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Japan sees fewer COVID-19 hospital deaths than other nations: study

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Japanese Abe government or authorities favor to compare with high damage countries only.

But Japan's shortage of virus test caused nosocomial infection, have still increased victim.

moreover, mortality rate of Covid19 patients in other countries of Eastern Asia are far smaller than Japan.

"Japan is good because better than China or UK or US" is wrong clearly.

2 ( +2 / -0 )

Japanese Abe government or authorities favor to compare with high damage countries only.

But Japan's shortage of virus test caused nosocomial infection, have still increased victim.

moreover, mortality rate of Covid19 patients in other countries of Eastern Asia are far smaller than Japan.

"Japan is good because better than China or UK or US" is wrong clearly.

3 ( +3 / -0 )

Its really quite simple, lighter cases are admitted to hospital in Japan than in other countries. Those that are admitted are much less likely to be obese which is the number one factor in a patients survival chances.

Deaths are not being hidden under carpets, autopsies are expensive and time consuming and are only undertaken when the cause of death is uncertain.

5 ( +9 / -4 )

Is Japan's overall mortality rate still lower than it was at the same time last year? This is more important to know, than who died from what illness.

That's a good question. The number of higher than expected deaths, especially of it closely matches the number of deaths recorded as Covid-related, seems about the best data we could get right now. There are some links below, but I can't find much comparable data for Japan. The nikkei link only covers the first four months of the year. I've seen mentioned that Japan's excess death rate is still low (even negative) but have not seen any clear data.

https://www.economist.com/graphic-detail/2020/07/15/tracking-covid-19-excess-deaths-across-countries

https://www.health.org.uk/news-and-comment/charts-and-infographics/comparing-covid-19-impact-in-the-uk-to-european-countries

https://asia.nikkei.com/Spotlight/Coronavirus/Japan-had-no-excess-deaths-in-1st-4-months-of-year-despite-COVID

10 ( +11 / -1 )

Makes sense, comprehensive personal hygiene and mask wearing here are decades ahead of other countries, not to mention pretty much most people at least in the English speaking countries are overweight or obese and have generally poor health and diets. It doesn't take grade 3 math to see why less people are dying here.

But no, the death numbers are fake and all the dead bodies are buried in Abe's backyard to keep the numbers low for the Olympics right? Japan baaa-aahd!

5 ( +11 / -6 )

Maybe that's because of the lack of testing, and that people with symptoms are told not to come to hospital, but to suffer at home?

1 ( +8 / -7 )

Is Japan's overall mortality rate still lower than it was at the same time last year? This is more important to know, than who died from what illness. There's been a ridiculous amount of reporting globally on death tolls associated with this one specific virus with very little of the data behind those numbers being shared, like age, pre-existing conditions, whether the deaths occurred in an aged care facility, whether the person who died had had it months ago, recovered then died from another cause, or was already on their deathbed in a hospital when they contracted the virus a week before they died. Numbers by themselves are about as close to useless information as you can get, but people seem morbidly focused on these death tolls as if they tell us all we need to know. The data behind the numbers is the actual relevant information... There's very little to be gained knowledge wise from publishing daily death tolls. I actually think Japan has done well not to fall into that trap.

10 ( +10 / -0 )

However, if Japan really wants to be an example to the world of 'winning' (i find the whole idea of winning and losing comparisons distasteful) then the current strategy is not working.

Exactly. This is not about 'winning' or 'losing,' it's about finding clarity on the "official reports" which are issued by government-related institutions.

It's probable that most people haven't bothered to check the background of who has issued this 'report'-

[ History of the National Institute of Health Services Management

The National Institute of Health Services Management was established in June 1949 as the Training Center for Hospital Management within the First National Hospital of Tokyo (current National Center for Global Health and Medicine) as a research institute directly under the Ministry of Health and Welfare. ]

https://www.niph.go.jp/en/information-en/

How soon people seem to forget how the 'low numbers' of infection reported on in March in "official reports" while Abe still harbored hopes of hosting the Olympics suddenly ballooned when it was conceded that would be unfeasible.

-3 ( +4 / -7 )

Very well put Vinke, great points, definitely not fear mongering.

-2 ( +2 / -4 )

One other reason, other countries were forcing people on to ventilators recommended by the WHO, which ended up killing 90 percent of the patients.

Japanese doctors mostly did not participate in this practise and used aerosol steroids instead which was proven to be more effective

8 ( +8 / -0 )

So many posters rush to reject good news but believe every negative story irrespective of validity.

