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The curious case of Japan's mysterious pandemic success

  • Published at 09:36 am May 24th, 2020
File photo: The head of Godzilla, a Japanese monster movie character, is seen on a building of Toho Cinema in Tokyo, Japan, February 18, 2019 Reuters

A little over a month ago, health experts were saying Japan risked becoming one of the world’s coronavirus 'disaster zones'

The likelihood of the Japanese government lifting a state of emergency in Tokyo and nearby prefectures, as well as Hokkaido, altogether on Monday is growing, as the number of new coronavirus cases continues to decline, according to The Japan Times.

A little over a month ago, health experts were saying Japan risked becoming one of the world’s coronavirus “disaster zones.”

Its government was already facing criticism over its decision to quarantine passengers and crew aboard the Diamond Princess cruise liner, and had been accused of underplaying the Covid-19 threat while it clung to the increasingly faint hope of hosting the Olympics this summer.

Japan was testing too few people, critics said, opting instead to focus on clusters of cases rather than overburden its healthcare system with patients displaying no or only mild symptoms who, by law, had to be admitted to hospital. One of the world’s richest countries, they said, was bungling its response.

But today, Japan can make a strong case for being another coronavirus success story, albeit one that has failed to resonate globally in the same way as those in South Korea, Hong Kong and Taiwan.

So far, Japan – a country of 126 million people with one of the biggest elderly populations in the world – has confirmed 16,433 infections and 784 deaths, out of a global death toll of more than 300,000 people.

Achieving such low figures barely seemed possible in early April when, just as the number of cases began to rise sharply in Tokyo and other major cities, neighbouring South Korea – with its widely praised regime of testing, tracing and treating – was flattening the curve.

Analyzing just how Japan defied the odds and contained the virus while disregarding the playbook used by other successful countries has become a national conversation. 

“Just by looking at death numbers, you can say Japan was successful,” Mikihito Tanaka, a professor at Waseda University specializing in science communication, and a member of a public advisory group of experts on the virus told Bloomberg News. 

“But even experts don’t know the reason.”

One widely shared list assembled 43 possible reasons cited in media reports, ranging from a culture of mask-wearing and a famously low obesity rate to the relatively early decision to close schools. 

Among the more fanciful suggestions include a claim Japanese speakers emit fewer potentially virus-laden droplets when talking compared to other languages.

Contact tracing

Experts consulted by Bloomberg News also suggested a myriad of factors that contributed to the outcome, and none could point to a singular policy package that could be replicated in other countries.

Nonetheless, these measures still offer long-term lessons for countries in the middle of pandemic that may yet last for years.

An early grassroots response to rising infections was crucial. While the government has been criticized for its slow policy steps, experts praise the role of Japan’s contact tracers, which swung into action after the first infections were found in January. 

The fast response was enabled by one of Japan’s inbuilt advantages - its public health centers, which in 2018 employed more than half of 50,000 public health nurses who are experienced in infection tracing. 

In normal times, these nurses would be tracking down more common infections such as influenza and tuberculosis.

Diamond Princess cruise

The early response was also boosted by an unlikely happening. 

Japan’s battle with the virus first came to mainstream international attention with its much-criticized response to the Diamond Princess cruise ship in February that led to hundreds of infections. Still, the experience of the ship is credited with providing Japanese experts with invaluable data early in the crisis on how the virus spread, as well as catapulting it into the public consciousness.

Different strain

Infectious disease experts also pointed to other determinants, with Shigeru Omi, the deputy head of the expert panel advising the Japanese government and a former chief of the WHO Western Pacific office, citing Japanese people’s health consciousness as possibly the most important factor.

The possibility that the virus strain spreading in Japan may have been different, and less dangerous, to that faced by other nations, has also been raised.

Researchers at the Los Alamos National Laboratory in the US studied coronavirus variants in a database and found one strain of the virus spreading through Europe that had several mutations distinguishing it from the Asian version, according to a paper put in early May. 

Although the study has not been peer-reviewed and drawn some criticism, the findings point to a need to more thoroughly study how the virus changes.

Cultural distancing

The country's success is due to the easy adoption of protective measures. 

Hand-washing, physical distancing and the wearing of masks were already a part of Japanese culture. Despite Japan's high domestic production capacity, shortages of essential items have nevertheless occurred. 

Japan also has a health care system designed for senior hospital care. 

Economic focus

Since the outbreak began, Japanese prime minister has focused on protecting the economy. 

A significant €915 billion support plan was announced. It included over €2 billion to help its companies, particularly in the electronics sector, to relocate production capacity from China to Japan or a third country.

In mid-April, the Japanese government added the healthcare industry to the list of its strategic sectors, which are subject to systematic investigation for any equity investment of more than 1% by a foreign group. This is one way to protect them from foreign influences, and to avoid the risk of diverting strategic health products, such as vaccines, drugs, masks and ventilators.

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