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Japan divided over coronavirus control

Posted By on March 9, 2020 @ 14:46

If the Japanese government’s performance in dealing with the threat of the novel coronavirus Covid-19 is any indication, the upcoming Tokyo Olympic Games are doomed to fail even before they begin. Prime Minister Shinzo Abe is preparing emergency 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.

The scary truth is that no one is in charge of managing Japan’s response to the coronavirus.

Bureaucrats have failed to put together a competent team or provide transparent reports about decision-making processes. Meanwhile, political leaders have made 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 focusing 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’s little detailed symptom data available from authorities and 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 taskforces and meetings convened by the prime minister’s office, the cabinet office, the ministries 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 authorities from implementing a desperately needed nationwide effort that includes the best experts from academia, research centres and industry. The National Center for Global Health and Medicine—one of the main research centres for infectious diseases—wasn’t invited to be part of a crucial taskforce [1]. There have also been delays in rolling out favipiravir, the antiviral drug being developed by Fujifilm that could be effective [2] against the virus, because it was approved only as a treatment for influenza and not Covid-19.

Lessons learned from past crises in Japan such as the 2011 tsunami and Fukushima nuclear 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 addressing domestic issues rather than on building global networks. The recommendations [3] from the first-ever independent investigation committee of the Diet haven’t improved the system, and nor have they 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 diagnosis kits and to handle testing because it sits under the Health Ministry’s supervision. But NIID is not the most productive device maker and its testing method takes at least six hours to produce a result. The institute originally had the capacity to conduct only 200 tests per day. It was able to increased that 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 faster testing devices in late February.

The authorities could have turned to the private sector for help from the beginning; there are many efficient device makers in Japan that 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 even hysteria in foreign media coverage of Japan’s response to the crisis. 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 Olympics.

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URLs in this post:

[1] taskforce: https://www.kantei.go.jp/jp/singi/novel_coronavirus/senmonkakaigi/konkyo.pdf

[2] effective: https://www.nature.com/articles/s41422-020-0282-0

[3] recommendations: https://www.cas.go.jp/jp/seisaku/icanps/eng/final-report.html

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