THE ASAHI SHIMBUN
February 18, 2020 at 18:45 JST
Health minister Katsunobu Kato on Feb. 17 announces the government’s guidelines for those worried about being infected with the new coronavirus. (Ichiro Matsuo)
The health ministry is urging people with cold-like symptoms and mild fevers to sit tight at home and not panic rather than rush to hospitals, so medical facilities can focus on handling serious cases of coronavirus infection.
Guidelines issued Feb. 17 recommend that people with mild symptoms remain at home for three days, and if they persist for a fourth day, to contact a consulting counseling center at a local public health center to seek help at a designated medical institution.
The guidelines were released after an expert panel led by Takaji Wakita, head of the National Institute of Infectious Diseases, met to discuss the issue.
As of Feb. 17, 520 cases of coronavirus were confirmed in Japan, including 454 from the cruise ship Diamond Princess quarantined at Yokohama Port.
As an initial step, people with mild cold-like symptoms should stay away from school or the workplace, remain at home and avoid going out. They are advised to monitor their health condition by taking their temperature daily.
Health authorities recommended these steps on grounds that many patients have recovered from COVID-19 after coming down with only a mild fever and sore throat.
“If their symptoms are stable, they do not need to rush to seek a medical examination,” said Nobuhiko Okabe, director-general of the Kawasaki City Institute for Public Health, who was involved in crafting the criteria.
When cold-like symptoms or a fever of at least 37.5 degrees persists for four days, people are advised to call consultation centers dealing with COVID-19 issues.
A fever of 37.5 degrees for four days was set as a guide as those infected by the coronavirus initially display symptoms like cold and flu. But when the coronavirus is present, a person's condition can sharply deteriorate after four or five days, unlike flu and colds.
Those who experience fatigue and difficulty breathing are urged to waste no time in contacting a consultation center.
The guidelines also recommend that elderly people and those with underlying ailments, such as diabetes, heart problems and chronic obstructive pulmonary disease or who are undergoing dialysis or chemotherapy, should seek counseling if cold-like symptoms persist for two days.
“The elderly and people with pre-existing health conditions are more likely to contract severe pneumonia,” said Atsuo Hamada, a professor of travel medicine at Tokyo Medical University Hospital. “They should undergo a check-up as soon as possible.”
Pregnant women are advised to consult health experts immediately if they display cold-like symptoms for a couple of days.
If a consultation center assesses that a person is highly likely to be infected by the virus, they will be advised to seek treatment at a specified medical institution tasked with treating the disease.
When potential patients visit a medical institution for diagnosis, they are asked to wear a surgical mask, as the virus spreads through exposure to droplets from coughing or sneezing, and wash their hands thoroughly.
The government’s criteria were in response to growing anxiety about a rapid rise in new cases of infection across Japan that apparently are not directly linked to the outbreak that started in the city of Wuhan, in central China's Hubei province, where the most deaths from the disease have been logged.
“We are trying to respond to people’s fears about the disease and ensure that patients understand where to get help before they develop serious health problems,” health minister Katsunobu Kato said at a news conference on Feb. 17.
There are 540 consultation centers nationwide, and some are open 24/7.
Those considered highly likely to have contracted COVID-19 will be referred to a designated medical institution. The names of the facilities are being withheld so priority can be given to treating patients in a serious condition, according to health experts.
The Ministry of Health, Labor and Welfare also moved to expand the testing of suspected patients even if they have not knowingly been in contact with people who have recently been in Hubei province or other parts of China.
People with pneumonia who require hospitalization and also display prolonged fever and respiratory symptoms as well as those who are regarded as highly likely to be infected based on a doctor's assessment, will be tested.
If those individuals test negative for flu, they can undergo the coronavirus test after counseling at a consultation center.
The ministry will expand its ability to test for the coronavirus to more than 3,000 potential carriers a day with cooperation from the National Institute of Infectious Diseases, local public health institutes, testing agencies in the private sector and universities.
World Health Organization data shows that in many cases, people with the virus exhibit no symptoms for five to six days after the infection. The asymptomatic period lasts up to two weeks at the most.
But it is possible those with no symptoms can transmit the virus to others.
The fatality rate from COVID-19 is 3.2 percent, compared with 9.6 percent for severe acute respiratory syndrome (SARS), which raged in the early 2000s, according to a Feb. 16 report by the WHO.
(This article was compiled from reports by Shuichi Doi, Yuko Matsuura and Senior Staff Writer Kenji Tamura.)
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