I agree, and vice versa. My take looking at the statistics and reporting to date is that Japan initially performed better than average at limiting the spread and impact of the virus through to mid-June, with mortality relatively average on a global scale, and slightly below average on an East Asia scale. Following policy and strategic changes from early May, late June saw the situation escalate in Japan to where it is now performing below average on controlling spread, while mortality and serious cases (icu) remain fairly average for the world generally. Basically its pretty average here, but appears to be heading in the wrong direction. It may or may not result in Japan moving toward the situations seen in the 'losing' countries. However, if Japan really wants to be an example to the world of 'winning' (i find the whole idea of winning and losing comparisons distasteful) then the current strategy is not working.

10 ( +11 / -1 )

Also. About the autopsies. The main reasons countries did the pcr test after the body was dead was to try to get the government money.

Also, in America, you did not have to have a positive on a pcr test to receive the money. You only had to have a doctor sign that the person hand covid-19 like symptoms and the hospitals could recieve the money.

5 ( +8 / -3 )

So many posters rush to reject good news but believe every negative story irrespective of validity.

1 ( +10 / -9 )

It's well known that Japan tests very little, and that is still very difficult to get tested for covid-19 here, even with clear or serious symptoms. Yes, apparently all positive cases are hospitalised in Japan - but, like mentioned, very little testing is done (perhaps also because of this? To avoid overflowing the hospitals.).

Not many tests not many official, hospitalized covid-19 cases not many official covid-19 deaths.

It's been also mentioned in a few articles earlier in the spring & summer, how many deaths from underlying issues are marked as such - i.e., they could've been covid-19, but as they were never tested, the deaths are marked off as pneumonia etc. There were 1000 excess deaths in April-May according to some data. Autopsies are rarely done, and require the permission from the family. Out of fear of being stigmatized, families rarely give this permission/demand autopsies.

https://www.japantimes.co.jp/news/2020/06/11/national/death-toll-coronavirus/#.XyzIjhMzaCU

Just a couple of days ago there was a story on tv, how an elderly lady was first denied testing several times. Her daughter suspected she had covid-19. The elderly lady then died at home. Covid-19 test was never done, and her death was marked off as pneumonia.

Also, as said many times before - please don't concentrate only on the number of deaths or ICU cases. By now it's become clear that the virus can cause serious long-lasting effects also in the 'mild' cases, which will make lives much more difficult and at least be a nuisance (and be an expenditure for the governments, if money is what you care about).

When you put 1 + 1 together, it's just common sense and rationale, that there are far more covid-19 deaths -and cases- than stated. It doesn't mean millions, but probably hundreds. And admitting all of this is not 'fear-mongering' or 'panicking' - it's merely facing the truth. In order for anything to function properly, and for any rational progress to be made, finding out and admitting the truth is the first step.

2 ( +11 / -9 )

Deaths in hospitals. What about all those deaths in care homes or at home; wait a minute, these people don’t get tested.

-1 ( +8 / -9 )

Possibly because they aren't including motorcycle accidents and other deaths as covid-19 as they do in America and the UK.

Yeah, this isn't a thing.

Spreading falsehoods and conspiracies, that's a thing. The case you're referring to was one unfortunate guy in Florida.

https://www.snopes.com/fact-check/florida-motorcyclist-covid-death/

0 ( +6 / -6 )

Amazing really. What can I say? The cat can keep smugly purring...

2 ( +2 / -0 )

@Vinke

It does seem to be add odds with their comments from a couple of months back:

... hygiene in Japan is far and away superior than in the West. In my home Germany, the healthiest in Europe, hygiene standards are pitiful compared to Japan and even South Korea but not as much. I'm not surprised that the virus has collapsed Mediterranean and Western Europe, and the Americas have failed in every single category. It doesn't take much critical thought to see the catastrophic health and hygiene problems of these countries. In the end for most of us expats on this site, our home countries lost badly to this virus and apart from Australia and NZ, no matter how you look at it we did much, much worse than Japan did. Just accept it and look forward to fixing your home countries' health situation. Rampant obesity and diabetes and shocking hygiene and lack of common sense was the cause of the disaster in the West. Not so in Japan.

Oh, wait. Sarcasm. I get it now. My bad.

0 ( +0 / -0 )

All confirmed cases in Japan are hospitalised if possible. Even those with minor or no symptoms

I'd just add that "used to be", but exactly - the explanation to such statistics should be as obvious as it can possibly get.

It has hardly anything to do with the quality of the medical services.

-3 ( +3 / -6 )

i@n

Okay, sorry, the more I contribute here the more paranoid I become regarding posts it seems! But it is strangely addictive, and at least it motivates me to research more which, if nothing else, actually helps me feel more in control of my life.

