Japan’s COVID-19 Strategy, Focused on Warnings Rather Than Mandates, Points the Way Forward

People with differing policy preferences were present throughout the COVID-19 epidemic. One game I played was this: Find a place where there were either very strict or extremely loose mitigation steps, and then show your evidence to support that decision. Even though cherry picking is tempting, it has its drawbacks.

This caveat is important to remember for Japanese virologists

Oshitani claims that by February 2020 Oshitani and his co-workers had identified three key facts about COVID-19. These were important for policymakers who are weighing various measures to control disease against the likely benefits. The coronavirus spread from people with no symptoms or who weren’t yet symptomatic. Second, it seemed likely that “aerosols—tiny infectious particles or droplets suspended in the air—were playing a role in how the coronavirus was spreading.” Retrospective contact tracing is a method that identifies the source of an infected carrier. It aims to determine how they were infected.

Oshitani along with several others conducted a study of Japanese clusters and reported that in April 2020 “it was plausible that closed environments contributes to secondary transmission and promotes superspreading.” Oshitani points out that Japanese health centers have more data that confirms that the majority of Covid-19 clusters occur in close-contact indoor spaces such as gyms and night clubs.

Oshitani said that although all of this is now “common knowledge”, it was still a key component in Japan’s public policies from the very beginning. Japan adopted a targeted, less strict approach to virus transmission than most other countries.

Oshitani notes that COVID-19 might have been spread “by aerosols” and could easily be transmitted to other people before symptoms develop. This would make Covid-19 virtually invisible, making it very difficult to eliminate. He says that a strategy to contain the virus would prove too complicated and Japan needed to find a way to live with it. The result was a public information campaign that emphasized the importance of avoiding “the three C’s”: closed spaces, crowded places, and close-contact settings. The Japanese government made this information available to the public in March. [2020]Oshitani: “And it became all-pervasive.”

In practice, what did the advice of government mean? Oshitani states that this depended upon “individual circumstances” and the risk tolerance. Some people might be able stay at home. To avoid spreading, others may be silent while commuting to work on crowded trains. Some may eat at restaurants, but they will not be seated directly next to one another. The majority of people will continue to hide their identities.”

Oshitani suggests that the social pressures played a crucial role in encouraging these safeguards, even for those who were otherwise not inclined. Japan is known for its ability to adhere and respond to peer pressure. While not everyone agrees with preventive measures and many people are reluctant to accept the criticism of their neighbors or friends, they do support them.

Oshitani claims that lockdowns were not an option because Covid-19 was the ultimate goal. This is contrary to what many other countries believe. Oshitani also stated that Japanese law does not permit lockdowns and therefore Japan could not have made them mandatory.

What happened? Oshitani said that Japan had weathered Covid-19 very well. This is actually an exaggeration. Worldometer estimates that Japan has experienced 147 COVID-19-related deaths per one million inhabitants. It is 18 times higher for the United States. Current ranking of the United States is 19th according to Worldometer. Japan, however, ranks at 154th. Even states in the United States that have imposed lockdowns earlier and more often (like New York and California) have higher fatality rates than Japan, at approximately 2,000 per million and 3,300 respectively.

Japan is experiencing an omicron surge similar to other countries. Since January, new cases of omicron have been reported. As in many other countries, however, there has not been an increase in deaths per day. This is due to the fact that vaccinations, natural immunity and mild symptoms of this highly contagious variant have helped to reduce the number of cases.

Oshitani may particularly be inclined to give credit for the country’s low mortality rate, describing it as his “three C” campaign. Oshitani notes that Japan has imposed “some travel restrictions” on residents and banned foreign tourists from the country. In spring 2020 schools closed, but there wasn’t any significant effect on viral transmission. Japan also placed restrictions on large crowds. It also boasts a high level of vaccination; 79 percent have received at least 2 doses of vaccine, as opposed to the 63 percent in America.

Oshitani also mentions Oshitani’s “tendency towards adherence and responding powerful peer pressure.” Lockdowns might have been an added effect to COVID-19. Americans responded by cutting back on their travels, even though they weren’t legally obliged to. It is unclear how an approach that focuses on warnings and not mandates could have worked in Japan due to cultural differences. Oshitani also points out that voluntary measures, even with lockdowns have an economic impact. Therefore, it is a mistake for U.S. companies to blame all of the difficulties they have faced on government policies.

Some countries, like Australia, China and New Zealand have lower death rates than Japan. Others, like the U.K. or France, have had much higher fatalities. Based on these simple comparisons, we can only conclude that lockdowns and less restrictive policies do not consistently correlate with deaths rates. And as I mentioned, more sophisticated attempts to measure the impact of lockdowns have reached divergent conclusions, ranging from large public health benefits to no significant effect.

While the debate is certain to continue, it’s clear that we are now free of lockdowns. You can find more information at The New York TimesAs noted yesterday, even Democratic politicians such Michigan Gov. Gretchen Whitmer, Pennsylvania Governor. Tom Wolf was the one who had imposed the most extreme and arbitrarily designed mitigation measures in response to the pandemic. He didn’t say a thing about revitalizing that strategy in light of the new omicron wave. Oshitani’s strategy, which aimed to give people all the information necessary to decide which precautions and risks they are willing to accept, is a good example of how to move forward.