Coronavirus: lessons from Hokkaido, Japan, from the success story to the second wave of contagion | Coronavirus

In late February, Hokkaido became the first place in Japan to declare a state of emergency due to Covid-19, a disease caused by the new coronavirus.

Schools closed and meetings with many people ended up being canceled. Authorities “encouraged” the population to stay home. The local government hunted down the virus, tracing and isolating anyone who had contact with the victims.

The policy worked, and by mid-March the number of new cases had dropped to one or two per day. On March 19, the state of emergency was suspended and, in early April, schools reopened.

But now, just 26 days after the emergency was lifted, that measure needed to be imposed again.

Hokkaido acted independently of Japan’s central government, which put Tokyo, Osaka and five other prefectures in a state of emergency last week. On Thursday, a national state of emergency was declared.

Almost a success story

In the past week, Hokkaido recorded 135 new confirmed cases of covid-19. Unlike the first outbreak in February, there is no evidence that the virus was imported from outside Japan.

None of the new cases is foreign, and none of the infected have traveled abroad in the past month.

What does this tell us about how the virus outbreak in Hokkaido was treated?

First, if you take action when the first cases appear, you can control the virus.

“It is relatively easy to deal with groups of people, contact people with symptoms and isolate them,” says Professor Kenji Shibuya of King’s College London.

“Authorities were successful in their approach to controlling groups of people. Japan was in the early stages of the outbreak at the time. The outbreak was localized and Hokkaido was a success story.”

In that sense, Hokkaido shows some resemblance to what happened in the South Korean city of Daegu. There, a major outbreak of covid-19 occurred within a religious cult, but it was tracked and contained. The infected were discovered and isolated.

But Hokkaido’s second lesson is much less reassuring.

After the Daegu outbreak, the South Korean government began a large test program to try to trace the epidemic. Japan did the opposite.

Even now, more than three months after the country recorded its first case, the country is still testing only a small percentage of the population.

The government initially said the large-scale tests were a “waste of resources.” Now, he had to change the speech and says he will speed up the tests.

Japan’s Ministry of Health says the country’s hospitals are overburdened with care for patients with covid-19. On a broader scale, testing is the responsibility of local health centers and not the national government.

Some of these local centers are simply not equipped with staff or entrances to handle large-scale testing. Even getting a referral from a doctor for a test is a struggle.

The combination of these factors means that authorities in Japan do not have a clear idea of ​​how the virus is moving among the population, Shibuya says.

“We are in the midst of an explosive phase of the outbreak,” he said.

“The main lesson to be learned from Hokkaido is that even if you are successful in containment for the first time, it is difficult to isolate and maintain containment for an extended period. Unless you extend the testing capacity, it is difficult to identify health transmission. community and hospital transmission, “says Shibuya.

Long way ahead

Another lesson is that this “new reality” is going to last much longer than most people expect.

Hokkaido has now had to impose the restrictions again, although the Japanese version of the quarantine is slightly lighter than those imposed elsewhere.

Most people still go to work. Schools may be closed, but shops and even bars remain open.

Shibuya believes that, without stricter measures, Japan has little hope of controlling the so-called “second wave” of infections that is now occurring, not only in Hokkaido, but across the country.

“The main lesson,” he says, “is that even if you are successful in local containment, but there is transmission in other parts of the country, as long as people move, it is difficult to stay free of the virus.”

Still, Hokkaido’s economy is already suffering a lot. The island is extremely dependent on tourism, and Japan has banned travel originating from the United States, Europe, and most Asian countries.

The owner of a bar in the city of Chitose was forced to fire his team. Further north, in Asahikawa city, Naoki Tamura told BBC News that his bar is still open, but now he is hardly receiving more customers.

“One or two people pass each night,” he says.

“There used to be a lot of tourists from China and Southeast Asia. They have completely disappeared. Now we don’t hear any foreign languages ​​on the street. The smallest accommodation sites are being closed. Tourism companies are really struggling to survive.”

The new state of emergency is expected to officially end on May 6, the end of Japan’s “Golden Week” vacation.

A local government official working on suppressing epidemics in Hokkaido said the island still needs to keep the measures in place for much longer.

“We feel we have to keep doing the same thing,” he said, who asked not to be identified. “The goal is to minimize contact between people to prevent the spread of the virus.”

So how long does that mean?

“Until we find a vaccine,” he says. “We have to keep trying to stop the expansion.”