Failure to fight epidemic tarnishes image of “Japanese competence”

Japan approved the first vaccine for use against COVID-19 on February 14 this year, two months later than countries like the United States and the United Kingdom.

After the late start of the campaign, mass vaccination did not go as planned: just days before the start of the Tokyo Olympics, only 35% of Japanese had received at least the first dose. The percentage is lower than in Brazil, where up to 45% of people have been vaccinated with a single dose or a full vaccination, according to data from the Our World in Data platform.

The Japanese authorities were also unable to prevent the increase and spread of COVID-19 cases in the Olympic Village: on Friday (23/7), more than 100 cases were diagnosed among athletes, delegates and journalists.

The setting is the exact opposite of the image of effective Japan the world has come to see in recent decades. Even in times of crisis: Reactions to the 2011 earthquake and tsunami in the Fukushima region, to name a few, made headlines around the world. At that time, the country in just six days managed to rebuild a highway in the city of Naka, which was torn in half by the disaster.

What happened?

The country’s epidemic control has been criticized from the start. In August 2020, an article published in the British Medical Journal (BMJ) cited problems ranging from a reduced ability to screen, resulting in an increase in the number of undiagnosed cases, and thus infection, to a failure to communicate the importance of social contact. Distance and the need to stay at home to protect the health system.

The text, signed by researchers Kazuki Shimizu and Elias Masalo, of the Department of Health Policy at the London School of Economics and Political Science, and Haruka Sakamoto of the University of Tokyo, also speaks of a “tension between politics and science”.

The expert committee set up at the beginning of the outbreak, as an example for scientists, did not have the pluralism and independence to have the importance it should have in the decision-making process. The government also lacked greater transparency – the decision to postpone the Olympic Games, according to the article, was taken abruptly and without detailing its reasons.

For Craig Mark, professor of international relations at Kyoritsu University in Tokyo, one explanation for the government’s erratic stance has been to try to preserve the economy.

“The government did not want to put itself in the position of imposing stricter measures. The argument used was that Japan’s constitution does not give the executive the power to implement lockdowns, but that could have been changed through an act with Parliament’s approval. The government chose not to go this route” , According to him.

However, the country has not achieved the world record for cases and deaths. Of the 126 million inhabitants, just over 15,000 deaths from the disease have so far been recorded. In comparison to the criterion of deaths per million inhabitants, Japan follows countries such as Brazil, the United Kingdom, the United States, Canada and Germany.

One explanation is the self-discipline of the Japanese people, who largely complied with recommendations to wear a mask and avoid crowds.

“The government has relied on the Japanese sense of cooperation, but that has limitations, especially now with the spread of the delta variable,” Mark says.

“There is friction, for example, among young people, who want to get out of the house, and meet friends. I’ve seen bars that sell alcohol after hours allowed by restrictive measures,” he says.

Faced with an increase in cases on the eve of the Games, Japan declared a state of emergency for the fourth time, and it is expected to last until August 22. In Tokyo, public attendance at competition venues has been banned.

slow immunization

The country was also poorly prepared to start vaccination, which started later than other developed countries.

article Published about a month ago in the scientific journal The Lancet Prepared by Japanese researchers and highlighted three factors of slowness.

First, the regulatory agency’s delay in approving the first vaccine (in this case, the Pfizer vaccine), among other reasons, due to a requirement for in-country clinical trials—a prerequisite that, in the opinion of some experts, could have been relaxed. Currently, only the Pfizer and Moderna vaccines are available.

Thereafter, there was a delay in importing the doses, in this case due to the high level of global demand and the difficulty of the manufacturer in providing the fortifying agent.

Finally, the immunization program for several months failed to reach sufficient capillaries to ensure mass vaccination. The authors authorize only physicians and nurses to apply the immunizing agent. Consequently, the government had difficulty hiring enough staff to administer the doses.

Fax machines and personal stamps

Delays in the vaccination schedule, caused in many cases by issues that the government could have organized to resolve in advance, have cast light on an aspect of the country little known among foreigners – the state bureaucracy.

“In general, things in Japan work very efficiently. I think one famous example is the trains, which are very meticulous. The cities are very clean and tidy…but there are some factors, especially bureaucracy, that sometimes get in the way of work,” says Mark He is an Australian who has lived in Japan for nearly 10 years.

Many processes that could have been digitized are still done in analogue on paper. It is no coincidence that fax is still widely used in public offices, as well as in offices and even in homes.

Another symbol on the analog side of Japan is the character stamp, known as pitchfork, which is still a prerequisite for the release of some official documents.

“It’s nice when you look at it…but keeping the need to stamp a lot of papers ends up creating unnecessary bureaucracy,” says the professor. “I think this is an example of how old traditions and state bureaucracy can delay things,” he adds.

The government has been trying to digitize the public sector for years. This time, Prime Minister Yoshihide Suga has appointed a minister in charge of the task: Hirai Takuya, who officially holds the title of “Minister of Digital Transformation.”

Doctors demanded that the games be cancelled

Suga took over as prime minister in September 2020, after Shinzo Abe, a supporter of the Liberal Democratic Party, who was also receiving a lot of criticism for his handling of the pandemic, resigned.

Accusations of errors and failure to deal with the health crisis cost the government, which reached a record level of approval before the games started, at nearly 30%.

In May, a leading medical association in Tokyo, comprising 6,000 professionals, sent an open letter to Suga calling for the Olympics to be cancelled.

“Health facilities treating COVID-19 patients are at their limit and have virtually no way to increase their capacity to provide care,” the statement said.

The fear was that, with athletes and delegates arriving from all over the world, there would be a jump in the number of injuries, overburdening the health system at a time of year when the demand is traditionally greatest, when the Japanese summer is intense. Lots of people take to health units.

Indeed, the city of Tokyo has seen a significant increase in the number of cases in the past week, from 1,800 on Wednesday (21/07), the highest number recorded in a single day since January.

“Sadness and disappointment”

In addition to the pandemic, it has also seen a series of controversies surrounding the games setting, from accusations of plagiarism introduced in 2015 (which led to its replacement in 2016) to the resignation of the opening ceremony director on the day. He accepted the event because of a Holocaust joke he made on a 1998 show.

Five months earlier, sexual comments had removed the head of the Olympic Committee from office. Asked about an increase in the number of women among the panel’s members, Yoshiro Mori said they “talk a lot”. He initially refused to resign, but did so after pressure from public opinion, sponsors and the International Olympic Committee.

In the midst of controversies and facing what appears to be the fifth wave of the COVID-19 pandemic, Tokyo is experiencing an atmosphere that mixes, on the one hand, some apathy, and on the other hand, sadness and disappointment, says Professor Mark.

“A lot of people here feel that hosting the Games is an unnecessary risk. I was fortunate to be at the 2000 Sydney Olympics and the mood was completely different – cheery, festive. Let’s see if things change here in the coming weeks.”