Japan Badly Hit by Winter 2022 Omicron 6th Wave

⏱ 13 minutes

We announced it as soon as early December in our article commenting the sudden re-closing of the Japanese borders, and despite the many local medias and self-appointed international observers boasting the Japanese superiority and natural protection against Covid (the famous "Japanese gene" that is yet to be found): the Omicron strain is riding the 6th Coronavirus 🦠 wave in Japan and is striking the country very hard.

Like in many other countries, it is not exaggerating to say that Omicron is a tsunami, and without much surprise unfortunately, in Japan it seems that nothing was learned from:

The last 2 years of pandemics and the results of many other countries’ experiences,
Japan’s own past errors, especially during the 5th wave at the end of last summer.

It has become a habit now, let’s overview the latest information on the Covid wave in which Japan is currently engulfed.

🦠 The contamination boom

Until the early days of January, the contamination curve stayed low, with less than 500 new daily cases registered. However things quickly got out of control with a steep and sudden uptick that was unprecedented for Japan. The number of cases rose 🌹 to ~5,000 per day on January 10, then to ~20,000 before the end of the following week, and the ~50,000 cases have quickly been reached on the last weekend, which makes a tenfold increase in less than 2 weeks! The incidence rate is extremely high while the contamination peak is far from being reached. The rise is sharp, even more considering these figures are only the tip of the iceberg, in a country that purposely maintains a low testing rate (see below).

However, there is nothing new here: the contamination records were broken as soon as late December in many countries (of Europe, in the United States and Australia). The rise in Japan was certainly subtle, but it was undoubtedly trending upwards since the end of November, without much suspense left about the outcome.

While the disheartening borders restrictions at this time may have alleviated the damages on the short term, they only delayed the inescapable and tremendous spread of Omicron. Did Japan leveraged on this situation to administer a maximum of booster shots? Not at all, and we will talk about that further in the article.

In mid-January, the level of new contamination has quickly broken all the precedent records, be it by city (Tokyo and Osaka being naturally the most impacted due to their population density, as well as Okinawa for specific reasons that we will detail later), by prefecture or at national level. Each day the number of cases is exploding, rising way above the previous figures as everywhere in the world.

cas-omicron-japon-janvier-2022

Before the end of January, the active cases would make for ¼ of the total number of cases in Japan since the beginning of the pandemics…

📊 A chronical under-reporting of cases

We have been denouncing for nearly 2 years now something constant in Japan’s Covid crisis management: the "head-in-the-sand" policy and the under-testing intended to ~~hide the real infection number~~ keep flattering statistics. In view of the violent Omicron wave, this under-reporting is even more troublesome.

Conditions are indeed drastic to get a PCR test in Japan: in most cases it must be prescribed by a doctor, and it is up to them to deliver one, sometimes they don’t even if the patient declared all the symptoms. On the other hand, free tests were provided in the beginning of the year, but were unlikely to change anything as it was temporary, the number of tests available was too small and the wait was too long:

In Tokyo, only 30.000 (!) tests were available each day for 14 million inhabitants,
In Kyoto, results are provided 3 days later for the PCR tests and the next day for the antigens,
In Osaka, an appointment is required the day before testing to receive a self-test, that will not be counted in the statistics even if it returns positive!

When opting for a home-test, don’t expect it to be affordable either: in the archipelago the prices range from more than ¥1,000 (~US$6.54) per unit… quite pricey for a family that needs to be checked frequently.

Let us make more a simple calculation to show the under-reporting and try estimating the real number of cases in Japan. Let’s take the example of Saturday, January 22 as a reference day:

France, with about ~401.000 confirmed cases for 67,4 million inhabitants, has nearly reached the Omicron peak. To reach such result, about ~1,3 million tests were made, resulting in a ~31% positive rate;
Japan, in the ascending phase of contamination, discloses about ~55.000 new cases per 125,8 million inhabitants. The confirmed cases were found with only ~236.000 tests performed, resulting in a ~23% positive rate.
If the number of tests per inhabitants performed in France was performed in Japan, the result would be ~560.000 confirmed cases for this day, ~10 times more than the official figures!

While it is difficult to evaluate when the peak is reached, it is still probably far. And it is not unreasonable to think that Japan will quickly go over the million of new daily contamination.

According to the Japanese Ministry of Health, the country’s PCR-testing capacity is 100,000 daily in the capital and 400,000 nationwide (a threshold that has not moved with Omicron and that is already showing its limits). That is to say 8 times less than in France with equal population. But it does not prevent the staff in Narita Airport to state that PCR tests made outside Japan are less reliable than their own saliva tests (!) when they find positive cases at arrival… whereas the tests made by travelers are up to 72 hours old, in compliance with entry regulations, quite enough time to declare symptoms.

