Kamakura Komachi

Japan Losing to Summer 2021 Covid Fifth Wave

Whereas the archipelago has been relatively spared until recently, it is now facing its first real health crisis at national level. Prime Minister Yoshihide Suga talked about an "unprecedented" and "completely unexpected" wave, but regarding foreseeable events, there were no reason for Japan to be spared by the infamous Delta variant.

As always on Kanpai at each new wave since the beginning of the pandemic, let us have a look on the current Coronavirus 🦠 situation in Japan.

🦠 A contamination surge

The number of new cases suddenly surged in August : there were nearly 25,000 new Covid cases per day in the middle of the month, with only 120,000 tests performed, that is to say a 20% positive rate! More than one fourth of the new cases were found in the capital, and overall half are in the Greater Tokyo area. The figure is 4 times the ones of the 3rd and 4th waves of winter and spring 🌸.

As a comparison, the U.S., with a population 2,5 times bigger than Japan, has a 13% positive rate, with more than 1 million tests per day finding 150,625 new cases. The Japanese government sticks to the head-in-the-sand policy and needless to say that with such a low case research, the actual number of Japanese who were affected by Covid is certainly largely underestimated. As a matter of fact, it is complicated and still expensive (at least ¥3,000 / ~US$27.09) to get a simple PCR test in Japan, even when contact case…

Beyond the cases number, the real worry falls on patients with acute symptoms: they were more than 1,700 in mid-August. The Japanese healthcare system is structured to have one public hospital for about 15 private clinics. The latter cannot be mobilized and refuse most of the Covid patients. As a result: ICU beds in the archipelago become quickly unavailable. Japanese press is consequently frequently reporting disheartening stories of patients who were refused by all the clinics they tried to call – a 50 years old man was even denied by 120 establishments on August 9! All the patients are not even necessarily sick from Coronavirus, as the hospitals’ swamping is actually affecting patients with any kind of condition. On August 17, a pregnant woman from Chiba and Covid positive was denied hospital; she had to give birth at home and her premature baby did not survive.

In July, politics asked Covid patients with moderate symptoms to stay at home and to not go to the hospital. As a reminder, "moderate symptoms" include people who experience difficulty breathing for several days and even needing respiratory assistance, which is according to physician Kosuke Yasukawa, the worst condition that most people (who never had previous serious illness) could face in their life. Unsurprisingly, contamination within family and deaths at home rise after a sudden aggravation of the symptoms. The Ministry of Health is thus promoting a treatment supposedly reducing the risks of hospitalization for new Covid patients, with "casirivimab" and "imdevimab" in intravenous injection.

Moreover, the figures are still on the upward trend, enhanced by the Obon celebrations and the holiday rush. Therefore, the peak of the Japanese 5th wave is yet to come at the time of writing. Thus, it is expected that ICU beds might be full until October.

🏅 The Olympics as a scapegoat

We will not bring up again the sham that were Tokyo 2021 Olympic Games 🏅 and especially the terrible financial losses that will ensue. With most of the sport events staged indoor and without spectators, they indeed could have taken place anywhere else in the world. And the quick glimpses on the Rainbow Bridge or Odaiba’s giant Gundam robot did not help to make us cheer up.

Much more damaging was the choice of the Japanese government to not allow reporters and journalists cover Tokyo after their quarantine was over, or even not introducing the archipelago’s attractiveness to billion of spectators who watch the Olympics on TV, through short programs or videos. It is as if the 15 billion dollars communication campaign went to a waste without even trying to promote the country.

These Olympics were sometimes handled as the ideal culprit whereas they account to close to nothing in the uptick due to the Delta variant: eventually, there were about 500 cases linked to the event, throughout the 2 weeks during which it lasted. The so-called "Olympic variant," prophesied by doom-mongers, was only another piece of idiocy.

However, vigilance is required regarding the new Lambda variant, introduced on the territory by a Japanese woman working for the Games, who came back from Peru (from which the variant originates) 3 days before the opening ceremony.

