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There have been many theories, discussions and debates about what combination of factors contributed to Japan’s success up until now in preventing uncontrolled spread of COVID-19 and health system collapse. Oft-described as surprising or mysterious by foreign media, this success is presented as logical (in the context of Japan) by the Japanese government and official experts. However, this kind of over-confident way of thinking theoretically allows society to co-exist peacefully with a disease, without widespread testing. At the same time, it relies on closing international borders to keep the virus from entering the country. Together, these raise serious questions for the success of long-term strategies to manage COVID-19 within Japan, and the potential loss of trust within the international community, let alone any long-term impacts for society.
An early June article written by one of the experts shaping Japan’s COVID-19 response offers insights into the intentions behind Japan’s approach to the pandemic. Dr. Hitoshi Oshitani’s “Infectious Disease Response — to see the forest, not just the trees: What differentiated Japan from the Western countries?” clearly identified the virus as a foreign threat, regretting only that stronger control of the movement of people coming into Japan was not put in place earlier. This focus on a strong defense against the risk of foreign contagion stands in stark contrast to his argument that there is no need to eradicate the virus within Japan; in his analogy he prioritized attention to the “forest” of COVID-19 rather than the “trees” of individual COVID-19 cases. His argument also relies on a culturalist understanding of Japanese history, presenting the idea that Japanese people have somehow learned how to co-exist with diseases for centuries. He states:
… it has been recorded in history that Japan has suffered through numerous outbreaks, such as smallpox, since Nara period (710 AD – 794 AD). Through that process, people have seen that there are powers beyond human understanding, and they accepted such powers to a certain extent. For example, there are shrines and temples across Japan that enshrine smallpox as “pox god”. Of course, it is an evil god, but it is recognized as a god. Also, a famous folk toy from Aizu region in Fukushima Prefecture called “akabeko (red cow)” has black dots on its body. There are theories that it represents smallpox. I guess Japan and other Asian societies have developed a relationship with infectious diseases that contains a sort of resignation, as we had accepted living together with microbes.
This argument draws from an idea of an intrinsic, unchanging Japanese heritage that enables coexistence with COVID-19 based on evidence of how people tried to make sense of diseases a thousand years before the existence of viruses was understood. Coming from an expert in infectious diseases, the reference to smallpox, one of few diseases that has been eradicated, seems odd, especially since the use of smallpox vaccinations in China dating back to the 1500s directly counters the article’s oversimplified claims contrasting “Asian” and “Western” approaches to COVID-19. Oshitani argues that
…western countries, which have culture of trying to thoroughly eliminate threats of infectious diseases, all trapped themselves into dangerous situations, while Asian and African countries, which have adopted more of a “coexistence” approach, have been able to hold on up to this point.
This seems like an attempt to support Japan’s continued refusal of widespread testing, presented as an argument against attempts of “virus elimination” in European countries and the U.S. However, it disregards African countries’ experience with previous pandemics, as well as strong controls and measures to track cases and eliminate the virus in South Korea, Taiwan, Vietnam, as well as successful elimination of COVID-19 New Zealand.
Construction of a narrative of “covid-safe” Japan
The first cases of COVID-19 in Japan were identified in Chinese people with ties to Wuhan. Even after the virus began to spread within Japan, the rhetoric did not change—the presentation of COVID-19 as a foreign threat by the national government and official expert advisors allowed for the construction of an image of Japan as being safe from the coronavirus. This underlying narrative of safety was in turn used to rationalize domestic virus countermeasures and international border restrictions. Avoiding postponement of the 2020 Tokyo Olympics was a powerful motivation that shaped the timeline of virus countermeasures as well as international messaging downplaying risk within Japan. Facing growing criticism of management of the COVID-19 outbreak on the Diamond Princess cruise ship in February, government and official messaging directed inside and outside of Japan tried to draw a sharp distinction between the off-shore pandemic and safety inside the country. The term “covid-safe” is not used by the Japanese government, journalists, or other analysts. However, it can be understood as a narrative perpetuating an idea of a “covid-safe” Japan, constructed by both official messaging and countermeasures. In the shadow of domestic and international messaging of a “covid-safe” Japan, policies to control the spread of the virus focused on national borders as the line separating safety from risk.
A foreign virus
Even as more COVID-19 cases were identified among Japanese nationals without any history of travel or known contact with infected people, a recurring media narrative emphasized locating the source of the virus outside Japan. Such media narratives traced cases to foreigners or foreign travel, contributing to reassurance and justification of a feeling of safety in Japan. As COVID-19 cases were confirmed among Japanese nationals repatriated on charter flights from Wuhan, policies and messaging to minimize the appearance of risk within Japan included the creation of the first separate category of infections of “charter” cases, counted and reported apart from the total number of cases in Japan. Other categories would be created to separate “cruise” cases from the Diamond Princess and later “airport” cases discovered at immigration, from the total number of people with COVID-19 in Japan. The prevalent idea of the othered, foreign virus was directly reinforced by the naming of coronavirus call centers as Kikoku-sha sesshoku-sha sōdan sentā (Call Centers for Japanese Returnees and Potential Contacts), which translates quite literally to “consultation centers for people who have returned to Japan, or have had contact with infected persons.”