With Omicron, Japan’s leaders recently announced an unheard of solution: stop testing asymptomatic under 50 years old people to confirm a Covid diagnostic, and it is not even a joke! How is it possible to trust in statistics that were understated from the start?

🎖 The US Army and New Year holidays as superspreaders

December 2021 was the occasion for an unexpected turn of events based on appalling discoveries: the American troops stationed in Japan since the end of World War II (with 60% of the bases located in Okinawa) were exempted of getting tested before entry, of undergoing quarantine upon arrival and even to wear a face mask 😷 in public places!

Let’s put into perspective this diplomatic bomb: while the few foreigners granted entry in Japan (of which part of Kanpai’s team is allowed thanks to their residents’ status) must undergo drastic processes and are tested not less than 4 times over one week, the American army comes in Japan like it’s a free entry zone even during a Covid viral peak.

This careless move was decided on September 3 by the US army itself based on the fact that most of its staff was vaccinated. It was somehow corrected by the end of the year, following the general outcry it caused. Moreover, other restrictions would be implemented two weeks later. But it was already too late: on December 20, an 186 cases cluster was found, and Omicron quickly spread. Needless to say it is a major issue happening in one of the few periods of the year (with the Golden Week in spring 🌸 and Obon in August) when the Japanese travel, notably to Okinawa, for a couple of days’ vacation.

Moreover, while the 2021 New Year celebrations were especially quiet, in 2022 the Japanese made up for the lost occasions:

Train stations and airports were overcrowded for the New Year holidays,
Markets as well (such as here in Ameyoko) to prepare the New Year Eve’s feast,
Shrines opened throughout the night for the traditional celebration (like here in Meiji-Jingu) whereas they had closed in the afternoon the previous year; Fushimi Inari Taisha was visited by 4 times more people than last year.

All the ingredients for this explosive cocktail were thus combined and from early January, Omicron could spread throughout the archipelago with people returning from the short holidays.

🧑‍⚕️ The "preparedness" of the healthcare system

After a 5th wave that left its mark on the Japanese healthcare system, one might have expected that the new government would prepare for the foreseeable 6th wave.

The leeway was indeed sufficient to get ready, with:

1 month to observe how hard Omicron hit the Western countries.
4 months of reflection to improve from their last imperfect management.

By the way, one year ago exactly we published on Kanpai this article, of which many criticisms are still valid today unfortunately:

Moreover, preparedness was a key word in Kishida’s team press conferences since he came into power in the beginning of autumn 🍁, and even when Omicron has been starting to rampage and that it was not the time for preparation anymore. What has really been made, is dedicating 30% more of the available beds for Covid patients in a country in which only 7% of the hospitals are public and thus able to be mobilized for Covid patients (namely 2 points more in reality). The rest of the “preparedness” is unconvincing, with a shortening of contact-cases isolation period from 14 to 10 days.

Without much surprise, difficulties have been starting in the reality. In Mid-January, with an epidemic on the rise and still far from reaching its peak, ambulances had already a hard time finding hospitals willing to treat their Covid patients.

As for the official statistics institutions, they were quickly overwhelmed by the follow-up:

As the Omicron variant fuels a surge in COVID-19 cases in Japan, the people responsible for tracking the outbreak are struggling to keep up. pic.twitter.com/g86AXOwemp
— NHK WORLD News (@NHKWORLD_News) 19 janvier 2022

Fortunately, as for the rest of the world, hospital admissions and deaths due to Omicron are less numerous in proportion to the new cases. That is to say at the moment, since many other countries, including France, have a very high rate of booster shot injection, which is not the case at all in Japan: currently less than 2% of the Japanese have received their 3rd dose, compared to 45% in France. The archipelago might therefore become a real-life experiment in a not very encouraging pattern.

💉 The incredible belating of the 3rd vaccine dose

Japan in now boasting the inoculation of the 2nd dose to ~80% of its population (since November), and tries to make us forget the vaccination roll-out initial delays:

Vaccination campaign only started in mid-February, 2 months after most of the developed countries;
Nevertheless, the general population had to wait until mid-May to see the vaccination pick up pace, starting with the elderly, while in the United States half of their population was already vaccinated.

And then again for the 3rd dose ! The same mistakes were repeated absurdly. The booster dose roll-out started in early December, still following an outdated schedule giving priority to the few health workers at the slowest pace possible: whereas France can perform more than 600.000 booster doses per day, Japan’s capacity is 6 times less on average (with twice the population, however), and has not even started vaccinating the elderly, who are more at risk, before February...

