Reporting new COVID-19 cases became simplified across Japan on Sept. 26 as doctors no longer are required to report all cases to their local public health centers.

Under the new system, local public health centers will still examine some patients, including older ones, but younger patients or patients with mild symptoms need to look after themselves, in principle.

The new system--combined with shortened isolation periods for COVID-19 patients and the decision to allow such patients to go out to buy daily essentials--mark the start of the government’s “With COVID-19” policies, which seek to balance tackling the pandemic against social and economic activities.

Under the old system, doctors were required to report all COVID-19 patients.

Local public health centers then observed the health of patients or organized their hospitalization based on the information in such reports.

Under the new system, however, doctors are required to only report COVID-19 patients who are 65 or older, need hospitalization, require medication or oxygen, or are pregnant.

This marks an 80 percent reduction in the number of patients that doctors need to report on compared to under the old system.

Information on doctors’ reports will include the patients’ names, addresses and dates when they develop symptoms.

The new system will alleviate the burden on public health centers or other medical institutions.

However, it also means doctors will not report younger patients or those with mild symptoms and that public health centers will not check in on them.

If the patient's health deteriorates, it might be difficult for someone to notice.

To deal with this, each prefecture has set up a health follow-up center.

Younger COVID-19 patients or those with mild symptoms can report to such centers should their symptoms worsen.

Observers say the new system will test how effectively authorities can support all COVID-19 patients.

The health ministry will continue to obtain the total number of COVID-19 patients based on reports by hospitals on how many patients their doctors see and treat, as well as on registration of COVID-19 cases with prefectures made by people who voluntarily get tested and test positive.

However, under the new system, it will be difficult to detect cluster outbreaks at restaurants or schools.

In addition, it will be impossible to determine the number of cases in each municipality, observers say.

“Many younger patients develop only mild symptoms, which are not very different to those of the seasonal flu,” said health minister Katsunobu Kato about those infected with the Omicron variant.

He has left how much support should be provided to COVID-19 patients to the discretion of local authorities.

As a result, local authorities have made their own policies.

For example, the Tokyo metropolitan government and Kanagawa prefectural government are still giving COVID-19 patients whom doctors do not report about, a similar level of support to that of patients who are reported.

They check up on and deliver food to COVID-19 patients who have registered with their health follow-up centers, if they desire such services.

By comparison, the Ibaraki prefectural government has stopped checking up on, and delivering food to, COVID-19 patients with mild symptoms as it prioritizes alleviating the burden on doctors and its officials.

Ibaraki was one of the prefectures that simplified the reporting rule before the government implemented it across the nation on Sept. 26.

Saga, Tottori and Miyagi prefectures also simplified the reporting rule before it was introduced across the nation.

“The general rule is that patients with mild symptoms must look after themselves,” an Ibaraki prefectural official said. “If they call us, we can take care of such patients if their symptoms worsen, so we will have no problem.”

COVID-19 patients registered with health follow-up centers could get access to treatment more quickly when they are rushed to a hospital after developing serious symptoms as they don’t need to undergo a test to see if they are infected with the novel coronavirus.

However, analysts say the percentage of younger COVID-19 patients or patients with mild symptoms registered with health follow-up centers vary from prefecture to prefecture.

In Saga and Tottori prefectures, for example, more than 90 percent of COVID-19 patients whom doctors do not report under the new system have registered with health follow-up centers.

Some of them did so after their doctors advised them to.

In Miyagi Prefecture, around 60 percent of such patients have registered with the center.

However, in Ibaraki Prefecture, only between 10 to 19 percent of such patients have registered with its center because the prefectural government only asks those who test positive in voluntary testing to register with its center.

Observers say the new system, which makes it impossible to obtain data on all patients, could impact analyses concerning the government’s measures to tackle the novel coronavirus pandemic.

Without reports on younger patients or patients with mild symptoms, it will be difficult for local public health centers to collect the information on them such as their names, addresses and the dates when they develop symptoms.

(This article was written by Mirei Jinguji, Yuki Edamatsu, Hiromi Kumai and Kai Ichino.)