TOKYO — At the height of the coronavirus outbreak in Japan, one doctor couldn't take it any longer. It wasn't the patients. It was Japan's bureaucracy. 

Every new infection, he complained, involved medical professionals compiling lengthy reports by hand and then faxing them to the public health office. “Come on, let’s stop this already,” he wrote in a widely shared tweet. “Even with corona, we’re handwriting and faxing.”

Japan’s government, which sometimes seems hopelessly addicted to paper and faxes, also began to realize the system wasn’t working. Doctors were overwhelmed with paperwork, public health offices were drowning in faxes, which were a marvel of data exchange in the 1980s and are now more of a curiosity from another age.

It was taking up to three days between a case of covid-19 being discovered and it being reported to the public, officials acknowledged.

The system “made it difficult to grasp the spread of infection in real time nationwide, and exhausted health center staff,” an independent expert panel concluded in a new report on Japan’s coronavirus response. “The new coronavirus crisis was also Japan’s ‘digital defeat.’ ”

Japan often feels like a country that rushed to embrace an exciting high-tech future decades ago, and then abruptly stopped when boom turned to bust in the 1990s, leaving islands of older technologies like stranded relics. (Yet, in a bit of throwback spirit, there are still fax emoji.)

Two Japans

There is the Japan of bullet trains and humanoid robots. And there is the Japan of printed documents, humming faxes and an economy still largely dependent on cash. Its bureaucracy lives with at least one foot in the past, with a deeply ingrained desire to do things as they have always been done.

So when the government tried to switch a system of digital reporting of coronavirus cases by computer this year, the effort soon ran aground. Many hospitals and health centers were unable or unwilling to abandon faxes and move reporting online.

Japan’s new prime minister, Yoshihide Suga, wants all this to change. He has set the digitalization of the bureaucracy and ultimately of Japan’s entire society as a key priority of his new administration, and he aims to establish a new digital agency to put the idea into practice.

Suga’s Administrative Reforms Minister Taro Kono is starting with a new campaign to eliminate faxes, cut the paper trail and stamp out “hanko,” a personal seal — known as a “chop” in China — that is required on official documents in place of signatures.

The coronavirus crisis may not have been the main motivation for the new campaign, but it underlined the urgent need for reform, and has already helped encourage some long-overdue changes in the nation’s ossified work practices.

Japan’s analog culture proved a major barrier to working from home during the pandemic, with more than 60 percent of the employees canvassed in one survey complaining they had to come into the office just to check printouts or get a stamp on a document.

For Kono, the first step is to take on the centuries-old culture of the hanko, the small stamp that is embossed with a person’s name and is used for a huge range of documents, from opening a bank account to signing an employment contract.

“To be honest, I don’t think there are many administrative procedures that actually need printing out paper and faxing,” Kono told a news conference shortly after taking his post last month.

“Why do we need to print out paper? In many cases, that’s simply because the hanko stamp is required,” he continued. “So if we can put a stop to that culture, it will naturally lead to the next step, where we would not need printouts and faxing.”

Stamp of disapproval

In late April, Hiroaki Nakanishi, chairman of the powerful Keidanren business lobby, was even more forthright, arguing for the introduction of electronic signatures.

“Hanko are nonsense,” he said. “They should be preserved as works of art.”

Yet the scale of the task should not be underestimated.

A survey by the Japan Research Institute found that of 55,000 administrative procedures involving the central government, only around 4,000, or about 7.5 percent, could be completed entirely online. Kono’s office has already identified 15,000 procedures that require a hanko and aims to eliminate more than 99 percent of them.

But he is already facing opposition from hanko makers, as well as sympathetic ruling Liberal Democratic Party lawmakers, whose petition calling the government’s actions “hasty and excessive” has already won the backing of the party’s powerful Secretary General Toshihiro Nikai.

After one meeting with a hanko industry association, Kono appeared to backtrack. He liked “hanko culture,” he said, and wanted to help promote it, but only decouple it from administrative procedures.

Faxes won’t be any easier to eliminate. The technology caught on in Japan in the 1980s, partly because of the cultural reverence for handwriting, and because of the complexity of its written language, which uses thousands of characters in three different scripts.

'Never adopted computers'

Small businesses, rather than big conglomerates, still dominate Japan’s economy. Many still demand orders be sent by fax.

“The primary mode of writing is by hand, and this is a technology that fits this perfectly,” said Jonathan Coopersmith, a professor at Texas A&M University and author of a history of the fax machine. “One of the reasons it’s still there is that you have an older generation that’s never really wanted to use computers, and a lot of small businesses that never adopted computers and didn’t need to.”

Sales of fax machines, which have declined in the United States, grew nearly 6 percent in Japan last year, while a government survey found that a third of all households still own fax machines.

Coopersmith said the government may have to wait until the older generation retires or dies out before it can fully achieve its objective.

But Yoshimitsu Kobayashi, chairman of Mitsubishi Chemical Holdings and a former chairman of the Japan Association of Corporate Executives, said the country often needed a significant outside force to change, and shouldn’t waste the opportunity unfortunately brought by the pandemic.

“The very negative damage it has inflicted on Japan has in turn served as a powerful accelerator,” he told a news conference. “If we miss this chance, we won’t be able to do it next time.”

Akiko Kashiwagi contributed to this report.