The Olympic Games and public confidence: two things Japan is desperately scrambling to hold on to in the wake of serious criticism of its handling of the coronavirus outbreak in the country.

Key points: The International Olympic Committee meets on March 3 to discuss the Tokyo Olympics

The International Olympic Committee meets on March 3 to discuss the Tokyo Olympics Japan has 973 confirmed cases of coronavirus including 705 from the Diamond Princess ship

Japan has 973 confirmed cases of coronavirus including 705 from the Diamond Princess ship One public health official said he fears the lack of testing in Japan is a "cover-up"

There are growing questions about the Government's handling of the quarantine on board the Diamond Princess cruise ship, in which more than 700 passengers and crew got infected and seven people died.

And one outspoken Japanese doctor has questioned why until recently, the Government only tested hundreds of people for coronavirus each day, compared to South Korea, which is testing thousands.

In his first interview since leading the Australian Government's successful evacuation mission from the ship, Perth-based Dr Paul Armstrong acknowledged the "unprecedented, difficult situation" facing authorities but said it was clear the quarantine on board was not perfect.

"Australia was under the impression that Japan was undertaking quarantine for these passengers and it was going to be successful," he told the ABC.

"It took some time before we realised that things weren't going as well as we would have liked and we had to be cautious."

Thousands of people were allowed to leave the Diamond Princess after quarantine, but some subsequently tested positive for the virus. ( Reuters: Athit Perawongmetha )

Dr Armstrong said getting all willing Australians off the ship appeared to be "the right thing to do".

One hundred and sixty four Australians got on the flight to Darwin for further quarantine.

All tested negative on the ship, and yet some have since tested positive.

Dr Armstrong said he still does not understand why.

"Some who tested positive were in high-risk groups [having been in close contact with a confirmed case] but [there were] others … who weren't close contacts that we know of," he said.

Thousands of passengers were quarantined on board the Diamond Princess for 14 days. ( ABC: Jake Sturmer )

He speculated that there could have been a number of pathways in which people caught it.

"[It] could be food prepared by the crew, where the quarantine was less good. Was there a breach of quarantine when people were out on deck to get fresh air?" he wondered.

"We don't know and there's some analysis that will be carried out to try to determine that."

A litany of mistakes may have allowed the virus to spread

Japanese health experts believe many of the infections occurred before the quarantine began, but they admit it was not perfect because a cruise ship is not an ideal place to try to isolate 3,700 people.

The Australians on board the Diamond Princess were flown to Darwin for another 14 days of isolation. ( ABC News: Jake Sturmer )

Nevertheless, there were numerous mistakes:

The Government failed to test 23 passengers who were later released from the ship

The Government failed to test 23 passengers who were later released from the ship Forty-five passengers who were released have since developed flu-like symptoms

Forty-five passengers who were released have since developed flu-like symptoms Two people who initially tested negative on the ship and were released, later tested positive

Two people who initially tested negative on the ship and were released, later tested positive A Japanese woman in her 80s was left on the ship for a week after reporting a high fever. She later died

A Japanese woman in her 80s was left on the ship for a week after reporting a high fever. She later died Several Health Ministry officials who worked on the ship later tested positive

Several Health Ministry officials who worked on the ship later tested positive Japan initially said they did not need to be tested, but agreed to tests a few days later

Professor Kentaro Iwata, a Japanese infection control expert, went on board the ship and described the situation as "chaotic".

He said that bureaucrats in charge had no clear distinction between infected and infection-free zones.

Diamond Princess passengers who were thought healthy were allowed to catch public buses and taxis, but some later developed flu-like symptoms. ( Reuters: Athit Perawongmetha )

While Dr Armstrong did not agree with all of Professor Iwata's points, he agreed that the infection control was not appropriate for quarantining a lot of people on the ship.

The Japanese Health Ministry's Senior Assistant Minister Yasuyuki Sahara told the ABC the department had done its best.

"We should be 100 per cent perfect and we are trying to do that," Dr Sahara said.

"There were some criticisms of that but we accept those criticisms sincerely and will try to improve."

Why is Japan not testing more people for coronavirus?



Off the ship, complaints are growing that there are not enough coronavirus tests being done in Japan.

