We would like to inform you that the Elementary and Secondary Education Bureau, MEXT has released the attached notification dated April 28, 2023.
We are sharing this notification with you with the hope that it will be utilized as a reference for your consideration of your responses to COVID-19.

Contact:
The Office for a Professional Platform of Health and Hygiene Environment in
Schools for Foreign Students provided by MEXT （mediPhone, Inc)
Tel: 050-3187-8114 (Multilingual consultation service),
E-mail: hsfs@mediphone.jp

Enforcement about Ministerial Order Partially Amending Enforcement Ordinance of School Health and Safety Act (Notification)

Akio Fujiwara
Director-general of Elementary and Secondary Education Bureau, MEXT

The Ministerial Ordinance for Partially Amending the Enforcement Regulations of the School Health Act (Ordinance of the Ministry of Education, Culture, Sports, Science and Technology No. 22 of 2023; hereinafter referred to as "Amended Ministerial Ordinance") was promulgated on April 28, 2023 and will come into effect on May 8, 2023. 
The purpose and outline of the amendment are as follows. We hope you fully understand its contents and take appropriate measures.

1. Objective of the Amendment

The Ministerial Ordinance Partially Amending the Enforcement Regulations of the Act on Prevention of Infectious Diseases and Medical Care for Patients with Infections (Ordinance of the Ministry of Health, Labour and Welfare No. 74 of 2023) was promulgated on April 28, 2023, and is to become effective from May 8, 2023. Corresponding to the amendment, the legal classification of COVID-19 will be changed based on the Law on Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases (Law No. 114 of 1998; hereinafter referred to as the "Infectious Diseases Control Law"). The types of infectious diseases to be prevented in schools stipulated in the Enforcement Regulations (Ordinance of the Ministry of Education, Culture, Sports, Science and Technology No. 18 of 1958; hereinafter referred to as "Enforcement Regulations") of the School Health Act shall be amended, as necessary.

2. Summary of Amendments

(1) Addition of Novel Coronavirus Infectious Disease (COVID-19) to Type II infectious diseases (related to Article 18, Paragraph 1, Item 2)

Currently, COVID-19 is regarded as "novel influenza" as defined in Article 6, Paragraph 7 of the “Infectious Diseases Control Law,” and thereby, falls under Type I infectious diseases in accordance with provisions of Article 18, Paragraph 2 of the “Enforcement Regulations.” Meanwhile, it will be downgraded in the Infectious Diseases Control Law. Consequently, it will no longer fall under "novel influenza." Accordingly, the status of COVID-19 as an infectious disease to be prevented in schools was reviewed, and COVID-19 (limited to coronaviruses whose pathogen is of the genus betacoronavirus [which China newly reported as a contagious virus to humans to the World Health Organization in January 2020]) was added to Type II infectious diseases, which are frequently prevalent among students and have high risks of spreading within schools.

(2) Establishment the standard period of suspended attendance pertaining to COVID-19 (related to Article 19, item 2)

Currently, under the Enforcement Regulations, COVID-19 is regarded as a Type I infectious disease. The guideline for the suspension of attendance is "until the patient is cured." However, since the classification of COVID-19 will be changed to Type II infectious disease, a provision for a standard period of COVID-19 related attendance suspension was added, stipulating the period of suspension to "at least 5 days after symptom onset plus another additional day after the symptoms are resolving.”

(3) Date of enforcement (related to supplementary provisions)
The amended ministerial ordinance shall come into effect as of May 8, 2023.

３．Points of notes on handling of attendance suspension at schools

• The period of attendance suspension for students infected with COVID-19 shall be "at least 5 days after symptom onset and another additional day after the symptoms are resolving.”
  * The period of attendance suspension for asymptomatic students shall be at least 5 days after the specimen was collected.
• "The symptoms are resolving" means that the fever has subsided without the antipyretics, and the respiratory symptoms have improved, similar to the conventional concept of a self- isolation period. 
• The beginning day of "at least 5 days after symptom onset" and "another additional day after the symptoms are resolving" should be counted from the day following the disease onset date or the following day when the symptoms are resolving.
• After the attendance suspension has been lifted, the students should be encouraged to wear masks until 10 days have passed since the disease developed. Appropriate guidance is necessary to prevent discrimination and prejudice among children/students because of any episodes of contracting infection or wearing-mask/not wearing-mask.
• The proviso of Article 19, item 2 of the Enforcement Regulations basically does not expect shortening the standard period of attendance suspension indicated the same Item with regard to COVID-19.
• On and after May 8, 2023, the amended standard period of attendance suspension shall apply to also students who were identified to contract COVID-19 before May 8, 2023.

