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Some medical institutions in Japan have been rejecting possible COVID-19 patients under the strict but ambiguous testing guidelines currently in place, leaving many patients shunted from hospital to hospital.

Experts point out that the vague criteria have caused confusion among medical staff.

According to the health ministry, eligibility for the test is limited to two groups of people: those who have come into close contact with patients confirmed as infected with the new virus, and those who have traveled recently to infected areas in China, have a fever of at least 37.5 degrees Celsius and have pneumonia-like symptoms that require hospitalization.

But the final decision on whether to test a patient is also “up to the doctor’s overall judgment.”

A government worker in his 30s who lives in Tokyo visited a hospital after his temperature rose to 39 degrees on Feb. 17. When he mentioned that he had recently visited Taiwan, he was advised to go to a dedicated COVID-19 consultation center.

The center told him that visitors to Taiwan were not eligible for the test. After being refused by two more hospitals due to reasons such as inadequate facilities, he was finally seen by a doctor at a general hospital where he took a lung X-ray. He was given the all-clear.

“I suppose it couldn’t be helped” with the ongoing spread of the virus, he said.

A 29-year-old male company employee in Tokyo called the COVID-19 consultation center after developing a fever of 39 degrees on Feb. 12 as well as feeling lethargic and having diarrhea. He had recently been in contact with a person who had traveled to the Chinese city of Wuhan, the epicenter of the outbreak.

The center told him to visit a local hospital because he had not had close contact with the individual with Wuhan travel history. He was then refused by a hospital in Tokyo, but was later able to see a doctor at a hospital that specializes in treating infections.

Symptoms of infection with the novel coronavirus may be difficult to distinguish from those of other illnesses, and it is said that most cases of infection do not become severe.

“It’s likely that many people have recovered without even realizing they’d been infected,” said an official at a disease control authority in Chiba Prefecture.

A Chiba woman in her 70s who on Feb. 20 was found to have been infected had previously been told to note her symptoms, but had not been tested. She had gone on a three-day bus tour ending Feb. 18, but the symptoms continued and so she visited the hospital and then tested positive.

Suggesting one reason so many hospitals have been refusing patients, a Tokyo Metropolitan Government official said, “Medical institutions are probably overreacting,” fearing the risks of in-hospital infection.

“There seems to be confusion among medical staff because the wording of the virus test criteria, ‘up to the doctor’s comprehensive judgment,’ is unclear,” the official added.

Masahiro Kami, a physician and head of the nonprofit Medical Governance Research Institute, said that almost every day he sees patients who are suspected of having the coronavirus but cannot be tested because their symptoms are mild.

“The current criteria, that only people with severe symptoms can be tested, is not appropriate,” Kami said. “The government lacks the perspective of responding to patients’ anxieties.”

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