Japan’s testing bottleneck sows wider virus dissemination

Linda J. Dodson

TOKYO — In early April, it took an average 5.5 days from when people in Japan developed fevers or coughs to receiving positive test results for the new coronavirus. As of Saturday, it had slowed to 7.3 days. 

The set back in the seven-day moving average, according to an analysis of data from consulting firm J.A.G Japan, is reflective of the country’s struggles in expanding testing. With the system unable to keep up with the outbreak’s spread, patients and doctors have had to wait longer for results, underscoring the need for private-sector help.

Such long waits not only increase the risk that carriers will unknowingly spread the virus further, but also make it more likely that infections will go undetected before a “second-week crash” — a sudden deterioration that many patients experience a week or more after first developing symptoms.

Japan has conducted about 8,000 polymerase chain reaction, or PCR, tests per day nationwide since mid-April. Private labs run by such companies as Miraca Holdings handle about 2,000 — compared with a total capacity of about 4,000 — with the rest covered by the Tokyo-based National Institute of Infectious Diseases or local public-sector institutions.

The country was slow to get businesses involved in testing, with no tests at all done by private labs on some days until late February.

In particular, hospitals designated by municipal authorities to handle COVID-19 cases tend to rely on government-run testing facilities. “There’s a strong sense that infectious diseases should be handled by the government,” said a representative from a testing company.

In Nagano, the prefecture determines whether to send tests to public or private labs depending on the priority level, but such arrangements remain rare.

The aversion to private labs has made it harder to expand testing of mild cases, which are handled mainly by the private sector. People with only minor symptoms, such as fever or malaise, may not be able to get screened immediately.

Kyoto University Hospital issued a statement April 15 calling for PCR testing of even patients showing no symptoms, either publicly funded or covered by insurance, to help keep the virus from spreading at the facility.

Hong Kong and South Korea have kept the outbreak under control thanks partly to widespread use of simple COVID-19 tests. Japanese e-commerce giant Rakuten on Monday began selling test kits that allow users to collect samples at home.

But hurdles remain to widespread screening outside medical settings. The Japan Medical Association warned Wednesday that improperly administered tests may not give reliable results, potentially causing confusion.

Prime Minister Shinzo Abe said on April 6 that Japan would double its daily PCR testing capacity to 20,000 tests. But even some in the government are increasingly alarmed by the lack of progress.

“The government has been too focused on stamping out clusters and fallen behind on ramping up testing,” said Yasuhisa Shiozaki, a former health minister and now a lawmaker in the ruling Liberal Democratic Party.

Health Minister Katsunobu Kato on Wednesday visited a new PCR testing center in Tokyo’s Shinjuku Ward, which will have tests processed by a Miraca subsidiary. “We will support nationwide expansion of similar efforts,” Kato said.

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