Japan Hit by a Third (Small) Wave of Covid at the End of 2020

Subsidized "Go To" Campaigns Backfiring

⏱ 8 minutes

In the second half of November, Japan was undergoing a new surge of Coronavirus 🦠 cases, with about 2,500 new confirmed cases and several Covid-related deaths per day.

Any victim is naturally too many, but the contamination rate is still very low compared to the United States where an average of 150,000 confirmed cases were reported daily over the same time period. Other countries, such as France with twice as less population than Japan, needed to impose a new lockdown starting in the end of October, in order to lower the confirmed cases per day to 5,000.

However, figures that seem low to the most affected countries are actually breaking records in Japan’s history with the pandemic so far. So let us have a new overview of the situation in the archipelago, of the actions that have been implemented, and of the possible consequences for next year.

The 3 Japanese waves

The prefectures with the highest number of cases in Japan

The most affected prefectures’ ranking is quite consistent since the beginning of the epidemic in January (not including "Diamond Princess" cruise ship’s cases). Thus, the highest figures of confirmed cases can be found in the following prefectures:

Tokyo
Osaka
Kanagawa
Aichi
Saitama
Hokkaido
Chiba
Hyogo

Kanagawa, Saitama and Chiba are part of the greater Tokyo area, a region that consequently gathers half of the reported cases.
In terms of numbers, about 500 new confirmed cases per day were found in both Tokyo and Osaka prefectures on late November. Over the same period, Paris, with 6 to 7 times less inhabitants, had 4 times more confirmed cases, an incidence rate ~25 times higher!

Statistics at the end of November and overview

On November 25, the figures in Japan were:

About 140,000 confirmed cases since the beginning of the pandemic;
About 3,3 million performed tests, with a 4% positivity rate;
Less than 2,000 deaths since January 2020.

It is crucial to keep in mind that these figures are very low compared to the rest of the world: Japan is still one of the countries that best tackled Sars-Cov-2 pandemic and continues to do so while sustaining economy, freedom of travel and activity.

What is striking is that there were less Covid-19 confirmed cases in year 2020 overall in Japan, than in the United States on any day of late November.

Very few tests performed and a small number of Intensive Care Unit beds

Truth is that with very few tests performed, the number of actual cases is likely to be higher than officially stated.

Despite a testing capacity of ~85,000 per day according the Japanese Ministry of Health, less than 40,000 PCR tests per day were performed on epidemic peak days, about 8 times less than in France.

Testing, however, is not free in Japan (except when symptomatic or contact case validated by a doctor), and even rather expensive, a fact to be taken into consideration to reflect on the low number of tests. We recently experimented this fact first hand:

Moreover, only a few thousand of ICU beds are available in the archipelago, about 2,500 in Tokyo for example. The Japanese healthcare sector raised the alarm on November 20 when half of the beds were occupied.

Obesity rate, an important comorbidity factor, is low in Japan but is compensated by the fact that Japanese population is old, and consequently more fragile to the virus.

Reasons behind the fall-winter surge

Lower temperatures, koyo season and holidays

Warm weather lingered in Japan until November’s first half, with an average temperature of 25°C (77°F)! However, as in the rest of the northern hemisphere, the cold wave finally arrived. As a consequence:

People spend more time indoors than outdoors;
Rooms are less frequently ventilated and on a shorter period;
The virus spreads faster.

Moreover, it is the full season of momiji 🍁 foliage and Japanese people go contemplate them in crowds, all the more as they could not enjoy cherry trees 🌸 blooming in spring. Encouraged by the official "Go To Travel" campaign (see below), Japanese rush to the usual important touristic attractions, emptied from the foreign tourists:

Kyoto has seen a surge of frequentation, with 65% more visitors in Arashiyama on Sunday 22 November compared to 2019, despite the absence of international tourists! On weekdays, the city is crowded with school trips;
In Tokyo, the "JR East Welcome Rail Pass 2020" (a kind of temporary JR pass aimed at residents in Japan) encourages to visit Tohoku;
Due to a holiday on Monday 23 November allowing for a 3-day weekend, Haneda airport’s domestic terminal was overcrowded (something almost unseen in 2020).

