A Nepalese man who lives in Kanagawa Prefecture tested positive for the novel coronavirus, but after some misunderstandings, he decided against self-isolation and stayed at home.

His family members later tested positive.

Although the government has named foreign communities in Japan as sources of cluster infections, many non-Japanese say they are not receiving adequate information about the pandemic and what steps to take to avoid the contagion.

The language barrier is cited as the biggest reason.

In addition, some foreign nationals tend to conceal their infections out of fear of losing their jobs or facing further discrimination.

Shakya Sandeep, a 38-year-old doctor and a member of the Japan branch of the Non-Resident Nepali Association (NRNA), heard about the Nepalese man’s case in early May last year.

The man, who works as a cook at a curry restaurant, tested positive after he suffered from a headache, mild fever and a sense of fatigue.

The prefectural government arranged for the man to be transferred to an accommodation facility for treatment. A public health center provided a courtesy car to pick him up from his home.

But the Nepalese cook decided not to go.

He realized that he would have to read and write Japanese to fill out daily reports on his health condition, but he didn’t have the language skills to perform that task.

He also assumed the meals provided to patients at the facility would not accommodate his religious practices.

But Sandeep said he heard that another reason for the Nepalese man’s refusal to leave his home was that he was worried about the expenses.

The infected man apparently did not know that public funds cover all the costs of isolating COVID-19 patients at accommodation facilities.

Sandeep, who came to Japan at the age 18, graduated from Tokyo Medical and Dental University and has worked as a cardiovascular internal medicine doctor for 13 years. He delved further into the situation at foreign communities during the pandemic and said he was shocked at what he found.

One Kanagawa prefectural government official admitted that some patients who could not speak Japanese were not allowed to stay at the accommodation facilities at the beginning.

Sandeep joined a pandemic-related panel established by the branch in March 2020, when the novel coronavirus was spreading rapidly around Japan.

The 28 panel members, including health care workers and interpreters, have tried to spread information about anti-virus measures in Nepalese through videos and other means.

“Expat communities are vulnerable to exposure to the virus unless they share necessary information,” Sandeep said.

The Cabinet Secretariat, after analyzing domestic news reports and interviewing public health centers, confirmed at least 20 infection clusters involving foreigners from Sept. 1 to Nov. 10.

The clusters occurred at dormitories, workplaces and at restaurants where employees entertain customers.

The central government’s expert panel on dealing with the COVID-19 pandemic in September suggested strengthening the support system for foreign communities to prevent such infection clusters from occurring.

Since then, the government has formed a team to discuss measures to help foreigners survive the pandemic.

Takashi Sawada, 60, who heads the Minatomachi Medical Center in Yokohama that has treated many foreign patients, said he was interviewed by the central government.

He said he told the officials that information services were needed particularly for Vietnamese, Nepalese and Indonesians, who have increasingly settled in Japan’s labor force.

The health ministry in June 2020 started providing a free interpretation service for phone calls from health care workers.

The 24-hour service initially covered five languages--English, Chinese, Korean, Spanish and Portuguese. In December, French and Vietnamese were added.

Based on a suggestion from the central government’s panel, the ministry included expenses in third supplementary budget for fiscal 2020 so that public health centers nationwide could start using the interpretation service as early as Dec. 25.

But the ministry has not decided on whether to include other languages, such as Nepalese and Indonesian.

Another fee-based telephonic interpretation service that covers less-common foreign languages has been available to medical institutions since before the pandemic. The first five minutes cost 1,500 yen ($14.50) and 500 yen for every additional minute. The ministry said health-care providers can charge the fees to the patients.

Sawada said the cost is one reason foreign nationals are hesitant to use that service.

“In order to thoroughly contain the infectious disease, there needs to be an environment where people, regardless of their economic status, can smoothly access health care,” Sawada said.

Other problems stand in the way of containing the virus in foreign communities.

‘SHUNNED BECAUSE I AM A FOREIGNER’

Zoya Verzbitskaya, a 38-year-old Russian living in Tokyo’s Meguro Ward, said she was told by a dentist in May, “We can’t see a patient whose native language is not Japanese.”

At that time, the COVID-19 situation in many European countries had rapidly deteriorated.

Verzbitskaya, who studied Japanese literature at a graduate school in Japan and now works at a Japanese cosmetics company, said she thought the dentist “politely shunned me because I am a foreigner.”

“I have peacefully lived as a member of Japanese society. But once the pandemic hit, I felt like society treated me as the ‘other,’” she said.

At a discussion held by the government’s panel in September, some experts expressed concerns that foreigners would likely become targets of prejudice and discrimination in the health crisis.

Sandeep said he has heard about cases in Chiba Prefecture, where he works, in which medical staff have not given basic examinations to patients because they were not Japanese. The staff instead recommended that the patients go to a large hospital.

He also noted that foreign nationals are afraid of losing their jobs if they contract the novel coronavirus.

“If they are worried about being discriminated against and feel concerned about their lives, they are likely to hesitate to speak about any change in their health condition,” Sandeep said. “Even if their access to health care services is improved, it will not solve the problem.”

An estimated 2.89 million foreign nationals lived in Japan as of the end of June 2020, a significant increase from around 1990.

Chinese nationals lead the pack with 790,000, followed by 440,000 South Koreans and 420,000 Vietnamese. There were also 280,000 Filipinos, as well as 210,000 Brazilians, 100,000 Nepalese and 70,000 Indonesians.