Private COVID-19 test centers popular in Tokyo, but not obliged to report results to gov't

TOKYO -- Private facilities that offer cheap polymerase chain reaction (PCR) tests to detect coronavirus infections have recently been opening one after another in Japan's capital and have been hit with a deluge of reservations.

The desire to seek a feeling of relief at a low cost ahead of the New Year holiday seems to be behind their popularity. However, such facilities do not have an obligation to file reports on positive test results with prefectural governments, prompting calls of concern over their effects on preventive measures against infection. Onsite workers have also expressed their fears over inconsistencies in the tests' precision.

When this Mainichi Shimbun reporter visited "COVID-19 PCR test center" in front of JR Shimbashi Station in Tokyo's Minato Ward on Dec. 16 amid the third wave of infections in Japan, people were in a queue before the building, waiting for their turn to be tested.

A 35-year-old office worker and Tokyo resident who was in line with his wife told the reporter, "I was asked by my elderly parents to check that I test negative." The man, who planned to return to his parents' home in Hyogo Prefecture in western Japan on Dec. 28, said, "I don't have symptoms, so I shouldn't test positive. My purpose is to confirm our safety." His wife revealed, "If the price was over 10,000 yen, we would have not proceeded."

The test is completed in five minutes by simply putting saliva in a container. The results are apparently sent by email the following day. The test costs 2,900 yen (about $28), excluding tax, and is about a 10th of the market price.

This test center was opened on Dec. 4 by the Kinoshita Group, based in the capital's Shinjuku Ward, which holds a major housing construction firm under its wing. Unlike administrative PCR tests which are taken by individuals with symptoms and those who came into close contact with the infected, the test center offers its services only for individuals showing no symptoms.

Reservations are required for the private test center, which can check up to 1,300 individuals per day. Available slots have been fully booked until the beginning of next year. The operator opened its second test center in the Kabukicho entertainment district of Tokyo's Shinjuku Ward on Dec. 21. It also spoke of planning to expand its centers outside the capital.

A public relations representative commented, "We have also been asked by companies, whose employees became infected, to examine their other workers, and about 1% of test results come back positive. There has been an increased demand for confirming negative test results as infections rise."

A venture capital company in Yokohama, south of Tokyo, also opened a testing facility near JR Tokyo Station on Dec. 10. The test costs 1,980 yen (about $19), including tax, and applications flooded the website on the first day, causing it to crash. The facility allows applicants to take tests by sending in their saliva by mail, without visiting the establishment. It has proven popular and has already received around 7,000 applications from across Japan.

What the aforementioned testing center operators have in common that enables private PCR tests at a low cost is that they prepare equipment and conduct tests independently.

For many previous cases of private coronavirus tests, the examination of samples to determine if one was infected was entrusted to major testing firms, and the testing fee tended to be expensive. However, the two companies mentioned above have prepared testing equipment on their own, and have made bulk purchases of necessary reagents, among other measures, to lower costs.

Meanwhile, the operators use reagents that have been authorized by the Ministry of Health, Labor and Welfare, and also check samples under the supervision of a technician.

However, the two companies do not inform public health centers of the results, even if positive test cases arise. Although the infectious diseases control law makes it mandatory for reports to be filed with prefectural governments when a doctor issues positive test results, the two operators, which do not involve medical practitioners, do not have such an obligation. Therefore, individuals who have been confirmed with infections via tests at these private facilities are not included in the infection figures compiled by each prefectural government.

A public relations representative of Kinoshita Group emphasized, "We advise individuals who are suspected to be infected to get examined once more at medical institutions, and also introduce partnering medical corporations. We have been taking sufficient measures for patients to get reexamined and have been cooperating with public health centers." The Yokohama venture has also expressed similar views.

However, there is no guarantee that individuals suspected of infection will actually consult medical institutions, and the fear that thorough medical treatment and health management will not be given to such people at public health centers and hospitals remains.

The health ministry has also acknowledged such issues, and health minister Norihisa Tamura said at a press conference following a Cabinet meeting on Oct. 20 that he wishes to "create some kind of system" regarding private test centers. The health ministry requested in November that those who tested positive for COVID-19 via private testing consult local medical institutions, and that testing centers establish a system where they decide on partnering medical institutions to which they swiftly relay test results. However, these requests are not legally binding, and their effectiveness remains unknown.

A doctor who is involved in administrative tests in the capital, pointed out, "There is the risk that there will be people who determine by themselves that they've recovered without contacting public health centers or hospitals. It is also feared that the accurate number of infected individuals cannot be grasped, and the national government must bolster its control over private testing facilities."

(Japanese original by Nobuyuki Shimada, City News Department)