Weekly Update: News on Japan & the Netherlands – Week 52, 2020

By age group, the highest number of cases were people in their 20s (133), followed by 120 in their 30s, 96 in their 40s and 77 in their 50s. The number of infected people hospitalized with severe symptoms in Tokyo is 64, up one from Monday, health officials said.

Nationwide, the number of reported cases was 2681. After Tokyo, the prefectures with the most cases were Kanagawa (348), Osaka (283), Saitama (196), Hyogo (190), Aichi (190), Chiba (152), Fukuoka (88), Hokkaido (84), Kyoto (81), Hiroshima (76), Miyagi (41), Tochigi (34) and Shizuoka (30). Twenty-nine coronavirus-related deaths were reported.

Speaking in a prerecorded TV interview, Suga said the government may instead ask restaurants and bars to further shorten business hours in a bid to curb the spread of the novel coronavirus. He has been reluctant to repeat his predecessor Shinzo Abe’s decision in April to declare a nationwide state of emergency, vowing instead to strike a balance between fighting the pandemic and restarting economic activity.

The government is working hard toward making vaccines available for the entire population to “protect lives and livelihoods,” Suga told Tokyo Broadcasting System Television’s “News 23” program.

In a press conference, Tokyo Gov Yuriko Koike urged people to stay at home with their families and refrain from going outside as much as possible during the holidays. “I understand this is a special time of the year. But this year, please prioritize your life and the lives of those around you,” she said.

Koike said the capital will provide financial support to hospitals that accept COVID-19 patients between 29 December and 3 January, 2021. The metropolitan government will pay 300,000 yen per patient each day to medical facilities that treat individuals with severe symptoms, and 70,000 yen when they accept people with more moderate symptoms. Pharmacies that operate eight hours or more per day during the period will receive 30,000 yen a day, Koike said.

The surge has increasingly strained hospitals that are also bracing for the flu season, prompting the Japan Medical Association and eight other health organizations on Monday to declare a “medical state of emergency.”

JMA President Toshio Nakagawa called on the government to take more steps to fight the pandemic, telling a press conference that “effective measures against infections will also serve as the most effective economic measures.”

The government’s top spokesman, meanwhile, said Japan has yet to find any cases of a new fast-spreading strain of the coronavirus that has been detected in Britain and other parts of the world.

Chief Cabinet Secretary Katsunobu Kato told a press conference the health ministry is in close contact with the British government and the World Health Organization, adding there were no immediate plans to tighten travel restrictions.

“We will strictly screen the effectiveness and safety (of the vaccine) before making a judgment,” Health, Labor and Welfare Minister Norihisa Tamura told a news conference. Akihisa Harada, president of the Japan unit of Pfizer, said the company wants to help get life back to normal. “In the event that we win approval, we would like to ensure a fast delivery of our vaccine to people in Japan and play a part in normalizing their social life,” he said.

The company is seeking fast-track approval without having to conduct large-scale trials on the basis that the vaccine has been approved in other countries. It has already conducted clinical trials involving 160 people in Japan, aiming to report the results to authorities by February. The government plans to ask municipalities to prepare venues and medical institutions to conduct vaccinations, and make systems available for accepting reservations.

The United States and Britain have already begun administering the coronavirus vaccine jointly developed by Pfizer and its German partner BioNTech SE, while Singapore and some other countries are expected to follow suit. But concerns remain over its safety as U.S. authorities said Wednesday a health care worker in Alaska suffered a serious allergic reaction to the vaccine. Similar allergic reactions from two health care workers have also been reported in Britain.

Earlier in the month, Japan’s parliament enacted a law to cover the costs for residents to be vaccinated, with a recent resurgence in infections demonstrating the importance of the inoculations. The Pfizer-BioNTech vaccine is projected to be delivered in batches of 1,000 doses but they need to be stored at minus 75 C or lower and administered within approximately 10 days.

