Japan’s approach to COVID-19 testing

From the beginning of the pandemic, Japanese approach to testing operations was pragmatic – early detection as a key to obtaining the best outcome for any disease. Many countries around the world have implemented lockdown measures and conducting massive testing, while Japan managed the situation without taking such measures.

The article published by Foreign Policy summarises Japan’s approach saying: “In its battle with the coronavirus, Japan appears to be doing everything wrong. It has tested just 0.185 percent of its population, its social distancing has been half-hearted, and a majority of Japanese are critical of the government’s response. Yet with among the lowest death rates in the world, a medical system that has avoided an overloading crisis, and a declining number of cases, everything seems to be going weirdly right.”

According to the article, Japan skipped the worst of the pandemic despite ‘poor testing’ and ‘indifferent lockdowns’. It states that officials limited testing to those who likely needed hospitalization, in order to reduce the number of people who died.

This strategy was described by Shigreru Omi in mid-February – a former World Health Organisation official – that the goal is to ‘slow the speed of expansion of transmission and reduce mortality’.

The results have been impressive despite the increase in the number of new cases since late March. On June 25, the number of deaths per million people in Japan was 7.65, comparing to other countries such as 106.55 in Germany or 634.61 in the United Kingdom. Before that, as of May 14, article states that Japan had 687 fatalities directly attributed to Covid-19 nationwide, equal to 5 per million people.

Japan decided to focus testing operations on potential and identified clusters as opposed to mass testing. This was based on the scientific finding described in The Diplomat – “most of asymptomatic cases do not spread the infection, but a small proportion of them- so called ‘super-spreaders’- infect multiple people, resulting in a pattern of clusters of new infections’.

The testing policy has been criticised by many, despite the low number of deaths in Japan – as testing capacity was focused on people who had underlying conditions or contact with Covid-19 patients. Some people were concerned about the inadequate capturing of data, because of the small number of PCR tests.

The Diplomat describes the criticism of Japanese methods simply because they are unique. It states that the similar pattern has been adapted in Sweden – adopting mitigation strategy. Moreover it is said to make PCR testing easier for the general public to understand. However it says: “testing is only one part of comprehensive crisis management activities, and a discussion on how to position testing operations within an overall exit strategy is needed.”

The need for overall exit strategy has been described further in the source, explaining that developing a stepwise approach from the end of the state of emergency to a final exit strategy is necessary. The numerical indicators that will define “new normal” as well as how to optimize testing operations to make those numbers clear is said to be needed. Foreign Policy summarises:

“These almost miraculously low figures come despite Japan being close to China, with a large number of tourists. It is also the world’s fastest-aging society—yet has escaped, it seems, being severely hit by a virus that is particularly deadly to older people.”

By Julita Waleskiewicz

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