PART 1: An update on the Covid-19 situation in Japan and preparations for the 80th Annual Meeting of the Japanese Orthodontic Society (JOS) & The 5th International Congress

Written by:
Professor Koutaro Maki

Chairperson of the 80^th Annual Meeting of the Japanese Orthodontic Society (JOS) & the 5^th International Congress

Professor, Department of Orthodontics, School of Dentistry, Showa University

The status of COVID-19 infection in Japan, its transition and government responses

Since its confirmation in 2019, COVID-19 has spread all over the world in the blink of an eye. In Japan, the first infection was confirmed in January 2020, and the infection has since spread throughout the country in a similar manner to other countries. In March 2020, the World Health Organization (WHO) declared the infection as a pandemic. Every day, new infection counts for each country are recorded and updated, and the conventional lifestyle of people has undergone considerable changes. These conditions have forced us to live under various social restrictions. Even though the global vaccination rates against COVID-19 have recently been increasing, the repeated emergence of various mutations of this virus indicates that we have yet to find a solution to end this pandemic. The graph below shows the new infection counts and their trends in Japan thus far.

Trend of COVID-19 cases in Japan

• January 15, 2020 First COVID-19 infection confirmed in Kanagawa Prefecture
• January 30, 2020 Establishment of the COVID-19 infection control unit by the government
• January 31, 2020 State of emergency declaration by the WHO
• February 13, 2020 First confirmed death from COVID-19 infection in Japan
• February 26, 2020 Request for response to nationwide suspension of events
• March 6, 2020 Commencement of public health insurance applications for PCR tests
• March 24, 2020 Postponement of the Tokyo Olympic Games
• April 7, 2020 First state of emergency declaration
• May 25, 2020 End of the state of emergency
• January 7, 2021 Second state of emergency declaration
• February 17, 2021 Commencement of priority vaccination for healthcare professionals (with Pfizer vaccine)
• March 18, 2021 End of the state of emergency
• April 23, 2021 Third state of emergency
• July 23, 2021 Start of the Tokyo Olympic Games
• September 28, 2021 End of the state of emergency
• November 30, 2021 First confirmed infection with the Omicron variant in Japan
• December 1, 2021 Commencement of booster vaccination

Infection control measures at the 80^th Annual Meeting of the Japanese Orthodontic Society (JOS) & The 5^th International Congress

Since October 2018, the Department of Orthodontics, School of Dentistry, Showa University was tasked to oversee the administrative affairs of the conference. Given that the conference is a jointly hosted international affair, the preparations for the 2020 event started with grand plans to be implemented on site. However, the situation changed very rapidly with WHO’s declaration of a state of emergency due to COVID-19 on January 31, 2020.

The 9^th International Orthodontic Congress (IOC) and the 79^th Annual Meeting of the Japanese Orthodontic Society (JOS), which were set to be held in October 2020, were converted into web sessions and this required changes to some parts of the program. As the situation in the coming year could not be predicted, the secretariat of the 80^th Annual Meeting decided to prepare three modes to host the event: on-site hosting, web hosting and a hybrid of on-site and web hosting. This is something that we had not experienced previously and the process proved challenging.

In August 2021, with Japan seeing the fifth wave of COVID-19, we were forced to decide on the hosting method of the event because of issues such as venue cancellation fees. Ultimately, we decided to push forward with the hybrid hosting method. At that time, we were very disappointed that some activities, such as the on-site certification exams and social gatherings had to be cancelled. The registration to participate in the conference was basically based on web participation. When on-site hosting would be made possible, the participants would be asked via questionnaire about whether they would like to participate in the on-site program.

Due to the increased number of people receiving their second vaccination dose, the state of emergency came to an end on 28^th September 2021. This prompted a return to some normality. We could then relax the conditions for the on-site participation. The infection control measures implemented on the day of the conference were as follows:

• At the venue, participants were monitored using questionnaires, and their temperatures were measured using thermography.
• We ensured thorough virus elimination using sanitizer disposal and antibacterial mats, as well as imposing social distancing through seating patterns.
• We equipped the conference homepage with an application that informed the participants of the venue capacity status during the lectures. In this way, they could monitor the congestion status of the venue online.
• The trading company exhibition was held with a reduced number of exhibition booths and a limited number of visitors. Strict infection control measures were also implemented.
• The lectures were conducted and streamed live so that participants could participate in real time from their homes, clinics, and local exhibition halls.

1. Overseas lecturers pre-recorded their presentations, which were then provided on demand.
2. The presentations of the lecturers in Japan were conducted at the venue and streamed live online.
3. After editing, the lectures were made available online on an on-demand basis until November 30.

Fortunately, the event could be held during a time when the infection levels were low. There was a total of 4,426 participants, including more than 1,000 participants at the venue. In addition, 50 companies participated in the trading company exhibition, and the publicly delivered video lectures were accessed more than 4,000 times.

This event was held in a new and hybrid format of hosting academic conferences, with on-site hosting amid the COVID-19 crisis, in accordance with government and local infection control measures and with adequate control of the level of congestion using the lamp display. As a result, we did not see any clusters forming. Many participants gave this hybrid approach high ratings.

What we learnt about hosting a hybrid approach:

Having completed the hybrid hosting of on-site and web hosting, we summarised below the advantages and disadvantages of this form of hosting for an academic conference.

Advantages

• The archives are available for viewing so doctors in private practice can attend without having to close their clinics.
• The lectures can be watched repeatedly.
• It is possible to listen to almost all lectures even if the lecture times overlap.
• It is possible to control the number of on-site attendees.
• It is easy to switch contents (without having to move from venue to venue).
• It is easy to understand the talks given by foreign lecturers because of the translated subtitles.

Disadvantages

• It would not be possible to listen to a lecture if a lecturer does not provide permission to make the presentation available online for various reasons, such as personal information protection. In addition, this information could not be communicated to the society members.
• Several people may listen to the online lectures using only a single account.
• Not all society members were informed about the details of hybrid hosting, with some members not being familiar with hybrid hosting.
• The registration format was complex.
• It was not possible to communicate smoothly with the presenter(s).
• Although the infection control measures were understandable, the audience in the venue was limited, and the whole experience lacked excitement (e.g., no applause from the audience could be heard during the event).
• The scale of the trading company exhibition was small.
• The web environment was unfamiliar, and elderly members were not likely to participate.
• Issues with the network environment, such as the Wi-Fi or web transmission, would be difficult to deal with it, hence the need to prepare a backup system.

As of February 2022, Japan is in the midst of its sixth COVID-19 wave because of the Omicron variant. Fortunately, the 80^th Annual Meeting of the Japanese Orthodontic Society & the 5th International Congress could be hosted in a hybrid format, including on-site hosting, between the fifth and sixth waves. We struggled to organize this event, as we had no prior experience. Nevertheless, we were able to put forward a new way of hosting academic conferences in line with the conference’s main theme: “The Expected Future of Orthodontics.” Overall, the event was a great experience. Thus, we would like to thank all the members of the society and the people involved in the conference. We may have yet to see the end of COVID-19, but we will strive to never stop the progress in orthodontics. We do pray that COVID-19 will end and those peaceful days will return to everyone around the world.