Why was Japan relatively spared by Coronavirus

Less than 10,000 Covid-19-related deaths in the archipelago as of spring 2021

⏱ 7 minutes

As far as North America and Europe are concerned, the realization of the Covid-19 outbreak's importance came as a shock in March 2020 and lead to a global lockdown, of various enforcement gradations depending on the countries. Schools and non-essential businesses were closed, and travels were discouraged, especially through borders closures.

Japan, our main interest here, underwent great changes in its image at the beginning of 2020:

First the country was ranked second one with the highest number of cases due to the Diamond Princess, from which Japan had the hardest time to separate its own victims count. The cruise liner however, was initially sailing in the international waters before being quarantined off to Yokohama port (the ship’s cases were since counted separately).
A couple of months later, as Europe started to cautiously lift the lockdown, Japan ended its state of emergency earlier than scheduled and was back to an almost normal life, without having strictly locked down the country.

It seems that the archipelago succeeded to contain the outbreak with about 17,000 confirmed cases and less than a thousand deaths in total (30 times less than France that has twice the population). Among developed countries, Japan scores as one of the places counting the less Coronavirus 🦠-related casualties in the world.

Several simple reasons for this situation can be suggested.

Cultural reasons

On June 5, 2020, Taro Aso, Minister of Finance and Deputy-Prime Minister of Japan, listed these cultural reasons under the concept of mindo (民度) or "cultural standards" that he thinks are higher in Japan.

These "cultural standards" are considered characteristic traits and habits of Japanese people and can be easily identified.

The habit of wearing sanitary mask

Japanese people are used to wearing a face mask whenever necessary, to avoid spreading germs when sick or as a protection against hay fever. This habit was developed from the beginning of the 20th century, but it was still surprising for the occasional Western visitor in Japan before the pandemic outbreak and source of questions.

Yet, it was scientifically proven that wearing a sanitary mask 😷 helps reduce the Covid-19 transmission risk by 75%.

On top of that, the outbreak peaked during hay fever season (kafunsho), between February and April. Hay fever is a nuisance for many Japanese people so they tend to wear sanitary masks more than usual during early spring 🌸.

Hay fever and Coronavirus counter measures induced about 99% of Japanese people to use face masks in public transportations and closed spaces, as well as in public spaces in April and May 2020.

A Natural social distancing

Another commonplace: Japanese people tend to avoid physical contact. In Japan, people don’t kiss, don’t hug and rarely shake hands for greetings. Such habits really reduced the spread of the virus.

A simple nod or bow are enough to greet someone. It thus maintains a physical distance of at least one meter, especially when bowing: The ideal way of greeting to prevent emission of airborne droplets.

In the same vein, Japanese people rarely meet friends at home. They usually prefer going out, which helps limit close contacts and sharing surfaces.

A Rather low obesity rate

According to the World Health Organization, about 40% of adults were overweight in the world in 2016. Behind this figure are however a lot of disparities among territories. Thus, when comparing the list of the countries that were the most severely hit by Coronavirus, it seems that there is a correlation with the overweight prevalence rate (that is to say a BMI higher than 25):

United States: 67.9%
Brazil: 56.5%
Russia: 57.1%
United Kingdom: 63.7%
Spain: 61.6%
Italy: 58.5%
France: 59.5%
Germany: 56.8%
Turkey: 66.8%
...
Japan: 27.2% !

As obesity (as well as diabetes, often linked to obesity) is a strong comorbidity, Japan is protected, mainly thanks to a more balanced diet and maybe thanks to genetics predispositions.

High personal hygiene standards

As we will discuss in a coming article about cleanliness in Japan, Japanese people are taught hygiene consciousness from childhood, for their bodies as well as for the places they live in.

For example, children help clean their classrooms and their schools, they learn to wash hands frequently, especially when coming back home (by the way washing hands is one of the most efficient and easiest ways to kill Covid-19’s virus).

