Photo/Illutration A woman acting as a patient shows an antigen test kit to a doctor via a laptop camera during a simulated diagnosis in Tokyo on Dec. 9. (Yuka Honda)

The number of new COVID-19 patients in Japan topped 200,000 on Dec. 21 for the first time in around four months, exacerbating the concerns among health officials.

They are dreading a possible simultaneous outbreak of both COVID-19 and seasonal influenza, which would strain health services in winter, the season that sees more people rushed to emergency care with other diseases.

Local governments and medical facilities are increasingly providing online services, mainly for feverish people, to prevent excess pressure on the health care system.

The Tokyo metropolitan government, for example, on Dec. 12 opened a temporary online fever diagnosis center.

The metropolitan government was already running an online service in which doctors remotely determine if patients are infected with the novel coronavirus by looking at the results of antigen tests.

From Dec. 12, the service has allowed doctors to talk with feverish patients about their symptoms and give them advice.

During a simulated diagnosis conducted before the new service started, a woman moved an antigen test kit closer to a camera lens at the top of a laptop screen.

A doctor on the screen saw the result through the camera and said, “You’ve tested positive.”

The doctor asked the woman about her symptoms for several minutes, and said, “If you develop other symptoms, you need to see a doctor in person.”

The metropolitan government expects up to 93,000 fever patients daily in the capital if the simultaneous outbreak occurs.

Metropolitan officials predict that around 4,900 hospitals and clinics in the capital that accept fever outpatients can treat up to 105,000 patients per weekday.

However, some medical facilities in Tokyo were severely strained during past waves of COVID-19, partly because other centers would only treat their regular patients.

The number of new COVID-19 patients in Tokyo has recently topped 20,000 on some days, and the metropolitan government raised its medical preparedness alert to the highest level on Dec. 22.

Many hospitals and clinics will be closed during the year-end and New Year holiday period, when the flow of people will likely increase.

Metropolitan government officials believe the online diagnosis service will help ease the burden on hospitals and clinics that remain open during the holiday period.

The health ministry on Dec. 2 said it had made arrangements to treat up to 900,000 patients a day across the country to prepare for the simultaneous outbreak of COVID-19 and seasonal influenza.

One measure that made the arrangements possible was the expansion of online diagnosis services.

The Chiba prefectural government on Dec. 5 started an online diagnosis center for fever patients.

The Fukuoka prefectural government opened a similar service on Dec. 21 aimed at COVID-19 patients recuperating at home.

Hospitals or clinics have also embarked on online care.

The Kanagawa prefectural government, which expects up to 35,000 outpatients at the peak of COVID-19 cases, decided to provide up to 300,000 yen ($2,250) for each hospital or clinic to set up and run online diagnosis services.

Health ministry officials said doctors can also prescribe medication online.

However, some experts have voiced concern about the trend of medical services going online.

Members of the Tokyo Medical Association said people can develop fevers from a variety of diseases, not just COVID-19 or influenza, so they should first try to see a doctor in person.

Only when they can’t book a face-to-face appointment with a doctor should they use online diagnosis services, the members said.

They also said that doctors might be unable to thoroughly understand the patient’s condition online because they can’t do such things as listen to heart sounds over computers.

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