Japan’s emergency has reduced to just a dozen new cases of coronavirus. It got there despite being largely ignored by the default playbook.

No restrictions were placed on the movements of residents, and businesses from restaurants to hairdressers remained open. No high-tech apps were deployed to track people’s movements. There is no centre for disease control in the country. And even as nations were indicated to “test, test, test”, Japan has tested just 0.2% of its population – one of the lowest rates in developed countries.

Yet the curve has flattened, with deaths below 1,000, the lowest among the group of seven developed nations. In its dense centre Tokyo, cases have fallen into single digits for most of the day. While a more severe second wave of infection is sometimes expected, Japan has entered and is ready to leave its emergency in a few weeks, with the situation already lifted for the country and Tokyo and the remaining four others Set out in areas Monday.

Analyzing how the virus has become a national conversation, disregarding how Japan defended the odds and disregarded the playbook used by other successful countries. Only one thing is agreed: there was no silver bullet, there was no factor that made any difference.

“Just looking at the death toll, you could say that Japan was successful,” said Mikhito Tanaka, a professor at Waseda University specializing in science communications, and a member of a public advisory group of experts on the virus. “But even the experts don’t know the reason for this.”


A widely shared list gathered 43 possible reasons cited in media reports, ranging from a mask-wearing culture and relatively low obesity rate to a relatively early decision to close schools. Other hypothetical suggestions include that Japanese speakers claim fewer virus-laden drops when talking than other languages.

Contact tracing

Experts in consulting with Bloomberg News also suggested a mix of factors that contribute to the outcome, and no one can point to a singular policy package that can be replicated in other countries.

However, these measures still provide long-term lessons for countries during an epidemic that may still last for years.

An early grassroots response was critical to the growing infection. Although the central government has been criticized for its slow policy steps, experts praise the role of Japan’s liaison trainers, who went into action after the first transition in January. The rapid response was enabled by one of Japan’s inbuilt advantages – its public health centres, which in 2018 hired more than 50,000 public health nurses who are experiencing symptoms of infection. In normal times, these nurses are reducing common infections such as influenza and tuberculosis.

“It’s very consistent – it’s not an app-based system like Singapore,” said Kazuto Suzuki, a professor of public policy at Hokkaido University, who has written about Japan’s response. “But still, it has been very useful.”

While the U.S. And U.K. As countries are beginning to hire and train contact trailers as they attempt to reopen their economies, Japan has been tracking the movement of the disease since the first cases were found. These local experts focused on involving cases before they went out of control, to deal with groups of infections, such as clubs or hospitals.

“Many people say that we don’t have a Center for Disease Control in Japan,” said Yoko Tsukamoto, a professor of infection control at the University of Health Sciences of Hokkaido, citing a frequently held complaint about Japan’s infection management. “But public health centres are a type of local CDC.”

Burning car

A bus carrying Diamond Princess passengers left from a port in Yokohama on 17 February. Photo: Toru Hanai / Bloomberg

The initial response was also aggravated by an unexpected event. Japan’s battle with the virus first brought the Diamond Princess cruise ship to international mainstream in response to its criticism in February, causing hundreds of infections. Nevertheless, the ship’s experience is credited with providing early data of the crisis to Japanese experts on how the virus spread, as well as converting it to public consciousness.

Tanaka said that in other countries the virus is still seen as someone else’s problem. He said that in Japan, international investigations about infections and the speed at which the virus is onboard increased the awareness and recognition that this could happen across the country. “For Japan, it was like a car burning outside your house.”

It was however criticized as lacking political leadership, which allowed doctors and medical experts to come forward – usually seen as a best practice in managing public health emergencies. “You can say that Japan has an expert-led approach compared to other countries,” said Tanaka.

Experts are credited with creating an easy-to-understand message of avoiding the “Three C’s” of closed spaces, crowded spaces, and close contact settings – which are said to be rather than keeping them completely away from others.

Suzuki of Hokkaido University said, “Social disturbances can work, but it doesn’t help to continue a normal social life.” “The Three C’s ‘is a much more practical approach and very effective, having a similar effect.”

Different Strain

Infectious disease experts also pointed to other assessors, citing the Japanese people’s health consciousness as possibly the most important factor, along with Shigu Omi, a former head of the Japanese government and WHO Western Pacific Office.

It is likely that the virus strain that spreads in Japan can be isolated, and is less dangerous than other countries have to face.

Researchers at the Los Almos National Laboratory in the US studied coronavirus variants in a database and found a strain of the virus spreading through Europe, with many mutations that could distinguish it from the Asian version, a paper in early May According to. Although the study has not been peer-reviewed and some criticisms have been drawn, the findings point to the need for more in-depth study of how the virus mutates.

Big questions remain on the actual extent of the spread of pathogens. In April, a hospital in Tokyo conducted a handful of trials of non-COVID patients and found that about 7% had a coronavirus, showing a risk of missing asymptomatic or light carriers that could become the source of an outbreak. An antibody test on 500 people in the capital suggested that the correct outbreak could be about 20 times larger than the figure showed. Analogue contact tracing breaks down when the number of infections is high, and people pipette to social media during the height of the news of people being unable to get tests or even medical treatment for symptoms such as Kovid.

And the fact that Japan’s response was perfect. While the total population is very small, only seven people died of the virus in Asian neighbours such as Taiwan, while Vietnam had none.

“You would say that Japan’s response was amazing,” said Norio Sugaya, a visiting professor at KIO University’s School of Medicine in Tokyo and a panel member of the World Health Organization, suffering from epidemiological influenza. “If you look at other Asian countries, all of them had a mortality rate of 1 / 100th of that of Western countries.”

Time to buy

The Tsutenkaku Tower in Osaka, lit in a green sign, has met its goal to lift the perfect restrictions. Photo: Buddhist Verasinghe / Bloomberg

While Japan may have avoided the worst of the health consequences, the loose lockdown has not saved the country from the economic impact. Its economy, already dealing with the effects of sales tax increases in October, has officially hit a downturn in the first three months of the year. Economists have warned that the second quarter will be the worst on record, and the spectre of deflation, which has harmed the economy for decades, looms once again. The number of tourists fell 99.9% in April after closing its borders in the country, which put a brake on a fast-growing industry. Like other countries, insolvency laws have increased rapidly.

Even with the state of emergency ends, officials are warning that life will not be normal. When case numbers slowed in early March, there was public optimism that the worst was over – only for cases to spike again and trigger an emergency declaration.

If a deadly second wave is followed, the risk factor in Japan, which has the world’s oldest population, remains high. The country has swiftly approved the remade of Gilead Sciences Inc. and is still scrambling to allow the use of unproven Fujifilm Holdings Corp’s antiviral avians. There have been calls for the country to use the time it has bought to shore up its trial and learn from its neighbours and SARS the way it did.

Authorities have begun to talk of a phase in which people “live with the virus”, with the recognition that from the Japanese point of view there is no possibility of eradicating the pathogen.

“We have to admit that the second wave can be much worse and make up for it than the first wave,” said Yoshihito Niki, a professor of infectious diseases at the School of Medicine at Shoa University. “If the next eruption of cases worsens, the medical system will collapse.”