National / Science & Health

Coronavirus testing now covered by Japan's national insurance

by Ryusei Takahashi

Staff Writer

Amid mounting criticism over the low number of people who have been tested for COVID-19 in Japan compared to its neighboring countries, screenings are being covered from Friday by the national health insurance in an effort to increase testing.

But whether more people will be screened as a result remains uncertain, and confusion is spreading among some municipalities and hospitals that don’t have the necessary equipment to test for the novel coronavirus.

At the same time, the health ministry is calling on the private sector to help develop faster, more reliable and cheaper testing methods.

“We’re hopeful that the private sector can help expand the country’s testing capacity,” health minister Katsunobu Kato said during a news conference Friday. “We will support these efforts as best we can.”

COVID-19 screening was already free for patients, but doctors needed the approval of local public health centers to administer them using public funding. This, as well as a lack of necessary equipment, slowed the process or outright forced them to turn patients away.

Now, doctors can make the decision themselves whether to test patients and specimens can be tested not only at regional public health institutes but also at hospitals with sufficient infection control measures and pharmaceutical companies with necessary equipment.

While the health ministry says about 860 hospitals across the country are capable of conducting COVID-19 tests, a number of them can only collect samples.

“We don’t have the equipment or chemicals necessary to conduct a test within the hospital,” said a representative of a designated medical center in Tokyo, which has to send the samples it receives to a separate facility for analysis. “Now the tests are covered by the national health insurance but that doesn’t mean things will immediately change here.”

Experts say insufficient testing could be masking the true severity of the domestic COVID-19 outbreak, and proactive testing could be the only way to stop the virus from spreading further.

It would be prudent for the government to proactively conduct tests in communities around the country to gauge where the virus is concentrated and to what degree, said Scott Burris, director of the Center for Public Health Law Research at Temple University in Philadelphia.

Late last month, the health ministry released a basic set of policies for dealing with the outbreak that prioritized the treatment of those who are at risk of developing pneumonia, encouraging those with mild symptoms to stay home in order to avoid overwhelming hospitals and keep limited testing resources for those with more severe conditions.

Though the government claims it has the capacity to conduct 3,800 tests a day, only 5,700 were carried out between Feb. 18 and 23, the health minister told the Diet last week.

With 6,284 confirmed cases of infection, South Korea has quickly become the second-biggest epicenter of the virus accoriding to official data. But transmission of the same scale could already be happening in Japan, Burris said.

“That would be the safe thing to assume,” he explained. “If the Abe government is not actively trying to find cases and assess where Japan stands, then it’s making a big mistake.”

The reliability of current testing methods in Japan, as well as the accuracy of the results they yield, were questioned further after several individuals who initially tested negative for COVID-19 later tested positive.

As the central government fumbles in its effort to contain the coronavirus outbreak, pharmaceutical companies and regional governments across the country are spearheading the development of faster, more accurate testing methods to detect — and possibly prevent — further spread of the virus.

On Wednesday, Shimadzu Corp. announced it was going to release a newly developed COVID-19 testing method by the end of March that can provide results in one hour. The precision manufacturing company also said the new method would be cheaper. It aims to produce around 50,000 kits every month.

In Japan, most people suspected of carrying the virus are screened using a polymerase chain reaction (PCR) test, which takes between 90 minutes and two hours to produce results and requires test samples to be kept at a certain temperature. With additional time needed to prepare the test and transport samples, in some cases the process can take up to six hours.

In late February, the Kanagawa Prefectural Institute of Public Health and government-backed research institute Riken announced they were developing a reagent that would enable PCR test kits to yield results within 10 to 30 minutes and eliminate the need for precise temperature control.

Any facility with the equipment to run a PCR test will be able to use the method to produce results faster, according to Kenichi Oki, executive director of the research lab responsible for developing the reagent.

In comparison to China, Oki said Japan’s testing methods are lagging because the outbreak started more than a month after reports emerged in Wuhan, which is thought to be the origin of the novel coronavirus.

South Korea, which had 6,284 confirmed cases as of Friday, implemented drive-thru testing stations for people concerned they may have caught the virus.

In China, despite mounting a strategic cover-up in the early stages of the outbreak, aggressive measures taken to contain the virus since then have helped reduced the number of new cases in the country from 3,000 a day to 200.

In Japan, however, it remains unclear when the new test kits will be available for commercial use, how many will be provided and at what cost.

“It’s difficult to say when the technology will be available,” Oki said. “The fact is, we don’t know because we’re still in the process of gathering data.”

Information from Kyodo added

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