Future actions toward the second wave of COVID-19 Outbreak

Hokesen Letter, No 208 (English ver.), June 23, 2020.
Health Care Center, Tokyo University of Foreign Studies.
Yasuhiro Yamauchi, MD, PhD.

The number of COVID-19 infected patients is still increasing worldwide every day. But in Japan we have overcome the first wave. Showing the stability of the increase in COVID-19 patients and the medical systems have been improved. However, it is expected that the second wave is coming with the relaxation of behavioral regulations and the international exchange will be recovered. Therefore, it is important to keep the measures for infection prevention continuously.
So far, it has been pointed out that droplet infection and contact infection are the infection modes of COVID-19, but in addition to this, the high level of virus is secreted in saliva and micro droplets which are generated during conversation. It has turned out that droplets (micro droplets) are important route of infection. For this reason, the importance of wearing a face mask is recognized in order to suppress the generation of micro droplets containing saliva during conversation
Furthermore, it has been pointed out that this micro droplet can float in the air for a long time, and under poorly ventilated conditions, a large amount of micro droplet will float in the same space, increasing the risk of infection. For this reason, it is reported to be important to avoid the risks of “3 Cs”, closed spaces, crowded places, close-contact settings.
In addition, the infectivity of COVID-19 was found to be infectious from the stage several days before the onset, in other words, when the person has no symptoms and the person was unaware of it. Also, there were asymptomatic infected persons who had no symptoms at all, It was also reported that the person could spread the infection to others without their knowledge.
As described above, we assimilated both existing and newly proved knowledge, and we performed both prevention of micro-droplet spreads by wearing face mask and thorough action to avoid “3 Cs”. For this reason, it is thought we were able to overcome the first wave of COVID-19.
Therefore, in the future, it is necessary to continue to carry out daily life incorporating a ‘new lifestyle’ while keeping in mind infection prevention.

For the measures of infection prevention individually, continue to practice, that is, washing hands with soap and running water frequently, and when it is difficult to wash hands use alcohol disinfection. Keeping social distancing is also recommended, and please avoid positioning in front of the persons who are talking without face mask. Also please avoid touching your face with your hands.
In addition, when you talk face to face, please wear a face mask, even if you do not have any symptoms. And please perform cough etiquette thoroughly. Avoidance of 3 C’s is recommended, adjusting the room temperature with air-conditioner, and performing room ventilation frequently (about once every 30 minutes). Please check your body temperature every morning, and if you have fever or cold, please stay and rest at home.
It is still unclear when the second wave will come or how long this pandemic will last. However, it is said that we should expect the prolonged coexistence with COVID-19. It is necessary to perform sustainable measures for infection prevention individually as much as possible.

If you have any concerns, please contact the Health Care Center, TUFS.


1. For the general public, overcoming the first wave, understandings and actions required for us. Japanese Society for Infection Prevention and Control. June 15, 2020.

2. Example of practicing “New Lifestyle”, Ministry of Health, Labour and Welfare