DIPLOMACY

COVID-19: Japan’s Measured Response

Cooperation, self-restraint and the habits of a lifetime. How Japan is tackling the COVID-19 outbreak. 

On April 23, 2020, The Rolling Stones released their first new song in eight years, the aptly named “Living in a Ghost Town.” Frontman Mick Jagger set the tone with fitting lyrics:

I had to go underground

Life was so beautiful

Then weallgotlocked down

Infections of the COVID-19 coronavirus, believed to have originated in December 2019 in Wuhan, China, have spread around the globe in the blink of an eye. The lockdown of Wuhan that started on January 23 was finally lifted on April 8, and at the national level China appears to have gotten the virus under control and shifted to a recovery track. But in the rest of the world it is uncertain when things will return to normal.

Prime Minister Abe holds a press conference at the Prime Minister’s Office on April 7 following his declaration of a state of emergency in seven prefectures, April 7, 2020. The state of emergency was extended to all of Japan on April 16. CABINET PUBLIC RELATIONS OFFICE

On April 27, Japan’s National Institute of Infectious Diseases reported on the results of a study that involved collecting samples from 562 coronavirus patients in Japan and comparing the viruses and genomes with samples from 4,511 coronavirus patients registered overseas. According to the report, in January and February Japan successfully contained clusters during the first wave of infections that flowed directly from Wuhan to Japan and prevented the spread of infections from the Diamond Princess cruise ship. However, when the Japanese government asked people to avoid overseas travel in mid-March, there was a sudden influx of Japanese returning home from overseas. Among them were those who had contracted coronavirus after it had spread from Wuhan to the United States and Europe, and this caused a second wave leading to a sudden rise in infections. In other words, during the first wave Japan’s cluster-based approach was successful in ending COVID-19 infections originating in Wuhan, which it achieved by tracing back the source of infections, determining who had been in close contact with infected patients, and imposing restrictions on their movements. In the second wave, however, some of those who had been infected returned home before presenting symptoms and went back to their regular lives, making it difficult to trace the source of infections.

In Tokyo, which has produced the highest number of infections in Japan (4,883 reported by Tokyo as of May 11), the metropolitan government has taken further steps. In addition to the cluster-based approach, Tokyo has pushed the concept of avoiding the “three Cs” (closed spaces, crowded places and close-contact settings), asked people to refrain from going out, asked businesses to close or implement teleworking schemes, and sought to secure additional hospital beds.

Despite these efforts, as of May 11 the number of infected in Japan stands at 15,630, with 621 deaths (mhlw.go.jp data).

The various measures put in place produced only marginal improvements, and in response on April 7 the Japanese government declared a state of emergency in seven prefectures, namely Saitama, Chiba, Tokyo, Kanagawa, Osaka, Hyogo and Fukuoka. The state of emergency was extended to all of Japan on April 16.

Source: CABINET PUBLIC RELATIONS OFFICE

One of the consistent appeals the government has made to the Japanese people is the goal of “reducing person-to-person contact by 80%.” At the 31st Meeting of the Novel Coronavirus Response Headquarters on April 24, 2020, Prime Minister Abe also stressed this point: “We will continue to accelerate efforts to reduce person-to-person contact by 80%, in close cooperation with local governments, business associations, and others.”

Prime Minister Abe also acknowledged medical professionals at the meeting, saying “I would like to reiterate my heartfelt gratitude to those who are right now devoting themselves at medical sites to saving as many lives as possible,” and then made a request of relevant government officials. “I request you to mobilize all the resources of the government to deliver as many pieces of personal protective equipment (PPE) as possible to healthcare workers, who are on the front lines in the fight against the virus despite such circumstances.”

Manufacturers have also responded to the crisis. Auto makers have begun manufacturing PPE, major electronics companies and small-to-medium-sized enterprises have taken to producing masks, while breweries have started disinfectant production. We may be seeing an embodiment of the sampo-yoshi (“good for everyone — purchasers, buyers and society alike) spirit that was embraced by Omi merchants during the Edo period (1603–1867). 

