WHEN Diamond princess, a cruise ship suffering from a covid-19 epidemic, arrived in Japan in February, it seemed like a stroke of bad luck. A small floating Petri dish threatened to turn the Japanese archipelago into a large one. In retrospect, however, the early exposure taught authorities lessons that helped make Japan’s epidemic the mildest of any major economies in the world, despite a recent spike in infections. A total of 2,487 people have died from the coronavirus in Japan, just over half the number in China and fewer people than on a single day in America several times over the past week. Japan has suffered just 18 deaths per million population, a higher rate than in China, but by far the lowest in g7, a club of large industrialized democracies. (Germany comes in second, with 239.) Most strikingly, Japan has achieved this success without strict restrictions or mass testing – the main weapons in the battle against covid-19 elsewhere.
“From the start, we did not seek to contain it,” says Oshitani Hitoshi, a virologist who sits on a panel of experts advising the government. This would require identifying all possible cases, which is not feasible in a country the size of Japan when the majority of infections produce mild or no symptoms, argues Oshitani: “Even if you test everyone once a week you will always run out. “Japan performs the fewest tests in the g7: an average of 270 per day for every million people, compared to around 4,000 in America and Great Britain (see graph).
Instead, the government tried to apply the lessons of the Diamond princess. After quarantine officers and trained nurses were infected aboard the ship, despite protocols followed for viruses that spread by droplets, Mr. Oshitani’s team concluded that the virus was spreading through the air. As early as March, Japanese authorities began warning citizens to avoid the san-mitsu or “3VSs ”: closed spaces, crowded places and places of close contact. The phrase was broadcast on traditional and social media. Spring surveys found that a large majority avoided 3VS settings. Jiyukokuminsha Publishing House recently declared it ‘Buzzword of the Year’ for 2020.
the Diamond princess also inspired an early focus on clusters. The government established a cluster control task force in March.
This information has allowed authorities to make granular distinctions about risk, opting for targeted restrictions rather than oscillating between the extremes of strict lockdowns and free openings for all. Nishimura Yasutoshi, the minister overseeing the government’s response to covid-19, wears a device that monitors carbon dioxide to measure the quality of ventilation during his meetings. (The room where he and your correspondent meet registers 506 parts per million, safely below the 1000 ppm threshold which indicates poor air circulation. The interview takes place on a large table, behind plastic screens. and with masks.)
The researchers deployed Fugaku, the world’s fastest supercomputer, to model different situations. Crowded subways pose little risk, if the windows are open and passengers are wearing masks, Nishimura insists. Sitting diagonally, rather than directly across from each other, can reduce the risk of infection by 75%. Movie theaters are safe, “even if viewers eat popcorn and hot dogs,” Nishimura says. While most cinemas in the West are closed, “Demon Slayer,” a new animefilm, played in full swing in Japan, becoming the second highest grossing film in the country. In addition to the 3VSs, the Japanese government warns of five more specific dangers: dinners with alcohol; drink and eat in groups of more than four; speak without a mask up close; live in dormitories and other small shared spaces; and use changing rooms or rest rooms.
Of course, these ideas would have been in vain if ordinary people had ignored them. But the Japanese heeded the government’s advice to stay home and quarantine if they showed symptoms of the coronavirus, even though those warnings had no legal force. “Sometimes we are criticized for being too homogeneous a society, but I think it played a positive role this time,” says Nishimura. And already, Japan has become even more picky when it comes to hygiene. As Americans argued over whether face covers were an attack on personal freedom, the Japanese lined up in front of Uniqlo for the release of its new line of masks. In the first ten weeks of the flu season this fall, Japan recorded just 148 cases of the common flu, less than 1% of the five-year average for the same period (17,000).
Best of all, while Japan’s population is disproportionately old, and therefore potentially more vulnerable to covid-19, they are also in very good health. Only 4.2% of Japanese adults are obese, a condition known to make the disease more deadly. This is the lowest rate of OECD and a tenth of America. Japan also has a good health care system, with universal coverage and many well-equipped hospitals. He even had many contact tracers already trained, part of a public health network established since the 1930s.
These advantages clearly have their limits. The virus has spread rapidly in recent weeks, reaching record levels in terms of daily cases and daily deaths. The government had to send medical personnel from the self-defense forces to consolidate hospitals in the worst affected areas. But at the same time, he has discouraged caution with a program that subsidizes indoor tourism and outdoor dining, in an effort to help the economy. While this appears to have contributed to the recent spread of covid-19, the government is only curbing it rather than suppressing it. And the cold now pushes people into 3VS spaces, as in the northern hemisphere. But in Japan, at least, the recent growth in the number of cases has started from a considerably lower base. ■
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This article appeared in the Asia section of the print edition under the title “3C epiphany”
