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What’s behind Japan’s surprisingly low coronavirus numbers?

25 Comments
By Aonghas Crowe
People look at cherry blossoms at Ueno Park in Tokyo on March 22. Photo: REUTERS file

"While the number of new daily cases of coronavirus is up in recent days, they remain enviably low compared to other countries at the moment. It wasn’t supposed to be like this — or was it?"

Wednesday would have been the first day of spring break for the kids in Japan, but thanks to the coronavirus, their break was extended by 24 days. For the time being, at least, schools here will reopen on schedule — Tuesday, April 7 —meaning we still have two more weeks of “family quality time” on our well-washed hands.

To be honest, I have been enjoying the past several weeks. I’m not getting much done, mind you, but every day has felt like Sunday — quiet, lazy mornings, afternoons spent outside hiking, riding bikes, or, more recently, hanging out at the beach now that it has warmed up. (The fights and tantrums, I could do with less of.)

Thanks to the closures and cancellations, we have also been able to make quite a bit of progress on their English reading skills, which makes me happy... and relieved.

In three short weeks, the university will start up again — knock on wood — and this lull in our normally frenetic lives will become a memory. Gotta make the most of it.

I doubt people in America will be able to say the same thing.

There, the situation has gone from bad to worse pell-mell and it’s anyone’s guess when things will return to normal, if ever. For starters, a number of municipalities and states have passed ordinances to “shelter-in-place.” Some have also ordered the shuttering of all so-called “non-essential” businesses, the daily reality of which is something I find hard to envision. I suspect that similar orders will be passed down in other areas as the virus continues its inevitable spread throughout America. Many schools in the U.S. have been closed indefinitely, meaning they may not reopen until next fall. Unbelievable.

How has that been allowed to happen and — more importantly — how has it not happened here in Japan? Here life has quickly returned to something approaching normal, and it’s something that’s been on my mind a lot lately.

I don’t remember exactly, but I believe it was in mid-January that I first started hearing of a new virus spreading in China. Perhaps it was one of my more “in-tune” students who mentioned it. At any rate, it wasn’t the first time a deadly epidemic originated in China, so I didn’t pay much heed to it initially. On Jan 16, though, a man who had visited Wuhan became Japan’s first confirmed case. Not long thereafter — on Jan 23 to be precise — there were reports of an emergency field hospital being constructed in Wuhan. The whole of Hubei Province with a population of some 50 million people was quarantined. That caught my attention.

Then the first cases among people who hadn’t personally traveled to China —  including a bus driver and tour guide — started to appear in Japan (Jan 28).

Japanese nationals traveling or residing in Wuhan were repatriated at the end of the month and told to self-isolate. It was also at this time that the mayor of Fukuoka made headlines when he said cruise ships coming from mainland China should be turned away. While it may have sounded strident and paranoid, in hindsight, he was right: especially in light of what would happen on another cruise ship a few weeks later.

So, from quite early on, the concern was out there and palpable.

By early the following month, any non-citizen with a history of traveling to or from Hubei Province was not allowed into Japan. A similar restriction was imposed in the U.S. on Jan 31, but by then the first case of the virus had already been confirmed in Washington (Jan 20).

Further restrictions on travel from the coastal province of Zhejiang were then announced in Japan. It’s interesting to note that, although the virus spread to America at about the same time as it did in Japan, the response by the government — and more crucially by the people themselves — to the new infection has been different.

By Feb 21, there were reports in Japan that public fear of the coronavirus had caused people to be more serious about taking measures to prevent infection, such as hand washing, gargling, wearing masks and avoiding crowded places. As a result, cases of influenza plunged by 60%. This was achieved not through government mandated shut downs and hygiene guidelines, but by people merely taking responsibility for their own well-being as well as for those around them. It’s also worth noting that pollen masks and hand sanitizer were already selling out by the end of January. When I asked family back in the States if they could find N95 masks and hand sanitizer for us, they laughed at me first, then said: yes, the stores were fully stocked.

