Japan’s regionalized public health system has helped that nation weather the COVID-19 pandemic—but not without pitfalls, according to experts at Ariadne Labs, a joint center for health systems innovation at Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital.
In a July 22, 2020 blog in Health Affairs, researchers described Japan’s public health model, which features local public health centers that act as “miniature CDCs” within their respective communities. When COVID-19 first hit, the public health centers were able to quell community spread of the virus. They managed patient triaging, contact tracing, and testing on their own, and funneled COVID-19 patients to designated hospitals for isolation, regardless of the severity of their symptoms.
But as case numbers grew at the end of March, the public health centers became bottlenecks and the hospitals that had been designated for COVID-19 patients were overflowing, the authors wrote.
By mid-April, the public health centers, working with local governments, began to allocate patients to a wider network of hospitals while urging people with mild or asymptomatic cases to isolate either at home or in converted hotels. In addition, commercial labs were brought in to help process COVID-19 tests, and testing criteria were relaxed. By May, Japan had flattened its curve.
Although inefficiencies in Japan’s public health system need to be addressed, the public health centers helped minimize the damage from COVID-19, in part because they were able to act more nimbly than a large, centralized public entity could, according to the authors. They wrote that Japan’s experience can provide lessons for other countries considering using a similar system during a pandemic.
Co-authors included Ariadne Labs’ Ryoko Hamaguchi, June-Ho Kim, and executive director Asaf Bitton, as well as Harvard Chan School MPH student Masafumi Funato.
Read the Health Affairs blog: A Regionalized Public Health Model To Combat COVID-19: Lessons from Japan