The COVID-19 pandemic: How did Japan avoid the worst?

Marta Gallina



A new threat called COVID-19

In January 2020, the world started hearing about a novel coronavirus spreading in China, with a hot spot in Hubei Province. The pictures of the ghostly city of Wuhan, where the lockdown suspended all the normal activities and forced people not to leave their homes, have travelled around the world. The chances of an outbreak of the deadly virus outside the Chinese territory drew the attention of the media and raised concerns among the public opinion.


On January 16, the first coronavirus infection was confirmed in Japan. The virus first entered the country through travellers from China. Then, a few weeks later, the first cases of infection among people who had never visited Wuhan emerged throughout the country. At the end of the month, Japanese nationals in Wuhan were repatriated using five chartered flights and were asked to self-isolate.


In February, Japan has been under the spotlight because of the famous case of the Diamond Princess, a cruise ship that has been quarantined in the port of Yokohama after that the novel coronavirus started spreading on board. More than 700 passengers have been found positive for COVID-19 and the quarantine has lasted for almost one month. As of March 4, there were 1000 confirmed cases in Japan, including the Diamond Princess’ figures.


At the beginning of March, concerns over a massive spread of the virus started to rise, with palpable repercussions for ordinary activities and life styles. The Prime Minister Shinzo Abe requested the closure of all Japanese elementary, junior high, and high schools from March 2 until the end of April. Indoor and outdoor facilities where many people usually gather (e.g. museums and theme parks) were closed down and events involving many people were cancelled. Hand sanitizers were made available in all restaurants and public locals such as universities. Restaurants and public spaces became less crowded than usual, although trains were still packed with commuters. Moreover, as a consequence of the recommendations not to travel and of the beginning of the travel restrictions, the flow of tourists that usually gets around the center of Shinjuku and Shibuya decreased significantly. As in many other countries, the uncertain situation has caused panic buying: most of the drug stores, supermarkets and konbini (i.e. convenience stores) ran out of facemasks and toilet paper.


Is a normal life still possible?


On March 11, the COVID-19 outbreak was declared a pandemic by the WHO. The virus spread was causing health and social crisis around the world, but the situation in Japan kept being rather stable. As of mid-March, the Olympic Games were still planned for summer 2020. Some restaurants, to re-attract customers, proposed a 30% discount ‘against’ the coronavirus outbreak. The majority of the companies did not consider smart working as an option and indeed commuter trains remained crowded. Japan opted for containment policies, with the extension of the entry ban – already applied to China, Republic of Korea and Iran - to most of the European countries, the United States, Canada, Hong Kong, etc. While closing its borders to the outside, Japan was trying to maintain a semblance of normality in the inside.


From mid-March onwards, the cherry blossom season (sakura) started in Tokyo. Although festivals and the traditional hanami (i.e. outdoor parties or picnics to watch the flowers) were prohibited and the major gardens were closed, thousands of people gathered in the most popular places of the city to experience the blooming. In the meantime, the spike of infections started to worry the government. On March 24, the Prime Minister Abe announced a one-year postponement of the Tokyo Olympic Games. During the same week, a surge of cases in the Tokyo metropolitan area drove the governor Koike to ask the population to refrain from non-essential outings over the weekend. This caused panic buying all over Tokyo, where supermarkets ran out of meat, fish, water and many other ordinary products. The following week, Tokyo government suggested to stay home also in the evenings. On March 29, Ken Shimura, a popular Japanese comedian, died from the coronavirus. The news shocked Japan and raised public awareness about the possible risks connected to the spread of the disease.


Towards the state of emergency


Due to the frightening increases of the COVD-19 cases in Japan, on April 7 the Japanese Prime Minister Abe declared a month-long state of emergency for Tokyo and six other prefectures. On April 16, with a number of infected people around 10,000, the state of emergency was expanded to the entire nation. Grocery stores, pharmacies and all the essential services were guaranteed and public transportation kept running. Smart working was encouraged, but not forced. The Japanese work culture and life style showed not to be prepared to rapidly switch to the remote-working reality. In the workplace, face-to-face interactions are preferable to encourage cooperation rather than individuality and companies are often not equipped with the necessary cloud computing and video conferencing tools. Moreover, the living situation - especially in large cities, where apartments are often very small and do not have Wi-Fi – does not favour good conditions for smart working. For all these reasons, many encountered difficulties in following the recommendation to stay home and thus the commuter flows decreased only partially after the state of emergency declaration.


