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There were no restrictions on the movement of the population, companies, from restaurants to hairdressers, continued operating all this time. High-tech apps that track people’s movements were not used to help. The country does not have a Center for Disease Control (CDC). And even when many countries announced a “test, test, test” strategy, Japan passed the tests with just 0.2 percent. Population is one of the lowest rates among developed countries.
However, the curve has flattened, with fewer than 1,000 deaths recorded, apparently the least developed among the G7s. In Tokyo, the number of infections recently has often not exceeded the single-digit level. And while there is still the possibility of a second wave of more severe infection, Japan completely lifted the state of emergency on Monday.
Considerations on how Japan has managed to meet the challenges and curb the spread of the virus, despite successful tactics used by other countries, are becoming a common topic of conversation in the country. One thing is unanimous: there is no miracle solution: the “silver bullet”, any decisive factor.
“Judging only by the number of victims, Japan can be said to have met this challenge,” said Mikihit Tanaka, professor of scientific communication at Waseda University and a member of the public advisory group on the virus. “But even experts don’t know why.”
A publicly available list cites 43 possible reasons cited in media reports, ranging from a culture of wearing face masks and a known low level of obesity to a relatively early decision to close schools. Among other more interesting assumptions is the fact that the Japanese speak less of the potentially virus-infected droplets when they speak compared to other languages.
Track contacts
In an interview with reporters at Bloomberg News, the experts also mentioned a number of factors that could have influenced these achievements, and none of them identified any exclusive policy package that could not be applied by any other country.
However, these measures offer long-term lessons for countries in a pandemic that can continue for a year or more.
The initial massive response to the increasing number of infections was crucial. Although the central government has been criticized for its slow political movements, experts praise the role of Japan’s contact trackers, who took office in January when the first infections were identified. One of Japan’s strengths was its ability to respond quickly: the country’s public health centers, which in 2018 employed more than half of the 50,000 public sector nurses with experience in infection traceability. Under normal circumstances, these nurses mainly try to track down more common infections like the flu and tuberculosis.
“It is a very similar model, a non-device based system like Singapore,” said Kazut Suzuki, a professor of public policy at Hokkaido University, who wrote about Japan’s response to the pandemic. “Still, it helped a lot.”
While states such as the United States and the United Kingdom are just beginning to hire and train contact trackers in an effort to reopen their economies, Japan has been following the disease movement ever since the first cluster of cases was identified. These local experts focused on so-called hot spots in an area, such as clubs or hospitals, to curb the infection before it became uncontrollable.
“A lot of people say we don’t have Centers for Disease Control in Japan,” said Yoko Tsukamoto, a 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.”
Burning car
An early reaction was also fueled by an unpleasant incident. Japan’s fight against the virus has attracted international attention for the first time for its widely criticized response to the February outbreak of the Diamond Princess cruise ship, which has infected hundreds of people. However, experience with the onboard incident has helped Japanese experts obtain invaluable insight into the ways in which the virus spread early in the crisis and bring this important message to the attention of the public.
Other countries still saw the virus as someone else’s problem, Tanaka said. But in Japan, an international investigation into infections on board and the rapid spread of the virus on board has led to the realization and recognition that the same thing could happen across the country, said: “For Japan, the incident was like a burning car near his house. “
Although politicians have been criticized for lack of leadership, this has allowed doctors and medical experts to break the front lines, a practice generally considered ideal for handling public health crises. “It could be argued that Japan relied on an initiative led by experts, unlike other countries,” said Tanaka.
Experts must be accredited and avoid the so-called “three Cs”: “closed spaces”, “crowded spaces” and “close contact” (“closed spaces”, “congested spaces” and “close contacts”) to send messages in a clear language. instead of completely distancing from each other.
“Social isolation can work, but it doesn’t help much to continue a normal social life,” said Professor K. Suzuki of the University of Hokkaido. “Three C’s is a much more practical and effective method, although the effects are similar.”
Another variety
Infectious disease experts also pointed to other determinants. According to Shigeru Omi, deputy director of the expert group advising the Japanese government, and former head of the WHO Office in the Asia-Pacific region, the health awareness of the Japanese population is probably the most important factor.
The possibility that a strain of the virus spreading in Japan is different and less dangerous than that faced by other countries has also been raised.
As published in an article in early May, researchers at the US National Laboratory. USA In Los Alamos they studied the coronavirus variants in a database and identified a strain of the virus that spreads in Europe that had several mutations that distinguished it from the Asian variant. Although this study has not been reviewed by other experts and has received some criticism, the findings suggest that a more detailed study is needed to show how the virus is changing.
Important questions about the true extent of the spread of the pathogen remain unanswered. In April, a Tokyo hospital tested a group of people suspected of not having COVID-19 and found that approximately 7 percent of them had coronaviruses; This indicates how dangerous it is to see mild or asymptomatic forms of coronavirus infection that could become a source of an outbreak.
An antibody test conducted on 500 residents of the capital showed that the outbreak could actually be almost 20 times larger than the data suggests. The contact-tracking chain breaks when the number of infections rises sharply, and during the peak of the outbreak, a wave of social media reports of people being unable to test or even receive treatment for COVID-19 symptoms.
And yet: it must still be recognized that Japan’s response has no longer been so perfect. Compared to the neighbors of our Asian region, which have a much smaller population; For example, Taiwan reported only seven victims of the virus, while Vietnam did not.
“Japan’s response cannot be said to be surprising,” said Norio Sugaya, a visiting professor at Kejo University School of Medicine in Tokyo and a member of the WHO Pandemic Influenza Advisory Commission. “Compared to other Asian countries, the virus death rate for all of them is about one hundredth that of the West.”
Gain time
While Japan may have avoided the worst-case scenario, the mild quarantine has not protected the country from the economic impact. Its economy, and therefore feeling the pressure of an increase in the sales tax in October, has officially entered a recession in the three months of this year. Economists have warned that the second quarter will be the worst, and the country is again threatened by the specter of deflation, which has plagued the economy for decades. Tourist flows fell 99.9 percent in April after the country closed its borders, halting a thriving industry that promised to be a growth engine for many years. As in other countries, the number of bankrupt companies has increased considerably.
Even after the state of emergency is lifted, authorities warn that life is far from back to normal. When the growth of infections slowed in early March, the public was optimistic that the bottom had already been reached, but the number of cases leaping up soon prompted a state of emergency declaration.
If an even more devastating second wave begins, the risk factor in Japan, famous for the world’s oldest population, remains high. The country hastily approved Remdesivir, developed by US biopharmaceutical company Gilead Sciences Inc., and is now struggling to get approval for Avigan, an antiviral drug from Fujifilm Holdings Corp., which is not yet approved. The country is encouraged to use the time it has gained: consolidate its evidence and learn the lessons from its neighbors who have survived SARS and MERS.
Authorities spoke of a phase in which people “would live with the virus”, acknowledging that the Japanese method had no chance of eradicating the pathogen.
“We have to recognize that the second wave can be even more severe than the first, and prepare for it,” said Yoshihito Niki, professor of infectious diseases at the Shiva University School of Medicine. “If the next explosion is even more powerful, the medical system will no longer resist it.”
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