I do wish these articles would link to the studies though... I have a bit more time, but I'd rather not spend it stalking Google...

3 ( +3 / -0 )

Its almost comical seeing people try their very best to criticize Japan and the Japanese while Japan keeps winning and while their own countries and people keep losing. They won't even try to explain or even entertain any possible reasons why Japan is doing so well. Pathetic, bitter people who are actually worse than useless. Japan IS winning. Refusal to even think some or many of even these more mundane of Japanese ways could be significant is simply the hallmark of a bitter loser.

4 ( +13 / -9 )

Sorry, I have no links this time, as I mentioned before I rely mostly on postings of well meaning posters such as yourself, I don't have much time to hunt for and vet good info and sources

1 ( +1 / -0 )

Hey Tobias,

I was in no way referring to your post, haven't read it yet in fact.

And I would never refer to your well considered posts as imaginings in sure

1 ( +1 / -0 )

will just push the pump bottle with the sterilizer in it to clean their hands, meaning that button will house many peoples dirty stuff on it!

Yeah, but immediately after pushing the button you have sanitizer on your hands. Bacteria and viruses not only won't have any time to establish themselves but then they get hit with sanitizer. I hardly think this is a problem.

11 ( +11 / -0 )

The study's findings are consistent with well known info regarding the most at risk part of population

i@n, do you have a link for the study? I would be interested to see the findings and the methodology.

But of course our imaginings and suppositions has more weight and far more credible, the result is clearly wrong and misleading, right?

As I point out in my post, I found the reporting to be unclear and incomplete, so I attempted to add context. I apologize if this appeared to be 'imaginings' or 'supposition', although I do give citations for the data, and preface my conclusion with 'In my opinion', meant to indicate that the proceeding is my own opinion.

3 ( +4 / -1 )

Stats are stats. Low death rates in japan seem legit, no wonder people arent panicking. Are we seeing a well equipt and apt health system that was already suited and geared towards caring for its aging demographic?

If so, well done Japan. keep on keeping on. No one knows jack for sure yet , so let the data come in and be carefully examined. May be worth curbing the hip flex "yeah, but....." reactions? Death rates sort of key.

-4 ( +0 / -4 )

Kiwikid nails this. It's because every case is hospitalized regardless of symptoms.

I must admit that like Derek Grabe, even recently, around half the toilets I have been to have had no soap. That includes convenience stores where they have a chart on the wall indicating an impressive-looking cleaning rota. Often no paper towels either.

0 ( +4 / -4 )

"There are lies, damned lies, and statistics"... and then there are Japanese statistics, which take the shenanigans to zen master level.

4 ( +9 / -5 )

How many deaths have you had related to covid? None. How many postmortem covid tests have you done? none. Ok

-1 ( +6 / -7 )

Do they have stats for those admitted to ICU due to COVID19 in Japan? I just read an article last week saying that Australia has the lowest mortality rate. 85% of people admitted to Australian ICUs survive COVID, compared to 30% in the US. Would love to know how Japan compares.

5 ( +5 / -0 )

The study's findings are consistent with well known info regarding the most at risk part of population

It said the survey added to evidence that those who tend to develop severe COVID-19 symptoms are older, male, with a history of smoking, and with chronic disease.

And attributes the results of the study to one differentiating factor

Criteria for hospitalization vary from country to country, the center acknowledged, while attributing the result to fewer people being obese or having diabetes in Japan.

But of course our imaginings and suppositions has more weight and far more credible, the result is clearly wrong and misleading, right?

2 ( +3 / -1 )

This ware-ware Nihonjin greater cleanliness nonsense needs to be dismissed for the arrant bilge it is.

My local station STILL doesn't have soap in the restrooms. Neither does much of Kita Senju, a main hub. Parks where kids play and then picnic, the same.

After 25 years here, I am still shocked by the nonchalance with which oyajis hawk and spit in the streets and on station platforms.

So far, Japan has got lucky. I hope she continues to do so. But let's not pretend it's by any form of genetic predisposition to cleanliness, or expert leadership. This is a ship without a captain, and it has been for months.

We, the people, and our responsible conduct - or lack thereof - will drive the results of this plague.

10 ( +13 / -3 )

Japan has clean toilets yes, but the users...because of fear of spreading the virus, air dryers have been shut off in toilets. So now many persons (not just men, women as well) find it to much of a hassle to use their own hand towel and will just push the pump bottle with the sterilizer in it to clean their hands, meaning that button will house many peoples dirty stuff on it!