That was early February right at the time that the Diamond Princess became Japan’s first cluster.

By mid-month, Japan had the third-highest number of cases after Mainland China and the doomed cruise ship. Closer to home, Fukuoka Prefecture announced its first case on Feb 20, a man in his 60s with no known travel history overseas. His wife would be hospitalized soon thereafter.

By the middle of February, companies in Japan were already starting to switch to telecommuting or staggered work schedules. People wearing masks, always a common sight during the flu and hay fever season, became ubiquitous. On one train I calculated that almost 90% of the passengers were wearing masks.

"My pet theory is that rates of infection come down to national characteristics and culture."

Now masks, some might argue, are next to useless in preventing one from catching the virus, especially the flimsy ones so many Japanese people wear.

I will counter, though, that people wearing masks are most likely doing other things to protect themselves. Just like being able to do 20 push-ups is linked to fewer heart attacks. It’s not the push-ups that are preventing heart attacks, but rather the push ups as an indicator of a healthy lifestyle that also includes a nutritious diet and regular exercise. Masks were indicating a heightened awareness and precaution.

Compare that with what was going on in the U.S. By late February, the virus was being politicized. Trump downplayed the severity of it, calling it the Democrat’s newest hoax.

“By a margin of 10 percent, Republicans are less likely to say that they are ‘washing my hands or using disinfectant more frequently,’” reported the Washingtonian, unsurprisingly. “Republicans were also less likely to avoid physical contact that might transmit the virus, such as handshakes.”

Only in America could something like hand washing become a partisan issue.

And so, in the U.S., for instance, there are now 64,765 cases, 910 deaths and 393 recoveries. There were over 11,000 new cases of Covid-19 (the virus that causes the novel coronavirus) on March 24. Tomorrow there will most likely be more. New York continues to be the hardest hit with 30,811 cases, followed by New Jersey (4,402), California (2,853), Washington (2,469), Michigan (2,295) and Illinois (1,865). New York has had the most deaths from the virus (285), Washington has the second most (123), Louisiana has the third (65) and California the fourth (64). Across America, there were 130 new fatalities from Covid-19 on Tuesday.

In stark contrast to what is going on in America and several European countries, we have in Japan 1,193-1,299 confirmed cases in Japan (as of March 25), 98 more than yesterday, of which 865-983 are active, 54-57 are critical or serious, 272-285 have recovered and 43-44 are know to have died from Covid-19. Between 23,521-24,430 have been tested. (Ranges reflect the different stats reported by a number of sites, including Johns Hopkins' interactive dashboard, Worldometer and covid19japan.com.)

While the number of new daily cases is up in recent days, they remain enviably low compared to other countries at the moment. It wasn’t supposed to be like this, was it? Japan’s proximity to China, her overdependence on the country as a manufacturer and market for Japanese products, her sluice gates wide open to the influx of Chinese tourists, all meant that Japan, too, would become the next hot spot for the virus. And yet it didn’t happen. Why not?

My pet theory is that rates of infection come down to national characteristics and culture.

The first one being reserve and self-restraint. While the American is pounding his chest and shouting, “You can’t tell me what to do! This is a free country! the Japanese merely shrugs, “Shikata ga nai (It can’t be helped.)” and complies quietly. Some will argue that this ungrudging conformity is the result of Japan being a society based on rice farming where cooperation was vital for a village to survive. I only need to point to another rice-dependent, yet rambunctious society — China — to suggest that there might be more to it than that.

Gaman, or forbearance, has a lot to do with it, too. The Japanese are taught to gaman or be patient or endure from a very young age. As I was walking my eight-year-old son to school one hot day, I suggested he take a sip of water from his thermos. I can’t be replied. Why not? Because we’re not allowed to. But you’re hot and thirsty, right? Yes, but I can’t. Okay, suit yourself.

It’s often like that here: there is a proper way to do things and there can be no exceptions. The only time that seems to work in America is boot camp.

