The numbers are down. Relief is in the air. Is the worst over?
Coronavirus at its peak was infecting 2,500 a day in Greater Tokyo alone in January. Now the daily figure hovers between 200-300. Hope surges. Normal life beckons – maybe not treacherously.
Josei Seven (March 18) has no quarrel with optimism, but it raises a question about the government’s shift from individual PCR testing to “pool” testing – testing five at a time instead of one, and examining individuals only if the pool test yields a positive. The question is not specifically about the medical soundness of the shift – though that of course is the ultimate issue – but about the health ministry’s failure to offer the public a full and clear explanation.
“Pool testing is not as not as accurate as individual testing but it can be effective,” says Masahiro Kami, head of the non-profit Medical Governance Research Institute. “To keep the virus under control we need more testing. Pool testing makes that possible, especially in overpopulated and underpopulated areas where medical facilities, tend to be short-staffed."
Pool testing, Josei Seven explains, was first developed in Wuhan, the Chinese city that emerged as the global pandemic’s incubator in late 2019. China since then has earned international recognition for remarkable success in stifling the virus. Taking note, Japan’s health ministry introduced pool testing – “sneaking” into the policy initiative, the weekly claims, a little noticed directive to local governments that the numerical standards determining a positive or negative test result be lowered.
The numerical standards relate to what’s known as the CT severity index, a measure of lung inflammation. The higher the standard, the more patients will test positive. Lower the index, and testees who formerly would have tested positive will test negative. In lowering the standard, Japan in effect lowers the number of those deemed infected.
Is something dodgy going on? Not necessarily. Not necessarily not. How is the non-expert to decide? By asking experts. And when experts disagree? What then? Gut feeling? Is that reliable? No. So?
First, a fact: Japan’s previous standards were high, globally speaking, Japan’s CT 40-45 corresponding roughly to Taiwan’s 35 and China’s 37. It’s this high standard that yields Japan’s tabulation of 430,000 coronavirus victims. Among them are those who tested positive despite displaying no symptoms. Lower standards might have dismissed them as negative.
The higher standard, moreover, Josei Seven hears from a health ministry spokesperson, was set not by the government but, informally, by the private Japan National Institute of Infectious Diseases. “This is tantamount to saying,” the spokesperson explains, "‘Let private industry set the standards’” – meaning the pharmaceutical industry and medical instrument makers, with vested interests of their own.
The magazine lets an unnamed “medical journalist” voice the doubts that will naturally occur to the lay mind: Is the government merely eager to keep the numbers down so the Olympics can proceed, so the Go To Eat and Travel campaigns can resume, so the economy can get back on track as soon as possible, possibly too soon?
The article ends inconclusively. “In my opinion,” says Kami of the Medical Governance Research Institute, “the decision was based on sound considerations. Still,” he adds, “if the CT index is changed, the public is entitled to a clear explanation of why that change occurred. Otherwise, as is only natural, doubts will remain.”© Japan Today