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Forecast of the COVID-19 outbreak, collapse of medical facilities, and lockdown effects in Tokyo, Japan

By Junko Kurita, Tamie Sugawara, Yasushi Ohkusa

Posted 06 Apr 2020
medRxiv DOI: 10.1101/2020.04.02.20051490

BackgroundThe number of patients of COVID-19 in Tokyo has been increasing gradually through the end of March, 2020. ObjectSupport for policymaking requires forecasting of the entire course and outcome of the outbreak including the date of collapse of medical facilities if a lockdown is not initiated. Moreover, the effects of a lockdown must be considered when choosing to initiate one. MethodData of Tokyo patients with symptoms during January 14 - March 28, 2020 were used to formulate a susceptible-infected-recovered (SIR) model using three age classes and to estimate the basic reproduction number (R0). Based on the estimated R0, We inferred outbreak outcomes including the date of collapse of medical facilities if a lockdown were not enacted. Then we estimate the lockdown effects. ResultsResults suggest R0 as 2.86, with a 95% confidence interval of [2.73, 2.97]. Collapse of medical facilities can be expected to occur on April 26 if no lockdown occurs. The total number of deaths can be expected to be half a million people. If a lockdown were enacted from April 6, and if more than 60% of trips outside the home were restricted voluntarily, then a collapse of medical facilities could be avoided. Discussion and ConclusionThe estimated R0 was similar to that found from other studies conducted in China and Japan. Results demonstrate that a lockdown with reasonable cooperation of residents can avoid a collapse of medical facilities and save 0.25 million mortality cases.

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