The Japanese method of victory over the corona: acute social pressure


There are no rules that say what to do, but everyone knows the rules. Wear a mask, keep a distance, disinfect hands, check for heat. Do not touch, do not shout. Do not cheer at football games and do not scream on roller coasters at the amusement park. But if you are infected with the virus, it could be your fault.

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This dystopian vision also happens to be Japan’s solution to the most pressing problem facing the world today: how to survive alongside corona disease. The number of infections is plummeting in the Japanese islands as it jumps around the world, and Tokyo thinks they may have finally cracked the code. Smart science and social pressure have united to maintain general stability against the virus, without legal fines or official closure. The country seeks the elusive middle ground between Chinese tyranny and Swedish permissiveness, and presents itself as a model for life in the “new age of plagues.”

Tokyo subway. Photo: AFP

“From the beginning we tried to suppress the infection as much as possible, by maintaining social and economic activity,” explained Prof. Hitoshi Ushitani, a virology expert at Tohoku University, who was one of the government’s top advisers on the epidemic. “With our legal system, we can not do what China has done. Korea and Singapore do a lot of testing, but our testing capability was limited at first,” he said. “So we looked for a different approach.”

Months before the rest of the world awoke to the masks and dangers of enclosed spaces and crowded crowds, Japan set out to find a way to live in a plague without a dragon closure. In May, more than a hundred industries in Japan outlined guidelines for how to conduct business in minimizing the transmission of the virus. Restaurants have opened their windows and kept their customers away from each other. Stores have placed assistants behind plastic panels. Bars closed early. Sports games have resumed in incredibly sparse and quiet stadiums. Tokyo’s passenger trains were largely emptied during the state of emergency imposed in April and May, but are now quite crowded again – but the windows are open and everyone is wearing masks.

The social fear of severe anomalies in Japan is almost as much the fear of the corona, and most people respect the guidelines. A study published in August found that the main reason people wear masks is social pressure, rather than preventing the spread of the plague.

Ushitani describes Japan’s approach in the cultural context: “coexistence” with the virus instead of trying to eradicate it makes sense in a country that has suffered many waves of deadly epidemics for centuries, from smallpox to cholera, flu and measles. “There are a lot of stone monuments in Japan to ‘To the Smallpox,'” Oshitani explained. “For the Japanese, epidemics are a force beyond our control, and we respect them. We accept the fact that they cannot be eradicated. In fact, the vast majority of infectious diseases cannot be eradicated.”

Cultural characteristics influenced the citizens of Japan and made them accept the need to wear masks, strengthen hygiene and obey the rules. But just as important was smart science – and early warning. The outbreak of the plague aboard the cruise ship “Diamond Princess” – a kind of giant petri dish moored outside the port of Yokohama, near Tokyo – allowed Japanese scientists to begin early on the contagion analysis, and decipher the unique features of the corona virus.

Alarm bells began to ring as seven or eight quarantine officers, Japanese nurses and officials contracted the virus after boarding. “The quarantine officers are professionals, they know how to defend themselves,” Oshitani said. “Therefore we suspected that there was an unusual infectious condition.”

The virus appears to have spread through microscopic droplets — not just by coughing, sneezing, and touching, but by micro-particles floating in the air, which scientists call “aerosol transfer.” By mid-February the disease had also spread throughout Japan, and the epidemiological data led Oshitani’s team to two more surprising conclusions.

The first was that people with few or no symptoms were able to transmit the disease. The second is related to a phenomenon now known as “mass infection events”. Unlike the flu, in which patients could transmit the disease to two or three other people, most people infected with corona – almost 80 percent – did not pass the virus on at all. However, a small minority of people caught up with many others, often in crowded and unventilated places, during close contact and conversation.

These conclusions are now accepted by many scientists around the world, but it took months for the Japanese findings to be widely backed up. Meanwhile, in the Japanese islands these conclusions laid the groundwork for the country to deal with the virus. The use of masks was critical to contain the virus that spreads in the air, and scientists have concentrated on locating and eliminating widespread foci of infection.

This simple conclusion shaped the unique Japanese alternative to difficult closures: the notion that the spread of the virus can be controlled if people simply avoid the most dangerous areas, so-called “San Mitsou” – closed locations with poor ventilation, crowded places, or places where close conversations take place. Walking in the park and even running are fine: there is no need to imprison people in their homes. Children can return to school, provided wearing masks and keeping their distance.

There are those who criticize the approach. Scientists and doctors complain that the lack of tests made it difficult to monitor the disease, and provoked frustration and fear. The central government response often seemed slow and confusing, and its performance received very poor scores in public opinion polls. Compared to countries in its neighborhood, Japan looks less impressive: Thailand, Vietnam and South Korea register far fewer deaths and emerge faster from the crisis. In China and Taiwan, normal life is renewed. Japan, on the other hand, is still facing a wave of bankruptcies and unemployment. From this point of view, the middle road of Japan sometimes seems more like a confused compromise than genius, critics argue.

Relying on social pressure also causes a negative side effect, Oshitani admits: bad treatment of those infected with the disease. Social pressure also does not always work. According to a study by the National Institute of Infectious Diseases, the latest outbreak of corona in the country came from a nightclub in Tokyo that simply ignored the new guidelines.

Japan is now beginning to loosen some restrictive procedures, with the aim of reviving the economy. Can she do this without provoking another deadly wave of infections? This is the big test of its strategy.

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