Japan, a country with a population, on average, 10 years older than that of the United States of America, experienced a comparably minimal impact from COVID-19 despite multiple waves of infection. In fact, the country’s case and death rates remained low through the early years of the pandemic despite never shutting down businesses. The “Japan Model” formed with the influence of virologist Hitoshi Oshitani, was largely responsible for managing COVID-19’s effect on the island chain.
Guessing in the Dark
SARS-CoV-2, the novel coronavirus responsible for causing COVID-19, spreads rapidly. At the onset of the global pandemic, the method of transmission for this virus was not fully understood and many countries behaved as if SARS-CoV-2 propagated like common respiratory illnesses. Countermeasures for the virus included washing hands and disinfecting surfaces, which would have been sound methods for dealing with a pathogen transmitted through contact with large droplets in the air or on surfaces. The primary route of transmission for COVID-19, however, was through aerosols — tiny particles or droplets suspended in the air. It was later acknowledged that contact with surfaces was not a significant source of transmission, and that disinfection measures had a negligible effect.
Western governments responded to soaring hospitalizations with behavioral mandates such as business closures or mask requirements. These measures facilitated drops in infections, but when these governments eased these mandates, infections and hospitalizations once again soared.
Japan, though, experienced COVID-19 differently. The country saw low case numbers throughout much of the pandemic and a very low mortality rate, all without any forced closures or government mandates. Instead, the country used what has become known as the “Japan Model,” which involved an active and vocal government speaking to a receptive population.
Acting with Information
The Japan Model relied on conscientious citizens and the dissemination of information. The Japanese government could not legally exert the strong control over public life seen elsewhere at the time, but it still needed to address the pandemic. To do so, Japan used messaging to inform its public on how to effectively avoid the virus.
Japan’s public health system helped make this possible. Early on, public health employees performed contact tracing which enabled Japan to track spreader events and deepen its understanding of how SARS-CoV-2 spread. Their efforts revealed that a relatively small number of individuals were responsible for spreading the virus. Virologist Hitoshi Oshitani, while serving on the Advisory Committee for COVID-19 in Japan, used this data to accurately identify aerosol transmission as the principal means of spreading the virus. The best defense against such a pathogen was reducing contact with potential infectors.
Armed with a better understanding of how the virus was transmitted between individuals and how behaviors supported the spread, Japan’s government was ready to craft a strong message for its citizens. Oshitani and other committee members developed a message advising Japanese citizens to “avoid the three C’s” that facilitated the spread of COVID:
- Closed environments
- Crowded conditions
- Close contact with others
This simple list allowed citizens to assess their own risk and act accordingly to mitigate chances of infection. Along with this messaging, the Japanese government discouraged its citizens from participating in activities that put them at greater risk of infection. While unable to close restaurants and bars, the Japanese government could inform people about how crowds and alcohol increased an individual’s chances of contracting SARS-CoV-2.
Thus, Japan provided its citizens the ability to make informed decisions with their own wellbeing, and the wellbeing of those around them, in mind. Combined with a cooperative, proactive populace willing to mask up, an informative Japanese government was able to prevent the high levels of hospitalizations and deaths seen elsewhere.
The Japan Model — and Beyond
The winter of 2020-2021 saw Japan’s weekly average for new COVID cases remain mostly in the low thousands. During the summer of 2o21, that average reached the milestone of what was an initial case rate for the United States, in the tens to hundreds of thousands. By this time, though, a vaccine was available. As of summer 2023, Japan’s death rate was comparatively low: only about 32,000 people in Japan died from COVID out of the 11 million total coronavirus cases reported across the country.
Today, there are strong medical and safety countermeasures in place for coronavirus, and Japan has a high vaccination rate. Still, as scientists like Oshitani warn, attempting a return to normal life without considering vulnerable populations will only result in further suffering. Instead, nations must continue to balance suppressing transmission with maintaining social and economic activities. The best way to do that is to take a lesson from Japan’s playbook — craft a mitigation strategy that considers the cultures, traditions, legal frameworks and existing practices of each local society.
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