Will Japan's virus testing policy be enough to flatten the curve?

With the number of COVID-19 infections continuing to grow in Japan and the nation’s efforts to contain the outbreak having yet to show results, some are asking whether current testing policy is adequate to manage the pandemic.

Starting Monday, laboratories and medical institutions tasked with testing for novel coronavirus SARS-CoV-2 have been able to purchase kits that can detect the virus in 15 minutes — far quicker than the tests currently used at facilities designated to treat COVID-19 patients.

A spokeswoman for textile and chemical product company Kurabo Industries Ltd., which sells the 15-minute test kits developed by a Chinese firm, said it has the capacity to supply 10,000 tests per day and may increase production should the need arise.

“What I am aware of is that today we have already received many phone calls and other inquiries” from institutions interested in buying the kits, she said.

According to the company, the test kits can help detect infections even before symptoms appear. The tests are conducted by placing a drop of blood and a reagent onto a special membrane, which identifies whether antibodies are present. Infection with the new virus is confirmed if antibodies specific to it are detected in the blood.

The company hopes the tests will help respond to growing demand in Japan.

“These kits have already been used in hospitals and other institutions across China … and we hope that they will be helpful for diagnosis in Japan,” the spokeswoman said.

Currently, polymerase chain reaction (PCR) tests, which require a phlegm or throat swab sample, remain the main method used to detect the novel coronavirus in Japan. The results of PCR tests can take up to six hours.

But as patient numbers have risen worldwide, Japan has been criticized over the small number of people it has tested for COVID-19 compared to neighboring countries.

In a news conference Saturday, Prime Minister Shinzo Abe gave assurances that Japan has the capacity to check around 6,000 samples daily and that the number will increase to 8,000 by the end of the month. But testing capacity varies from place to place.

According to the health ministry, institutions in Japan only tested 19,420 samples between Jan. 15 and March 6, including multiple samples for some patients. During that period, Hokkaido, which has seen a record number of COVID-19 cases within Japan, had the capacity to conduct 114 tests a day. But the capacity in Iwate, Yamaguchi, Yamanashi and Toyama prefectures was much lower, at just 20. Kanagawa had the highest capacity at 190 tests per day.

The ministry’s data also shows that just 13,026 people have been tested so far.

While the health ministry says about 860 hospitals across the country are capable of conducting COVID-19 tests, some of them are actually only able to collect samples.

A precision equipment company, Shimadzu Corp., is now working to develop a testing method, a PCR variant that skips the procedure for taking DNA from the virus, that can detect the new virus in one hour, for release by the end of March. The company plans to produce around 50,000 kits per month.

Qiagen, a German molecular testing company with an office in Tokyo, is also fast-tracking a quick test that reportedly will be capable of detecting other types of viral infections at the same time, including seasonal influenza.

Company representative Kazuhiro Isono explained in a telephone conversation Monday that unlike standard PCR tests, Qiagen’s kits use specialized one-step cartridges in which swab samples are placed to detect the novel coronavirus.

“Our kits can extract RNA and process PCR specimens, as well as receive results within an hour,” Isono said. “These tests can be easily used at clinics.”

Currently, many laboratories in Japan are running out of supplies needed to extract RNA from swab samples, but medical staff at institutions treating COVID-19 patients aren’t trained to extract RNA from patients’ samples, he said.

As symptoms such as fever, runny nose or cough can be developed in both flu infections and infections with the new coronavirus, many patients have been left undiagnosed if they tested negative for COVID-19. Isono said the kits will enable health care staff to specify which one of 22 detectable virus types the patient has contracted.

He added that machines for testing using Qiagen kits should be available for introduction to medical and other testing institutions even within a month with a capacity to verify samples from 600 patients per week.