How Japan Got the Pandemic Right – and Wrong

As Japan reopens, a look back at its handling of the COVID-19 pandemic from the beginning.
Japan ultimately defied specific entry requirements on October 11 to welcome visitors from abroad. A full year after the United States, numerous other nations reopened their borders to foreign tourists before Japan made its decision. Although the epidemic in Japan has mostly had beneficial public health results (such as a relatively low death rate despite elderly and densely populated demographics), the precise causes are yet unknown. The dominant incumbent party’s concentration of political power and unique elements including the human capital of public health officials, historical behavioral norms, and underlying medical conditions of the populace appear to be the main causes of Japan’s achievements and failures thus far.
While judging Japan’s pandemic response focuses mostly on reducing negative health effects, the nation’s institutional capacity to quickly and effectively address new difficulties has been questioned by observers due to the country’s recent trend.
When compared to its G-7 counterparts, Japan’s COVID-19 policy has been successful on almost all key metrics. Japan saw only a small portion of the case and death rates commonly seen abroad, despite having an elderly population and densely populated urban regions (although it should be noted that neighboring South Korea and Taiwan fared similarly).
With its first confirmed patient in Tokyo on January 15, 2020, and confirmed illnesses on the Diamond Princess cruise ship docked at the Yokohama Port on February 3, 2020, Japan was propelled into the COVID-19 pandemic before many Western nations. In contrast to the years that followed, the government did not instantly want to seal up its borders at the start of 2020. Japan didn’t prohibit entrance from China until March 9, when several other nations did so in February. On April 7, seven prefectures were declared to be in a state of emergency, one month after New York City.
Regarding public outreach, Japan’s early messaging regarding the pandemic was concise and guided by scientists. The government assigned a professional panel COVID-19 response and duty at the start of the pandemic. Avoiding the “three C’s”—closed areas, crowded places, and close-contact settings—was the key to early messaging. While the CDC in the US dallied on its public messaging about masks, masking was almost immediately encouraged (including through the Abenomask program, which provided masks to every household during a shortage). These warnings were widely disseminated, and at first, the advise was mostly heeded.

RELATED: Japan Has Weathered COVID-19 Better Than Many, but Problems Persist

Two years into the pandemic, Japan has proven more effective than the United States and European countries at managing outbreaks. Still, the Japanese public has criticized government efforts, and two prime ministers have stepped down.

Japan’s strict entry and testing requirements, cluster-based contact tracing program, and universal masking kept per capita COVID-19 case and death rates to a mere fraction of those seen in the United States and European Union. It was not until an initial Omicron wave in early 2022 and a second Omicron wave beginning July 2022 that Japan would see the kinds of case rates experienced abroad. Importantly, once Japan did see these comparable spikes in cases, 80 percent of its population was fully vaccinated.
As a result of the government’s efforts to locate and identify infection clusters (such as those at bars, gyms, karaoke bars, and nightclubs), the number of cases had decreased to less than 0.5 per 100,000 by the time Japan’s first state of emergency ended in May 2020. Clusters were located, and individuals were then isolated and treated as appropriate. As a result of this early cluster-based strategy and widespread masking (severely enforced by social norms) in other crowded places, such as trains, Japan was able to prevent the serious domestic spread of the virus until summer 2021.
Low levels of vaccine reluctance also contributed to Japan having one of the highest immunization rates among its advanced democratic counterparts by the time the vaccine rollout was complete. Japan has historically experienced vaccine hesitation, but it has not seen the political polarization or even much of the misinformation that contributed to lower immunization rates abroad.
Despite these achievements, Japan nevertheless needs to be criticized for some of its pandemic policies. It should be remembered that Japan’s border policy was very divisive when it reopens. Foreign residents were not permitted to enter Japan, although citizens were permitted to do so freely (subject to testing and quarantine procedures). Families were divided by this legislation, which also prevented university students from graduating and workers from beginning new jobs in Japan. Given that the epidemiological hazards were the same for citizens and permanent residents, the government could have easily applied the same entrance standards to both groups.
Another widely criticized policy was Japan’s “Go To Travel” campaign, which launched in July 2020 and encouraged domestic tourism to aid the tourism industry, and almost certainly increased early spread of the virus. Japan’s pandemic mitigation policies at home also paled in stringency compared to international efforts. For example, throughout the “state of emergency,” indoor restaurants, gyms, and theaters remained open, and most universities (including social clubs) and high schools remained in-person. Outdoor dining did not catch on in Japan, and was never encouraged on a policy level.

RELATED: COVID-19 in Japan news round-up

Japan has finally opened its borders to foreign independent tourists after almost three years — although it may be some time until the level of tourism returns to its pre-pandemic peak.

