Julian, what you say about Hong Kong and Malaysia also applies to Japan I think. What follows is an extremely interesting article from the Economist which tries to explain this. Apologies for the rubbish spacing etc but this is down to my reformatting. It's normally a pay-to-read article.The Japanese authoritiesunderstood covid-19 better than most.That has helped keep Japan’s outbreak relatively small When the Diamond Princess, a cruise ship sufferingfrom an outbreak of covid-19, arrived in Japan inFebruary, it seemed like a stroke of bad luck. A smallfloating petri dish threatened to turn the Japanesearchipelago into a big one. In retrospect, however, the earlyexposure taught the authorities lessons that have helpedmake Japan’s epidemic the mildest among the world’s bigeconomies, despite a recent surge in infections. In total2,487 people have died of the coronavirus in Japan, justover half the number in China and fewer people than on asingle day in America several times over the past week.Japan has suffered just 18 deaths per million people, ahigher rate than in China, but by far the lowest in the g7, aclub of big, industrialised democracies. (Germany comesin second, at 239.) Most strikingly, Japan has achieved thissuccess without strict lockdowns or mass testing—themain weapons in the battle against covid-19 elsewhere.“From the beginning we did not aim at containment,” saysOshitani Hitoshi, a virologist who sits on an expert paneladvising the government. That would require identifyingall possible cases, which is not feasible in a country ofJapan’s size when the majority of infections produce mildor no symptoms, argues Mr Oshitani: “Even if you testeveryone once per week, you’ll still miss some.” Japanperforms the fewest tests in the g7: an average of 270 a dayfor every million people, compared with 4,000 or so inAmerica and Britain (see chart).Instead, the government tried to apply the lessons of theDiamond Princess. After trained quarantine officers andnurses were infected aboard the ship, despite followingprotocols for viruses that spread through droplets, MrOshitani’s team concluded that the virus spread throughthe air. As early as March, Japanese officials began warningcitizens to avoid the san-mitsu or “3cs”: closed spaces,crowded places and close-contact settings. The phrase wasblasted across traditional and social media. Surveysconducted in the spring found that a big majority wereavoiding 3c settings. The publishing houseJiyukokuminsha recently declared it “buzzword of theyear” for 2020.The DiamondPrincess alsoinspired an earlyfocus on clusters.The government setup a cluster-bustingtaskforce in March.These insightsallowed theauthorities to makegranulardistinctions aboutrisks, opting fortargeted restrictions rather than swinging between theextremes of strict lockdowns and free-for-all openings.Nishimura Yasutoshi, the minister overseeing thegovernment’s response to covid-19, carries a device thatmonitors carbon dioxide to measure the quality ofventilation during his meetings. (The room where he andyour correspondent meet registers 506 parts per million,safely below the threshold of 1000 ppm that indicates poorair "ow. The interview takes place across a large table,behind plastic shields and with face masks on.)Tracking covid-19across the worldLessons from thepandemicGRAPHIC DETAILINTERNATIONALResearchers deployed Fugaku, the world’s fastestsupercomputer, to model different situations. Crowdedsubways pose little risk, if windows are open andpassengers wear masks, Mr Nishimura insists. Sittingdiagonally, rather than directly across from each other canreduce the risk of infection by 75%. Movie theatres aresafe, “even if viewers are eating popcorn and hot dogs”, MrNishimura says. While most cinemas in the West areclosed, “Demon Slayer”, a new anime flick, has been playingto full houses in Japan, becoming the country’s second highest grossing $lm ever. In addition to the 3cs, theJapanese government warns of five more specific dangers:dinner parties with booze; drinking and eating in groups ofmore than four; talking without masks at close quarters;living in dormitories and other small shared spaces; andusing changing or break rooms.Of course, these insights would have been for naught ifordinary people had ignored them. But Japanese heededthe government’s advice to stay home and to quarantine ifshowing any symptoms of the coronavirus, even thoughthese admonitions carried no legal force. “Sometimes weare criticised for being an overly homogeneous society, butI think it played a positive role this time,” Mr Nishimurasays. And already spick-and-span Japan became even morepunctilious about hygiene. While Americans argued overwhether face coverings were an assault on personalfreedom, Japanese lined up outside Uniqlo for the releaseof its new line of masks. During the first ten weeks of fluseason this autumn, Japan saw just 148 cases of commoninfluenza, or less than 1% of the five-year average for thesame period (17,000).Better yet, although the population of Japan isdisproportionally elderly, and therefore potentially morevulnerable to covid-19, it is also very healthy. Only 4.2% ofJapanese adults are obese, a condition known to make thedisease more lethal. That is the lowest rate in the oecd anda tenth of America’s. Japan also has a good health-caresystem, with universal coverage and lots of well-equippedhospitals. It even had lots of already trained contact tracers, part of an established public-health networkdating back to the 1930s.These advantages clearly have their limits. The virus hasspread rapidly in recent weeks, reaching record highs interms both of daily cases and daily deaths. Thegovernment has had to dispatch medical personnel fromthe Self-Defence Forces to shore up hospitals in the worst hit spots. But at the same time it has discouraged cautionwith a scheme that subsidises domestic tourism and mealsout, in an effort to help the economy. Although this seemsto have contributed to covid-19’s recent spread, thegovernment has only curbed it rather than scrapping it.And cold weather is now pushing people into 3c spaces, asit has been across the northern hemisphere. But in Japan,at least, the recent growth in the number of cases hasstarted from a dramatically lower base
Alastair Banton ● 2127d