Kyoto University School of Public Health

Summary of KUSPH Short Course on October 5th

Generals 2020/11/18

Kyoto University School of Public Health held a Short Course on measures and research for the COVID-19 in Asian countries.
Students and faculty members from the University of Malaya (Malaysia), National Taiwan University (Taiwan) and Kyoto University participated.
The event report is posted below.


Topic:Comparing COVID-19 Prevention Measures and Research in Asia
Date: October 5th, 2020 15:00-17:00
Method: Online Seminar (using ZOOM)

Kyoto University School of Public Health Short Course Webinar on 5th October 2020 (3:00-5:30 PM, JST)
Comparing COVID-19 Prevention Measures and Research in Asia

  1. Prof. Noran Naqiah binti Mohd Hairi, University of Malaya
  2. Prof. Chang-Chuan Chan, National Taiwan University
  3. Prof. Hiroshi Nishiura, Kyoto University

Opening Remarks:
Opening remarks were made by Prof. Takeo Nakayama, Dept of Health Informatics, Kyoto University. He welcomed the speakers and the participants to the meeting and asked that all should contribute their ideas to make the webinar successful.
He made a brief introduction about the global status of COVID-19 emphasizing on Asia. He also mentioned the impacts of COVID-19 on economics, society & lifestyle, information access, and mental health. He also briefed about the various solutions which are being used to tackle COVID-19 like contact tracing, analysis of big data, adoption of telework, and vaccine development.

Speaker 1:
Professor Noran Naqiah binti Mohd Hairi,
Centre for Epidemiology and Evidence-based Practice,
Dept of Social & Preventive Medicine, Faculty of Medicine,
University Malaya

The Topic of Presentation:
Navigating through the COVID-19 Pandemic in Malaysia
Prof. Noran gave us an overview of the COVID-19 situation in Malaysia. The first case was detected on 24th January 2020. There were few social gatherings in the country which led to the spread of the infection. In Malaysia, lockdown is called movement control order (MCO) which was started on 18th March 2020 with the closure of all international borders, restricted domestic movements, and closure of many businesses. These measures had a very positive effect with a remarkable reduction in the number of COVID-19 patients till September. There was a rise in cases after 26th Sep due to the elections in Sabah, a state in Borneo Island. Malaysia’s approach was by public health intervention and health promotion and empowering communities. They also focused on protecting healthcare workers and universal health coverage for COVID-19 cases. Ministry and social media played a key role in clear communication about the COVID-19 situation and reminding the public about the required precautions. Various innovations like digital contact tracing, E COVID database, and Global COVID-19 Index were designed to battle the pandemic. Thus, Prof. Noran concluded that trustworthy and able management can effectively help in controlling the pandemic.
Speaker 2:
Professor Chang-Chuan Chan, ScD,
College of Public Health, National Taiwan University

The Topic of Presentation:
The Taiwan Model of COVID-19 Control and Its Global Implication

Prof. Chan shared the experience of SARS in Taiwan, stating that they had a high fatality rate in SARS cases. Harsh lessons learnt from the 2003 SARS outbreak forced them to make strong decisions to contain the COVID-19 pandemic in Taiwan. So, despite WHO recommendations against restrictions of international traffic, Taiwan started a border control early. Taiwan focused on clear communication and nonpharmaceutical interventions (NPI) as a vaccine is still under development. Four major NPI are; 1) contact tracing, 2) border control, 3) social distancing, and 4) resource allocation. Taiwan was the first country to start border control measure to contain the pandemic. Taiwan was predicted by the world researchers to have the second-highest risk to get imported cases of COVID-19 but it was saved by its effective NPI model. Prof. Chan emphasized that a unified society is one of the reasons behind the Taiwan Model’s success. Taiwan’s single-payer National Health Insurance (NHI) system enables them to mobilize the healthcare resources of the entire country during an outbreak. Prof. Chan mentioned about “Four-Tiered Joint-Command System” which consists of the President, Executive Yuan, Ministry of Health and Welfare, and Taiwan Centers for Disease Control which work very closely in evaluating the situation, making decisions, issuing commands, and execution of the required action for the public. Hence Taiwan can control the COVID-19 infection with only 517 confirmed cases as of 4th Oct and still working aggressively on the approaches not used before, while maintaining the preventative measures that have been effective so far.
Speaker 3:
Professor Hiroshi Nishiura, Professor
Kyoto University School of Public Health

The Topic of Presentation
COVID-19 Control in Japan via the Emergency Operating Center
Prof. Nishiura mentioned the epidemic curve of Osaka city in Japan with a rise in the first wave from March and a second wave from July. Any radical countermeasure to reduce contact for the entire population was not carried out during the second wave. Prof. Nishiura along with his team members worked with the Ministry of Health, Labor, and Welfare on contact tracing as Cluster Busters approach (stochastic phase) to explore cluster intervention in Japan and call for avoiding 3Cs (i.e., close contact in a confined space and crowded environment), because close contact in closed space was considered as affecting in spreading the infection during early surveys. Cluster was found in the indoor places like karaoke, gym, night clubs and source of spread spotted was sputum, saliva, high respiratory rate, and sometimes loud voice. Once the number of cases increased, a state of emergency with self-restraint movements was declared on 8th April in Japan. This resulted in decline in secondary cases and was able to maintain the reproduction number below the value of 1 for more than 1 month. He also explained the COVID-19 cases on the cruise ship Diamond Princess. After noticing increased cases on 3rd February, onboard quarantine started on 5th February, and the quarantine led to a reduction in cases and the disembarkment was initiated on 19th February 2020. In the present day, the country has faced difficulties in balancing between economic activity and pandemic control. Japan is also working on maintaining the hospital capacity before we anticipate an increase in the number of patients during winters 2020.

Panel Discussion:

Professor Noran Naqiah binti Mohd Hairi
Professor Chang-Chuan Chan
Professor Hiroshi Nishiura
Professor Takeo Nakayama
Professor Naoki Kondo
We had a very active discussion among all the speakers and participants. Prof. Nakayama asked reasons behind Taiwan’s ability to take a quick decision of border control. Prof. Chan answered that immediate decision was based on the harsh experience of SARS and minimum debatable problems in the Ministry due to less information available about coronavirus initially. Prof. Chan shared a very good solution of reminding people about mask adherence to Prof. Noran that announcement was made every 30 minutes about wearing the masks in public and increased the number of the tests helped people to recall about taking precautions. Prof. Nishiura shared that the date of Olympic games in summer 2021 will be decided by February 2021. Also, Prof. Chan offered that Malaysia and Taiwan can share responsibility by having a few games there. On and off lockdown will be required in Japan to suppress the COVID-19 cases in order to prevent overburden in the hospitals. Prof. Chan mentioned that using currently available information about coronavirus, we can make a proper model of social distancing, contact tracing, masks, flu shots for preventing the infection as it is very difficult to achieve zero cases since it is a pandemic.
Closing Remarks:
Prof. Naoki Kondo from Kyoto University School of Public Health gave the closing remarks by thanking all the speakers for their valuable time and inputs. Prof. Kondo mentioned that scientific evidence, logical thinking, affordable social security systems, and governance can be the key factors for crisis control.
Organized by:
Ayako Kohno, Program-specific Assistant Professor
Internationalization Promotion Office (IPO),
Kyoto University School of Public Health
Mai Takeshita, PhD candidate, Dept of Health Informatics
Swati Mittal, MPH candidate, Dept of Health Informatics