Commentary: Japan shows how not to deal with a COVID-19 outbreak
Japanese authorities have demonstrated hesitance in tackling the virus outbreak but could afford to impose stricter measures to shore up public confidence, says Yuka Hasegawa.
OSAKA: Japan has a lot riding on how it deals with the COVID-19, the infectious disease that has seen a doubling of infection numbers in the country over the past week and a spread across prefectures from Hokkaido to the city of Tokyo.
Beyond the potentially awkward loss of national pride associated with the possibility of having to cancel the Tokyo July 2020 Summer Olympics should the situation deteriorate, Prime Minister Shinzo Abe faces an uphill climb in regaining the trust of citizens.
His approval rating saw sharp falls according to polls carried out by news outlets Yomiuri, Kyodo and ANN last week, with the majority of correspondents indicating dissatisfaction with how Japan has managed the COVID-19 outbreak.
The Japanese economy also saw a contraction of 6.3 per cent in the last quarter ending in December prior to the COVID-19 outbreak, leading Barclays Tokyo to raise the spectre of a technical recession.
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The warning sirens that the country stood on the cusp of a major outbreak were sounded by former commissioner of the US Food and Drug Agency Scott Gottlieb in an interview with CNBC on Feb 18, which he pointed out stood in stark contrast with Singapore. But they have gone largely unheeded.
UNDERESTIMATING THE THREAT
Experts have pointed out that Japan begins from a position of disadvantage and lack of preparedness where the country was untouched by SARS in 2003. Since the outset of the outbreak in Wuhan, Japanese healthcare professionals initially joined in chorus in the official line that the COVID-19 could be likened to the flu and was not to be feared.
That position now looks like complacency, when the Health Minister Kato Katsunobu has just raised alarm bells that the bigger challenge facing the country is not the surge in infection numbers, but the untraceability of the route of transmission in many cases.
Another sign of worry is the shortages of masks despite local governments replenishing stock from contingency reserves.
Where Japanese authorities should have asked more to stay at home after the number of cases rose in the first half of February, the Health Ministry had initially declined to issue a public advisory on large crowds. Although the first COVID-19 death in Japan was reported on Feb 13, on the same weekend, city marathons were held throughout Japan, with participants in the hundreds.
NOT TAKING DECISIVE ACTION TO MITIGATE THE RISK OF SPREAD
There was a slight shift in posture on Feb 16, when the Japanese government urged people to avoid non-essential gatherings. But it continued to leave the onus on large-scale events to organisers, and remained reluctant to take stronger action to curb the risk of spread.
The Japanese government has also largely resorted to moral suasion, in urging people with cold-like symptoms to avoid work and school, but did not offer compensation despite knowing that workers operate in a culture that values presenteeism and face time.
So Japanese cities, some of the densest in the world, chugged on with packed, peak-hour trains and crowded high-speed rail travel. Information about infection cases, transmissions and the conditions of infected patients remained scarce.
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Part of this hesitance stems from the lack of clarity of responsibilities as the state government delegated to municipalities critical decisions such as public disclosure on essential details like the travel history of patients. But local authorities demurred in the face of personal privacy concerns even when weighed against larger national public health considerations.
The Japanese government also issued rather vague guidelines for closing schools, on the one hand urging educators to bar students from attending classes if they have symptoms, yet not fully tackling concerns from parents for schools to close considering the mounting numbers from the COVID-19 outbreak. In Hokkaido, a lunch delivery worker found infected only led the school to do a deep clean over the weekend before reopening but public concerns about whether this was sufficient remained unadressed.
Earlier, when Japanese citizens were evacuated from Wuhan, the government also did not impose quarantine conditions or administer tests to those who refused them.
BELITTLING ATTITUDE TOWARDS EXPERTS
One of the biggest problems in Japan is that, when it comes to issues with political implications, politicians have led the charge with professionals sidelined. This was little different.
With the absence of a scientist-driven communicable disease centre, Japan faces an uphill climb in arresting the situation.
News of the escalating situation associated with the Diamond Princess cruise ship has also shone an incredibly uncomfortable spotlight on the country.
Revelations from Kobe University’s infectious disease expert Kentaro Iwata about huge lapses and the inadequacy of quarantine and segregation efforts onboard, where people could move around between infected and non-infected zones rather freely and without the use of masks have sent shockwaves through the country.
His accusations that he was kicked off the ship after attempting to advise on how the situation could be remedied were responded to by Chief Cabinet Secretary Yoshihide Suga’s attempts to assuage the public of the proportionality of measures.
But such assurances quickly unraveled when workers from the Japanese Ministry of Health and the Cabinet office onboard confirmed they were COVID-19 positive, reinforcing Iwata’s claim of the ship being “completely chaotic”. A woman was also allowed to travel home to Tochigi prefecture right after leaving the cruise ship, and was later found to have COVID-19.
More disembarking from the cruise ship were untested during the quarantine period but have been found to be infected with the virus after returning to their homes in the UK and Australia.
Japanese political leaders are coming under fire during this period for not taking the outbreak more seriously.
Twitter is awash with accounts that say their requests to be tested were rejected, because they did not have severe symptoms of pneumonia coupled with close contact with known cases or travel history to affected countries and regions.
This general reluctance to acknowledge the enormity of the challenge have led to dithering. What could have been contained – whether the Diamond Princess ship situation or the risk from citizens repatriated – have mushroomed into an international debacle and turned Japanese public opinion against the Liberal Democratic Party, which Abe leads.
The COVID-19 outbreak will also make for awkward conversation when Abe meets with Chinese President Xi Jinping in the spring. Japan’s handling of the situation may be the watershed in what may become a global pandemic.
The Japanese government is due to outline a plan of action on Tuesday (Feb 25). Japanese citizens and the international community will certainly be watching for some sign of decisive leadership that has been seen in many other countries, like Singapore, but is sorely lacking in Japan.
Yuka Hasegawa is a researcher who writes on social issues and politics in Japan.