1/ An integral but low-key part of Japan’s coronavirus response were its public health centers. These centers were early gatekeepers, helping contact trace infections from the very 1st cases & continue to today

We wanted to tell that story w/ @shoko_oda https://www.bloomberg.com/news/articles/2020-06-23/the-low-tech-way-that-japan-managed-to-tackle-the-virus-quickly?sref=V906pjsH

We spoke to employees at public health centers across Japan about their work arranging tests, informing patients of results, contact tracing, checking on the quarantined, arranging hospital stays for the severely ill. Most had been working nonstop since the coronavirus hit 2/

Some countries are just starting to build a system of contact tracing as part of their reopening effort, but the public health centers (called hokenjo) and its workers/nurses in Japan meant such a system was already in place and ready to go. 3/

Part of that is rooted in history. Japan’s public health centers were set up to help fight TB in the 1930s, a task it still oversees today. There wasn't a SARS or MERS outbreak here, but experts say the experience of track & trace for TB monitoring aided Japan's virus approach 4/

Nowadays, the public health centers have myriad functions — newborn checkups, elderly health advice, restaurant licenses, investigating child abuse, food poisoning, etc -- all activities that meld them into the local community. 5/

The community connection was key to gain the trust of patients to share personal information for contact tracing in Japan. Tracers explained how they must constantly balance getting the info quickly + respecting the patients’ needs and worries as a person, and ensuring privacy 6/

Like all virus responses, the public health center system isn't a perfect solution. Yes, fax is infamously used to report positive cases, the workers (many women) did crazy overtime, and center numbers have fallen as municipal funding dwindled - adding to the workload 7/

Also remember that contact tracing works well only when infections numbers are low and manageable. A lot of this system broken down during height of Japan's Covid-19 infections. Nevertheless, we wanted to shine some light on this system and these commendable workers. /END

Addendum: I’m not much of a tweet threader, and now have much more respect for those who do it because that took an absurdly long time to adapt to tweeptop shape... Also would be remiss not to thank @GearoidReidy (himself also a great tweet threader) for a great edit on this.