Thursday, June 4, 2020

How Japan Beat COVID-19

One country that the lockdown enthusiasts seem to conspicuously avoid talking about is Japan.  Sweden is their favorite punching bag, as is Florida, but Japan?  It's as if they don't even exist.  And yet, they managed to beat the COVID-19 virus by doing everything "wrong".  And by "wrong", we actually mean RIGHT for the most part.

Despite being in the original geographical danger zone for the pandemic, and being one of the earliest countries to be infected that was not named China, their per capita death rate (the most important indicator) remains so low that it barely even gets on the chart relative to the rest of the world.  So how did they do it?

They did not impose a compulsory lockdown, opting instead for what they called a "soft lockdown" that did not even have the force of law (as their constitution, that they actually take seriously, strictly forbids doing such a thing), and even that was fairly brief and quite belated.  Nor did they close their borders either, opting instead for health checks at ports of entry and fairly modest visa restrictions early on.

What they did do, rather famously, is habitually wear face masks in public, as they did even before the pandemic began during flu season as well as allergy season.  Not everyone, but apparently enough to make a difference. And they are generally very good about hygiene overall there as well.  But less famously, and yet likely contributed even more to their success, was their virtually unique strategy of contact tracing despite doing relatively few tests for the virus.  Instead of going high-volume, labor-intensive, and prospectively, they quietly went after the larger clusters and traced contacts retrospectively, working backwards.  And that strategy really seemed to out-ninja this rather stealthy virus, since the spread pattern is highly skewed and heterogeneous, overwhelmingly driven by a fairly small number of "superspreaders" (10-20% of infected people), while about 70% of infected people statistically don't pass the virus on at all to anyone.  So this pattern lends itself more to that kind of contact tracing paradigm.  And best of all, they did it with excellent timing, unlike so many other countries that squandered and missed their chances to do so before it was too late.

Some cynics may think that Japan deliberately did as few tests as possible so as to make their numbers look good to the outside world, in the hopes of hosting the 2020 Olympics in Tokyo (which nevertheless got postponed to July 2021), thus sweeping it under the rug.  While that may or may not have been part of the motivation for running a low number of tests, their death numbers don't lie, and they seemed to have outsmarted the virus in any case.

And last but not least, despite having the oldest population in the world, they apparently protected the elderly quite well, and apparently did NOT screw up with their nursing homes like so many other countries (especially the UK and New York) unfortunately did royally.  That alone is worth its weight in gold, and the proof is in the numbers.

Now THAT is a shining city on a hill!

(The Wall Street Journal has another great article about Japan's success story here.)

OCTOBER UPDATE: While Japan still seems to have quite a lot of "cases" (positive tests), their per capita death rates are still very low and barely even get on the chart. Another good article can be found here.

2021 UPDATE:  We now basically take back anything we said about Japan "beating" the virus, especially anything about masks which turned out to be largely a red herring all along.  Japan had lots and lots of cases, even with low testing, but very few deaths and essentially no excess deaths, most likely due to low obesity and prior immunity from related coronaviruses common in East Asia.  That is a far better explanation than masks or ingenuity.  Their two worst waves so far both occurred in 2021, and they also had quite the surge in RSV in 2021 as well, despite a whopping 98% mask compliance.  Otherwise though, we still praise Japan for avoiding a hard lockdown, or even any serious mandates prior to 2021.  The virus was always destined to become endemic, and on some level they seem to be accepting that despite their initial elimination strategy.

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