Good manners in public transportations

Except for the Shinkansen 🚅 (high-speed trains) and a few express trains, eating in public transportation in Japan is not accepted. Moreover, talking on the phone is forbidden in all trains and smartphones 📱 must be on vibrate mode.

As a consequence, when people talk in trains, they tend to do so in a low voice and droplets naturally don’t spread far.

Which connects to the next point.

The softness of Japanese language

In May 2020, the Japanese television channel TBS broadcasted a video that was widely shared on Twitter and entertained the Japanese-speaking community. It compared the emission of droplets by spoken-Japanese and other languages, especially spoken-English:

A theory on why Japan was able to contain the coronavirus outbreak... according to TBS pic.twitter.com/9d0cIxvS1X
— Kurumi Mori (@rumireports) May 21, 2020

This is of course a fancy comparison but somehow still shows that spoken-Japanese uses softer consonants, and that the way of speaking tends to be softer than in other languages (for example: English, Chinese, Italian or Spanish).

As a consequence, people tend to spit less when speaking Japanese.

Herd immunity and cross-protection

Despite its insularity, Japan has a record of suffering several harmful epidemics that caused hundreds of thousands deaths:

Cholera, in the second half of the 19th century;
Spanish flu between 1918 and 1920;
And more importantly tuberculosis, in the first half of the 20th century, which is still carefully monitored up to this day through a national tuberculosis control program.

In mid-May 2020, scientific studies suggested that Japanese people may benefit from cross-protection, due to contacts with earlier Coronavirus strains, especially:

SARS (2003);
H1N1 (2009);
And/or MERS-CoV (2012).

It may be why Covid-19 seems less harmful in Japan.

Fast and efficient responses

While Japanese government is not renowned for flexibility and quick-mindedness in crisis time, it is worth to note that both the population and the government reacted well facing the outbreak.

WHO even praised Japan for its management of the epidemic, and WHO Director-General Dr Tedros Adhanom Ghebreyesus explained in a news conference on May 25 that: "We can see the success of Japan".

The closure of Japan’s borders

Cruise liner Diamond Princess’ cases hurt Japan’s pride as the country was first listed as one of the most impacted countries in the world by Coronavirus.

As a consequence, Japan’s borders were closed early to avoid further spread of the virus from people that:

Recently transited via Hubei and Zhejiang in China from February 1;
Arrived from or transited by China or South Korea from March 9;
Originated from a hundred of countries in the world (!), including most European countries and the United States, from March 27.

Japan is now considering to reopen its borders, but slowly and with caution!

The economy partially put on hold at an early stage

In the same vein, Japanese economy was voluntarily slowed down earlier than in any other countries.

As soon as mid-February, several museums and amusement parks have closed and events were postponed or canceled. Big fast food chains such as McDonald’s or Starbucks progressively lowered down their offers to pedestrian drive and take away only.

As for closing schools, the decision was taken as soon as late February / early March. The beginning of the new school year was postponed to June 2.

Telework was not a habit in Japan, but its spread quite easily, showing an unexpected adaptability of the economy.

Tokyo 2020 Olympic Games 🏅 were a very sensitive topic economically speaking, and the decision to postpone them was made on March 23. The next week, the new dates were announced: The Games are to take place in summer 2021, at almost the same dates.

A Self-determined lockdown

Japanese government does not have the right to force citizens staying home nor enforcing punishment. The stay-at-home instructions were only "suggested guidelines" to implement in a spirit of cooperation, as in other countries where a strict lockdown was not enforced, such as:

In Asia: South Korea, Singapore, Taiwan;
In Europe: Sweden, Nederland, Switzerland.

Japanese people, true to their reputation of an educated and civic-minded people, have generally complied with the instructions. Most of them even refrained from traveling in their own country, following the demands of prefectures’ governors asking not to travel under the state of health emergency.

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With the handling of Covid-19 crisis, Japan once again proved that it was one of the safest countries in the world. So feel free to travel with confidence in Japan.