⑥19

まとめ①
1. 地域単位で、行政と、医師会と大学病院基幹病院が協議会を作って地域の実情に合った対策を策定、実施→ 新型コロナ感染症専門診療センター(予備病院)の設置と運営

2. 日本の研究者の研究成果を適切に評価して対策に反映→ 感染拡大防止に重要な研究結果はすべてなされている!
3. 診療ガイドラインの普及と遵守、バージョンアップ

2022/7/23

兵庫県保険医協会・政策研究会

20

まとめ②
4. 汚染防止の基本原則「検疫・消毒・隔離」を徹底
・人混みを避ける・換気の徹底・粉塵除去の徹底
・マスクの着用・うがいの励行
・手洗い、洗顔洗髪入浴・栄養・休息・熟睡・運動

5. 感染経路の徹底調査
6. ワクチン接種者の感染状況と感染実態の調査

2022/7/4

兵庫県保険医協会・政策研究会

21

まとめ③
7. ワクチン接種者の接種後受診状況(中長期的な副作用)の把握
・抗体依存性感染増強、抗原原罪仮説に関する検証

・ワクチン接種者における感染の遷延、不顕性化、慢性化(保菌、排菌)、新たな疾患の発生等々についても調査

8. ワクチン接種後死亡（接種後の経過期間を問わない）、及びワクチン接種者で新型コロナウィルス感染後死亡に関して病理解剖の徹底、当該患者受診後の診療の全例調査
9. ワクチン接種者の感染状況と感染実態の調査

2022/7/23

兵庫県保険医協会・政策研究会

22

まとめ④
10. 上記5から9までは、当然のことながら精密なプロトコール作成の上調査しなければならない！

臨床科学の厳格な適用

ご清聴ありがとうございました
2022/7/23

兵庫県保険医協会・政策研究会

23