Photo/Illutration Osaka Governor Hirofumi Yoshimura attends a Feb. 16 meeting of a prefectural panel of health experts on the COVID-19 pandemic. (Toshiyuki Hayashi)

Osaka’s grim record as the prefecture with the highest number of COVID-19 deaths during the sixth wave of infections shows no sign of letting up any time soon, leaving health experts struggling to explain why.

The current ratio of nine deaths per 100,000 people in the prefecture is more than double the national average of four, making it the nation’s highest.

Why the prefecture with 8.79 million people is witnessing more deaths from COVID-19 remains something of a mystery.

Osaka Governor Hirofumi Yoshimura cautioned at a March 4 news conference that the higher trend in fatalities will likely continue for some time when asked by reporters about the trajectory that shows cases are declining in the prefecture.

“New deaths are a lagging indicator,” he said. “A drop in new cases does not immediately translate into fewer deaths.”

An Asahi Shimbun study showed that 799 patients died in the prefecture between Dec. 17, the start of the current sixth wave, and Feb. 26.

It was followed by 438 deaths in Aichi Prefecture and 421 in Tokyo.

There are two plausible explanations for the situation in Osaka Prefecture.

One is that the ratio of infected patients who die is simply higher there than elsewhere in Japan.

The other is that there are bound to be more deaths when the prefecture has more cases of infection than any other in the nation.

The first scenario appears less plausible because the number of deaths accounted for 0.18 percent of all the patients confirmed infected with the virus in the prefecture, according to the Asahi study.

The figure compared with the national average of 0.16 percent, a point Yoshimura has repeatedly cited to deflect criticism over the prefecture’s handling of the pandemic.

“We are ranked around the middle of the national ranking in the ratio of fatalities among patients,” he said.

The number of daily new cases in Osaka Prefecture has been declining over the past several days after topping 10,000.

Even so the prefecture has the distinction of still reporting the highest number of new cases nationwide.

During the current wave of the health crisis, the prefecture posted 4,910 new cases per 100,000 people, the worst in the nation, and higher than Tokyo’s 4,251. The national average is 2,507.

Even if the case fatality rate remains almost on par with the national average, the larger number of new patients resulted in raising the number of deaths.

The data also showed that 93 percent of deaths from COVID-19 involved patients aged 70 or older in the prefecture.

By age group, the case fatality rate was 0.02 percent for people in their 40s and 50s.

But the figure jumped to 1.26 percent for those aged 60 or older.

Outbreaks at numerous facilities for the elderly are causing major concern.

It remains unclear why cluster infections are occurring so rapidly in these facilities, said Shigeto Shigematsu, head of the Osaka Medical Association, a prefectural group of doctors.

However, he said a key reason for the high fatality rate from COVID-19 among senior patients is that doctors are unable to start aggressive treatment in the early stage because it takes time for the patients to be admitted to hospitals after their infections are confirmed at the care facilities.

(This story was written by Takahiro Takenouchi and Fumi Yada.)

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