A population-based study of the trend in SARS-CoV-2 diagnostic modalities from the beginning of the pandemic to the Omicron surge in Kyoto City, Kyoto, Japan.

BACKGROUND: The coronavirus disease 2019 (COVID-19) presents critical diagnostic challenges for managing the pandemic. We investigated the 30-month changes in COVID-19 testing modalities and functional testing sites from the early period of the pandemic to the most recent Omicron surge in 2022 in Kyoto City, Japan. METHODS: This is a retrospective-observational study using a local anonymized population database that included patients' demographic and clinical information, testing methods and facilities from January 2020 to June 2022, a total of 30 months. We computed the distribution of symptomatic presentation, testing methods, and testing facilities among cases. Differences over time were tested using chi-square tests of independence. RESULTS: During the study period, 133,115 confirmed COVID-19 cases were reported, of which 90.9% were symptomatic. Although nucleic acid amplification testing occupied 68.9% of all testing, the ratio of lateral flow devices (LFDs) rapidly increased in 2022. As the pandemic continued, the testing capability was shifted from COVID-19 designated facilities to general practitioners, who became the leading testing providers (57.3% of 99,945 tests in 2022). CONCLUSIONS: There was a dynamic shift in testing modality during the first 30 months of the pandemic in Kyoto City. General practitioners increased their role substantially as the use of LFDs spread dramatically in 2022. By comprehending and documenting the evolution of testing methods and testing locations, it is anticipated that this will contribute to the establishment of an even more efficient testing infrastructure for the next pandemic.

The International Transfer of Patients With Positive SARS-CoV-2 Test Using a Framework.

The Japanese Fellowship Program at the U.S. Naval Hospital Yokosuka has served as a liaison with Japanese hospitals during the transfer of acutely ill U.S. Navy patients since 1952. The SARS-CoV-2 pandemic has complicated this process and prompted the creation of a new framework that involves the Public Health Center. We present two international transfer cases of patients with positive SARS-CoV-2. The creation of a framework enabled a safe and smooth transfer process of patients with a favorable outcome. This report can help guide future cases of international transfer, especially for patients who need infectious disease surveillance. To our knowledge, we describe the first report of an international transfer of patients with positive SARS-CoV-2 test using a framework.