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A Japan divided over COVID-19 control

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Japanese Prime Minister Shinzo Abe covers his face with his hands as he lisyens to a question by an opposition lawmaker at the National Diet in Tokyo, 3 March 2020 (Photo: Reuters/Yoshio Tsunoda/AFLO).

In Brief

If the Japanese government’s performance in dealing with the COVID-19 threat is any indication, the upcoming Tokyo Olympic Games are doomed to fail even before they begin. Prime Minister Shinzo Abe is preparing emergency coronavirus legislation, and a majority of schools are now closed as Abe requested for around a month in an effort to contain the spread of the virus. But the move is too little, too late.


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The scary truth is that no one is in charge of managing Japan’s response to COVID-19.

Bureaucrats have failed to put together a competent team or provide transparent reports about decision-making processes. Meanwhile, political leaders make themselves look busy by jumping from meeting to meeting and repeating experts’ statements to the press instead of making the difficult decisions that are becoming increasingly urgent.

The contrast between Beijing and Tokyo is striking and unflattering to Japan. Downtown Beijing is deserted as people try to avoid spreading the virus by staying home. Tokyo looks like business as usual, with trains and subways still packed.

The Japanese government has shifted its efforts to contain the spread of the virus from seaports and airports to focussing on communities and asking people to stay at home. But the messages have been mixed. The media remains optimistic, reporting that the virus is mild and will likely taper off as summer arrives. As a result, not all local communities are adhering to Abe’s request to close schools. There is little detailed symptom data available from authorities and medical doctors. Only healthcare workers are voicing real concern, while the public struggles to judge how to protect itself from this ‘very mild’ yet deadly virus.

This is not to downplay the efforts of the individual authorities who are engaged at the frontline. The emergency budget of US$138 million — though far less than emergency funding in the United States — is a significant step forward, helping to produce more testing kits, secure more beds in health facilities and fund research about the virus. But what’s lacking is coordination and leadership.

Bureaucratic silos have resulted in parallel task forces and meetings convened by the Prime Minister’s office, the Cabinet office, the Ministry of Health, Labour and Welfare and the Tokyo metropolitan government. Health experts and officials from various agencies debate the same topics repetitively in multiple meetings, while Abe has put no one in charge.

Arbitrary bureaucratic interference is preventing the authorities from implementing a desperately needed nationwide All-Japan efforts that include the best experts from academia, research centres and industry. The National Center for Global Health and Medicine — one of the main research centre for infectious diseases — was not invited to be part of a crucial task force. There have also been delays in rolling out favipiravir, the antiviral drug being developed by Fujifilm that’s believed to be potentially effective against the virus, because it was approved only as a treatment for influenza, not COVID-19.

Lessons learned from past crises in Japan such as the 2011 tsunami and the Fukushima nuclear power plant disaster appear to have been forgotten. Japan’s civil service lacks institutional memory as the system circulates bureaucrats from one position to another every two years and prioritises internal incentives on domestic issues rather than on building global networks. The recommendations from the first ever independent investigation committee of the Diet have not improved the system, nor changed the mindset of the policy elite.

This time of crisis is a chance for Japan to develop innovative solutions to these complex challenges. But the authorities are blindfolded within the existing jurisdiction-based framework and continue to misallocate resources and prevent cross-sector collaboration.

The National Institute of Infectious Diseases (NIID) was solely designated to produce polymerase chain reaction (PCR) diagnosis kits and to handle testing because it sits under the Health Ministry’s supervision, for example. But NIID is not the most productive device maker and its PCR testing method takes at least six hours to produce a result. The Institute originally only had the capacity to test 200 cases per day. This increased to over 400 tests per day when it introduced three-shift operations to run 24-hour testing. But by early February NIID was crying out for help to increase its capacity, prompting the government to finally go to the private sector to produce non-PCR testing devices in late February.

The authorities could have turned to the private sector for help from the beginning; there are many efficient flu-diagnosis device-makers in Japan who would have responded to incentives for quick and effective diagnosis kits. The hesitation to give the antibody to private makers has resulted in a severe shortage of testing capacity across the country.

The absence of appropriate risk communication is feeding confusion and hysteria in the foreign media. The chain of command is vague and bureaucrats have incentives to cast-aside things that are not written in the rules, further delaying responses.

The good news is that despite all the mishandling and delays, the majority of Japanese people still trust the government and try to follow its instructions. Local institutions and individuals are taking serious prevention measures, even as the Japanese leadership is failing to manage the situation.

Before it’s too late the authorities need first to designate a person in charge, and second, to provide reliable data and patient symptom information in a timely manner so that communities can fight the virus effectively.

The world is watching to see if the Japanese government can step up and show the commitment needed to overcome this enormous challenge ahead of the Tokyo Olympic Games.

Hiromi Murakami is a Visiting Fellow with the Global Health Innovation Policy Program at the National Graduate Institute for Policy Studies (GRIPS), Tokyo.

This article is part of an EAF special feature series on the novel coronavirus crisis and its impact.

2 responses to “A Japan divided over COVID-19 control”

  1. Thanks for a sobering analysis. There is one other related worrisome piece of info not noted here: a few days ago NHK reported that the government officials responsible for approving the testing of individuals suspected of having COVID-19 are denying many requests made by MD’s who have patients that fit the criteria for the disease. Is this because the country has not yet ramped up production to have enough test kits? Or is it because Abe, et al want to keep the number of identified cases of COVID-19 as low as possible out of a desire to prevent the postponement of the upcoming Olympics in July?

    Admittedly the latter explanation sounds cynical, at best. But the government tried to minimize the dangers after the Triple Disaster in March 2011. Given that legacy, which some feel is still playing out in Age’s pro nuclear power policies, there is some legitimate cause for concern about how he is (mis)handling the COVID-19 situation.

    • Thank you for your comments. The actual testing capacity seems much smaller than what the government claims. Also up to quite recently, MD has to direct suspected patients to local health center (Hokenjo), then the center decides whether she/he needs to take the testing for COVID-19. In other words, those denying decisions were made by Hokenjo. Now, MDs are able to directly send suspected patients to testing facilities, bypassing Hokenjo, and that will make less confusion. Another reason to limit the number of testing is capacity problem of hospitals, in accommodating patients once they are tested positive, but with less severe condition. If those “light” conditioned patients fill the limited number of beds, then hospitals are not able to take care of severe-conditioned patients. Therefore, my answer is the former. However, as you pointed out, and I also intended to argue that the fundamental impediment of Japan’s system continues to exist, and it seems not so many people think the change is necessary. That is my grave concern.

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