Abstract

BackgroundInstead of the complete lockdown, since the outbreak of coronavirus disease 2019 (COVID-19), Japan has been trying to control the infection by self-restraint request policy. It seems that the number of infected people has subsided, however, the increasing human activities again in the resumption of economy may lead to the second wave of infections. Here, we analyzed the major factors behind the success control of the first outbreak in Japan and the potential risk of the second wave.MethodsEmploying a localized stochastic transition model, we analyze the real data and the results of simulation in Tokyo from March 1 to July 31. In the model, population is divided into three compartments: susceptible, infected, and removed; and area into three zones: crowded, mid and uncrowded. Different zones have different infection probabilities characterized by the number of people gathered there. The flow of the infection simulation in one day consists of three steps: (I) intercity movement of population, (II) isolating infected people, and (III) zone shifting following group behavioral patterns.ResultsThe major cause for the success of controlling the first outbreak in Tokyo is demonstrated through our simulation to be the early request of self-restraint as well as the early detection of infected people. Meanwhile, the observation that the increasing human activities again in the resumption of economy will lead to the second wave of infections is also found in the simulation with an extended period. Based on the analysis of intercity movement and behavioral pattern on Tokyo where normally about 2.9 million people come from the surrounding cities to the central area by using the public railway system every day, results showed that turning the workstyle of 55% of working people ranging in age from 20 to 64 years old into teleworking (remote work) may control the spread of infection without significant economic damage. Meanwhile, to keep about 75% of the normal activity level and to advocate the shift to telework are indispensable because a sudden resumption of activity from the lockdown sate can rapidly spread infection.ConclusionsAs a new normal in face of COVID-19 for Tokyo and other cities that with a high population density, shifting the workstyle of 55% of working people to teleworking and to reduce 25% time staying in the high infection risk area could be an effective measure to control the spread of infection while maintaining a certain level of economic activity.

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