Now closed for nearly 18 months, and as demonstrated the ban of overseas spectators for the Olympics, Japan is not ready to announce a date for the reopening of its borders yet. However, our tentative estimate is that the reopening will occur from early 2022, as per our opening timeline calculator below:

As for the Paralympic Games, they will take place in Tokyo from August 24 to September 5, behind closed doors as well.

⚠️ A quasi-permanent state of emergency, but to no avail

Japanese people are largely continuing to implement the hygiene etiquette, even if they tend to be less strict on wearing a face mask 😷 indoor (for example in public transportation or some shops).

The state of emergency, mainly declared in the capital and densely populated prefectures, was almost never lifted since the beginning of the year and seems to last without any foreseeable end (September 12 at the time of writing). However, we dare say that the state of emergency is close to useless:

  • Incitations to teleworking and staying at home are sparsely followed, as show the number of metro users that came back to pre-pandemic levels as soon as spring 2021.
  • The prohibition to serve alcohol is not really enforced (for example, 40% do not enforce it in Shinjuku and surroundings).
  • The closing of bars and restaurants at 8 p.m. is not enforced either.
  • The financial aids to companies have loopholes and are difficult to get, even if Mister Suga is considering an additional 300 billion yens (~2.7 billions dollars) budget.
  • Matsuri are canceled or reduced in scale, whereas they are held outdoor and thus less at risk.
  • The turning off neon signs in the touristic areas is akin to a symbolic measure.

Including the states of emergency and "states of quasi-emergency" (sic) declared, 29 out of 46 prefectures in Japan are affected: the whole Tokyo Greater area, the Tokaido area, Osaka and Kyoto, Hokkaido, Okinawa, etc. In the political spheres, calls to extending the state of emergency to the whole country are increasing, but for what result?

As a consequence, dissatisfaction is growing in the population: a Kyodo survey of August 16 found that the Japanese government received only 32% of the people’s support, and 65% did not want Prime Minister Yoshihide Suga to stay. National elections will take place around October 21 (at the earliest on September 26 and at the latest on November 28) and will decide the next political party to rule the country; a wave of rejection of the ruling politicians is to be expected.

In the meantime, more coercive measures such as lock-downs are not on the agenda as they would require fundamental legislative changes. Meanwhile, the lead is taken at community level, such as in Yokohama where the municipality decided to keep elementary schools closed at the end of summer.

💉 A dawdling and occasionally disrupted vaccination roll out

In mid-August 2021, about 50% of the Japanese population had received at least one dose of vaccine. A reassuring figure after the vaccination campaign started quite late and at a terribly slow pace. The vaccination pace did indeed increase in mid-May after the Golden Week, but fears of doses shortage and several successive holidays in particular have prevented a high and steady pace in injections.

At the time of writing, Japan has not implemented any kind of health pass, and the Covid certificate is only intended for Japanese citizens to avoid the 14-days self-isolation after coming back from a small number of foreign countries (not including the U.S.A., the U.K. and many others who rightfully complain at the lack of reciprocity). When arriving on the Japanese territory, all travelers are handled the same way, be they vaccinated or not.

Amid the summer Delta wave, worldwide figures demonstrate that a widespread vaccination do help avoiding congestion in hospitals, something that is particularly urgent in Japan. Herd immunity is expected in November, but talks about a 3rd dose of Pfizer, Moderna (and maybe Novavax) are underway for the older patients and immunocompromised people, starting in 2022, without consideration for the needs of the less developed countries.

However, at the moment, just booking an appointment to get a shot is already quite the ordeal for the general population in Japan. When one eventually succeeds in getting a date, the delay is often more than one month for the first dose. And do not even think of canceling, unless you are prepared to loose your turn in the roll out!

Lastly, let us make a parallel with a comparable neighboring country : South-Korea, that closed its borders even more tightly and began its vaccination campaign around the same time as Japan. Korean officials failed to ensure sufficient dose supplies and the vaccination progresses have severely slowed down. In the meantime, the country has been facing an uptick in cases and health restrictions had to be increased. As is clear in view of the global cases increase, protectionism and blaming foreigners are nothing but lame arguments regarding the crisis management in Japan!

Updated on August 24, 2021 - La 5ème vague de l’été 2021 a fait perdre au Japon son immunité Covid