Loan-word vocabulary to emphasize foreignness
An extensive use of foreign English loan-words adds to this narrative, and exists in parallel to ideas of Japanese exceptionalism, linguistically and culturally locating the virus outside of Japan. Including terms for which Japanese words are already in use and understood, some of these words describe different aspects of approaches to COVID-19 management: targeting kurasutā (clusters); avoiding o-ba-shuutto (overshoot); and rokkudaunu (lockdown). Others are used to call upon the public: to alter their behavior by following requests to sutei hōmu (stay home) and practice sōsharu disutansu (social distance). Including both new policies created in Japan, as well as ideas from other countries, Tokyo Araato (Tokyo Alert) and a nyuu normaru (new normal) demarcate the temporality of changing levels of safety. The impetus for this use of borrowed loan words is unclear and confusing with multiple possible reasons, including to underscore the seriousness of the pandemic. However it has been suggested that it may be part of efforts to downplay the crises.
Border controls keep foreign danger outside
Many countries implemented border controls as part of COVID-19 pandemic countermeasures. However, Japan’s border restrictions, especially entry bans on foreigners, are distinctive both in terms of their restrictiveness, and also that unlike domestic virus countermeasure they are strictly enforced. Japan’s reliance on strict enforcement of entry bans of non-Japanese people is extreme in that it makes no distinction between visiting tourists and long-term foreign residents or those with Japanese spouses and families; Japan is the only G7 country denying entry to foreign long-term residents. Affecting three million foreign residents, Japanese entry bans are both stricter and less clear than other countries. These draconian bans, which do not allow foreign residents to leave and reenter Japan, continue to cause a variety of disruptions and difficulties in the lives of foreign residents, especially for those working or studying in Japan who left temporarily and have not been able to return for several months.
Like other countries, Japan’s entry bans initially focused on specific areas or countries with COVID-19 outbreaks, however this shifted to blanket bans which have been expanded to exclude people from 129 countries over the three months since April 3. The entry bans represent the idea that banning foreigners in general is an effective countermeasure against COVID-19 infections. These have been recently reemphasized by experts who released statements in June that warn of the explosion of a “large scale epidemic” in Japan if even a few infected travelers enter each day. In addition, as entry bans remain in effect for passport holders of banned countries regardless of their travel history, this policy can be understood as xenophobic discrimination by nationality, rather than purely a public health measure. In contrast, Japanese people were initially advised to avoid travel to countries with COVID-19 outbreaks and then to avoid any international travel; however, unlike foreign residents of Japan, throughout the pandemic until now, Japanese nationals can travel to any country they wish and re-enter Japan so long as they quarantine for fourteen days after returning home. With no sign of significant changes in these exclusionary and xenophobic policies, this approach may lead to long term damage for attempts to promote ideas of internationalism in Japan. Recent statements by a national minister crediting Japan’s success with COVID-19 to its mindo (literally the “level of the people”), a term used to describe cultural and manners that also connotes Japanese nationalism and ethnic superiority, raises even more serious questions about ties between state-sanctioned xenophobia and COVID-19 countermeasures.
Mistakes on the Diamond Princess threaten Japan’s image of safety
At the time the Japanese government was making initial decisions about how the deal with the COVID-19 outbreak on the Diamond Princess, they were already struggling to find accommodations to isolate repatriated evacuees from Wuhan. Difficult for several hundred, the near-impossibility of accommodating the 3,700 people aboard the Diamond Princess made the decision to keep them on the ship the only choice. A few days after the Diamond Princess was quarantined, the Japanese government blocked another cruise ship, the Westerdam, from coming to into port in Okinawa, an action described by the headline “Japan, fearing pathogen, calls on cruise ships to stay away.” The basis for this action was more accurately described by the barring of foreigners, the majority of passengers, based on legal provisions in the Immigration Control and Refugee Recognition Act. It grants power to deny permission to step into the country to any person whom the Minister of Justice has reasonable grounds to believe is likely to commit an act which could be detrimental to the interests or public security of Japan.
By keeping people from the Diamond Princess and Westerdam off Japanese soil, the coronavirus was prevented from entering Japan both symbolically and literally (with the exception of several Japanese passengers whose cases were detected after they disembarked). Japan continued to be framed as a safe place even as the number of confirmed cruise ship cases grew to over 600. Accounts of failure to manage virus spread aboard the ship gained international attention, especially after infectious disease expert Dr. Kentaro Iwata raised alarm about a chaotic situation without proper quarantine protocols on the Diamond Princess by uploading a YouTube video in both English and Japanese. Although Dr. Iwata took down the original video, it can still be viewed as part of the extensive news coverage it received. As criticism of Japan’s virus management from inside and outside the country focused on the Diamond Princess outbreak, by framing any failures as the result of the “unavoidable” context of the ship, Japan could avoid admitting mistakes. Presenting the chaotic situation aboard the Diamond Princess as completely separate from the situation within Japan was key to bolstering emphatic rejection of any possibility for a postponed Olympics; this debate was at its peak while the ship was in quarantine. As cases among people repatriated from Wuhan were counted as separate “charter” cases, “cruise” cases from the Diamond Princess were also counted separately even after they became outnumbered by other cases in Japan on March 15. In the end, the Diamond Princess outbreak resulted in 712 cases of COVID-19 and 13 deaths.