The immediate reality is harsh. No one could enjoy the eagerly awaited cherry blossom season, and on March 30, right about the time the petals were falling, we learned of the official decision to postpone the 2020 Olympics and Paralympics. During Golden Week, a time that traditionally ushers in a season of fresh green, people were still being asked to remain indoors. In the middle of this period on May 4, news reports began to circulate that the government would extend the state of emergency, originally scheduled to end on May 6, to at least the end of May.

“No Ginger”

You may be familiar with the expression “No ginger.” This is derived from the Japanese sho-ga-nai, which is used to describe a situation that is unavoidable or for which there are no alternatives. When Japanese encounter a situation they have no way to overcome, they will often let out a sigh and utter “sho-ga-nai” with a feeling akin to giving up. It might be an appropriate phrase to sum up how the Japanese feel about the harsh situation we currently face. “No ginger” came about by rephrasing elements of this habitual expression into English. “Ginger” comes from its Japanese equivalent “shoga,” which is homonymic with the sho-ga part of sho-ga-nai, while the nai part (meaning “no” or “none”) was translated directly. If you have experienced living in Japan, you may have heard foreigners using it or even used it yourself. It may seem strange to many foreigners, because from one perspective “no ginger” connotes an attitude of avoiding resistance even when faced with pressure, and quietly accepting one’s fate. But the phrase sho-ga-nai actually incorporates a positive intent: that since no good can come from focusing on negative feelings, the only way forward is to act pragmatically. Even so, suggesting that the Japanese use it as an incantation to make themselves feel better could be overselling it.

Haplotype network analysis using genome-wide single-nucleotide variations (HN-GSNVs) of worldwide SARS-CoV-2 isolates by NIID. See note and link at end of article.

Amid spiking coronavirus infections, parts of the populace succumbed to hysteria and panic. In general, media outlets have devoted a significant chunk of their coverage to COVID-19 reports and criticisms of the government. Meanwhile, the ways regular people can track the situation is limited to media reports and the Internet, but issues like the spread of fake news over social media have done little to assuage their fears. On top of this, media reports from overseas presenting a counter-narrative have made their way back to Japan, highlighting the fewer PCR tests being conducted, questioning the legitimacy of Japan’s low reported infection and death numbers, and declaring Japan’s measures, which stop short of a lockdown, a failure.

Public Hygiene and the “Japan Model”

However, in his article “COVID-19 Strategy: The Japan Model—Has Japan found a viable long-term strategy for the pandemic?” published in The Diplomat on April 20, Hokkaido University Professor Suzuki Kazuto characterized the combination of the cluster-based approach and three Cs measures as the “Japan Model,” and emphasized that “Although this may also appear to be lax from an overseas perspective, this strategy of closing down the sources of clusters and blocking infection routes by combining the cluster-based approach and the three Cs measure has worked quite well to contain the spread of the epidemic to date.” He also pointed out that “The model allows for a certain level of economic activity and maintains people’s freedom to move about, and as such is more sustainable over the long term than more burdensome models such as lockdowns. That makes it a viable strategy to fight the long-term battle against COVID-19.”

A smattering of reports that appear to objectively support Professor Suzuki’s viewpoint have also flowed back from overseas, some based on information European and Latin American athletes playing professionally in Japan have relayed to the press in their home countries. 

Their comments go along the lines of “Japanese bow to one another in greeting instead of shaking hands or hugging, so there is less contact between people,” “They are careful by washing their hands well and wearing masks,” or “Since Japan is a clean country, the situation is not as bad as in other regions.”

This positive appraisal of Japan may be due to Japan’s traditional awareness of hygiene, something that foreigners who have stayed in Japan have to some extent shared in the past.

Take for example the Portuguese missionary Luis Fróis (1532–1597), who carried out missionary work in Japan from 1563 to 1597. In 1565, he laid eyes on a model of a public toilet in Kyoto, writing that while Europeans place their toilets out of sight, Japanese toilets are placed in front of homes and made available to all.

Another example is Townsend Harris (1804–1878), the first United States Consul General who was posted to Japan from 1856 to 1859. When visiting the small fishing village of Kakizaki (the outskirts of present-day Shimoda, Kanagawa Prefecture), he remarked that “You see none of the squalor which usually attends poverty in all parts of the world. Their houses are as clean as need be.”