So many little implicit and explicit rules that control how the Japanese act in society — what language must be used in which circumstances, how to hold something, how to point, how to stand, how to bow, how to pretend to be putting forth utmost effort and so on. Americans would bristle at all the micro regulations, as did I when I first got here, and still do from time to time two decades later.

The Japanese are also better at being mindful of others, what is called kio tsukau. Because of this, they will, again, gaman for the benefit of the team and gaman for the sake of strangers. Similarly, one of the Venial Sins in Japan is causing trouble for others, or meiwakuo kaku. And so, people will wear masks and wash their hands not so much with their own health in mind, but with that of others. If a Japanese is running a fever or has a bad cough, he will wear a mask so as to not spread germs or make others feel uncomfortable.

There is also the habit of jishuku, or self-control and self-restraint, which is different from gaman in that Japanese will jishuku in times of crisis or disaster. When the Tohoku region was hit by a massive earthquake and tsunami in March  2011, many people in unaffected areas stayed home. Why? Because it wouldn’t have been appropriate to go out and have fun while others were suffering so much. Thanks to all that jishuku-ing, the economy took a hit and everyone felt the pain. Now, contrast that with what George W. Bush said after the 9/11 attacks: “And I encourage you all to go shopping more… " And even more memorably: "Get down to Disney World in Florida. Take your families and enjoy life, the way we want it to be enjoyed.”

And because Japan is a land of disasters — earthquakes, tsunami, typhoons, landslides, volcanoes, and occasionally attacks from kaiju such as Godzilla — shikata ga nai, or it can’t be helped, ought to be printed on the currency as the nation’s motto. Submission to — even reverence of — uncontrollable forces be they natural or man-made, has been the oft-repeated refrain to the epic poem that is Japanese history.

Now, add to all that, a generally healthy populous with good access to affordable and quality healthcare, a fairly competent and well-educated bureaucracy, built-in social distancing thanks to bowing instead of handshakes or hugs, an obsessive-compulsive attitude towards cleanliness and handwashing, removing shoes at the entrance of one’s home, and it’s little wonder that the country has been able to keep Covid-19 at bay.

Knock on wood.

© Japan Today

©2020 GPlusMedia Inc.

25 Comments
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What’s behind Japan’s surprisingly low coronavirus numbers?

now that the Olympic has been postponed, ask that see if you can ask the same question two weeks later. May we all pray that I am wrong.

11 ( +13 / -2 )

Defiantly nothing to do with the low testing or denying people to test. It’s all thanks to the amazing Japanese people and spirit. Why can’t everyone be like this amazing country with such great manners and hygiene?

I think now that the Olympics are called off and people are actually able to get tested more easily, we will see many more cases that would have previously gone undiagnosed.

8 ( +13 / -5 )

I hope that culture was really the difference.

Lots of people smoke here and so I don't think the general population risk is low.

The lack of any fear in Japan baffles me.

8 ( +8 / -0 )

Stop giving people a false sense of security. The naivety is going to make things worse.

It's not a mystery that every single day since the Olympics were postponed, the situation has been getting worse daily.

The task force set up by Abe, is right now planning for a lockdown. And it's going to happen sooner than you think. They've had this timeline of reacting to the virus planned out a long time ago but had to make sure the Olympics could be postponed as late as possible to avoid any backlash for the delay.

Everything will happen quickly to limit the impact of COVID-19 on Japan, but not too quickly so that the government can avoid blame for acting too slow because of the Olympics.

The local governments of the Kanto area have asked for restraint weekend. Thanks to articles like this, many people will still go outside. This will allow the government to lockdown Tokyo and blame it on everyone's lack of restraint, rather than the government's attempt to save the Olympics.

7 ( +9 / -2 )

What garbage. Viruses don't give a bleep about culture but I bet the funny thing is many people here really think in this way. Revisit the headline a month from now.

9 ( +13 / -4 )

MocheakeToday 09:38 am JSTWhat garbage. Viruses don't give a bleep about culture but I bet the funny thing is many people here really think in this way. Revisit the headline a month from now.

History shows that to be true - over and over again.