Everybody is nonetheless aware of the main problem, reminded by the WHO: 2 doses only do not or only slightly protect against the Omicron strain. The Japanese government, mired in its lack of flexibility and pro-activity, thinking stubbornly that its people are different from the other human beings on the planet, put consequently its population in danger, without taking advantage of the delay in the Omicron wave. Even the arrogant Taro Kono, former Ministry in charge of vaccination and defeated challenger in the Prime Minister election, is acknowledging it...a sad official admission of failure.

Japan is still using the outdated system of mailed vouchers to make a reservation on site or at best by phone, and requires the involvement of companies who are increasingly reluctant for legal reasons, while laboriously reopening (quite late) the vaccine centers that were closed in November, at the time when the rest of the world started injecting the 3rd dose. Foreign residents have clearly understood what was happening: those who were lucky enough to come back home for the year end holidays took this opportunity to have their booster shot abroad and avoiding to depend on this lousy system.

⚠️ The come back of restriction measures and states of emergency

On January 19, the United Kingdom announced the lift of most of the Covid-related restrictions only a dozen of days after its peak (and France announced the next day its own easings starting in February), Japan had no other choice but to reestablish restrictions to face its delayed Omicron wave. Most of 2021 was spent under states of emergency or priority measures (called "manbo"), and it was not long before 2022 takes the same turn, and hopefully not for so long.

Okinawa quite logically opened the trend with the submission of a quasi-state of emergency request on January 1. Other prefectures quickly followed (already 30 out of 47 prefectures at the time of writing): Tokyo and neighboring prefectures, Yamaguchi, Hiroshima, Niigata, Nagasaki, Kumamoto, Miyazaki, Gunma, Aichi, Gifu, Mie, Kagawa, Hokkaido, Fukuoka, Saga, Oita, Shizuoka, Osaka, Hyogo and also Kyoto.

To put it simply, most of the Japanese population is affected by the measures, as the mentioned prefectures are the most densely populated. Were reintroduced restrictions such as:

Recommendation to teleworking (Tokyo Metropolitan Government moreover warned companies to have their business impaired by absenteeism),
Recommendation to avoid crowded places,
Recommendation to avoid non essential travels,
Recommendation not to eat in groups bigger than 4 persons,
Prohibition of serving alcohol after 6 or 7 p.m. or,
Closing of bars and restaurants at 8 or 9 p.m.

These manbo measures are officially expected to end on February 20, but it is easy to foresee that the "quasi" will become real states of emergency and probably be extended further. Restaurants owners and retailers are already at the end of the rope, considering the same restrictions had changed nothing to the tired citizens behavior. Japan still hopes that the restrictions will not overlap with the paramount hanami, which is forecast to begin earlier than usual this year, a situation that would remind of last spring’s darkest hours.

Naturally, the Japanese government made a few blunders, that were fortunately quickly forgotten, such as these 2 gold nuggets:

A fourteen-day isolation at the hotel for all Omicron contact-cases; and,
The ban on taking the important university entrance exam for students who were contact-cases.

Let’s also mention the request of not traveling between prefectures during the restriction periods; a ridiculous idea given the fact that millions of salary-men commute daily to Tokyo or Osaka from neighboring prefectures. Meanwhile at school, contact-cases are not traced nor tested, and the definition of contact-case varies according to the school… which does not prevent a massive closure of day-care centers.

Consequently, Kishida Cabinet’s favorable opinions started to decrease: it went from 60 to 55,9% of approval between December and January. The decline is likely to be only at its beginning.

What about a Covid pass? A health check system was undergoing testing but was eventually abandoned on January 18! Timing is really something in Japan. 🤡

🗾 Tourism restrictions and closed borders

The resuming of GoTo Travel, the subsidy campaign for domestic tourism, was scheduled from late January to mid-May, but it is easy to guess that it will be delayed due to the 6th wave. Consequently, the Japanese borders are likely to stay closed to overseas tourism at least until this summer.

You already know if you follow Kanpai: Prime Minister Fumio Kishida recently announced in a press conference that borders would stay closed even to foreign students and workers, at least until early March. With an astounding rationale: "The infection situations regarding Omicron are clearly different at home from abroad, so the framework (of the current border controls) will be maintained until the end of February."

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This lack of humility, the thought of Japan defeating the virus thanks to whatever miracle or that it would not face an Omicron flood, as well as the new government’s haughtiness, are starting to make outside observers raising an eyebrows, and developing strong doubts on their ability to manage the crisis after Suga’ spinelessness. We will write extensively on this topic in a specific article in the next weeks.