As 'twindemic' looms in Japan, here is what to do if you have a fever

Japan is preparing for a possible “twindemic” scenario this winter in which up to 750,000 people per day could be infected with either the coronavirus or the flu, once again resulting in strain on the health care system.

The government has already begun urging people with a fever who are deemed to be at a higher risk of suffering from severe symptoms to get a self-test kit and stay at home to recover, instead of going to a nearby clinic.

This winter, the cause of flu-like symptoms could be the coronavirus, the flu or the respiratory syncytial virus (RSV). What is the government’s guidance for the season if you have a fever or other symptoms? Here is what you need to know.

What do I do if I have a fever or other cold-like symptoms?

The answer depends on whether you are a high-risk patient — those age 65 and older, those in grade school and younger (typically 12 years old and younger), those who are pregnant and those with underlying disease — or not.

If you are in the higher-risk category, then you are urged to get medical attention at your nearby clinic designated for people with fevers or from your family doctor. You will then get tested for COVID-19 and the flu and be treated accordingly. The government is planning to purchase 38 million coronavirus testing kits that can simultaneously test for the flu.

If you aren’t a high-risk patient, you are encouraged to self-test for COVID-19.

The health ministry in August started encouraging low-risk people with COVID-like symptoms to test themselves using antigen tests, with the ministry approving the sale of such kits both online and at pharmacies.

If you test positive, you can register online with a local follow-up center monitoring coronavirus patients recuperating at home, meaning you can receive support without having to go to a clinic or public health center.

Follow-up center officials will contact you via smartphone apps to monitor your health until you recover.

If you test negative for COVID-19, you can contact a local medical clinic, including by phone or the internet, to arrange a test for the flu. Flu patients are likely to be prescribed the Tamiflu treatment and asked to stay at home to recover. If you test negative for both illnesses, doctors will look for other causes, including RSV.

A negative test for both would mean there is a chance you could have RSV, which has been spreading among children since the summer.

Does this mean I should not go to a hospital if I’m a low-risk patient?

No. If you feel the symptoms are serious, don’t hesitate to contact the fever clinic or your family doctor, according to the guidelines.

If you are recovering at home after developing COVID-19 and symptoms worsen, contact the local follow-up center you are registered with, or the hospital where you received treatment.

Do I need doctor’s papers to prove that I have recovered from COVID-19 or the flu when I go back to work or school?

Some companies and schools have been asking for such documents. But the health ministry issued a notice on Nov. 4 requesting that municipalities notify companies and schools that they should not require workers and students to obtain proof of recovery from the coronavirus or the flu, in order to avoid people going to hospitals and clinics just to get the documents.

What can I do now to prepare for a possible twindemic?

The health ministry is encouraging people to get vaccinated against both the flu — those age 65 and older and frontline workers — and coronavirus to be better protected against the viruses. If you are 12 years old or older, and have received the initial round of two shots for COVID-19, you can get a booster three months after your last one. For those 11 and younger, they can get a booster shot five months after the previous one. You can also be vaccinated simultaneously with both the coronavirus and flu shots.

The ministry is also calling on people to stock government-approved self-test kits for the coronavirus, as well as a fever reducer in case of infection. It is important to use the government-approved test kits, since many of the local follow-up centers only accept test results from those kits, as opposed to nonapproved “research purpose” test kits.

It also recommends that people find the necessary medical contacts beforehand, such as the phone numbers of nearby fever clinics and COVID-19 consultation centers.

When you have symptoms but are not sure whether it is serious enough to call an ambulance, residents in major cities such as Tokyo and Osaka can dial #7119 to speak with a doctor or a nurse in Japanese. When a child is ill, the nationwide consultation number is #8000.