1 ( +3 / -2 )

Statistics can be manipulated to give you the result that you want.

3 ( +4 / -1 )

As I said way back at the start when it was CLEAR Japan was LOATH to test.......the only way to get an idea of deaths is to compare 2020 data to the last few years, to see if there is any spikes, that would give us a ROUGH idea of deaths likely related to Corona.

The FACT the govt has & continues to do everything to keep numbers down leads me to the OBVIOUS & ONLY conclusion.....you CANT trust any govt figures!

And I would not put it past the govt to fudge any spikes in deaths based on year to year data, the govt sadly cant be trusted at all, no credibility there!

4 ( +7 / -3 )

As Kiwikid says, the diddle for Japan here is that all confirmed cases in Japan are hospitalised where possible. Other countries may have a higher threshold before hospitalization, due to policy, lack of beds etc.

If Japan was testing on a similar scale to China, the UK, the US, we would also be seeing issues surrounding lack of available beds - at which time you have to start triaging cases and not just hospitalising even mild cases. This is when the death rate of those hospitalised in Japan would jump to a much higher number.

I'd wager that if Japan spent 1 month testing at the same level as the UK, or China, that the death rate of all those hospitalised would be significantly greater than 7.5%, and much closer to the numbers reported for the UK and China (26%, 28%).

It stands to reason if you double the testing, you're going to find double the cases, and double the serious cases. These serious cases would be hospitalised over more mild cases, and have a higher probability of death. The hospitalised death rate would therefore increase.

6 ( +8 / -2 )

This article makes a good point acknowledging the covid-19 death rate in Japan is not spiraling out of control.

However, as the article notes, criteria for hospitalization vary from country to country, which is an important factor. In Japan, all confirmed positive cases were required to be hospitalized until late-May, when asymptomatic and mild cases where moved to lodgings or allowed to return home:

https://www.mhlw.go.jp/content/10900000/000634753.pdf

This effectively means deaths per hospitalized case in Japan is more comparable with deaths per case in other countries. By this metric, Japan is somewhat average in comparison to other countries, sitting at 2.43%:

https://www.realclearpolitics.com/coronavirus/#!

Furthermore, as of June 1, there were 889 confirmed deaths from covid-19 in Japan between March 1st and June 1st; https://toyokeizai.net/sp/visual/tko/covid19/en.html.

This article reports that the study found there was a 7.5% death rate amongst 2600 people hospitalized at around 230 facilities between March and June, which accounts for 195 deaths. So clearly 694 people died at hospitals not included in the study. Excluding the majority of deaths during the period in questions seems dubious. I have not read the study itself, however, so I can't comment on methodology.

The article also makes a point of comparison to Britain and New York, which are widely known to be the worst affected pandemic hotspots in the world. It would be more apt to compare Japan to it's East Asian neighbors or countries of similar size or geography:

China CFR 5.48%

Japan CFR 2.43%

South Korea CFR 2.08%

Philippines CFR 1.80%

Taiwan CFR 1.47%

New Zealand CFR 1.40%

The inevitable reply to these statistics is that CFR is a poor metric, because it favors countries that do wide testing and thereby have a high number of asymptomatic or mild cases which push down the CFR. For example, the U.S. is widely accepted to have one of the worst death rates in the world, however it only has a CFR of 3.24% thanks to 5 million cases having been identified in over 63 million PCR tests. In this case, many point to deaths per million population as a preferable metric:

Philippines DPM 20.2

Japan DPM 8.1

South Korea DPM 5.8

New Zealand DPM 4.5

China DPM 3.3

Taiwan DPM 0.3

 Swedes also remove shoes, and they are also doing relatively well.

Sweden CFR 7.03% DPM 566.2

In my opinion, Japan had a low incidence of cases through to July 2020, due to strong contact tracing, pre-existing behaviors around personal prevention, and the SoE. In terms of mortality, Japan has been pretty average in terms of the global situation, and one of the worse in terms of the East Asia region. The previous strategy has now begun to fail, due to a false sense of security based on early success and rapid reopening. As a result cases are increasing more rapidly and more widely throughout Japan. There is a real possibility that the situation regarding mortality could worsen, based on has happened in countries that faced similar situations. The government has chosen to take a reactive approach regarding a further SoE; essentially wait and see. That is clearly its job to decide. I am just hoping we don't become one of those countries other places compare themselves to in an effort to seem like they are fine.

15 ( +15 / -0 )

The cat's out of the bag. Japan keeps corona death numbers low by simply averting their gaze, which if you've lived here for an appreciable amount of time you'll recognize is an accepted way of doing things here.