In the last week, on average 900 tests have been processed in Japan per day, compared to thousands in South Korea.

Doctors said they had not been able to order tests for COVID-19 and that central authorities had rejected their requests because the cases were not serious enough.

Some experts, like Dr Masahiro Kami, believe the government does not want to know the full extent of the spread in the country.

"The Japanese Government wants to go ahead with the Olympics no matter what, so it doesn't want a large number of infected people," he said.

He said the situation feels to him like a "cover-up".

"I can say it's a cover-up. Not letting people take tests means it's a cover-up," Dr Kami said.

That is a point strongly rejected by the Japanese Health Ministry.

Dr Sahara said they had significantly increased their testing capacity to 4,000 per day and that Japan should not be compared to South Korea.

Japan says like South Korea and China, it will soon be able to process thousands of coronavirus tests each day. ( cnsphoto via Reuters )

In Japan, 973 people have tested positive, including 705 from on board the Diamond Princess.

But Dr Kami, who is both a GP and runs the Medical Governance Research Institute in Tokyo, believes it is just the tip of the iceberg.

"Japan is testing very few people," he said.

"Because the number of tests is so small, I think they're failing to see [the actual numbers]."

Dr Kami fears the virus is spreading widely throughout the country.

"About 100,000 people get influenza in a year. I think currently the number of infected people could eventually be in the tens of thousands or few millions [in Japan]."

At least 962 people have tested positive for coronavirus in Japan, but some doctors fear the real infection rate could be higher. ( AP: Jae C. Hong )

The Health Ministry's Dr Sahara said he was aware of the criticism.

He said within days, all doctors will be able to order their own coronavirus tests through the national health insurance scheme, which would result in a "much smoother process".

"In the beginning, only the National Infectious Diseases Institute and some quarantine offices were providing these tests and then universities and private laboratories [will be able to], so capacity is really increasing," Dr Sahara said.

Are the Tokyo Olympics really on the line?

As criticism and pressure mounted on the Government over its perceived mishandling of this crisis, Prime Minister Shinzo Abe suddenly announced that he would ask all schools to close until April.

Parents were stunned, and some Japanese media reported that even many within the Education Ministry were surprised by the announcement.

Japan's Prime Minister Shinzo Abe abruptly cancelled school until April in response to the coronavirus outbreak. ( Reuters: Athit Perawongmetha )

The Education Minister himself found out about the plans on the day of Mr Abe's announcement.

More than 10 million students are affected.

So why the sudden decision?

A poll by Kyodo News taken during the Diamond Princess cruise ship crisis revealed his Cabinet's approval rate had its sharpest fall in nearly two years, down more than 8 points to 41 per cent.

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It took the Government more than a month to outline a basic policy to fight the coronavirus outbreak, and even then it was criticised for lacking concrete steps.

Still, Mr Abe and the president of the International Olympic Committee, Thomas Bach, have both said the Games will go ahead.

Mr Abe has promised a second batch of measures around March 10 to prevent the spread of the coronavirus and mitigate its damage to the economy.

The Health Ministry's Dr Sahara said even though the next two weeks were critical, he did not think things would get to a point where the Olympics would be reconsidered.

"We are really preparing for the Olympic Games and we are working really hard to contain this outbreak as early as possible," he said.

He was adamant Australians should keep their flight bookings and come to Japan.

"Please come. Wear the masks, please know the coughing etiquette and try not to go to some big events," he said.

Last weekend, Tokyo's annual marathon was a shade of its former self because of the outbreak.

Tokyo's marathon this year was reduced to just a few hundred participants, while in 2019, nearly 40,000 people competed. ( Kyodo via Reuters )

Last year saw close to 38,000 amateur participants, but this year there were just a few hundred professional athletes, with the public strongly discouraged from lining the route.

Japan's professional baseball teams also staged pre-season openers behind closed doors on the weekend.

The Spring Sumo tournament in Osaka will be held behind closed doors with no spectators allowed.

The International Olympic Committee's Executive Board is meeting in Lausanne, Switzerland later today to discuss how to handle the coronavirus outbreak.

But Dr Kami is not feeling optimistic.

"Japan is not the one who decides whether the Olympics goes ahead or not. It's global opinion. I think it's not looking good at this rate. Japan's quarantine has failed," he said.