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No apps, just old-school contact tracing

Coronavirus Daily
Bloomberg

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No apps, just old-school contact tracing

Japan has so far kept its coronavirus cases relatively low, with only about 18,000 infections, and a large amount of the credit goes to a system that has its roots in the 1930's fight against tuberculosis.

Since early Covid cases appeared in January, workers at Japan's network of over 450 public health centers have been the first line of defense against the coronavirus—tracking infections, alerting contacts to quarantine and then checking in on them. The centers played a crucial but often overlooked role in getting the virus's spread under control.

While countries such as South Korea boast high-tech methods to tackle the coronavirus, Japan's system is among the examples at the other end of the spectrum, using a decentralized and community-based approach. Hyperlocal efforts from Germany, the tropical island of Bali in Indonesia, and the most crowded slum in India have also proved effective in containing the spread of the pathogen. In all of those places, connecting with members of the community and communicating the importance of being careful about the virus helped net results.

In Japan, that link proved crucial for contact tracing—workers at public health centers emphasized privacy and took a personal approach as they dealt with patients that tested positive, getting them to share information about contacts to help trace and alert others of potential infections. That could be an important lesson for other countries as they look to make contact tracing a more long-term part of their healthcare infrastructure.

"Everyone is captivated by the potential treatment and vaccines," said Toshio Takatorige, a public health professor in Osaka. "No one thinks about the system that's already part of daily life."

Tokyo's Shinjuku district is reopening.

Photographer: Soichiro Koriyama/Bloomberg

During normal times, Japan's public health centers look after various functions that meld them into the local community—newborn checkups, elderly health advice, restaurant licenses, investigating child abuse and food poisoning. When the coronavirus hit, they used that connection to spring into action.

Privacy proved to be key when it came to tracking coronavirus cases. The head of infectious disease response at public health centers in Kawasaki, a city of 1.5 million near Tokyo, was quick to emphasize the need to be careful about small details when releasing generic information about patients that could unveil the identity or place of infection for locals.

Still, the next test awaits as Japan remains wary of a potential second wave after lifting most restrictions put in place during the height of the pandemic. That's especially concerning for the health centers, whose numbers have fallen as municipal budgets in Japan shrank, adding to the workload in denser areas. In recent days, the numbers of infected in Tokyo have began to tick up, promising more action for the front-line forces.—Lisa Du

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