Sir Rutherford Alcock (1809–1897), the English physician and diplomat who served as Consul-General in Japan from 1858 to 1864, wrote about what was then the town of Edo, now Tokyo. When he saw beggars along the well-maintained streets, he noticed how remarkably clean they were, and also recounted the lack of any garbage piling up on the streets and blocking the way.

Goto Shinpei (1857–1929) is someone who took advantage of that traditional awareness of hygiene. Active as a physician, bureaucrat and politician during the Meiji, Taisho and early Showa periods, Goto focused on the fact that wars produced more deaths due to disease than combat, and as a quarantine officer for soldiers returning from the Sino-Japanese War (1895–1895), he averted an outbreak of cholera. Thereafter he was appointed head of civilian affairs of the Government-General of Taiwan and worked to improve public hygiene in various ways, such as by eradicating pests and malaria. 

In an essay that appeared in the April 30 edition of the Yomiuri shimbun, Keio University Professor Hosoya Yuichi made references to Goto’s accomplishments while indicating that Japan’s traditional awareness of public hygiene as typified by the strict observance of hand washing and the wearing of masks “is an important element underpinning the ‘Japan Model’ of dealing with the coronavirus through moderate restrictions (without imposing a lockdown).” He also emphasized that “the approach of asking people to make voluntary behavioral modifications may appear tepid, but is accompanied by comparatively fewer problems and is arguably a more sustainable measure against the coronavirus. What we should be showing the world is not self-absorption or worship of the West, but instead a wisdom rooted in a deep understanding of Japanese history and culture.”

The Post-Coronavirus World

Amid the ongoing anxiety over daily infection counts and epidemiological curves, discussions about the post-coronavirus world have also started to appear in Japanese magazines and newspapers, but coverage has mainly involved introducing the discussions underway in the West and offering arguments that go along the same lines. Various opinions have already been floated, and as most knowledgeable observers have pointed out, there is no stopping globalization. Given that reality, the country-first mentality and propensity to go it alone that has taken hold in recent years will likely have to be replaced with international cooperation. The world has overcome numerous crises in the past through science, technology and countries working together. As the world is now experiencing an unprecedented crisis that pits precious human lives against economic activity, an entirely new and powerful framework for cooperation will be needed.

Going forward, even when we start to make headway against the coronavirus and regardless of the impact coronavirus infections will have had, we will all be forced to restart our lives from a worse position than when the crisis began. As our battle with the coronavirus is not a conventional war, there will be no victory and no winners. For now, we must make a concerted effort to overcome the coronavirus. Once that is done, we need return our attention to international concerns that predate COVID-19, like warnings that global warming is approaching a point of no return, major forest fires, retreating glaciers and marine pollution, and promote international cooperation to tackle these issues hand in hand.

We may enter an era of even greater uncertainty in the wake of COVID-19.

As Mick Jagger cried out, Please let this be over / Not stuck in a world without end

Perhaps those were the heartfelt cries of everyone in the grip of this crisis. 

The current generation needs to take grand steps to map out a better future for subsequent generations. In Japan, it has been the companies that have expanded overseas and those involved with international cooperation who have continued to focus on the world and its future. The time has come to leverage networks and bring together that collective wisdom. That is the challenge COVID-19 has laid down to those of us living today.

SANO Kentaro is a freelance writer.

Note 1: This article first appeared in the May/June 2020 issue of the Japan Journal.

Note 2: For official up-to-date information such as the figure above, see Government Responses on the Coronavirus Disease 2019.

Note 3: In the calotype network analysis, whole-genome sequences of SARS-CoV-2 isolates in Japan (n = 562) were compared with all GISAID-available SARS-CoV-2 genomes (n = 4,511, updated on April 16, 2020) using median-joining SNV network analysis. SARS-CoV-2 that disseminated from Wuhan City, China, at the end of December, 2019 (one of the potential origins of Wuhan-Hu-1) is plotted at the center of the haplotype network. Animation and more at the NIID website.

 

 

 

 

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