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The Japan COVID conundrum: Japan’s response to COVID-19 has been widely criticized, and Abe’s approval rating has suffered, but the outcome measures in Japan paradoxically look very good. /1
A recent international survey finds that Japan’s political response to COVID is rated the absolute worst with only 5% support, way below 32% for the USA /2 https://www.japantimes.co.jp/news/2020/05/09/national/abe-coronavirus-survey/
Abe’s approval rating has suffered: he is one of the few leaders to see a decline during the pandemic along with Brazil’s Bolsonaro /3
https://www.economist.com/graphic-detail/2020/05/09/covid-19-has-given-most-world-leaders-a-temporary-rise-in-popularity
https://www.economist.com/graphic-detail/2020/05/09/covid-19-has-given-most-world-leaders-a-temporary-rise-in-popularity
Yet, in terms of COVID outcomes measures, Japan is doing surprisingly well: actually among the best in the world. This gap between perception and outcome is fascinating. /4
Japan only has a fraction of COVID deaths compared to hard-hit countries like the USA and Italy. Japan has roughly the same number of deaths per capita as widely-praised countries like South Korea, New Zealand, and Singapore. /5 https://ourworldindata.org/grapher/total-covid-deaths-per-million
There isn’t much evidence of missed deaths. At the national level, influenza deaths in Japan are down somewhat during the pandemic: Japan may be one of the few countries that ends up having fewer deaths during the pandemic than an average flu season /6
https://www.niid.go.jp/niid/ja/flu-m/2112-idsc/jinsoku/1847-flu-jinsoku-2.html
https://www.niid.go.jp/niid/ja/flu-m/2112-idsc/jinsoku/1847-flu-jinsoku-2.html
So why is Abe’s popularity suffering so much? I think there are a few reasons. COVID is cyclical. Japan was affected early in January, so the government response also started earlier. You can see this is the great stringency index put together by @thomasnhale and colleagues /7
Japan responded early to COVID; cases remained relatively low with measures like contact tracing and avoidance of high-risk interactions. The government faced a real dilemma about whether more stringency was worth the economic cost. Other countries didn’t have this luxury /8
Japan’s response has also been “off cycle” compared to other OECD countries because the initial response came early. Lock down fatigue was already setting in as deaths were skyrocketing in other countries. /9
In late March, when the US and much of Europe were going into serious lock down, the talk in Japan was about complacency and people returning to normal life prematurely. (Hint: this is likely what is now about to happen in N. America and Europe) /10 https://www.reuters.com/article/us-health-coronavirus-japan-experts/experts-warn-japanese-growing-complacent-of-coronavirus-risk-idUSKBN21B130
Along with international transmission, this led to a rise in Japanese COVID cases. Japanese cases started increasing just as other countries were bending their curves. The timing of this made Japan’s response look very ineffective. /11
Incidentally, FT’s highly-cited COVID charts used log scale with no adjustment for population size. That’s fine, but it had the effect of exaggerating Japan’s problem; here’s the same figure using linear scale and cases per capita /12
https://ig.ft.com/coronavirus-chart/?areas=jpn&areas=ita&cumulative=0&logScale=1&perMillion=0&values=cases
https://ig.ft.com/coronavirus-chart/?areas=jpn&areas=ita&cumulative=0&logScale=1&perMillion=0&values=cases
The Abe government certainly made some important mistakes and struggled with public messaging (topic for another thread). But the gap between perception and outcomes for Japan seems unjustifiably wide. /13
