Q&A about Novel Coronovirus (For the General Public)

April 4, 2020

7  What to do if you suspect infection

 

Q28   I have a fever or a cough. What should I do? (UPDATED)

If you have a fever or other cold symptoms, don’t go to work or school and refrain from going out or participating in any events. Resting is good for your health, and it can also help prevent the spread of infection. The Ministry of Health, Labor and Welfare and related ministries and agencies consider that it is important to create an environment where employees can take leave from their offices, and have asked labor associations and companies to cooperate in this matter.

For those who have a cough or other symptoms, please follow cough etiquette because if you use your hands to cover your coughs or when you sneeze, it is possible to spread the disease to others by touching doorknobs and other areas.   At present, the main causes of cold symptoms such as fever are predominantly due to diseases other than novel coronavirus infection. If you think you have a cold or flu, please consult with your local medical clinic as before.

If you are worried that you have contracted the novel coronavirus, please consult your closest Returnees / Contact Center (see Question 30). In particular, those people whose characteristics match the criteria released on February 17 should consult these Centers:

・ When the symptoms of a cold or fever of 37.5 ° C or more continue for 4 days or more (The same applies to those who have to keep taking antipyretic drugs.)

・If you experience a heavy sense of listlessness (fatigue) or breathlessness (dyspnea);

 

For elderly people; people with underlying conditions such as diabetes, heart failure, respiratory diseases (such as chronic obstructive pulmonary disease);  those who are receiving dialysis, and those who use immunosuppressants or anticancer drugs:

・If you have symptoms of a cold for or a fever of 37.5 ° C or more for 2 days in a row

・If you experience a heavy sense of listlessness (fatigue) or breathlessness (dyspnea)

Q29  How do I check for a continuous fever?

Fever is caused by infections, tumors, and inflammation.  Generally, if the temperature is higher than 37.5 degrees, it is considered to be a fever. If fever is noted, measure the body temperature daily, and record the body temperature and time it was taken.

Q30  What does the “Returnee / Contact Consultation Center” do?

If the "Returnees / Contact Consultation Center" suspects a coronavirus infection after receiving and discussing your case by telephone, they will arrange for you to visit the “Returnees / Contact Outpatients Clinic”.  In that case, please consult a medical institution recommended by the center. Please refrain from consulting more than one medical institution.

Even if the center determines that there is no suspicion of infection, you can continue to see your regular doctor as before. In that case, if you present pneumonia-like symptoms and your doctors recommends it to be necessary, you will be asked to have the PCR test for the coronavirus.

Returnees / Contact Consultation Centers are set up in all prefectures and are open 24 hours a day. For details, see the website below.

 

Returnees / Contact Information Center Page

 https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/covid19-kikokusyasessyokusya.html

Q31  Is the PCR inspection system expanding?  It is said that "Even if you want to have a test, you will be refused at the health center and you will not be allowed to do it." How will this change once insurance coverage begins? (UPDATED)

 

We will ensure that all medical facilities including your own doctor have sufficient testing skills to allow all patients to take PCR tests.  Specifically, with the cooperation of the National Institute of Infectious Diseases, quarantine stations, local public health institutes, private testing companies and universities, we have secured a testing capacity of about 6,000 a day, and by the end of March this is expected to exceed 8000.

 

To make it easier for all patients to get tested, the PCR test can now be taken using national health insurance.  When you have been introduced to the Returnee/contact person clinic via the Returnee/contact person consultation center, you can request a test directly from a private institution instead of going through the local public health center. 

 

If your local doctor deems it necessary for you to get a PCR test, you will be able to have a test after being checked by the Returnee/contact person clinic. 

 

To ensure that local testing capacities don’t become a limitation on testing, the government will assess the distribution of reagents and make sure that those regions which need them can conduct the tests.

 

At the same time, on March 18 it was confirmed that two testing instruments had the same level of accuracy as the current PCR test. As a result, the time required for testing at laboratories can be shortened, and testing at medical institutions can be expanded.

 

Q32  If one is worried about being infected with the novel coronavirus, why shouldn’t we visit a medical institution immediately and why should we refrain from visiting multiple medical institutions?