4 ( +5 / -1 )

I am rather familiar with the Japanese way of life and to answer the question, I have to say it's the typical Japanese sense of cleanliness imbued into the culture. Japanese washes their hands, at least the wives & kids and the majority of the husbands, when they return home and before meals and after toilet. There's no hiding of figures like the PRC Chinese are doing. I have also learned this habit while living with a Japanese wife for 25yrs, especially as I myself am a fastidious cleanliness freak.

-5 ( +5 / -10 )

m6bobToday 10:11 am JSTI am rather familiar with the Japanese way of life and to answer the question, I have to say it's the typical Japanese sense of cleanliness imbued into the culture. Japanese washes their hands, at least the wives & kids and the majority of the husbands, when they return home and before meals and after toilet. There's no hiding of figures like the PRC Chinese are doing. I have also learned this habit while living with a Japanese wife for 25yrs, especially as I myself am a fastidious cleanliness freak.

I have heard about Japan's clean living. It makes sense in its large metropolises anyway. I've heard about their gold latrines. And I remember reading about the Japanese national Olympic team cleaning up the locker rooms, shower rooms, bathrooms in Moscow a few years ago. Now that was classy to say the least.

3 ( +4 / -1 )

What’s behind Japan’s surprisingly low coronavirus numbers?

Let’s see......lack of testing people, ignorance, hiding numbers, worrying about the olympics (only japan and the IOC care about it, really), Abe, fake news from the Japanese media, denial, Koike, people that don’t pay attention to world news, people that don’t pay attention to anything that doesn’t directly involve them, corrupt government, stupidity, Aso, incompetency, etc etc etc.........

8 ( +11 / -3 )

So, to make sure of it, all of you who put the low numbers only on the lack of testing, think that they are also hiding deaths and severe cases that should be lining up in hospitals?

It may be only luck, but when you see what's happening in Europe and in the States Japan has been doing quite well until now. From now may be a different story still...

4 ( +6 / -2 )

The correct answer is "Public Relations".

5 ( +7 / -2 )

I don't doubt the Japanese culture and the way of life here has been a factor.

I feel safer in this country where I can trust people to sit tight and wait out a lockdown (if it happens).

I have a lot of faith in the people of Japan.

It's the government and their handling of Olympics that has been frustrating. And I hope it doesn't cost more lives.

-4 ( +3 / -7 )

Obviously nothing to do with the fact that they have barely tested anyone, and generally don't do autopsies.

7 ( +8 / -1 )

A load of guff, and dangerous if people believe this 'different culture has saved us' rubbish.

4 ( +5 / -1 )

m6bobToday  10:11 am JST

I am rather familiar with the Japanese way of life and to answer the question, I have to say it's the typical Japanese sense of cleanliness imbued into the culture. Japanese washes their hands, at least the wives & kids and the majority of the husbands, when they return home and before meals and after toilet.

Well, believe what you want but if you came to the public bathroom at my office (frequented by mostly Japanese men and boys), it would shatter the last part of that myth forever.

5 ( +6 / -1 )

This is SO offensive. I can’t believe this person is generalizing Americans like that. It’s irresponsible writing. If another culture had generalized Japanese in such a way they’d never hear the end of it. Not to mention, the generalization is incorrect and stupid. (SMH) “You can’t tell me what to do! This is a free country!  Give me a break. Who would say that?

0 ( +3 / -3 )

So, to make sure of it, all of you who put the low numbers only on the lack of testing, think that they are also hiding deaths and severe cases that should be lining up in hospitals?

They are not doing autopsies or COVID testing of people with pneumonia. They are also refusing to publish any statistics on pneumonia (they publish every 3 years and have said they will make no exception). Funeral homes have been directed to treat every pneumonia corpse as if it has COVID-19 because there is no testing.

4 ( +5 / -1 )

Or the government just wasn’t testing enough.

2 ( +3 / -1 )

Under-testing

0 ( +2 / -2 )

What garbage. Viruses don't give a bleep about culture but I bet the funny thing is many people here really think in this way. Revisit the headline a month from now.