CapuchinToday  07:13 am JST

But there's also this.

https://mainichi.jp/english/articles/20200522/p2a/00m/0na/010000c

'Over half of Japan pathologists' requests for postmortem coronavirus tests rejected: survey'

Because PCR tests are not being carried out sufficiently on deceased patients, there are concerns that the number of people who have died from COVID-19 is actually higher than reported. Kondo said, "If a cause of death cannot be ascertained, then accurate coronavirus death rates cannot be obtained."

5 ( +8 / -3 )

Do NOT become complacent. One only has to look at America to see how bad it could very easily be.

8 ( +10 / -2 )

All confirmed cases in Japan are hospitalised if possible. Even those with minor or no symptoms.

Im not sure about other countries but in New Zealand only if you were really in need of medical attention were you admitted. If not, you were asked to quarantine at home.

Assuming this is true for most countries, it's only logical they would have higher death rates for inpatient.

This is just Kyodo looking for anything to give themselves a pat on the back for how great Japan is.

11 ( +14 / -3 )

This disease is different from influenza. Though they do not die, many are reportedly suffering various sequelae even they are young.

10 ( +11 / -1 )

No kidding. When you're not testing and you need family approval for autopsies that you'll never get, then yeah, the number will look low.

LOL, Japan had 3.5% fewer deaths for the first six months of the year. Just accept the facts.

, while attributing the result to fewer people being obese or having diabetes in Japan.

The above is true. Just look the stats yourselfs.

-5 ( +3 / -8 )

"Japan sees fewer COVID-19 hospital deaths than other nations: study"

No kidding. When you're not testing and you need family approval for autopsies that you'll never get, then yeah, the number will look low.

Good going, Japan. /s

The patients studied were already confirmed to have covid19.

If the hysterics are to be believed that you have to be on your death bed to be tested, it's a wonder that Japan has lower covid19 hospital death rates compared to other countries.

-4 ( +7 / -11 )

Japan sees fewer COVID-19 hospital deaths than other nations: study

BS

Look for yourself

https://en.wikipedia.org/wiki/COVID-19_pandemic_by_country_and_territory

0 ( +11 / -11 )

That people are cleaner here is a myth.

To some degree. But even a single thing, like wearing shoes into the house and even on the bed, can make a huge difference. Swedes also remove shoes, and they are also doing relatively well.

-8 ( +10 / -18 )

Japan sees fewer COVID-19 hospital deaths than other nations: study"

No kidding. When you're not testing and you need family approval for autopsies that you'll never get, then yeah, the number will look low.

Exactly!!

Yeah, what he said.

(Capuchin)

I'll second that

6 ( +14 / -8 )

Criteria for hospitalization vary from country to country, the center acknowledged, while attributing the result to fewer people being obese or having diabetes in Japan.

It said the survey added to evidence that those who tend to develop severe COVID-19 symptoms are older, male, with a history of smoking, and with chronic disease.

Perhaps these factors constitute global patterns. Fatality rate and pathological process related to Covid-19 depend on one's pre-existing health conditions.

2 ( +7 / -5 )

Yeah, what he said.

(Capuchin)

3 ( +8 / -5 )

Perhaps Japan does not have the same financial or political incentives to mislabel a death as a Covid death.

This! ^^

The fear-mongers become more and more irrelevant with each passing day...

-5 ( +14 / -19 )

Perhaps Japan does not have the same financial or political incentives to mislabel a death as a Covid death.

-5 ( +18 / -23 )

But there's also this.

https://mainichi.jp/english/articles/20200522/p2a/00m/0na/010000c

'Over half of Japan pathologists' requests for postmortem coronavirus tests rejected: survey'

Because PCR tests are not being carried out sufficiently on deceased patients, there are concerns that the number of people who have died from COVID-19 is actually higher than reported. Kondo said, "If a cause of death cannot be ascertained, then accurate coronavirus death rates cannot be obtained."

19 ( +28 / -9 )

I don't understand the 'cleanliness' argument.

That people are cleaner here is a myth.

31 ( +38 / -7 )

"Japan sees fewer COVID-19 hospital deaths than other nations: study"

No kidding. When you're not testing and you need family approval for autopsies that you'll never get, then yeah, the number will look low.

Good going, Japan. /s

21 ( +36 / -15 )

You wouldn't know that with the way some people have been demanding a S of E again for no real reason.

We will next examine the efficacy of drugs as well as the relationship between symptoms and patients' lifestyle,"

I think this should already be doing.But we can do educated guesses as to why. Cleanliness and eating habits for starters.

-7 ( +11 / -18 )

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