The latest assessment by the Pharmaceuticals and Medical Devices Agency will serve as key material for a health ministry review panel that will likely decide on Monday whether to approve the use of Avigan to treat COVID-19 in Japan.

Drugmaker Fujifilm Toyama Chemical Co, a unit of Fujifilm Holdings Corp, filed for COVID-19 approval in October. Avigan has already received approval as an influenza drug. Some medical experts have opposed the use of Avigan, also known as favipiravir, in treating patients with COVID-19, the respiratory disease caused by the novel coronavirus.

Possible side effects include the worsening of liver function, but Fujifilm said no new safety concerns were identified. Pregnant women cannot use the drug as some animal studies have pointed to the possibility of fetal abnormalities.

Expectations have grown that Avigan would become the third treatment drug for COVID-19 in Japan, after the anti-viral medication remdesivir developed by U.S. firm Gilead Sciences Inc and the steroid dexamethasone. The assessment acknowledged that approving the use of Avigan as a COVID-19 drug would be “meaningful” at a time when there are limited treatment options available.

According to data gathered during clinical testing on 156 patients without severe COVID-19 symptoms, Fujifilm found those administered with Avigan showed improvement after 11.9 days, shorter than the 14.7 days for those in a placebo group.

One of the issues raised in the assessment report is the way the tests were performed. The doctors knew which patients received Avigan or a placebo, which the report argues prevented them from properly assessing symptoms, the sources said. The government sources also said the criteria for determining whether symptoms had improved, based on body temperature and other data, lacked clarity.

Fujifilm took longer than initially planned to complete its clinical study that began in March after facing difficulty in securing enough patients as the number of coronavirus cases was on a downward trend in Japan.

Former Prime Minister Shinzo Abe had expressed hope while he was in office that the drug would be approved in May and the government has decided to stockpile Avigan for 2 million people. Fujifilm is aiming to market Avigan for COVID-19 treatment overseas, including in China.

Millions of people across the country flood to the sites in the first three days of January to seek blessings for the year ahead — approximately 3.1 million visited Meiji Shrine between last New Year’s Eve and Jan 3 alone. But this year the shrine, among the most significant Shinto sanctuaries in Japan, will close its doors over New Year’s for the first time since the end of World War II.

“We are trying to avoid creating large crowds. We have been urging the public to delay their New Year visits to the shrine,” a Meiji Shrine spokeswoman told AFP. Some religious sites are asking visitors to reserve tickets for New Year’s visits, or make them now, and at others religious leaders will livestream crowd levels to help guide visitors.

The virus has already forced changes at some sites, including Kyoto’s Yasaka Shrine, which earlier this year replaced a rope for bell-ringing with an electronic system that visitors activate by passing their hand over a sensor, producing a recorded bell sound. But ironically, the shrine is now considering removing the novel system for the New Year season over fears it may attract curious visitors and create crowds.

“Then it would defeat the purpose of having it,” said an official at the shrine, which usually sees about a million visitors during the first three days of January. “We will be asking people to make their New Year visits very brief,” he told AFP. “We are also asking the public to delay their New Year visits.”

Tokyo officials took a similar measure earlier this year when the central government declared a state of emergency over the pandemic. They say it was applied in about 1,250 instances between April and June. One official said many people are likely to experience anxiety around the New Year because there will be fewer jobs than usual. He called on people to contact the helplines without hesitation.

WOTA Corp set up 20 of its WOSH-machines near popular Ginza stores in an initiative with a district association aimed at encouraging shoppers to wash their hands to prevent the spread of the coronavirus.

The machines don’t require connection to running water and don’t use fresh and waste water tanks. Instead they recycle the water through a three-stage process of membrane filtration, chlorine and deep ultraviolet irradiation.

They also have a device that cleans smartphones through 20-30 seconds of ultraviolet light exposure while users are washing their hands, since touching a dirty smartphone would otherwise negate their handwashing efforts.

