In Japan, navigating through the layers of bureaucracy to get tested for the new coronavirus can be difficult even for a Japanese speaker, with many passed from person to person and getting nowhere. Imagine what it would be like for a foreign resident or visitor.

Rebecca, a Canadian American who has lived in Japan for four years and speaks Japanese and gave only her first name, was one of them.

Rebecca contacted several coronavirus hotlines on Friday before being referred to a clinic in Tokyo that had already closed for the day. After taking a taxi to the emergency room at a hospital that evening, she tested negative for influenza and was sent home with cold medication and painkillers.

After a CT scan and blood test on Saturday confirmed that Rebecca had pneumonia, her doctor wrote a referral letter allowing her to take a polymerase chain reaction (PCR) test for the coronavirus.

After calling the public medical center to which she was referred, however, Rebecca was told that there would be no one available until Monday and that she should call the public health centers in Nakano and Nerima wards.

But dialing both numbers only yielded prerecorded messages, the first referring Rebecca to another Tokyo Metropolitan Government hotline “which just rings busy and disconnects,” while the latter “just says call back on a weekday,” she said.

After presenting her referral letter Monday at the medical center to which she was originally referred, Rebecca received the PCR test and an X-ray. Because her case was judged noncritical, she was sent home to await the results.

“If it’s positive they will call. If negative they will send a letter,” she said.

The following are answers to questions on where residents and visitors, especially non-Japanese speakers, can seek help if they think they have COVID-19:

What do I do if I think I have coronavirus?

If you think you have the relevant symptoms — a fever of 37.5 degrees Celsius (99.5 degrees Fahrenheit), fatigue and trouble breathing — for four days, call your local public health center or a coronavirus hotline, according to the health ministry.

Elderly people or those who are immunosuppressed should contact a public health center or the hotline after two days of having those symptoms.

You will not be tested by simply going to a hospital, which, if you are infected with the virus, will risk spreading it to other people there.

Local public health centers and people manning hotlines are basically performing triage, referring people deemed to be infected or showing severe symptoms to an outpatient clinic. Those with mild symptoms are simply being asked to stay home.

A doctor will determine whether a patient receives a PCR test. Those who test positive are admitted to a hospital with a specialist infectious disease ward.

The Tokyo Metropolitan Government recently made this information available in English in a flow chart on its COVID-19 task force website.

What if I don’t speak Japanese?

The short answer is to still call your local public health center or hotline as stated in the health ministry’s guidelines. The Japan National Tourism Organization, a government-recommended resource for tourists or residents who aren’t fluent in Japanese, may refer you to the nearest hospital, but hospitals basically aren’t accepting self-referral patients potentially infected with the coronavirus.

“All inquiries from Japanese, foreign patients and tourists are handled by the nearest health center, or a consultation center for returnees and people who have come in close contact (with people infected with the virus) that have been established in each prefecture or municipality,” a public relations official at St. Luke’s International Hospital in Tokyo said via email.

In many cases, the consultation centers that municipalities have established are within a public health center, which means local health centers are what you need to contact.

The Japan Times spoke to more than 10 hospitals in Tokyo, Osaka and Nagoya — the three cities with the most foreign residents — listed on the JNTO website; none confirmed different inquiry procedures for non-Japanese speakers who suspect they have the coronavirus.

But when you contact a public health center, the language barrier is likely to be a huge challenge, throwing non-Japanese speakers into confusion. And what kind of multilingual support they offer, if any, varies by municipality.

In Tokyo, for instance, many local health centers do not necessarily have multilingual staff even though the Tokyo Metropolitan Government is operating a coronavirus hotline in Japanese, Chinese, Korean and English.

Of five public health centers in Tokyo contacted by The Japan Times, three had interpreters available, but even so four of the five advised calling the Tokyo Metropolitan Government’s coronavirus hotline for multilingual advice — a typical case of getting the runaround.

A Tokyo official working on the coronavirus hotline pointed out that non-Japanese speakers should call Himawari, the metropolitan government’s health advisory service that offers assistance in English, Chinese, Korean, Spanish and Thai.

Himawari will contact the nearest health center on behalf of non-Japanese speakers to make arrangements for an outpatient examination. If the person needs to be tested following the medical assessment, Himawari officials can later assist in making arrangements for coronavirus testing.

In Aichi Prefecture, a service operator at the Aichi Multilingual Call Center said they are referring individuals to hospitals after asking health assessment questions.

“For the travelers, for the foreigners that don’t speak Japanese, we will call the hospital on behalf of them and make a reservation,” the operator said.

This suggests that non-Japanese speakers may not necessarily have to go to a public health center.

In the city of Osaka, Alvin Tan, a representative of the Osaka International House Foundation, which is handling multilingual coronavirus inquiries for the Osaka metropolitan area, said they sometimes connect callers to their local health center and provide interpretation via a three-way telephone line.

Tan, who estimated that the International House has been receiving between five and 10 English-language coronavirus inquiries a day, said however that he also tells foreign nationals to go directly to a clinic or a hospital to get checked instead of a public health center.

“For general inquiries, if people say that they think they have the virus we generally ask them to go to the hospital and have themselves checked because … the hokenjo (health center) is getting a lot of inquiries … they have about 400, 500 inquiries per day … they just can’t handle all of that,” Tan said.

If I do not speak Japanese and I suspect that I have the coronavirus, who should I contact?

If you are in the Tokyo metropolitan area, contact Himawari at 03-5285-8181 (available 9 a.m. to 8 p.m. every day, including holidays).

If you are in the city of Osaka, contact the Osaka International House Foundation at 06-6773-6533 (available 9 a.m. to 7 p.m. weekdays and 9 a.m. to 5:30 p.m. on weekends and holidays).

If you are in Nagoya, contact the Aichi Multilingual Call Center (available 24 hours every day, including holidays).

For all other places, check the website of the prefecture or municipality that you are in. If there is no information available in your language, contact the JNTO at 050-3816-2787 (available 24 hours every day, including holidays).

Staff writer Magdalena Osumi contributed to this report.

RELATED PHOTOS St. Luke’s International Hospital is one of the medical centers in Tokyo that offers multilingual services. Like all hospitals, St. Luke’s is testing patients for the new coronavirus only if they have been referred by another health center and after doctors deem it necessary. Self-referrals are not accepted. | YOSHIAKI MIURA