How Japan Managed to Curb the Pandemic Early On: Lessons Learned from the First Eight Months of COVID-19

Introduction

• COVID-19 emerged in Hubei, China in December 2019.
• WHO declared it a pandemic in March 2020.
• Over 33 million cases worldwide by September 2020.
• Japan has a high elderly population, which is a risk factor but managed to control the situation effectively.

COVID-19 Incidence and Mortality in Japan

• First case in Japan: January 16, 2020; first death: February 13, 2020.
• By September 28, 82,000 cases and 1,545 deaths reported.
• Case fatality rate in Japan during peak: 2.8%, lower than in the US and Italy.
• Effective reproductive number decreased from 1.38 to <1 by April.

Government Responses

National Emergency Declaration

• Early response included classifying COVID-19 cases, quarantining the Diamond Princess cruise ship, and school closures.
• National emergency declared on April 7, promoting voluntary social distancing and teleworking.

Retrospective Cluster-Based Approach

• Focused on tracing infection sources and isolating them rather than general mass testing.
• Implemented by Ministry of Health with a cluster response team and consultative centers.

Awareness Program: The Three Cs

• Avoid closed spaces, crowded places, and close-contact settings.
• Updated to include behavior modifications like avoiding loud talking.

High-Quality Health Care System

• Hospitals coordinated with hotels to manage patient overflow and used robots in care settings.
• Universal health insurance facilitated high-quality medical care access.

Introduction of COCOA Tracing App

• Launched on June 19, 2020, to trace contacts of COVID-19 positive individuals.

Lifestyle and Cultural Factors

• Healthy lifestyle and low prevalence of co-morbidities in Japan.
• Traditional practices like handwashing and mask-wearing played a significant role.
• High levels of compliance with government guidelines and public health measures.
• Possible contributing factors: high vitamin D levels and universal BCG vaccination.

Potential Second Wave

• Rise in cases in July 2020 led to fears of a second wave.
• Government opted not to reintroduce a state of emergency.

Criticisms and Controversies

• Criticized for low testing rates, possibly influenced by the upcoming Olympics and fear of healthcare system collapse.
• Relied on public compliance with health guidelines rather than enforced measures.

Contribution to Vaccine Development

• Japanese firms actively engaged in vaccine development, including partnerships with universities and biotech firms.
• Financial support from the Japan Agency for Medical Research and Development.

Lessons Learned

• Effective control through quarantine, social distancing, and isolation.
• Importance of early detection and response, high-quality medical care, and behavior modification.

Conclusion

• Japan's response has been effective due to cultural practices, health system strength, and strategic government responses.
• Lessons from Japan's approach can guide other countries in managing the pandemic effectively.