The firm had already been developing the machine in part to alleviate long lines at rest rooms when the COVID-19 crisis hit early this year, Chief Executive Yosuke Maeda told Reuters. “Amid the impact of COVID-19 we thought we had to implement this as soon as possible,” Maeda said. “So we sped up development and got things moving to have it in December in time for the third wave of the coronavirus.”

On average 20 liters of water provides around 500 washes, while the filters should be changed after about 2,000, he said. The machine, however, needs connection to a power supply.

WOTA has now begun shipments within Japan of roughly 4,000 units. It aims to expand internationally next year, with many inquiries coming from the United States. Maeda hopes the smartphone feature in particular will transform hygiene habits. “We thought if it had the smartphone sterilization function, maybe people who never wash their hands will start doing so,” he said.

People who receive the coronavirus vaccine will only enter the central vaccination register if they consent. This register records who has been vaccinated and with which vaccine. The Dutch public health agency RIVM can then monitor whether a vaccine is effective and safe. The system will be ready for use at the end of December, and people will be able to view their own vaccination data from the end of March.

In his letter, de Jonge writes that “since this vaccination program is of an unprecedented scope and complexity in the Netherlands, I consider proper registration essential in order to maintain a good overview of the safety and effectiveness of the individual vaccines at a national and regional level.”

It has not yet been determined whether registration can serve as a vaccination certificate. The cabinet is afraid that, for example, companies will ask their staff for such proof. De Jonge is waiting for advice from the Health Council on this before an official decision will be made. He wants to know whether the government should prevent private parties from asking for proof of vaccination.

He writes that “the cabinet is also not in support of favoring people who get vaccinated over people who don’t get vaccinated. The importance of public health and individual interests can be at odds with each other there.”

The timeline for the upcoming months is also outlined in his letter to Parliament. It is expected that all nursing home employees will be vaccinated by mid-March with the Pfizer vaccine that was approved on Monday. This concerns 250,000 people who will receive their first dose in January or February and their second dose in February or March.

About 350 to 400 municipal health workers will be needed for this first round of vaccination. According to de Jonge, there is enough personnel to carry out his plans. If necessary, the Ministry of Defense has a thousand medically trained professionals ready to assist with subsequent vaccinations.

The decision came as a response to a mutated version of COVID-19 which was identified in the UK. The mutation was first detected on 14 December in south-east England and has since been named VUI-202012/01 (the first “Variant Under Investigation” in December 2020). Such mutations are by no means rare. In fact, this variant is one among tens of thousands.

The coronavirus is continuously mutating, and by July 2020, there were already over 12,000 different strains. What makes this particular variant significant is the rate at which it appears to be spreading. “It’s the growth rate we are worrying about,” says Nick Loman, professor of microbial genomics and bioinformatics at the University of Birmingham.

Besides flights and trains rides, ferry lines which transport passengers from the United Kingdom across the North Sea to the Netherlands will also not be permitted from Monday as the Dutch government attempts to prevent the highly-contagious variant of the coronavirus from spreading through the Dutch population. For some, the ferries were the last feasible chance for residents of the Netherlands to make it back before Christmas, New Year’s Eve, or possibly longer if the travel ban is extended. A formal ban would mean a car in the Channel Tunnel is the only way to travel from the UK to the Dutch border.

On Monday, Dutch hospitals were treating 2,162 patients with the coronavirus, up a third since the start of the month. Some 586 of those patients were in intensive care, the most since mid-November. The hospitalized patient total was expected to rise to 2,540 by the end of the month, including 640 patients in intensive care, said acute care leader Ernst Kuipers on Monday.

With infections having risen dramatically and consistently for about three weeks, the Cabinet said it is anticipating the peak in Covid hospitalizations to come in January. At the same time, “The hospitals are struggling due to the high workload and contamination among staff causing high absenteeism. In addition, the schedules are even more difficult to fill during the Christmas period,” the Ministry of Medical Care said in a statement.