<Reference> The concept of the self-isolation period for novel coronavirus infection (COVID-19) after the change of its legal status under the Infectious Diseases Control Law (providing advance information on handling COVID-19 on and after May 8, 2023) (Administrative notice issued by the Headquarters for Promotion of Infection Control of the Novel Coronavirus Infections, Ministry of Health, Labour and Welfare, dated April 14, 2023).

〇Administrative Notice (body)
https://www.mhlw.go.jp/content/001087473.pdf (only in Japanese)
〇Administrative Notice (appendix)
https://www.mhlw.go.jp/content/001087453.pdf (only in Japanese)

4. Other Points to Note

(1) Consideration about obtaining certificates from medical institutions with regard to COVID-19

As in the past, children/students who have a diagnosed COVID-19 do not need to submit a negative test result certificate to school when they return school after ending their attendance suspension period. Also, they do not have to submit any evidence documents clarifying their result results issued by medical institutions when children/students with COVID-19 begin to be in the self-isolation period. 

(2) How to deal with students who had close contacts

Since close contacts are not identified after May 8, 2023, and that persons who were previously identified as ‘persons with close contacts’ will no longer be subject to behavioral restrictions or requested to cooperate for the restrictions, it is not necessary to subject children/students to suspension of attendance right away as long as the child himself/herself is not infected with COVID-19 even if those are:

・children whose a co-resident family member contracts COVID-19; and
・children who had contact with a patient of COVID-19 at school and ate and drank together without taking measures to prevent infection.

(3) Handling of attendance of a child/student whose a parent/guardian requests to get his/her child to be absent from school because of concerns about infection

In cases where the principal determines that there are reasonable grounds, such as when a child has an elderly person or a person with an underlying medical condition living together and his/her parent/guardian requests him/her to be absent from school and has no choice but taking a day-off unavoidably to prevent infection, then the principal can regard such a day-off as "a day when the principal allows him/her to be absent from school due to reasons not-attributed to the child nor his/her parent/guardian, such as in emergency disasters." The absence may be entered in the "days of suspension/bereavement, etc." column on the cumulative guidance record, and not counted as an absence.

In the case of a student who needs medical care or who is at high risk of aggravating the disease due to underlying diseases, the principal may also determine his/her absence from school as "a day when the principal allows him/her to be absent from school due to reasons not-attributed to the student nor his/her parent/guardian” after confirming the opinion of the student's doctor with the student's parent or guardian. In such cases, it is possible to enter the number of days in the "days of suspension of attendance, bereavement, etc." column on the cumulative guidance record and not count them as absence.In the case of kindergartens, etc., there is no column in the cumulative guidance record for "days of suspension of attendance, bereavement, etc.," so in these cases, it is possible to enter the number of days of non-attendance in the “remarks” column, etc., as "a day when the principal allows a child to be absent from kindergarten due to reasons not-attributed to the child nor his/her parent/guardian, such as in emergency disasters" and not count them as absence.

(4) Informing and reminding students not to attend school if they have unusual symptoms such as fever, sore throat, cough, etc.

If a child/student has unusual symptoms such as fever, sore throat, or cough, it is important to rest at home and they should not be forced to attend school. Schools should inform children/students and their parents/guardians to stay at home.
Since it is difficult to distinguish between symptoms of COVID-19 and those of allergic diseases, etc. schools do not need to impose uniform restriction on school attendance due to the presence of minor symptoms.
In addition, schools should not call for children/students to undergo tests at medical institutions or perform tests using self-test kits against their or their guardians’ will.