Unlike other countries, in Japan there is no law to force citizens to stay home or private companies to close and transgressions cannot be punished. As a consequence, rather than enforcing a lockdown and restricting the movement of people, the Japanese government relied on the cooperation of the population to contain the virus. People were asked to modify their social behaviour, avoiding the “three Cs”: closed spaces with poor ventilation, crowded places with many people nearby and close-contact settings such as close-range conversations. In the meantime, in order not to overwhelm the medical facilities, patients with mild symptoms were transferred to hotels and other designated facilities.


On May 2, Japan reached the 500 deaths from the COVID-19. In mid-May, while the number of new cases of infection per day was decreasing, the government started to lift the state of emergency in 39 of the 47 Japanese prefectures. The state of emergency remained in Tokyo, Hokkaido, Chiba, Saitama and Kanagawa until May 25.


Explaining the low numbers: culture or manipulation?


Contrary to the most pessimistic forecast, Japan did not see large-scale clusters of infection as happened, for instance, in Europe and in the USA. As of mid-June, Japan has registered 17,587 cases, 15,701 recovered and 927 deaths. Undoubtedly, this is quite peculiar in a country where a strict lockdown was not enforced, teleworking was only partially applied and crowded places (e.g., trains and subway), especially in large cities such as Tokyo, are hardly avoidable.


Commentators and pundits have tried to explain the Japanese anomaly during the COVID-19 pandemic, relying upon different interpretations of the facts. Two are the main explanations that have been proposed in this debate: on the one hand, a cultural explanation and, on the other, a denial explanation.


The Japanese culture teaches, through formal and informal rules, to be mindful of others from the early age. This is why, even before the pandemic, it was quite common in Japan to wear facemasks. Contrary to what we can imagine, the Japanese do not do that to protect themselves, but because they are considerate of others and they do not want to spread diseases. All this comes with high standard of hygiene, the custom of taking out shoes before entering a public or private space (e.g. museums, homes) and bowing rather than shaking hands or hugging. As a matter of fact, Japanese people have responded rapidly to the pandemic by reinforcing their common habits. Not by chance, convenience stores ran out of masks already in the first phases of the pandemic.


On the other hand, a less optimistic interpretation refers to the denial of the spread of the virus and the lack of testing. Indeed, Japan tested only a few number of people in comparison to other countries. Some experts defended the position of the Japanese government, maintaining that the medical response was adequate since it focused on cases with major symptoms aiming at saving lives. However, after being heavily criticized, the government opted for easing the procedures to get tested.


Other interpretations refer to the early closure of schools, the effective role of contact tracers and even the characteristics of Japanese speakers, who apparently emit fewer potentially contaminated droplets of saliva. Although it is difficult to find an explanation, figures clearly show that in Japan the virus has spread at slower rates than in other countries and that Japan avoided the exponential growth that Europe and the United States have experienced. A thorough study comparing different realities and taking account of similarities and dissimilarities between contexts can certainly explain why this was the case. Whatever the answer is, it is evident that Japan represents a unicum in the COVID-19 pandemic: it has restricted the least and it was successful in avoiding the worst.


Sources:


https://www.bbc.com/news/world-asia-52466834

https://japantoday.com/category/features/opinions/what%E2%80%99s-behind-japan%E2%80%99s-surprisingly-low-coronavirus-numbers

https://www3.nhk.or.jp/nhkworld/en/news/ataglance/976/

https://www.japantimes.co.jp/news/2020/05/09/national/japan-criticism-relaxes-coronavirus-testing-guidelines/#.XuiKMPkzZPY

https://www.japantimes.co.jp/news/2020/05/09/national/japans-hotels-mild-asymptomatic-coronavirus-patients-home/#.XuiKwfkzZPY

https://www.japantimes.co.jp/news/2020/05/09/national/tokyo-releases-covid-19-data/#.XuiLqfkzZPY

https://theconversation.com/lack-of-testing-doesnt-explain-why-japan-has-so-far-escaped-the-worst-of-the-coronavirus-134569

https://time.com/5842139/japan-beat-coronavirus-testing-lockdowns/

https://www.washingtonpost.com/world/coronavirus-japan-telework-business-culture/2020/04/05/a420a39a-74ec-11ea-ad9b-254ec99993bc_story.html

https://www.japantimes.co.jp/news/2020/02/27/national/hokkaido-coronavirus-school/#.Xun0VPkzaUl

https://english.kyodonews.net/news/2020/05/a1f00cf165ae-japan-poised-to-end-state-of-emergency-over-coronavirus-crisis.html

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