An overview of the reclassification of COVID-19 of the Infectious Diseases Control Law in Japan.

Japan's responses to COVID-19 have been conducted based on the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases (the Infectious Diseases Control Law) and the Act on Special Measures against Novel Influenza, etc. (the Act on Special Measures), as COVID-19 is classified as the category of "the Novel Influenza etc." under the Infectious Diseases Control Law. The government's Novel Coronavirus Response Headquarters decided to reclassify COVID-19 as a Category V infectious disease under the Infectious Diseases Control Law in May 2023 since the disease has become less lethal. Accordingly, the countermeasures such as surveillance and medical care are going to be reviewed, and COVID-19 prevention actions will depend on personal choices (Prior to the review in May, mask usage will be changed from 13 March). However, this does not mean that infection control measures are no longer necessary; it is recommended that such measures be taken in certain settings in order to prevent the elderly and those who at a high risk of severe illness from being infected, even after the disease is classified as Category V.

[What is necessary to make neurology a basic specialty?: Changing medical specialty system in Japan and the mission of a basic specialty].

The Japanese Society of Neurology decided to aim to convert neurology, which is currently a subspecialty of internal medicine, to a basic specialty in the Japanese medical specialty system at the special general meeting of corporate members in January 2018. Because the details of new specialty system in Japan remain unstable, the committee to promote achievement of neurology as a basic specialty planned to hold a special symposium regarding the specialty system at the 60th annual meeting of the Japanese Society of Neurology in May 2019. This article compiles the abstracts of speakers in this symposium. Speakers were from Ministry of Health, Labour and Welfare, the Japan Medical Association, and our society members. We discussed the reason why neurology should be a basic specialty, the consideration indispensable for the regional health care as a basic specialty, how to reach our goal, and problems to overcome. Based on the decision at the special general meeting of corporate members mentioned above and such discussion, we will continue making best efforts to achieve neurology as a basic specialty through negotiation with relevant players including the Japanese Society of Internal Medicine.

Absence of neonatal intensive care units in secondary medical care zones is an independent risk factor of high perinatal mortality in Japan.

AIM: National medical projects are carried out according to medical care plans directed by the Medical Care Act of Japan. In order to improve Japanese perinatal medical care, it is necessary to determine the factors that might influence perinatal outcome. METHODS: Statistical data of births and perinatal deaths were obtained for all municipalities in Japan from 2008 to 2012 from the Portal Site of Official Statistics of Japan (e-Stat). The perinatal mortality of all 349 Japanese secondary medical care zones was calculated. The number of neonatal intensive care units (NICUs), maternal-fetal intensive care units (MFICUs), pediatricians and obstetricians in 2011 were also obtained from e-Stat. Nine secondary medical care zones in two prefectures, Fukushima (7) and Miyagi (2) were excluded to eliminate the influence of the 2011 Great East Japan Earthquake. RESULTS: The 340 secondary medical care zones were divided into three groups according to population size and density: metropolis, provincial city, and depopulation. The number of secondary medical care zones in each group were 52, 168, and 120, respectively. The secondary medical care zones in the depopulation group had fewer pediatricians and significantly fewer NICUs and MFICUs than the metropolis group, but there was no significant difference in perinatal mortality. The only independent risk factor for high perinatal mortality, determined by multivariable analysis, was the absence of an NICU (P = 0.011). CONCLUSIONS: To consider directions in perinatal medical care, planned arrangement and appropriate access to NICUs is indispensable.