Yup.

They are not doing autopsies or COVID testing of people with pneumonia. They are also refusing to publish any statistics on pneumonia (they publish every 3 years and have said they will make no exception). Funeral homes have been directed to treat every pneumonia corpse as if it has COVID-19 because there is no testing.

Well, now we can say we know why the numbers are so low in Japan.

2 ( +3 / -1 )

I have question for the author :

What happened around 2-4 weeks ago ? (taking in account the delay after onset to be tested and the incubation period)

Regarding the "shikata ga nai" is one of the stuff which can explain the mass for hanami and the lack of social distancing. Can also be used to question the wearing of mask as they can not help than having their potentially ill self be stuck to potentially ill other ; but they can at least help this one.

How about linking all of these concepts with the low number of identified cases not as negative Schrodinger cat but positive ones ? Why if infected Japanese and their family were enduring the illness to not be a bother to other ?

Personally, I think the proximity with China and the reluctance of Abe to close border with it tensed Japanese up in protecting themselves. Then one of the first case of local transmission was identified at the time of death (tested before result after) and lead to a cluster involving taxi driver and medical staff, which brought more tense up. And to top it a cruise ship with lot of cases and official being infected too come up, alongside a new cluster in a hospital in the middle of the countryside, which must have not helped reduce the tense up. All of that could have brought people to be more careful without any regard to all the Japanese culture stuff. But since for a while the government was sending messages like it is ok, we win against the virus, we are handling thing well, we have almost no case and we can even reduce measure, ... ; Olympic should go on, go spend money ; people eased up.

So just another theory.

0 ( +1 / -1 )

Great article, just one comment. Although China is also a rice culture, as a result of being part of a huge land mass, its climate is relatively calm compared to Japan’s unpredictable climate and incessant natural disasters. This made rice farming particularly challenging in Japan’s early history and required, as you mentioned, conformity and cooperation from the whole village. Therefore, I would say that communal rice farming in conjunction with a highly a unpredictable climate and frequent natural disasters have created a strong collectivist/conformist attitude that has lasted to this day.

0 ( +1 / -1 )

This article is ridiculous. Everything you have said has since been proven incorrect. Bowing does nothing if there is virus shedding from your body and floating in the air. Japan's numbers are low right now because they are counting pneumonia related deaths as just that and not pneumonia cause by coronavirus.

2 ( +3 / -1 )

coincidence that the day after olympic got successfully postponed that in japan “new cases” of coronavirus showed up? Not at all. Should stop living in the clouds. Japan hides numbers and getting tested is almost impossible even if you want. The prevention measures are ridiculous. In japan people and culture listen to what governors says? Not at all. Go to yoyogi park and shinjuku station or any other station then you can see how the “avoid crowded places” is. I tell you if you don’t know it: they are packed of people! Some of them without mask and careless about the virus. People they don’t care about virus at all. Japan had problem with an “too old population”, and now this careless of virus, coincidence again? Dont think so

1 ( +2 / -1 )

This article is more like how it should be if you believe stereotypes about Japan. But I've been living in Kyoto for years and this fantasy about Japan is not entirely true. I mean yes they wear masks and wash their hands but what they don't do is social distancing. They still go to karaoke, libraries , restaurants, trains are full and even though government advised to be careful about hanami the sakura spots were so crowded you couldn't be careful. It's the thing to every people and Japan is no exception: If the government isn't doing firm restrictions people don't take advisory. They just act as they wish. They prefer to go to office instead doing the job online just to show off ( or because paperwork is still way of working here) . The lines in the shops are so tight no mask can help you there. Let's be realistic, masks are no magic tools. And most importantly, Japanese people are too carefree in this situation believing their country is not in danger and underestimating of the virus is inviting the virus. I don't feel that safe here and I'm sure there are many people with mild symptoms or no symptoms going in crowded spaces without being checked. So don't always listen to the myths and lies of the government. There is a way between panicking and being too carefree. It's called being reasonable.

1 ( +1 / -0 )

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