To cope with that, regular care provision will be reallocated to handle more critical cases, the ministry said. It plans to scale up the intensive care unit availability from about 1,150 spaces to 1,450. Minister Tamara van Ark said, “This means all hands on deck in hospitals during the upcoming weeks.”

Some ICU patients will also be transferred to facilities in Germany. Dozens of patients from the Netherlands were treated in Germany during the first wave, and a handful of other patients were transferred there during the first half of the second wave.

“I ams supporting hospitals with the extra regulations, and ask that everyone stick to the restrictions during the lockdown. Only then will we be able to provide care for everyone that needs it,” she said.

The Pfizer/BioNTech product, Cominarty, is the first of several vaccine candidates to win EMA approval. It was approved for use by people 16 years of age and older. The Netherlands is expected to take delivery of a first batch of 500 thousand doses of the vaccine by the end of the year, with two doses recommended per person.

“Today’s positive news is an important step forward in our fight against this pandemic, which has caused suffering and hardship for so many,” said EMA Executive Director Emer Cooke. “We have achieved this milestone thanks to the dedication of scientists, doctors, developers and trial volunteers as well as many experts from all EU Member States.”

The EMA decision opens the door for all 27 EU Member States to begin inoculating their residents against the coronavirus. Austria, Germany and Italy plan to begin vaccinating people from 27 December. Austria will begin with its health care workers, while Germany planned to also initially inoculate people over 80 years of age.

The Netherlands will invite health care workers, including home care providers and nursing home staff, to contact municipal health service GGD from 4 January to schedule an appointment. There were still questions about the GGD’s ability to establish IT systems in time to log and track vaccine delivery, and the Dutch government has not yet revealed full details of the logistics for providing the vaccines starting on  8 January.

Cominarty is given as an injection into the arm, and then a second injection at least three weeks later. “The most common side effects with Comirnaty were usually mild or moderate and got better within a few days after vaccination. They included pain and swelling at the injection site, tiredness, headache, muscle and joint pain, chills and fever,” the EMA said in a statement.

“Our thorough evaluation means that we can confidently assure EU citizens of the safety and efficacy of this vaccine and that it meets necessary quality standards. However, our work does not stop here. We will continue to collect and analyze data on the safety and effectiveness of this vaccine to protect people taking the vaccine in the EU,” Cooke said. The approval was based upon thousands of pages of data and research, including information about the production process, preparation, dosage, and testing. The Dutch Medicines Evaluation Board CBG was involved in the review on behalf of The Netherlands.

The vaccine is already being used in the United Kingdom and in the United States. In those countries, the Pfizer/BioNTech vaccine was approved earlier this month, albeit only for emergency use. In lengthy reports from the American Drug Authority (FDA) and the British Medicines and Healthcare products Regulatory Agency (MHRA), the drug’s effectiveness, possible side effects, and safety are outlined in detail. Both the Americans and British cite as common side effects a sore arm, fatigue, and headaches.

“In principle, the vaccine does not have to meet other requirements on the European market than in the US and Great Britain,” says a spokesperson for the Dutch regulator CBG. “Our standing points are the same. There may be differences in interpretation, for example in how we evaluate laboratory data. But we don’t expect that.”

We are now waiting for the European Commission to officially authorize the drug on the EU-market. This will probably happen by Wednesday at the latest. In addition, the Health Council in the Netherlands will issue new advice on the vaccination strategy this week. Currently, the plan is to vaccinate healthcare workers first, but perhaps this will change based on the information presented by the EMA.

The Cabinet acknowledged that citizens and residents of the Netherlands could be trapped in South Africa because of the decision and said it would only provide consular assistance if it determined it was necessary. People stuck in South Africa were advised to arrange for accomodation as the situation unfolds.

