The "success" of the Japan model in dealing with COVID-19

As Japan reopens, coronavirus testing slowed by bureaucracy and staff shortages

I think the above article has a part that best explains the "success" of Japan in dealing with COVID-19.

"In more than a dozen interviews with Reuters, public health officials, doctors and experts warned Japan’s slow scaling up of tests could mask the scale of infections and make its population vulnerable to future outbreaks.

Critics say vested interests and bureaucracy inside Japan’s health ministry caused bottlenecks at overworked public health centres, and officials waited too long to allow private labs to run tests."

The problem is that after the state of emergency was declared, public health officials were probably under pressure to "keep the numbers down so that we can reopen". The goal, of course, is to reduce the spread of COVID-19 so that the economy can reopen. The number of infections is the KPI for determining if the measures are working.

But the sense, being here in Japan, is that the KPI became the goal. Instead of working to slow the spread, the goal was to keep the numbers down. The result is that even though, on paper, the criteria for taking a PCR test was relaxed, people still did not get ready access to PCR tests. Call the hospital, and they redirect you to the health officials. Call the local health officials, and they redirect you somewhere else. And it goes on and on. Until you give up and just self-quarantine yourself at home (because most people are working from home anyway).

The problem with this approach is that you lose on contact tracing. So if Person A is infected but refused a test, he can stay at home to limit the spread. But if he had been in contact with Persons B and C before that, and they are also infected but without symptoms, then Persons B and C may end up spreading the virus to others.

The best way to get a sense of whether COVID-19 is really under control in Japan is to look at the number of positive cases vs the number of hospitalized cases. The number of hospitalized cases should be significantly lower than the number of cases because many people do not develop symptoms. (For example, as of May 28, there were 5,195 positive cases. At its peak, on May 5, there were already 2,974 hospitalized.)

There is, of course, a plus side to Japan. People are socially responsible, so even if a person has developed light to moderate symptoms but refused a test, he or she usually self-quarantines, which slows the spread. But it really doesn't do much to flatten the curve since there are many who do not develop symptoms.

When public health becomes a numbers game... sigh...