Domestic countermeasures — soft lockdown and science in the name of an image of safety
Japan’s approach to controlling the spread of COVID-19 targeted the spread of clusters of infections, by preventing large events and tracing contracts for identified clusters. Avoidance of widespread testing, and in fact restricting access to tests, was part of a strategy to reduce the number of people coming to hospitals. As Dr. Kenji Shibuya, an expert of global heath and epidemiology explained, Japan’s strategy prioritized protecting the health care system over a public health approach. Domestic measures relied on voluntary compliance. Schools were asked to close, and people were encouraged to work from home and to practice “self-restraint” by avoiding going out or traveling if “not urgent or necessary” to help achieve an 80% reduction in peoples’ movement and contact within society.
Countermeasures relied on the modification of people’s behavior, especially avoiding the “3 Cs” – Closed spaces, Crowded places, and Close contact – and practice hand sanitation. Compared to other countries that implemented a hard lockdown, or even compared to the cordon sanitaire approach used in the quarantine of the Diamond Princess, the logic supporting this self-restraint-oriented approach also can be understood as possible due to Japan’s relative covid-safety.
Although the general public may have been skeptical of these approaches and critical of virus management, especially the delayed implementation of the state of emergency, these approaches and measures were presented clearly and repeatedly, with convincing scientific risk communication. Belief in the accuracy of the science behind the detailed medical strategies and recommendations for behavioral changes can also be understood as another aspect complementary to the idea of covid-safety in Japan. If we can accept the scientific assumption that an 80% reduction in traffic, avoidance of the 3Cs, and cluster-countermeasures can be effective, we are also saying that the risk of COVID-19 is lower in Japan than in other countries which have hard lockdowns. Although low rates of testing have led to speculation about the real number of unreported infections, by the end of May it appeared that some combination of these measures and other factors, including Japan’s high levels of hygiene and routine mask-wearing, had been were successful in controlling the spread of the virus and avoiding a collapse of the health-care system. The situation in Japan is undoubtably safer than countries suffering severe public health crises in the COVID19 pandemic. However, over the long-term, overconfidence in the narrative of a covid-safe Japan, and relyiance on national borders to uphold this narrative, may compromise not only management of the COVID-19 pandemic within the country, but damage Japanese efforts towards internationalism.
Suggested Readings
Brasor, Philip. COVID-19 spurs debate over loan words. The Japan Times. April 11, 2020.
Doi, Shuinchi. “Tourist from China confirmed as 2nd case of coronavirus.” Asahi Shinbun, January 24, 2020.
Global TV. Coronavirus outbreak: “I was so scared” says infectious disease specialist on Diamond Princess. Youtube. February 19, 2020.
Normile, Dennis. Coronavirus infections keep mounting after cruise ship fiasco in Japan. Science, Feb. 25, 2020.
Oshitani, Hitoshi. Infectious Disease Response — to see the forest, not just the trees: What differentiated Japan from the Western countries? Japan Policy Forum. No.58, Diplomacy Jun. 5, 2020.
Shibuya, Kenji. Online Media Briefing: Kenji Shibuya, Foreign Correspondents Club of Japan. Youtube. April 23, 2020.
Smiley, Lauren. 27 Days in Tokyo Bay: What Happened on the Diamond Princess. Wired. April 30, 2020.
Subramanian, Sribala. The Ordeal of the Diamond Princess Crew. The Diplomat. February 22, 2020.
Takahashi, Ryusei. Japanese officials say Tokyo is at risk of an ‘overshoot,’ but what exactly does that mean? The Japan Times. April 4, 2020.
Wade, Stephen. Tokyo Olympic organizers try to dampen cancellation rumors. Associated Press. January 31, 2020.
Elizabeth Maly is an Associate Professor at the International Research Institute of Disaster Science (IRIDeS), Tohoku University, in Sendai Japan. With the theme of people-centered housing recovery, her research interests are community-based housing recovery and temporary, transitional and permanent housing provision within reconstruction–including policy, process and housing form–that support successful life recovery for disaster-affected people. Past and current research focuses on the experiences of people affected by disaster, and the roles of government and NGOs in the processes of housing reconstruction and resettlement after disasters in the U.S.A, Indonesia, Philippines, and Japan.
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The Teach311 + COVID-19 Collective began in 2011 as a joint project of the Forum for the History of Science in Asia and the Society for the History of Technology Asia Network and is currently expanded in collaboration with the Max Planck Institute for the History of Science (Artifacts, Action, Knowledge) and Nanyang Technological University-Singapore.