“The Outbreak Management Team (OMT) has stated in its most recent advice that a strain of the COVID-19 virus has been identified in South Africa that has some characteristics in common with the strain from the United Kingdom, although the strains are not identical,” wrote Cora van Nieuwenhuizen, the Infrastructure Minister, in a letter to Parliament on Monday night. She said the flight ban will be lifted by the start of New Year’s Day, and it could be cancelled earlier if the European Union coordinates on a strategy or if “an effective national testing obligation has been realized for travelers from South Africa.

Like the entry ban against modes of transportation arriving from the UK, cargo flights and their crews as well as the necessary transportation of medical personnel are exempted from the new rule. Anyone arriving from South Africa or another high-risk area must enter quarantine for 10 days, the minister said, though she did not state how or if the Dutch government would enforce that.

She reiterated statements from Prime Minister Mark Rutte and Health Minister Hugo de Jonge that travel abroad is “strongly discouraged” and creates a greater risk for outbreaks of the coronavirus in the Netherlands. “It is irresponsible to travel abroad if not stictly necessary, and the Cabinet calls on everyone to follow this urgent advice,” she wrote.

This was not just in the Netherlands. The average temperature around the world was exceptionally high this year. It was about 0.6 degrees above the average for the period between 1981-2010 and about 1.1. degrees above the average for the previous century.  It is already certain that 2020 will come in first or second on the list of hottest years ever recorded worldwide.

In the Netherlands, the lowest temperature was measured on 25 March, at -4.3 degrees. This meant that we were 0.7 degrees short of reaching the limit for moderate frost, which is -5 degrees. It has been almost 700 days since moderate frost was last recorded in the Netherlands.

Until Saturday, there were 284 days when the temperature rose above 10 degrees. The record is currently at 285 days, which was set in 2002. But, given the weather forecast, this record will likely be broken in the coming days.

It has been a year of many weather records. Ten months of the year were warm above average. 2020 also had one of the hottest summers ever recorded. A total of 13 date-related heat records were broken. These are specific dates on which a higher temperature had never been recorded previously.

The average sales price for a house last month was 344,217 euros. This was only slightly lower than the amount in October when the average price was just a little over 350,000 euros. A total of 18,449 housing transactions were registered, 1% more than the previous year.

The housing market continues to struggle with an extreme shortage. The range of properties that are up for sale has shrunk considerably, while many people still want to buy a house. Additionally, the low mortgage interest rates make buying attractive. As a result, competition is fierce among buyers, and first-time homeowners face great difficulty obtaining any property.

Until now, there has been no sight of any corona dip in the housing market, as many economists had initially expected. Estate agency NVM has recently predicted that house prices will probably continue to rise significantly in the near future. However, experts at ING disagree. Last week, they stated that next year house prices are likely to fall for the first time in five years. “First, the number of home sales will fall because people postpone their move due to rising unemployment and lower confidence,” explained ING-economist Mirjam Bani. After that, according to her, a slight price dip will probably follow.

The agreement is seen by both companies as an important step forward in plans to roll out industrialised building across Europe and tackle housing shortages. Jan Snel specialises in industrialised solutions for the residential, healthcare, office, educational and industrial sectors.

Harry van Zandwijk, CEO of Jan Snel, said: “The signing of this agreement is a reflection of our growth ambition. Daiwa House will add further expertise in industrial building to Jan Snel’s existing knowledge. With this, we want to become the clear market leader in Europe. In comparison to traditional construction methods, our modular construction method is smarter, faster and more sustainable. By combining our solutions and expertise with the strength of Daiwa House, we are laying a strong foundation for the future.”

Jan Snel will continue to use the trade name of Daiwa House Europe in the Netherlands. The company achieved a turnover of ‘just under € 200 million’ this year, with 350 permanent employees and 200 temporary employees. Within ten years it aims to reach a turnover of € 1 billion and within three to five years at € 500 million turnover. Van Zandwijk wants to more than double production in the Netherlands from 1,200 homes and apartments per year to 2,500. This may require ‘another production location elsewhere in the Netherlands’.