No lockdowns. No fines. No apps. No “test, test, test.” And yet Japan is about to lift the state of emergency with coronavirus cases now just a fraction of the peak.

How did Japan do it, and what lessons can we learn? From @lisadont and @xunxun365 1/ https://www.bloomberg.com/news/articles/2020-05-22/did-japan-just-beat-the-virus-without-lockdowns-or-mass-testing

This is what the curve of infections in Japan looks like now. Levels are back down where they were in mid-March. Japan didn’t restrict movement though it asked people to avoid interactions and stay home as much as possible. 2/

The frustrating thing about it is there’s no one reason, no silver bullet that we can point to and say “Japan did this.” And separate to policy there are many in-built advantages: people tend to wear masks anyway, avoid physical contact, and the obesity rate is incredibly low. 3/

One thing that worked was an early response by contact tracers at local public health centers. While the central response might have been slow, local public health nurses are used to contact tracing for flu or TB. This seems to have helped Japan contain the spread from Wuhan. 4/

Another thing that helped was the having the experience of the Diamond Princess. The virus ran riot on the cruise ship and enabled Japan to see first hand just how bad things could get. “It was like having a burning car right outside your house,” says one expert. 5/

And while the government has rightly gotten flak for its response, this has allowed the response to be led by experts. The Three Cs approach was mocked initially but is now starting to get intl attention as a common sense way of beating the spread without shutting society down 6/ https://twitter.com/marklevinenyc/status/1263479975157673985

There are still plenty of unknowns. The true scale of infection is almost certainly larger than we know. The possibility has been raised that Japan faced a different, less deadly strain of the virus. A second wave seems almost inevitable, the only question how big it will be. 7/

Japan’s approach has been to recognize that long term, until there’s a vaccine the virus won’t be wiped out. Life won’t go back to normal. If the emergency ends Monday, we’ll enter a phase where we must learn “to live with the virus”. Changes and challenges still await. 8/end