Undertesting in Japan could breed false sense of complacency

Japan, which has taken a much more relaxed approach to fighting the coronavirus than other countries, is being forced to re-assess its measures amid warnings that it is on the verge of an “explosion” in cases.

The government acknowledged a “high risk of spread” yesterday and established a special coronavirus headquarters, setting the stage for Prime Minister Shinzo Abe to declare a state of emergency.

Such a declaration allows the authorities to ask people to stay home. But with the protection of rights like freedom of movement enshrined in the Constitution, such requests are unlikely to impose criminal penalties or even be legally binding.

Japan warned on Feb 24 that the following two weeks would be the “critical moment” in its fight against the coronavirus. One month later, the numbers are surging faster even as the country is testing at only a fraction of its capacity.

Japan had 96 new cases on Wednesday – its largest one-day surge – with a further 84 as at 8.30pm yesterday.

Tokyo has become the centre of the outbreak, with its new daily highs for four straight days reaching 47 cases yesterday, of which over 20 are untraced.

Tokyo Governor Yuriko Koike urged residents to stay home and avoid going out unnecessarily this weekend. The neighbouring prefectures of Saitama, Kanagawa, Chiba and Yamanashi, which make up the Greater Tokyo region, have all followed suit. Some businesses, including Toho Cinemas, have taken the initiative to shut.

What has concerned critics is how Japan’s sudden surge comes despite tests being done only sparingly. The Health Ministry said this was necessary to avoid stirring paranoia and panic, which could overburden the healthcare system.

Its guidelines say that people should call their local health authorities only if they have a fever of more than 37.5 deg C or breathing difficulties for four days. The timeframe is halved for elderly and other at-risk groups.

Still, this raises the risk that milder or asymptomatic but still contagious cases could go undetected in a country where the overwhelming work culture frowns on people calling in sick for mild illnesses.

Further, the dawn of spring comes with the hay fever season, which means a sinister Covid-19 induced sneeze could be shrugged off as a pollen allergy.

Former health minister Yoichi Masuzoe thinks the 1,391 cases so far downplay the situation, adding: “The exact number of infected people is unknown in Japan, where testing is inadequate.”

Health Ministry figures show that 25,171 people in the country of 126.7 million had been tested as at 12pm yesterday. Singapore, with 5.7 million, has done 39,000 tests. Japanese business leaders, including Softbank founder Masayoshi Son and Rakuten chief executive Hiroshi Mikitani, have also called for more tests.

Mr Mikitani said he “cannot understand the reason not to test people” and that mild, low-risk cases can be quarantined or treated at home. “Anyone with symptoms should be examined.” That would be preferable to the current alternative of not having a full picture which, he said, “has bred a dangerous sense of complacency that Japan is safe”.

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