How Asia reopened after COVID, #5: Japan's fight highlights potential harm of domestic travel

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With B.C. now looking at a potential slow opening of the economy as soon as mid-May after the COVID-19 outbreak peaks, what may the path forward look like - and what are the potential pitfalls?

As COVID-19 first struck Asia in February, many Asian countries are now dealing with those questions as they are about 1-2 months ahead of the Canadian pandemic timeline. As such, Business in Vancouver is taking a closer look at a number of countries in Asia on how they dealt with the same re-opening questions that are now facing B.C.

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With B.C. premier John Horgan announcing people may be able to go to their local provincial parks for Victoria Day long weekend, some people may consider taking it a step further and making short trips - either to one of the islands or into vacation homes in several resort communities.

The dangers of travel, however, should not be underestimated even without the crossing of an international border. That’s the lesson offered by Japan, one of the few countries in Asia large enough geographically to offer Canadians an idea of what domestic travel patterns can feed the COVID-19 outbreak.

Japan originally had low COVID-19 case numbers when one looks at the country’s 120-million-plus population, many crammed into some of the highest-density cities in the world. New daily cases stayed below 100 until March 27, and no national state-of-emergency was declared until April 16.

Tsutomu Ishiai, deputy managing editor at Asahi Shimbun (one of Japan’s national newspapers), remembered back to March 20 - the Vernal Equinox Day that signalled the coming of spring every year. The day is a major holiday in Japan.

“During that time, that’s when we have a lot of our cherry blossoms,” Ishiai said. “So people wanted to be outside and have picnics, drinking sake under the trees. That wasn’t prohibited by the government at that moment, so people went out.”

Jeff Reeves, vice president of research at the Asia Pacific Foundation of Canada, said that was around the time when Japan’s rural areas started reporting seeing the usual crowds from urban centres like Tokyo and Osaka, even as the danger of COVID-19 wasn’t clear on the general public.

That, combined with a lack of aggressive testing for the virus in January, February and March, created a dangerous mix of unknowing carriers moving about the country - coming into contact with other people who did not know COVID-19 had stealthily arrived.

“We’ve seen instances [in Asia] where information has been less forthcoming, and here, I point to the Japanese model,” Reeves said. “Japan has not pushed forward as aggressively on testing, and a lot of people are looking around to see if the pandemic there is much more severe than they know at this point because the government has taken that approach.”

By April 4 - two weeks after Vernal Equinox - daily cases of COVID-19 jumped to 351. More concerning may be the fact that infection rates were not only highest in metropolitan areas like Tokyo and Osaka, but in more rural prefectures like Ishikawa and Hokkaido, as well. The spike led to Japanese prime minister Shinzo Abe announcing a 7-prefecture state-of-emergency on April 7, then expanding it nationwide on April 16.

In May, the daily new COVID figures have finally shown steady decreases, falling to 109 on May 6 after peaking at 743 on April 11. There are also currently 577 deaths among a population that leans heavier on older demographics - the group most vulnerable to the novel coronavirus.

“We conducted a poll on April 21, and it showed people were happy that the government expanded the emergency measures nationwide,” Ishiai said. “But at the same time, when it comes to Mr. Abe’s initial announcement of a state-of-emergency for the seven areas around Tokyo and Osaka, people see it as being a little too late. People thought it should have been done before.”

Reeves and Ishiai agree that one of the most likely reasons Tokyo did not act sooner to clamp down on the disease was because of the 2020 Summer Olympics, which were originally slated to be held in Tokyo in July. Many observers say the Olympics was even more substantial an event for Japan and Abe than it is usually, mostly because Tokyo intended the Games’ global spotlight to signal Japan’s return as a major international player and a resurgent economic giant.

“There was a underestimation of how serious COVID was, and I do believe that was a political choice,” Reeves said. “… The state and companies made a massive investment to develop good infrastructure around the Olympics. Of course, they wanted to achieve a return on their investment, whether it’s in monetary value or with Japan’s foreign policy. So they wanted to push ahead with the Olympics if possible. In the early days, it led to less of sense that this [COVID] was a national crisis than there is right now.

“Ultimately, that is going to put huge pressure on local health care centres - which are not as well developed as the ones in metropolitan areas. So those local hospitals saw a surge of patients and strained resources; had Japan been more proactive earlier on, I believe they could be in a better position than where they are right now.”

Another reason for the lack of testing, Reeves noted, was Japanese law requiring that - if they test positive - patients be hospitalized in a mandatory fashion. That would tax a health system that’s already stretched in some regions of Japan, he said.

Ishiai added that - instead of reaffirming Japan’s re-emergence - the Olympics (and the related botched effort to respond to COVID quickly) exposed a number of weaknesses in the Japanese economy despite Abe’s “Abenomics” stimulus plan in place since 2012.

“I think prime minister Abe was trying to deliver a message to the Japanese people - and to the world - by utilizing the Olympics,” Ishiai said. “But that kind of image is almost an illusion; the economy is shrinking, the population is shrinking, and we rely fairly heavily on inbound tourism - mainly from China. And it showed during this crisis; because it showed what happens when visitors stop coming to Japan. Just having an Olympics wouldn’t change that.”

Japanese officials have now taken the lesson to heart, clamping down on travel during “Golden Week” - a stretch from April 29 to May 6 that’s often the height of Japanese domestic tourism. The coming weeks will determine if Japan’s new measures - even though Tokyo technically cannot enforce the lockdown and relies on social peer pressure for citizens to comply - were successful in flattening the second wave.

As for a reopening date? Most Japanese aren’t thinking that far ahead, Ishiai noted.

“This is really the time to measure how effective the semi-lockdown has been,” Ishiai said. “Japanese authorities do not have the power to shut things down completely like what you see in Italy or New York, so people still have the freedom to get out - although most shops are closed. Also, not all the companies are allowing employees to work from home; many smaller businesses simply do not have that capacity right now. 

“So I think government is thinking about the best balance in economy and health, but at this moment, we are on the verge of medical collapse,” he added. “We are really on the edge, so people are paying more attention towards keeping medical systems effective in preparing for any big outbreak. The idea that we need to take care of the people’s health before thinking about reopening is prevailing among the people.”