In Depth

No lockdown, little testing, few deaths: why Japan is a coronavirus outlier

Only 744 people have died in country of 126 million - and infection rate is falling

With a cluster of early cases, an ageing population and a laissez-faire approach by the authorities, Japan appeared to be on course for a severe coronavirus outbreak.

Yet new excess mortality data appears to confirm official claims that Covid-19 has not run rampant in the East Asian nation.

“Tokyo has not seen an increase in overall deaths during the coronavirus outbreak,” reports The Japan Times. Indeed, the number of fatalities in the capital in the three months to March was slightly below the average for the time of year, according to city authorities.

In many countries with severe outbreaks, including the UK, excess mortality figures have revealed large numbers of deaths that have not been included in official coronavirus figures - but fears that the Japanese death toll might also be an underestimate seem to be unfounded.

Coronavirus outlier

As “one of the first countries besides China to have been affected by Covid-19, and with the highest percentage of elderly people in the world”, Japan might have been expected to take swift and decisive action, said The Diplomat in March. Instead, “every step of the way mismanagement has been rife”.

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Japan “appears to be doing everything wrong”, agrees Foreign Policy. “It has tested just 0.185% of its population”, compared with 2.9% in the UK, and “its social distancing has been half-hearted”.

In April, the government asked Japanese people to avoid large gatherings, but did not introduce a compulsory lockdown.

“Though the streets are noticeably quieter than normal, subways and buses are still jammed with commuters,” said The Washington Post shortly after the measures were introduced. “Many bars, restaurants and cafes are abuzz.”

Prime Minister Shinzo Abe last week lifted the restrictions everywhere except Tokyo, Osaka and Hokkaido, where they are expected to remain until the end of May.

Explaining the success

Despite criticism of the government’s response, the coronavirus outbreak seems to be in retreat. Hospitals have recorded “a sharp fall in new infections”, says the BBC, and in a country of 126 million people, the daily death toll has remained below 20 for most of the past week.

No one knows why Japan has escaped the worst of the pandemic, but the low infection rate has been “credited by some to Japanese societal norms”, says Professor Craig Mark of Tokyo's Kyoritsu Women's University in an article on The Conversation.

“Bowing instead of handshakes and hugs, the use of masks in flu season and generally high standards of personal hygiene” may all have helped, Mark suggests.

Another possible explanation is that Japan may be dealing with a slightly different variant of the virus. Researchers in the US have suggested that mutations circulating in Asia, Europe and North America may have different levels of virulence.

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