Japan’s vaccine rollout was also one of the slowest among advanced economies. Japan was one of the first countries to procure hundreds of millions of vaccine doses for its population. However, it required domestic trials for vaccines, despite sample sizes (160 individuals for the Pfizer vaccine) too small to establish a valid efficacy rate. This delayed rollout for months, and even once vaccines arrived, Japan was ill-prepared to administer them. Only doctors or nurses under doctor supervision could inject vaccines, and mass vaccination sites did not open for three months after the vaccines were approved. In the end, by the time the United States had finished vaccinating everyone who wished to be vaccinated, Japan had just begun rolling out vaccines to the most vulnerable individuals, and cases were rising.
Japan’s testing also lagged behind that of other nations. Then-Prime Minister Suga Yoshihide promised to ramp up testing to 200,000 tests per day in October 2020. However, Japan’s daily testing rarely surpassed 100,000 in the run up to the Olympics, and Tokyo’s daily tests rarely cracked 10,000. For comparison, New York City was testing over 40,000 people per day at the time, despite a smaller population and fewer overall cases. Tokyo’s test positivity rate was over 20 percent at certain points in 2021, and over 40 percent during its first 2022 Omicron wave, well over the WHO recommended 3-12 percent range that suggests testing is done “fairly extensively.”
In response to spiking cases of COVID-19 and decreases in hospital bed vacancies, Japan introduced successive “states of emergency” throughout the pandemic. While well-intentioned in practice, these unclear “states of emergency” and “quasi-states of emergency” largely failed to contain an increase in cases or secure needed resources, with constantly shifting rules and guidance. Japan failed to anticipate the increase in cases in 2021 that led to these “emergencies” by preemptively securing more hospital beds. While estimates vary, a number of COVID-19 patients died at home while waiting for beds.
Japan’s inability to adapt structurally and culturally also made some of the more successful pandemic policies from abroad difficult to implement. The same workplace norms that have hurt Japan’s economy made social distancing an impossibility during the pandemic. Japan has the lowest rate of pandemic telecommuting among advanced economies, and the highest rate of individuals who say that their job cannot be conducted from home. Trains remained packed at rush hour throughout the pandemic (good luck avoiding the three C’s), and a plan to reduce the number of trains per day made them more crowded as commuters were forced to go to work by their employers. Clear government guidance and credible commitments to subsidize adjustment costs could have prompted businesses to shift to a new normal.
In other cases, Japan has had difficulty ending certain practices put in place during the pandemic. For example, despite repeated notices from Japan’s health ministry that masking is unnecessary outdoors, the majority of the public continues to mask up outside.
The Tokyo Olympics – Japan’s first experiment in resuming international travel – also deserves special mention. The Tokyo Olympics was deeply unpopular in Japan. The general public, opposition parties, the vice chair of Japan’s COVID-19 advisory panel, and even the Emperor called for the cancellation of the Olympics or increases in safety measures until opening day. The majority of citizens preferred cancellation or postponement. However, public opinion largely fell on deaf ears as Japan’s ruling Liberal Democratic Party insisted on holding the Olympics.
This is a story familiar to observers of contemporary Japanese politics. The political system can be unresponsive to the people, as no viable opposition party currently exists. Scholars have shown how the ruling Liberal Democratic Party has not represented the median voterusing government resources to maintain its dominating coalition. The opposition offers alternative policy platforms, but remains fragmented, eroding democratic accountability.
To be sure, Japan was in a tough spot when it came to the Olympics. It is unlucky that the pandemic hit during the host’s designated year. And the International Olympic Committee (IOC) added numerous burdens, including an unforgiving contract. The IOC and its partners were unreasonable from the onset of the pandemic, only accepting a one-year postponement in response to swelling global resistance.

RELATED: Japan ends its COVID-19 state of emergency

The country’s COVID-19 countermeasures relied on voluntary social distancing and limited testing

However, the public health issue could have been mitigated in the year leading up to the rescheduled Olympics. The problem was not the lack of good advice, but the ruling party’s tendency to only lend a politically convenient ear. This was not unique to Japan’s pandemic response. The business community has voiced their concerns on a host of issues like immigration and capital controls, but the ruling coalition is only selectively responsive.
The same goes for pandemic containment. At the onset of the pandemic, the government delegated COVID-19 response and responsibility to an expert panel. Politicians let advisers such as Shigeru Omi, the vice chair with a venerable career at the WHO, come to the fore. All policy was explained as following the scientific advisers. But when Omi’s protests against hosting the Games grew louder, culminating in him telling a June parliamentary committee that “it is not normal to hold the Olympics in the pandemic,” LDP officials waved away the comments, claiming offense at the “strong words” from, in their eyes, the now-inconvenient outsider who had overstepped.
As we enter fall 2022, Japan is finally reopening its doors to international travelers once again.
A bundle of factors in Japan – public health implementation, cultural norms, and the political landscape – were successful in preventing many of the devastating public health outcomes relative to many advanced industrialized societies, and deserve both praise and study. However, there were also blunders and inconsistencies, especially toward the later period, when Japan’s government needed to respond to public opinion and new information. This highlighted an economic and political system that has difficulty adapting to quickly-changing circumstances. Increased transparency about the policymaking process and a thorough review of all factors are paramount for the people of Japan, and the world, to learn from the case of COVID-19 in Japan.
One of the essential roles of governments is to solve problems that are difficult to tackle by individuals. Economic policy addressing structural problems and a public health response to a global pandemic are prime examples of tough problems of this sort.
Just like promises to increase innovation in its corporations and economy, Japan’s COVID-19 responses have contained unfulfilled promises and shown an inability to respond and adapt. In the face of structural macroeconomic shifts from the 1980s, Japanese politicians failed to restructure the economy for the public good. In the face of a global pandemic and world sporting event, the ruling party bungled its response.
It is certainly unfair to blame the Japanese government for pandemic-related complications. But there were better paths, and the government did not take them.


by: Miss Cherry May Timbol – Independent Reporter
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