First a disclaimer: Telejournalist and author Jiro Shinbo fully admits his educational background is in the humanities, not science. He also tells readers of his weekly column in Flash (May 5) that what he writes is presumptive and requires substantiation by the scientific method. With those two points on record, let us now proceed to the article's headline, which is phrased in the form of a question: "Why hasn't the number of infected people in Japan undergone an explosive increase?"
Considering the predictions of widespread infections issued by a number of public health experts, many others may be asking the same question. Look at New York City, he writes. The number of new cases had increased to 50 per day; but then within a span of six days, the number had risen to four digits. In Tokyo by contrast, the "known" number of cases was at 50. And three weeks later, the figure had increased four fold to 200. The rate of increase in Osaka was similar.
Compared with what has been occurring in the U.S. and Europe, so far, Japan appears to be fortunate.
Looking at the average worldwide, it has been estimated that an average of 80% of people infected with the coronavirus show only light, or no, symptoms. Another 20% require hospitalization, of which around 5% depend on intensive care in attempts to keep them alive.
With that, Shinbo raises four hypotheses that relate to his question. The first is, despite the differences in the volume of testing being performed in Japan as compared to other countries, Japan's figures do appear lower -- even among the most the elderly, who are the most vulnerable to the contagion. In this country, it's not customary for younger people to exchange hugs and kisses with elderly members of the same household. In Japan, a higher proportion of elderly also live alone (or with a spouse) compared to households in, say, Italy, where it's common for three generations to live under the same roof.
For generations to live separately may be undesirable in good times, but during a pandemic, it may be working to Japan's favor. Moreover, from the low percentages of positive results when testing for the virus in Japan's rural areas, where several generations do live together, it does not appear that incautious young people are spreading the virus to their grandparents in large numbers.
The second factor, writes Shinbo, may relate some sort of racial component. Some public health officials have raised the issue of greater vulnerability to infection, along with more severe symptoms, among people of certain racial groups and sub-groups. While socio-economic factors are also likely to be involved, it's possible a greater understanding of this phenomenon can offer some insight into controlling the spread.
A third hypothesis relates to personal sanitary practices. In Japanese, the polite word for toilet, otearai, literally means "hand-washing place." Even before the pandemic many Japanese could be seen wearing masks in public due to seasonal hay fever -- although foreign tourists may have had the mistaken impression their purpose was avoidance of contagious diseases. Be as it may, it's possible habitual hand-washing and wearing of masks may have had a somewhat beneficial impact on limiting the spread of the virus.
Shinbo's fourth hypothesis involves the so-called "herd immunity" that is anticipated to follow mass infection that's occurred in the hardest-hit countries. Since Japan cannot be said to be on the downward slope from a peak, then it is possible there is no benefit for it to continue halting social interaction. After all, he writes, the policy of "self restraint" cannot be maintained indefinitely.
"If, for the reasons stated above, Japan's risk of exponential increase in infections is not as high as in Europe or North America," he writes, "then while boosting protection for the most vulnerable elderly and promoting 'Japanese-style' sanitary practices, I believe it will be safe to revert to normal social activities."
Still, Shinbo cautions, he would only advocate a return to normal activities if confirmed through scientific evidence.© Japan Today