Has Japan just beaten the coronavirus without blockages or massive testing?
No restrictions were placed on resident movements, and businesses from restaurants to hair salons remained open. There were no high-tech apps implemented to track people’s movements. The country does not have a center for disease control. And even when nations were called upon to “test, test, test,” Japan has evaluated only 0.2% of its population, one of the lowest rates among developed countries.
However, the curve has flattened, with deaths well below 1,000, by far the smallest among the developed nations of the Group of Seven. In Tokyo, its dense center, cases have been reduced to single digits on most days. While the possibility of a second wave of more severe infection is always present, Japan has entered and is ready to emerge from its emergency in just a few weeks, with the state already lifted for most of the country and Tokyo and the other four regions. remaining configured to leave on Monday
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Analyzing how Japan defied the odds and contained the virus without considering the playbook used by other successful countries has become a national conversation. Only one thing was agreed: that there was no silver bullet, no factor that made a difference.
“Just by looking at the death numbers, you can say that Japan was successful,” said Mikihito Tanaka, a professor at Waseda University specializing in scientific communication and a member of a group of public advisory experts on the virus. “But even experts don’t know why.”
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A widely shared list brought together 43 possible reasons cited in media reports, ranging from a culture of wearing masks and a famous obesity rate to the relatively early decision to close schools. Among the most fanciful suggestions is a claim that Japanese speakers emit fewer potentially virus-laden drops when they speak compared to other languages.
Experts consulted by Bloomberg News also suggested a myriad of factors that contributed to the result, and none were able to point to a unique policy package that could be replicated in other countries.
However, these measures still offer long-term lessons for countries in the midst of a pandemic that can still last for years.
An early-based response to growing infections was crucial. While the central government has been criticized for its slow policy steps, experts praise the role of Japan’s contact trackers, which kicked in after the first infections were found in January. Rapid response was made possible by one of Japan’s built-in benefits: its public health centers, which in 2018 employed more than half of 50,000 public health nurses with experience tracking infection. In normal times, these nurses would be tracking more common infections like influenza and tuberculosis.
“It is very analogous, it is not an application based system like Singapore,” said Kazuto Suzuki, a professor of public policy at Hokkaido University, who wrote about Japan’s response. “But, nevertheless, it has been very useful.”
While countries like the US USA And the UK is just starting to hire and train contact trackers as they try to reopen their economies, Japan has been tracking the movement of the disease ever since the first cases were found. These local experts focused on addressing so-called groups, or one-place infection groups, such as clubs or hospitals, to contain cases before they got out of control.
“Many people say that we don’t have Centers for Disease Control in Japan,” said Yoko Tsukamoto, professor of infection control at Hokkaido University of Health Sciences, citing a frequent complaint about infection management in Japan. “But the public health center is a kind of local CDC.”
The early response was also fueled by an unlikely event. Japan’s battle with the virus first caught international attention with its much-criticized response to the Diamond Princess cruise ship in February that caused hundreds of infections. Still, the ship’s experience is attributed to providing Japanese experts with invaluable data early on in the crisis on how the virus spread, as well as catapulting it into public awareness.
Other countries still saw the virus as someone else’s problem, Tanaka said. But in Japan, international scrutiny of infections on board and the rate at which the virus spread throughout the ship raised awareness and recognition that the same thing can happen across the country, he said. “For Japan, it was like having a burning car right outside their home.”
Although the political leadership was criticized for lacking, that allowed doctors and medical experts to come to light, which is generally considered best practice in managing public health emergencies. “You could say that Japan has had an expert-led approach, unlike other countries,” said Tanaka.
Experts are also credited with creating an easy-to-understand message of avoiding what are called the “Three Cs” (closed spaces, crowded spaces, and close contact environments) rather than staying away from others entirely. .
“Social distancing may work, but it doesn’t really help continue normal social life,” said Suzuki of Hokkaido University. “The ‘Three Cs’ are a much more pragmatic and very effective approach, while having a similar effect.”
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 head of the WHO office in the Western Pacific, citing the Japanese health consciousness as possibly the most important factor.
The possibility that the spread of the virus strain in Japan has been different and less dangerous than that faced by other nations has also been raised.
Researchers from the Los Alamos National Laboratory in the USA. USA They studied the coronavirus variants in a database and found a strain of the virus that is spreading throughout Europe that had several mutations that distinguished it from the Asian version, according to a document published in early May. Although the study has not been peer-reviewed and has drawn some criticism, the findings point to the need to further study how the virus changes.
There are still big questions about the true extent of the spread of the pathogen. In April, a Tokyo hospital tested a handful of non-Covid patients and found that about 7% had the coronavirus, demonstrating the danger of losing asymptomatic or mild carriers that can become the source of an outbreak. An antibody test on 500 people in the capital suggested that the true outbreak could be almost 20 times larger than the figures show. Analog contact tracking breaks down when the number of infections is high, and reports of people unable to get tested or even medical treatment for Covid-like symptoms splash social media during the peak of the outbreak.
And the fact is, Japan’s response was less than perfect. While the general population is much smaller, Asian neighbors like Taiwan had only seven confirmed deaths from the virus, while Vietnam had none.
“You can’t say that Japan’s response was surprising,” said Norio Sugaya, a visiting professor at the Keio University School of Medicine in Tokyo and a member of the World Health Organization panel advising on pandemic influenza. “If you look at the other Asian countries, they all had a death rate that was about 1/100 that of the western countries.”
While Japan may have prevented the worst health outcome, the loose blockade has not protected the country from the economic impact. Its economy, which is already grappling with the impact of a sales tax increase in October, officially fell into recession in the first three months of the year. Economists have warned that the second quarter will be the worst on record and the specter of deflation, which has plagued the economy for decades, is looming once again. The number of tourists plunged 99.9% in April after the country closed its borders, holding back a booming industry that had promised to be a growth engine for years. As in other countries, bankruptcies have increased considerably.
Even with the state of emergency about to end, authorities warn that life will not return to normal. When the numbers of cases decreased in early March, there was public optimism that the worst was over, only for the cases to increase again and trigger the emergency declaration.
If a deadlier second wave follows, the risk factor in Japan, which has the world’s oldest population, remains high. The country has quickly approved the remdesivir of Gilead Sciences Inc. and is now fighting to allow the use of Aviv antiviral from Fujifilm Holdings Corp., not yet proven. There are calls for the country to use the time it has bought to shore up its tests and learn in the same way as its SARS and MERS neighbors.
Authorities have begun to talk about a phase when people “live with the virus”, acknowledging that Japan’s approach has no chance of eliminating the pathogen.
“We have to assume that the second wave could be much worse than the first wave and prepare for it,” said Yoshihito Niki, professor of infectious diseases at Showa University School of Medicine. “If the next explosion of cases is worse, the medical system will break down.”