Fact sheet: COVID-19

Coronavirus disease-2019 (COVID-19) is a disease caused by severe-acuterespiratory syndrome coronavirus-2 (SARS-CoV-2).

1. Pathogen
SARS-CoV-2 is an enveloped, positive sense single-stranded RNA virus
belonging to family Coronaviridae genus Betacoronavirus. Other humanpathogenic viruses identified are clustered in this genus, such as middle
east respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-1
which causes MERS and SARS outbreaks, respectively.

2. Situation, signs and symptoms
 This disease was identified firstly in Wuhan, China as pneumonia with an
unknown cause on December 2019. Following its extensive spread, theWorld Health Organization (WHO) declared COVID-19 as a pandemic onMarch 11, 2020.
 As of April 8th, more than 1,350,000 positive cases of SARS-CoV-2 werereported worldwide (in more than 170 countries). Most of the affectedcountries have difficulties to contain the outbreak due to the complexityof social consequences.
 While most COVID-19 patients develop only mild or asymptomatic illness,about 14% develop severe symptoms requiring oxygen support and 5%
require the intensive care unit.
 In the early phase, COVID-19 mainly causes fever, cough, fatigue, andshortness of breath. The symptoms may appear around 1-14 days
(average 5 days) after exposure. In the late phase, pneumonia isobserved in the patients.
 People with symptoms shed a high amount of virus and are the primarysource of infection if not isolated and treated. However, some infected
people develop no symptoms. These asymptomatic cases may pass on
the virus to others accidentally or unknowingly.

3. Epidemiology and transmission
 SARS-CoV-2 is transmitted by direct contact with an infected person orcontaminated objects via droplets (sneezing, cough, saliva). Under theexperimental conditions, SARS-CoV-2 can remain on the surface ofplastic and stainless steel for up to 72 hours.
 To date, the COVID-19 has spread all over the world. Most of the positive
cases were reported due to contact tracing with the cases. The disease’stransmission depends not only on imported cases, but also on theexistence of local transmission.
 In Japan, as of April 8th, a total of 4,257 COVID-19 cases have beenreported with the highest number of positive cases reported in Tokyo,
followed by Osaka, Chiba, Kanagawa, Aichi, Hyogo, Saitama, andHokkaido.
 The Japanese government declared a state of emergency covering
Tokyo, Osaka, Kanagawa, Chiba, Saitama, Hyogo, and Fukuoka until
May 6th.
 The first case of COVID-19 in Hokkaido was identified in late January ina tourist from Wuhan, China. Since then, Hokkaido had a rapid increaseof positive cases. From February 28th to March 19th, the governor of
Hokkaido prefecture declared a state of emergency. During that time,
most of people were asked not to leave their homes during weekends, torefrain from visiting crowded places, and to not have any after work
parties.
 On April 12, 2020, the governor of Hokkaido prefecture issued anotherstate of emergency until May 6th. People are asked to stay inside, only goout if necessary, and to follow these precautions.
English:http://www.pref.hokkaido.lg.jp/ss/tsk/COVID19/coronavirus_20200407a_en.pdf
4. Diagnosis
 The golden method to detect SARS-CoV-2 is quantitative real-timereverse-transcriptase PCR (qRT-PCR) assay. This assay targets viralgenome in the swab samples collected from patients or people suspectedof being infected.
 By combining this test with chest X-rays, detection efficacy of the patientswith symptoms is improved. Several new tests with improved detection
ability in a short period are being developed and evaluated.
 Additionally, many nationalities also using serologic test that detect theantibody from blood samples.

5. Treatment
 Currently, there is no specific antiviral treatment for COVID-19; theCOVID-19 patients are receiving supportive care for it. However, there
are many ongoing clinical trials testing potential antivirals.
 There are reports of positive tests to the virus after recovery. It is unknown
if these cases were reinfection or the viral particles detected wereremnants of the previous infection. There is also limited information of thevirus neutralizing capacity of antibodies in recovering patients.

6. Prevention and protection
Individual hygiene measures

-Hand hygiene practices using water and soap, hydroalcoholic solution or
alcohol to reduce risk of infection from direct contact with contaminatedfomites.

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Wear a facemask if you have a cold or cough to limit the risk of being
infected or shedding virus by droplets.

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When coughing or sneezing, cover the mouth and nose with a tissuepaper to contain droplets.

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Discard tissue-paper or used facemask in a trash can.

-Don’t greet by shaking hands, kissing, or embracing.

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Pay attention to items which are often shared (computers, phones, etc).

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Avoid touching your face, eyes, or nose with your hand.

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If you have a fever or cold, call the toll free call of the Ministry of Health,
Labor and Welfare (MHLW) directly (0120-565-653).

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If you have been in contact with somebody who is suspected of having or
has tested positive for COVID-19, call the MHLW (0120-565-653) or theConsultation Centre for Returners and Contactees (Health Centre). (Tel.
011-272-7119).

Community-based measures-Avoid close contact to limit virus spread.

-Refrain nonessential services and businesses and stay at home to avoid
any contact with any sick person or SARS-CoV-2 healthy carriers. Be
sure to stay at home if you are having respiratory symptoms.

-Social distancing; keep distances of at least 2m from other people(especially those with fever, cold, or cough).

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When you have fever, cough, chills and respiratory symptoms, stay athome and report your situation to the MHLW (0120-565-653) for early
identification and isolation. If you must go to a hospital or clinic, but sure
to wear a mask.

-Report any sick persons in order to help to save lives and identify SARSCoV-2 carriers.

7. Response at the community level Identification of a new cluster (group of positive cases which emerge at
the same time and place) as soon as possible is one of the keys tocontrolling the local transmission.
 Some countries have locked down their territories to prevent a massive
spreading of COVID-19 to improve the health facilities, find the best antiviral, and develop a good vaccine.
 They quarantine people from the infected area at least for 14 days andisolate all the patients.

8. Response at the individual level If you meet any of the criteria set by the Japanese government below,contact the Health Centre. (Tel. 011-272-7119)-You have fever above 37.5oC and fever doesn’t go away for 4 days.

-Feeling tired badly (fatigue) or difficulty in breathing (dyspnea).

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You are old (65 years or older), have underlying disease (diabetes,heart disease, respiratory disease) or under chemotherapy withfever above 37.5oC for 2 days or with feeling tired badly (fatigue) ordifficulty in breathing (dyspnea).

 Non-urgent but important information regarding COVID-19 should beclarified by calling to the MHLW. (Tel. 0120-565-653)

9. More information
 Coronavirus disease (COVID-19) Pandemic in WHO
https://www.who.int/emergencies/diseases/novel-coronavirus-2019

 About Coronavirus Disease 2019 (COVID-19) by Ministry of Health,
Labor and Welfare, Japanhttps://www.mhlw.go.jp/stf/seisakunitsuite/bunya/newpage_00032.html

 Information Regarding COVID-19 (From the Hokkaido Government)
http://www2.hiecc.or.jp/soudan/upload/file/emg/file1_en_1584325701.pdf

 Hokkaido Foreign resident Support Center
http://www2.hiecc.or.jp/soudan/emg/index.html?lang=en

 General Information about COVID-19 in English
http://www.clair.or.jp/tabunka/portal/info/contents/114517.php