 

At present, even if you have the symptoms such as cold and fever, lethargy and breathlessness, there are overwhelmingly more illnesses other than the novel coronavirus, so if you are worried about having a cold of influenza type illness, please consult your local doctor as before.

 

On the other hand, those who are suspected of having the novel coronavirus infection are being referred to the “Returnees / Contacts Outpatient Center” by the “Returnees / Contacts Consultation Center”, so visiting such centers without conducting the appropriate consultation can lead to a risk of infection even if you don’t currently have the virus.

 

If you are concerned about being infected th the new coronavirus, please consult the “Returnees / Contacts Consultation Center” first. The names of the medical institutions that have “Returnees / Contact Outpatients Centers” are not disclosed.  This is because during the 2009 pandemic influenza epidemic, specific medical institutions in some prefectures were flooded with outpatients and they to respond to spend time responding to people who requested urgent attention.  Please understand that it is necessary to ensure that those who require urgent attention (for example, severely ill patients with intensive care) are given priority.

Q33  In Osaka Prefecture it was reported that a person who was once confirmed to be infected with a new type of coronavirus was discharged from the hospital [after becoming negative], and then tested positive when re-tested later. Why is this?

 

It is generally believed that once an infection has subsided, it is unlikely that re-infection will occur within a short period of time. On the other hand, it is possible for the PCR test to be negative but the infection is not completely cured, so the infection may recur.

 

This time, as there is a case where someone who was once confirmed to be infected with the novel coronavirus was discharged from the hospital [after becoming negative] and then later found to be positive again when the PCR test was conducted, we will collect more detailed information on this case in the future.  It is also necessary to analyze this information with the National Institute of Infectious Diseases and other experts and take necessary measures.

Q34  Is it easy for symptoms of the novel coronavirus to become serious? (UPDATED) 

Many people who are infected with the new coronavirus have a mild reaction and become better.  In cases in Japan, fever and respiratory symptoms often persist for about a week, and many people complain of strong sense of listlessness.

 

If pneumonia caused by coronavirus becomes severe, intensive care such as mechanical ventilation is required, and there have been reports of cases where the length of hospital stay is longer than for seasonal influenza.  Elderly people and those with underlying illnesses (diabetes, heart failure, respiratory diseases, etc.) are considered to be at increased risk of becoming more severe.

 

Combining the cases in Japan and those returning from charter flights from Wuhan, of the 996 patients with positive PCR tests who were symptomatic, about 5.5% were severely affected (i.e. needing respirators or were hospitalized in an intensive care unit) (as of March 24).

 

According to the China Center for Disease Control (CDC), based on the data of about 44,000 people diagnosed with coronavirus infection in China up to February 11, it is reported that more than 80% of light cases did not report breathlessness (dyspnea), while less than 20% were reported as having severe breathing difficulties (dyspnea) and respiratory failure.

 

http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51?from=timeline&isappinstalled=0

 

Source:  National Center for Global Health and Medicine,
http://www.kansensho.or.jp/uploads/files/topics/2019ncov/2019ncov_casereport_200205.pdf

 

Q35  What has happened with this winter’s flu epidemic?

 

 (not translated)

Q36  What are the symptoms and what are the effects on the fetus when infected with the new coronavirus during pregnancy? 

 

In general, pneumonia during pregnancy can be more severe than when not pregnant.  For that reason, please contact the "Returnee and Contact Center" located at local public health center:

・ When you have symptoms of a cold or fever of 37.5 degrees or more continuing for 2 days or more, and

・ When there is strong listlessness or breathlessness (dyspnea)

 

Returnees / Contact Information Center Page

https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/covid19-kikokusyasessyokusya.html

 

In addition, although the effects on the fetus of pregnant women are unclear, at this time it is believed that the risk of preterm birth in the first and second trimesters is not high. There are currently no reports of fetal malformations. Please refer to the following page for details. Japanese Society of Obstetrics and Gynecology: List of Information

http://jsidog.kenkyuukai.jp/information/index.asp?

 

Although the relationship between new coronavirus infection and fetal death is not clear, there has been one report of fetal death in an infected pregnant woman.  In this case, no infection has been confirmed in the fetus.