Passengers from China's Hong Kong Special Administrative Region are on their way to take the chartered flight at Haneda International Airport in Tokyo, Japan, Feb. 20, 2020.
Many predicted Japan would be hit hard by coronavirus, but the country has been relatively unscathed.
Some chalked that up to the culture of mask-wearing which is already prevalent.
Others said it was the government's clear messaging about avoiding closed spaces, crowded places, and close-contact settings that saved Japanese residents.
Some experts say Japan may not be as successful as we think, and there may be significant instances of under-reporting.
When the pandemic hit, experts predicted that Japan would be hit hard by the virus, with some saying 400,000 residents could die.
The country didn't enforce any shutdowns, only tested 0.2% of its population, and was slow to cancel the summer Olympics, even as the countries slated to participate in the Olympics went into shutdown. Japan did not employ surveillance technology the way China and Singapore did, and it did not employ wide-scale testing the way South Korea did.
And yet, although at least 26% of Japan's population is over the age of 65, and at higher risk of getting sick with coronavirus, most did not get sick.
The country of 126 million people has declared its nationwide state of emergency over, and many are saying their success story was due to the Japanese government's messaging. Instead of social distancing, the government exhorted the public to avoid the three Cs, referring to closed spaces, crowded places, and close-contact settings.
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Some say the secret to Japan's success is a mystery
"Just by looking at death numbers, you can say Japan was successful," said Mikihito Tanaka, a professor at Waseda University, told Bloomberg. "But even experts don't know the reason."
A list of reasons for Japan's success story is circulating around the web, including Japan's culture of mask-wearing, lower rate of obesity, push to close schools early and one claim that Japanese speakers emit less viral droplets than other languages.
There are cultural factors at play: Japan is a less touchy-feely nation than places like the United States, is known for its cleanliness, and has a dedicated public health system.
But most experts say there is really no knowing why Japan wasn't devastated by the virus, and we likely will not know until the pandemic ends.
Japan acted earlier than other countries
One thing that is clear is that Japan's early reaction to the virus, prompted by the infection spread on the Diamond Princess cruise ship, was crucial in ensuring that the country knew the disease was not some far-off problem, and could affect them, journalists Lisa Du and Grace Huang wrote in Bloomberg.
They also pointed out to Japan's robust network of contract tracers that began tracking the disease in January, as well as the possibility that the strain of virus may have been less dangerous than the version that spread to Europe and America, which may have already mutated.
What's more, Japan closed schools and suspended sporting events long before other countries.
Those government interventions, coupled with collective action by the public, made a difference, write Rob Fahey and Paul Nadeau in The Tokyo Review.
Why Japan took the 3 Cs approach instead of a lockdown
The three Cs approach, which Japan took instead of enforcing shutdowns or social distancing orders, involves avoiding closed spaces with poor ventilation, crowded places with groups of people nearby, and close-contact settings, like one-on-one conversations in close range.
The three Cs method leaves individual decisions about where to go and what kind of risks to take up to the individual, minimizing the effects of the virus while allowing life to continue, albeit in limited fashion.
"We need to create a new lifestyle from now on," Japan's Prime Minister Shinzo Abe said in a Monday press conference. "We need to change our way of thinking."
In the United States, the lockdown methods have been framed as extreme, temporary procedures, while in Japan, the three Cs approach has been framed as a new, permanent lifestyle choice for Japan's residents. This may bode well for the long-term sustainability of three Cs approach.
Is it too good to be true?
While many experts are lauding Japan for its decentralized, bottom-up approach, others have their doubts that it even worked. "The Japan conundrum is just the fact that if you don't test for it, you're not going to find a lot of cases," Jason Kindrachuk, assistant professor of viral pathogenesis at the University of Manitoba, previously told Business Insider.
The World Health Organization's former chief of health policy Kenji Shibuya told Bloomberg that Japan either has "contained the spread by focusing on outbreak clusters, or ... there are outbreaks yet to be found."
Japanese citizens are not best pleased with Prime Minister Abe's response to the virus, according to a recent survey, cited by The Tokyo Review. Abe received a worse rating from his own citizens than any other leader in the world, including President Donald Trump and Prime Minister Boris Johnson, whose nations have the highest COVID-19 death tolls in the world.
Yet some Japanese residents are praising the three Cs system.
"The model allows for a certain level of economic activity and maintains people's freedom to move about, and as such is more sustainable over the long term than more burdensome models such as lockdowns," Kazuto Suzuki, professor of International Politics at the Public Policy School of Hokkaido University, told the Diplomat.
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