TOKYO — In Japan, it has been a case of see no virus, hear no virus, speak no virus.
Or more to the point, don’t test people for the novel coronavirus and perhaps the Olympics can still go ahead as planned.
Japanese Prime Minister Shinzo Abe is facing mounting anger over his government’s handling of the epidemic, fueled this week by a sudden decision to ask schools to close in March.
But there is also frustration and unease that doctors simply cannot get patients tested for the pneumonia-like virus, a problem that may be causing a vast underreporting in cases of the illness and could become a global concern.
This is a repeat performance of the 2011 Fukushima nuclear disaster, critics say. They point to a political elite that reacts to damaging or embarrassing news by burying its head in the sand, sidelining critical experts and suppressing the facts — before finally being provoked by the unfolding disaster into taking extreme measures.
“It looks like Abe is sacrificing the public interest on the altar of the Olympics and is determined to prevent headlines of an escalating outbreak,” said Jeff Kingston, a political science professor at Temple University at Japan. “He has shirked and shifted responsibility in a sluggish crisis response and has tried to bury the bad news just like they do in dictatorships.”
Perhaps the biggest problem has been the lack of capability to conduct tests for the virus and the failure to sufficiently expand that capacity even two months into the epidemic, criticisms that have also been heard in the United States.
The Asahi newspaper has reported on many examples of patients who ran fevers for many days but could not obtain tests, including a man in his 60s who had a high temperature for 12 consecutive days and needed an oxygen inhaler but still could not get tested.
So widespread has the problem become that the Japan Medical Association issued a statement Wednesday asking for an investigation into cases in which doctors ordered tests that they deemed necessary, but public health centers refused to carry them out.
Japan initially limited tests to people who had developed symptoms and had traveled to China, or had come into close contact with an infected person. But it later expanded tests to people who had a fever for four consecutive days, or two days if the patient was elderly or pregnant. Many experts say those rules are too rigid but are not being respected because there are not enough tests for the novel coronavirus that causes the disease named covid-19.
The tests are also insufficiently sensitive, some experts say. They note that many former passengers from the quarantined Diamond Princess cruise ship who tested negative in Japan have been tested positive in the United States, Australia, Hong Kong and Israel.
Masahiro Kami, a doctor and executive director of the Medical Governance Research Institute in Tokyo, said people with mild symptoms are not being tested.
“Given that we get some 10 million cases of the influenza annually, I think there are probably already at least hundreds of thousands of cases in Japan,” he said.
Japanese Health Minister Katsunobu Kato told parliament he would look into the “stumbling blocks” over tests. He said Japan is capable of conducting 3,800 tests a day, yet carried out only 900 a day in the seven days from Feb. 18 to 24. South Korea is carrying out about 10,000 tests a day, one reason it has found 2,022 cases and Japan only 214.
Part of the problem is that Japan, unlike the United States, South Korea and China, has no Centers for Disease Control and Prevention.
All the power is closely guarded by the Prime Minister’s Office, and then by the Ministry of Health, Labor and Welfare, whose National Institute of Infectious Diseases (NIID) has much less independence than centers for disease control in other countries.
That structure leaves politicians and bureaucrats running the show rather than medical experts. The NIID has also been overwhelmed by the scale of the crisis, bureaucrats admit.
Japan’s tendency to bury bad news was thrown into stark relief last week when a leading infectious disease expert recorded a widely watched video complaining of inadequate infection controls on board the Diamond Princess.
Within two days, Kentaro Iwata was forced to remove the video from YouTube in the face of a concerted attempt to undermine his claims and disparage his character, with one senior official calling him a “maverick” and “not a team player.”
Stubbornly insisting that Iwata was wrong and that the 14-day quarantine on the Diamond Princess had been a success, Japan released hundreds of passengers back into the general population and refused to even test medical staff members who worked on the ship, even though at least eight officials, a medic and an ambulance driver had caught the virus.
A mounting tide of criticism and falling poll numbers may have prompted Abe to try to regain the initiative by asking schools to close this week.
But the decision robs millions of parents and children of the chance to attend graduation ceremonies, as the academic year ends in March. It also creates headaches for parents who work and lack child-care options.
Kyodo quoted a senior official in the Education Ministry as being stunned by the announcement, which apparently came without consultation. A ruling party lawmaker was quoted as saying the party should urge Abe to retract it.
In the western Japanese city of Kyoto, the municipal education board said schools would open as normal on Monday, while a decision on how to proceed for the rest of the week would be made later.
The major of Chiba, a city near Tokyo, tweeted that the school closure “could result in a breakdown of Japanese society.”
On Friday, Abe told parliament that his government plans to push ahead with the plan to close schools. He asked for understanding and called a news conference for Saturday evening.