Amid shortages, Japan gov't urges COVID antigen test production boost to 800,000 kits daily

TOKYO -- Japan's shortage of coronavirus infection testing kits is becoming a serious issue amid the omicron variant's rapid spread. Antigen test orders are particularly strained, with hundreds of times more requests for tests than the actual amount being carried out, thereby forcing manufacturers to adjust shipments to avoid stocks running out. The Japanese government is looking to solve the shortage by requesting manufacturers increase production to 800,000 units per day.

In Japan, there are two main options for PCR tests: "administrative tests" and "self-financed tests." Administrative testing is for people who have symptoms such as a fever or a cough or have close contact with infected people, and the government covers the cost of testing for those deemed necessary by doctors or public health centers.

Self-financed testing is for people who have no symptoms and no close contact with infected people. They pay for the procedure themselves at a clinic or private facility. These tests are used as proof of a negative result when traveling overseas on business or participating in events. If a person tests positive and the clinic or a doctor affiliated with the testing organization diagnoses a coronavirus infection, the doctor notifies a public health center. In cases where the testing service provider only informs the recipient individual of their test result, that person needs to find a medical institution and see a doctor on their own, or contact the local government's consultation service.

In response to the recent spread of infections, more municipalities are making self-financed tests available for free. But now the number of people wanting to be tested is increasing rapidly, making it difficult to make appointments for the tests. About 386,000 PCR tests could be performed per day as of Jan. 23, but only about 100,000 of them were self-pay tests.

Professor Tetsuya Matsumoto of the International University of Health and Welfare, an expert on infectious diseases, pointed out, "The number of newly infected people alone exceeds 60,000, and the current testing capacity is completely insufficient. We should have improved our testing capacity last fall when the infection situation had calmed down."

Since last September, individuals have been able to purchase antigen test kits at pharmacies as a self-financed testing option. While less accurate than PCR tests, antigen tests' advantages are that they can be done by wiping mucus from the nose with a cotton swab and results can be obtained in 15 to 30 minutes. However, demand for antigen test kits has skyrocketed with the rapid spread of infections, and they are reportedly in short supply.

According to the Ministry of Health, Labor and Welfare, the 16 companies selling the kits were receiving orders from medical institutions and pharmacies for up to 300,000 tests per week. But in the week leading up to Jan. 24, demand for the kits surged, with hundreds of times more orders than the actual number of tests being conducted, and the manufacturers responded by using their stock of about 4.6 million tests as of Jan. 24.

Pharmaceutical wholesalers reportedly said that manufacturers are limiting their shipments to avoid running out of stock. In response, Prime Minister Fumio Kishida announced on Jan. 24 that the government has requested manufacturers increase production to 800,000 units per day and that it will guarantee the purchase of the products.

But companies are not able to immediately shift to a system of increased production. Denka Co., Japan's largest testing kit manufacturer with a production capacity of 130,000 units per day, will from early February start operating its plant on holidays and after hours to increase production. The company said, "Considering the manpower and material procurement, it is difficult to shift to increased production in one or two days."

Demand for antigen tests is rapidly increasing, but it can be dangerous to use them without proper understanding. Matsumoto explained, "For example, a person who has contracted the virus from an infected person with whom they ate the day before will not test positive even if the antigen test is done the next day. This may lead the person to think they're negative and spread the virus."

(Japanese original by Yuki Ogawa and Shunsuke Kamiashi, Lifestyle and Medical News Department)