1/30 In two forthcoming pieces, I examine #Japan
's response to the #COVID19 #coronavirus #pandemic
. I'll summarize the main non-theoretical points here (long thread alert!).
’s figures have always looked good compared to many other countries, which initially led to suspicion that the ‘real’ numbers of #COVID19 #coronavirus
infections & death were being played down.
Metropolitan Government at least has now released full #COVID19
figures, including general death rates, seeming to put this argument to rest (but these figures are also now being challenged). https://www.japantimes.co.jp/news/2020/05/09/national/tokyo-releases-covid-19-data/
& collection of data by local health bodies was discouraged by central government because it would 'overwhelm' them. Deep cuts made from 1994 Community Health Law onwards have affected the ability of local governments & hospitals to cope. https://hatarakikata.net/11189/
5/30 The February #COVID19
outbreak in #Hokkaido
was contained through a state of emergency & cluster-tracing, but was not followed up with widespread testing, resulting in a second wave. This lesson was also not learned on a national scale. https://news.yahoo.com/coronavirus-lockdown-lessons-hokkaidos-second-081728538.html
6/30 The #DiamondPrincess
debacle pushed the government into taking the #pandemic
more seriously, but #Abe
also responded with a state #propaganda
campaign to counter stories about #Japan
’s response, widening the rift with the foreign press. https://www.washingtonpost.com/world/asia_pacific/japan-coronavirus-image-abe/2020/04/15/73bf1dee-7f00-11ea-84c2-0792d8591911_story.html
7/30 The effect of the 2020 Tokyo #Olympics
was twofold: a pre- #COVID19
shift in resources away from pandemic preparation to terrorism that happened just when the reverse was needed; and during the early outbreak, a paralyzing fear that the Games would be postponed or cancelled.
8/30 Critics claimed #Abe
’s stance on #pcrtesting
was motivated by the #Olympics
. However government argued their approach was entirely based on #cluster #tracing
not individual diagnosis & normal pneumonia surveillance picked up #COVID19
9/30 After the announcement of the postponing of the #Olympics
to 2021, the infection rates for #COVID19
did suddenly jump and the pattern of increase thereafter assumed a more ‘typical’ pattern, although death rates remained low.
remained discouraged and accounts of attempts to obtain a test show patients being moved from clinic to clinic, entering by back doors, & being told by nurses not to reveal the location of the testing site. This carousel could be fatal: https://mainichi.jp/english/articles/20200511/p2a/00m/0dm/011000c
11/30 State #compensation
following voluntary #lockdown
policies were ludicrous and the ridicule over $40 meat and fish vouchers was deserved, especially in comparison to what was provided by countries like Canada.
12/30 Many observers have put forward a "cultural hypothesis", which proposes that #Japan
has several sociocultural traits that make #infectiousdisease
spread less rapidly and widely. These include:
13/30 A propensity towards #socialdistancing
and reserve. #Japanese
people generally try to avoid touching each other in public, and especially not skin-to-skin, for example holding hands, kissing, touching each others faces etc.
14/30 Everyday #hygiene
. It is argued that #handwashing
, even it is often perfunctory, is frequent; taking off shoes before entering the house in #Japan
is normal etc.
15/30 Citizen #responsibility
. Wearing of non-medical #facemasks
is normal in #Japan
, not to stop the wearer from being infected, but for anyone with a cough, cold and so on, to protect others.
16/30 At worst this cultural hypothesis is combined with a #xenophobia
that posits #Japanese
people as stronger than or #Japan
as morally superior to the rest of the world. https://japan-forward.com/speaking-out-the-power-of-the-japanese-in-avoiding-a-coronavirus-explosion/
17/30 Some of the elements are exaggerated or even completely wrong – e.g. research actually shows that #Japan
has amongst the lowest rates of #handwashing
, even in hospitals, in the world. https://www.journalofhospitalmedicine.com/jhospmed/article/126977/hand-hygiene-intervention-japan
18/30 Some elements are looking increasingly irrelevant – e.g. shoe-removal is shared by many countries with varying infection figures, and in any case, it seems that object-to-object transmission of #COVID19
is now considered unlikely. https://www.cbsnews.com/news/cdc-coronavirus-doesnt-spread-easily-on-surfaces-transmission-before-symptoms/
19/30 What remains is the lack of skin-to-skin touching, and the use of #facemasks
. It is no exaggeration to say that the non-medical facemask may be the most important everyday technology deployed in #Japan
and other East Asian countries to fight #COVID19
20/30 However, studies of #facemasks
have often been unable to convincingly explain the effectiveness of mask without resorting to broader ‘cultural’ explanations (usually outside the formal study). A paradox that needs resolving. https://doi.org/10.1186/1471-2458-12-1065
21/30 Cultural factors are not all positive. #Japan
has seen widespread #bullying
of those (suspected of being) infected with, #COVID19
, and even of #healthcareworkers
, in a complete reversal of the celebratory attitude in most other countries. http://www.asahi.com/ajw/articles/13362712
22/30 In addition, while #Japan
has a reputation for social compliance, the broadly voluntary #lockdown
measures to control movement, encourage people to work from home and not to go out to entertainment centres, have been far from universally observed.
has not taken off in #Japan
as in other countries, partly for bureaucratic-technological reasons: office workers have had to go into work physically because they have to use official hanko (ink stamps) on their documents. https://www3.nhk.or.jp/nhkworld/en/news/backstories/1088/
24/30 Until recently, #Japan
had not showcased any novel #technologies
containment or monitoring. Unlike some neighbouring countries, there is no real case to be made for #surveillance
overreach in Japan’s response to #COVID19
25/30 A lot of #datacollection
& collation in local government in #Japan
is low-tech & uses pencils, paper, the fax-machine & hanko. There has been no change in these practices during the #pandemic
. This had led to problems with both speed & mistakes in the copying of figures.
26/30 Japan is now backing a 'contact confirmation' #app
(“Protect Together”), produced by a national “civic hacking” organization, Code for Japan. https://www.nikkei.com/article/DGXMZO58928290R10C20A5000000/
27/30 According to the developers, #Mamoriai
is based the #AppleGoogleAPI
, will be #decentralized
, only hold data on phones and share it as the user wants & will not track the user beyond actual moments of localized ( #bluetooth
) contact between users. https://jxpress.net/contact-tracing-apps-japan/
are probably unnecessary and ineffective, however if an app is to be used, then a limited, #anonymized
app would be the most #privacy
appears to be among the less privacy-invasive approaches.
30/30 No-one knows for sure why #Japan
has ‘done well’. Early #cluster #tracing
, cultural #hygiene
factors and luck have all played a part. One thing that has not helped has been the shambolic performance of PM #Abe
and cabinet. That's it (for now) https://foreignpolicy.com/2020/05/14/japan-coronavirus-pandemic-lockdown-testing/
I should say that there are quite a few other things not in these tweets notably the possibility of the #BCG
vaccination being protective; and the role of the Line app, which is ubiquitous in #Japan
and increasingly difficult to live without...
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