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The Yomiuri Shimbun People hoping to take a free PCR test line up in front of a testing bus in Minato Ward, Tokyo, on Jan 24.
By Takaya Toda and Muneaki Ishihara / Yomiuri Shimbun Staff Writers
12:20 JST, January 29, 2022
The PCR testing system is increasingly under pressure in areas where the coronavirus is surging. In addition to the tests that have so far been conducted by administrative bodies on people who have been in close contact with coronavirus patients, the demand for free tests for the general public is growing rapidly. Experts are calling for people at higher risk of developing severe symptoms to be given priority.
Short supply
Many medical institutions that accept possible coronavirus patients are experiencing a severe shortage of simple testing kits. The Kakuta general surgery and gastroenterology clinic in Mitaka, Tokyo, is visited by more than 20 people a day, and its stock of testing kits had decreased to 10 around Jan. 18.
About 100 units were delivered to the clinic on Jan. 20, but no additional kits are scheduled to come in for the time being. Clinic director Toru Kakuta said: “If we use up all our testing kits, we won’t be able to diagnose coronavirus infections on the same day that patients come to the clinic. That means delays in starting treatment.”
Many drugstores are out of at-home test kits, and free PCR test venues are fully booked for several days ahead. On Jan. 24, a temporary free PCR test bus was stationed in the Odaiba district of Tokyo, and more than 10 people lined up to be checked.
Sloppy plan
Japan has had insufficient testing capacity since the first wave of infections, and the government’s lack of foresight has again come to the fore amid the latest surge. In November last year, the government estimated that the number of coronavirus infections in the sixth wave would be almost the same as that in the fifth wave.
Based on this assumption, prefectures established a system sufficient to test about 31,200 people, about 20% more than the number of infected people — 25,990 — during the peak of the fifth wave.
However, due to the spread of the highly infectious omicron variant, the number of infections has surpassed the estimates for the sixth wave in Tokyo and 40 prefectures.
In Okinawa Prefecture, where many so-called test refugees cannot get tested, the prefectural government established the capacity for up to 26,000 tests, twice as many as last summer. However, implementation stands at about 60% due to a shortage of testing personnel.
Testing negative
Another source of strain is the dramatic increase in new demand for coronavirus tests. In December, for example, the government started to conduct free PCR tests on people without symptoms who were concerned about infection.
From January, the government shortened the self-isolation period for essential workers, including nursery school staff and firefighters, who were into close contact with infected people, on the condition that they test negative for the coronavirus.
The suspension of the so-called “vaccine and testing package,” which relaxes the limits on the number of people at events and the size of groups that can enter eateries has also had a huge impact. All participants are now required to take tests when attending events or dining out in large groups that exceed the limit.
“If an event involving several tens of thousands of people is held, the testing system will be under further pressure,” an official at the Tokyo metropolitan government said.
According to the Health, Labor and Welfare Ministry, about 170,000 PCR tests were conducted on Jan. 15, and about 70,000 of them, or 40%, were self-paid tests conducted by private institutions (some free tests are included in this number).
Reducing burden
On Jan. 20, an advisory board to the health ministry comprising experts on infectious disease proposed giving priority to testing people who need it more urgently than the general public, such as people with symptoms and those who came into close contact with infected people.
The Okinawa prefecture’s PCR testing center reserves tests for older people.
Efforts are under way to reduce the burden of testing. To be registered as a coronavirus patient, people are required again to take a PCR test at a medical institution even if they have tested positive through a commercially available test they administered themselves.
The Okinawa prefectural government will introduce a system under which such people can be registered without getting re-tested after an online consultation with a doctor.
The Kanagawa prefectural government will introduce a system in which it issues a “self-recuperation” notice to people who test positive through a test they took themselves and stay at home without receiving tests or treatment at medical institutions. Patients can submit the notice to their employers.
According to the University of Oxford and other sources, the number of tests per 1,000 people is 1.2 in Japan, smaller compared with 20.4 in Britain, 5.7 in the United States and 3.4 in South Korea.
Simple kits in short supply
There are two tests for the coronavirus: the PCR test that checks if genetic material from the coronavirus is present in nasal and other discharge, and the antigen test that detects and measures the amount of proteins from the virus.
A PCR test is most accurate and takes one to four hours, while an antigen test requires only 15 to 30 minutes. Antigen tests are divided into two types: quantitative and qualitative.
Quantitative antigen tests are as accurate as PCR tests, while qualitative antigen tests use simple testing kits.
Testing kits have been available at drugstores from September last year. However, since the beginning of January, they have been in short supply due to large bulk orders from administrative bodies, medical institutions, drugstores and others amid the spread of the omicron variant.
Nihon Chouzai Co., which has provided free tests at some of its drugstores on behalf of local governments, said that while supplies were previously delivered the day after they were ordered, it now takes about a week or so at some stores.
In response to the nationwide shortage of testing kits, the health ministry asked manufacturers in mid-January to increase production. The total supply by major five companies, including domestic and imported products, is believed to be about 8 million a month. They will increase production or imports by extending operating hours at factories and other means.
Fujirebio Inc., has operated factories on holidays since this month to increase the current output of about 480,000 units a week.
Japan’s largest maker Denka Co., which is capable of producing 130,000 units a day, plans to increase production from early February and is now preparing to operate plants on holidays and after normal hours.
“There are difficulties such as securing plant workers and procuring raw materials, but we want to increase production as much as possible,” a public relations official at Denka said.
