Wide-Scale Testing Will Identify A Lot Of Cases. WHO Promotes It. Comparing Two Success Stories in The Battle To Save Lives From COVID-19
Edo Naito March. 24, 2020 Updated March 25, 2020
WHO continues to daily exhort countries to test for COVID-19 “as many and as early as is possibleâ€. South Korea has been roundly praised globally for its "aggressive" testing approach after the Daegu “mega†infection cluster was discovered. Japan’s efforts have generally been either ignored or pilloried (undeservedly IMO) for the "prioritized" testing approach that was deployed here. South Korea’s testing approach is being credited with the “slowing†of new cases. Japan’s approach is accused of vastly undercounting the actual number of cases. South Korea’s testing approach is to test as many people who think they MAY be infected however slight the symptoms or anyone who MAY have been in contact with someone who had. Japan’s approach is to test our elderly as a priority and anyone else who, due to symptoms and/or to an underlying medical condition, that MAY lead to their eventual hospitalization.
Japan and South Korea confirmed their first cases now over two months ago are there any early signs of which approach is minimizing the number of deaths in each country?
South Korea had tested 66,652 up to Feb 27 and around 281K from Feb. 28 through Mar. 24. So a total of 348.6k tests in total. Kindly note however that 349K is at best only 0.6% of the South Korean population (assuming one test per person, many are tested twice) and even if that level is doubled or tripled there will still be 51 Million people who have not been tested. Given the large percentage of people who show no symptoms at all but can still be contagious, it can be safely assumed that some unknown portion of the untested 51 Million is also infected. What this means is one can be tested and cleared but then literally catch the virus while in the testing center or a week later. Testing of a virus as infectious as this one is essentially endless in nature unless you are dealing with a quite small population.
When Japan was focused on the 3711 passengers and crew on the Diamond Princess, the 820 Wuhan evacuees, and the early community infections, it only tested about 7500 in total between Jan.15 (1st confirmed case) to Feb.17 (last batch of tests for the ship). Between Feb.18-Mar.22 (latest available), 41,758 PCR tests have been conducted. Japan has tested a bit over 49k in total up to Mar. 22.
Confirmed cases as of March 25 Noon: In S. Korea, 9,137 or 2.6% of those tested (@348,582). In Japan, 1,193 or 2.4% of those tested (@49, 258k).
Seoul does not disclose the number of patients in hospital or in ICU wards so we cannot gauge the stress levels of their health system. Japan updates these figures daily. On Mar. 1, there were 58 in critical care and 65 as of today, both totals including from the ship. There has been no surge in ICU patients, no evidence yet of a “ticking time bomb†that some have predicted. Given the 3-4 week lag time from infection, whether confirmed by testing or not and admission into critical care units or worse case death the “bomb†should have manifested itself if it were actually there.
Japan's first case was confirmed on Jan. 15 and the first death was Feb.13. South Korea’s first case was confirmed on Jan. 20 and first death on Feb.20. Japan has suffered 43 deaths in total from community infections over the 41 days since its first death while South Korea has suffered 124 deaths in total (2.8X) over 34 days since its first death. On a population-adjusted basis, South Korea has suffered 0.244 deaths per 100K population and Japan 0.034. That is 7x.
South Korea’s approach to testing and mitigation has been praised globally and held up as a model. It is wonderful that Seoul is receiving this recognition and that its mitigation efforts to date appear to be working effectively for the Korean people.
I do not suggest that Japan's approach to mitigation is right for any other country but, SO FAR, on the facts, it appears to be right for Japan given the number of elderly in Japan (28.3% highest in the world), the comparatively overall good health of our elderly, and the Japanese national health and senior care community service systems. (The extensiveness of the latter system ("kaigo" system) is virtually unknown abroad and not well known even to Japanese unless they or a family member is using it. If Japan is successful in minimizing the number of deaths for the balance of this outbreak I will be curious to see if future studies call out the "kaigo" system as one of the key factors.)
Every country should be learning from every other country and then implementing the plans best for its population and its health system. One size does not fit all when it comes to fighting off COVID-19.
Japan Ignored:
Japan Pilloried.
https://www.japantimes.co.jp/news/2020/03/02/national/limited-virus-testing-japan/#.Xnm8okBuKF5
Where Is the Expected Explosion?
Actual Results To Date Show Japan’s Efforts Are Minimizing The Number of COVID-19 Deaths
VP North Asia @ Nuvei | Chairman at Moneytree | Harvard MBA
4 å¹´Thank you for this fascinating and helpful perspectives.
I help companies evaluate, enter, grow, and succeed in Japan | ConsumerTech Entrepreneur I Award Winning Japan Insights | 3x Founder | Board Member | CXO Leadership Strategy & Coaching I LinkedIn Top Voice
4 å¹´Thanks as always, Edo! Have you read the loooong English article on Medium by a lawyer who reviews various Japanese sources? Curious to your thoughts.
Global Health Specialist ? Social Entrepreneur ? Advisor and Analyst ? Science Communicator ? Author and speaker
4 å¹´Thanks for this. There is so much noise and debate over testing and increasing testing and people tend to forget that it need to be weighed against all other priorities, specially during mitigation phase. Also, a positive test will bot, so far, change the course of care for the individual. And finally, as you well point out, people testing neg today may not be so tomorrow.
Thanks for your updates and commentary.?