Challenges of community point-of-care antibody testing for COVID-19 herd-immunity in Japan

Takita, Morihito; Matsumura, Tomoko; Yamamoto, Kana; Yamashita, Erika; Hosoda, Kazutaka; Hamaki, Tamae; Kusumi, Eiji

doi:10.1093/qjmed/hcaa182

Cited by 11 publications

(16 citation statements)

References 3 publications

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“…Tokyo, Japan [16,179] The authors of this study specifically cautioned against interpreting their results as representative of the general population. In particular, the sample of 1,071 participants included 175 healthcare workers, 332 individuals who had experienced a fever in the past four months, 45 individuals who had previously taken a PCR test, and 9 people living with a COVID-positive cohabitant.…”

Section: H2: Studies Excluded Due To Accelerating Outbreakmentioning

confidence: 99%

Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-analysis, & Public Policy Implications

Levin¹,

Hanage²,

Owusu‐Boaitey³

et al. 2020

104

129

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To assess age-specific infection fatality rates (IFRs) for COVID-19, we have conducted a systematic review of seroprevalence studies as well as countries with comprehensive tracing programs. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities four weeks after the midpoint date of each study, reflecting typical lags in fatalities and reporting. Using metaregression procedures, we find a highly significant log-linear relationship between age and IFR for COVID-19. The estimated age-specific IFRs are very low for children and younger adults but increase progressively to 0.4% at age 55, 1.3% at age 65, 4.2% at age 75, and 14% at age 85. About 90% of the geographical variation in population IFR is explained by differences in age composition of the population and age-specific prevalence. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults. Moreover, the population IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to protect vulnerable age groups could substantially decrease total deaths.

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Section: H2: Studies Excluded Due To Accelerating Outbreakmentioning

confidence: 99%

Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-analysis, & Public Policy Implications

Levin¹,

Hanage²,

Owusu‐Boaitey³

et al. 2020

104

129

View full text Add to dashboard Cite

show abstract

“…We previously reported our interim analysis of point-of-care antibody testing for COVID-19, conducted in primary care clinics throughout Tokyo, Japan. 12 Here, we describe our extensive analysis, which revealed the unique geographical characteristics of participants identified as SARS-CoV-2 IgG positive.…”

Section: Introductionmentioning

confidence: 99%

Geographical Profiles of COVID-19 Outbreak in Tokyo: An Analysis of the Primary Care Clinic–Based Point-of-Care Antibody Testing

Takita

Matsumura

Yamamoto

et al. 2020

J Prim Care Community Health

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Introduction: The primary care clinic plays a major role in triage for coronavirus disease 2019 (COVID-19), where seroprevalence in the setting of primary care clinic remains less clear. As a point-of-care immunodiagnostic test for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the serosurvey represents an alternative to the polymerase chain reaction (PCR) test to measure the magnitude of COVID-19 outbreak in the communities lacking sufficient diagnostic capability for PCR testing. Methods: We assessed seropositivity for the SARS-CoV-2 IgG between April 21 and May 20, 2020, at 2 primary care clinics in Tokyo, Japan. Results: The overall positive percentage of SARS-CoV-2 IgG was 3.83% (95% confidence interval [CI]: 2.76-5.16) for the entire cohort (n = 1071). The 23 special wards of central Tokyo exhibited a significantly higher prevalence compared with the other areas of Tokyo after classification by residence ( P = .02, 4.68% [3.08-6.79] vs 1.83 [0.68-3.95] in central and suburban Tokyo, respectively). In central Tokyo, the southern area showed the highest seroprevalence compared with the other areas (7.92% [3.48-15.01]), corresponding to the cumulative number of confirmed COVID-19 patients by PCR test reported by the Tokyo Metropolitan Government. Conclusion: The seroprevalence surveyed in this study was too low for herd immunity, suggesting the need for robust disease control and prevention. A regional-level approach, rather than state- or prefectural-level, could be of importance in ascertaining detailed profiles of the COVID-19 outbreak.

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“…Actually, some institutions have started screening of individuals without definite symptoms related to COVID-19 using RT-PCR or serological testing and found 3–6% of them could have already been exposed to SARS-CoV-2, suggesting the presence of much higher number of undiagnosed populations. 17 Given that extensive RT-PCR testing for a wider population has gradually become a consensus in containing the disease worldwide, the restricting policy for testing in Japan can be considered suboptimal.…”

Section: Discussionmentioning

confidence: 99%

Underestimation of COVID-19 cases in Japan: an analysis of RT-PCR testing for COVID-19 among 47 prefectures in Japan

Sawano

Kotera

Ozaki

et al. 2020

QJM: An International Journal of Medicine

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Summary Background Under the unique Japanese policy to restrict reverse transcriptase–polymerase chain reaction (RT-PCR) testing against severe acute respiratory syndrome coronavirus 2, a nationwide number of its confirmed cases and mortality remains to be low. Yet the information is lacking on geographical differences of these measures and their associated factors. Aim Evaluation of prefecture-based geographical differences and associated predictors for the incidence and number of RT-PCR tests for coronavirus disease 2019 (COVID-19). Design Cross-sectional study using regression and correlation analysis. Methods We retrieved domestic laboratory-confirmed cases, deaths and the number of RT-PCR testing for COVID-19 from 15 January to 6 April 2020 in 47 prefectures in Japan, using publicly available data by the Ministry of Health, Labour and Welfare. We did descriptive analyses of these three measures and identified significant predictors for the incidence and RT-PCR testing through multiple regression analyses and correlates with the number of deaths through correlation analysis. Results The median prefectural-level incidence and number of RT-PCR testing per 100 000 population were 1.14 and 38.6, respectively. Multiple regression analyses revealed that significant predictors for the incidence were prefectural-level population (P < 0.001) and the number of RT-PCR testing (P = 0.03); and those for RT-PCR testing were the incidence (P = 0.025), available beds (P = 0.045) and cluster infections (P = 0.034). Conclusion Considering bidirectional association between the incidence and RT-PCR testing, there may have been an underdiagnosed population for the infection. The restraint policy for RT-PCR testing should be revisited to meet the increasing demand under the COVID-19 epidemic.

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Challenges of community point-of-care antibody testing for COVID-19 herd-immunity in Japan

Cited by 11 publications

References 3 publications

Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-analysis, & Public Policy Implications

Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-analysis, & Public Policy Implications

Geographical Profiles of COVID-19 Outbreak in Tokyo: An Analysis of the Primary Care Clinic–Based Point-of-Care Antibody Testing

Underestimation of COVID-19 cases in Japan: an analysis of RT-PCR testing for COVID-19 among 47 prefectures in Japan

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