Suspicion on the "Go To Travel" and "Go To Eat" campaigns

The Japanese government has released a ¥1,35 trillion (~8.7 billions dollars) budget to cover up to 50% of expenses in domestic tourism, to pay for hotel 🏨, transportation and restaurants, since the end of July 2020 and possibly until spring 2021. The campaign was designed to sustain the tourism industry, heavily hit by the pandemic.

Over the four first months of the campaign, 40 million of travels have been subsidized.

However health experts agree to call into question the "Go To Eat" campaign in particular, as it is well known that clusters easily form in restaurants, where people are not wearing masks, rather than outdoors where everyone covers one’s mouth and nose with a facemask.

The general public may have predicted such outcome as the campaign for travel was mocked as soon as it was launched: "Go to travel" does indeed sound very much like "Go to trouble" in Japanese.

To face the epidemic surge, the government announced on November 21 new adaptations that were unveiled on November 24, especially:

Reducing of opening hours for bars and restaurants (closing hour at 10 p.m.) for three weeks;
Suspension of Hokkaido and Osaka prefectures from the "Go To" campaign, for three weeks (however travel from these two prefectures is still possible…);
Suspension is under discussion for Tokyo (that joined the campaign later in early October, as it was one of the most affected area since the beginning, quite logically for the largest city in population).

However, cancelling trips already booked for the next weeks is not mandatory. Only new reservations are suspended, for a limited effect.

On a side note, Kyoto mayor had first accepted to hold a giant Pokemon Go event on November 22 as a support for tourism, before cancelling it on the last minute.

All the foreigners’ fault?

Of course, "Hell is other people," and Coronavirus pandemic sadly revealed once again Japan’s ordinary xenophobia.

Some Japanese Medias accused the newly arrived immigrants (see below) of bringing Covid-19 with them, despite mandatory PCR tests to enter the territory. Some health experts even targeted expatriates as a cause for the new uptick of the pandemic, considering they do not have a good command of Japanese, and therefore do not understand the precautions to take or fail to implement them.

Even so, Japan is not the only country to face a third wave of Coronarus in the world :

South Korea, Denmark and Maldives archipelago, but within contained levels;
The United States, that suffered the heaviest blow.

What are the prospects for 2021 in Japan?

New guidelines: after the 3C, the 5S

Japan’s Prime minister has called for an "extreme vigilance" to counter this third wave. However the state of emergency has not been declared, and schools are still operating.

Yoshihide Suga’s recommendations are to avoid the 3C:

Confined spaces;
Crowded places;
Close-contact settings.

In November 19 press conference, Tokyo governor Yuriko Koike followed the same guidelines and recommended the 5S (Itsutsu no Ko in Japanese) or the 5 small to keep in mind when eating with people:

Small number of people eating simultaneoulsy;
Small amount of time to eat;
Small voice : conversations should be quiet, in a low voice;
Small plate: make sure that everyone can eat from one’s individual plate and not from a shared one.
Smallest factors: take heed of any detail, use sanitizer, vent the rooms, use face mask 😷 and wear it correctly.

The current situation and vaccination in Japan

There might be many things to criticize about Japan’s management of the epidemic, but one must acknowledge the difficulty of taking good decisions in such a delicate situation without any prospect about the future.

Nevertheless, it is noteworthy that Japanese government never locked its population down, and will likely never do it, as it is rendered impossible by Japan’s constitution.

Moreover, as many other countries, Japan has to face the challenge learn how to deal with seasonal influenza during the Covid-19 pandemic, even if last winter flu’s impact was softened by sanitary measures implemented as soon as January 2020.

2021 Olympic Games and borders reopening

It was announced multiple times since September by all organizing parties (International Olympic Committee, Japanese government, Tokyo city, etc.): summer 2020 Olympic Games 🏅 are postponed by one year, but will take place with adjustments to the situation.

The president of the IOC, Thomas Bach’s recent visit to Tokyo is another proof of everyone’s willingness to hold the Olympics.

The Olympic Games are a further guarantee that Japan will reopen its borders, maybe in early April, according to hints from Japanese journalists in early October.

In the meantime, Japan reopened its borders since the end of summer to all visa holders, except foreign tourists. So do not forget to subscribe to Kanpai's newsletter to stay up to date on Japan's borders reopening to international tourists: