Lessons Learned from Japan’s Response to the First Wave of COVID-19: A Content Analysis

Abstract

While the epidemiological impact of the coronavirus disease 2019 (COVID-19) pandemic has been relatively moderate in East-Asian countries, the pandemic has significantly impacted on citizens’ lives and livelihoods, and Japan is no exception. In the early phase of the COVID-19 pandemic, Japan managed unprecedented quarantines and realized the difficulty of controlling COVID-19, finally recording a relatively high number of deaths per million in the Western Pacific region. However, scant research has highlighted the distinctive features of Japan’s reaction and the challenges encountered. To clarify these points and examine Japan’s first response to COVID-19, we performed a content analysis. Minutes of expert meetings were analyzed from multiple viewpoints, including epidemiology, health systems, border control, and health communication. The obscure evolution of the testing strategy, the usefulness of retrospective contact tracing, the rapid scientific risk assessment, a sluggish expansion of health system capacity and response in border control, and misunderstanding between risk communication and crisis communication are made evident by our analysis. Examining previous responses and gathering lessons learned in each country will improve global responses to COVID-19 and strengthen regional health security. Therefore, while investing in public health and ensuring transparency, Japan needs to clarify the previous decision-making process of each countermeasure towards COVID-19.

Workplace measures against COVID-19 during the winter third wave in Japan: company size-based differences

“…A state of emergency was first declared in some areas of Japan on April 7, 2020; this declaration was later extended to the entire country until May 25, 2020. 3 Although Japan did not impose a mandatory lockdown, many companies followed the voluntary-basis request from the government during the period, which included temporary closures and restrictions on business. 4 One reason for the relatively low COVID-19 infection rate in Japan may be the corporate infection control efforts in the workplace.…”

Early COVID‐19 testing is critical to end the pandemic

“…While many countries gravely expanded the testing capacity for diagnosing COVID‐19, citizens’ access to testing had not been adequately ensured in Japan 2,3 . Although the infectiousness among asymptomatic and presymptomatic individuals had been recognized in earlier phase, patients suffered from COVID‐19–related symptoms were generally instructed to stay home for 4 days in early 2020 2 .…”

“…While many countries gravely expanded the testing capacity for diagnosing COVID‐19, citizens’ access to testing had not been adequately ensured in Japan 2,3 . Although the infectiousness among asymptomatic and presymptomatic individuals had been recognized in earlier phase, patients suffered from COVID‐19–related symptoms were generally instructed to stay home for 4 days in early 2020 2 . Even after lifting the state of emergency in May, Japan made insufficient efforts to ramp up its testing capacity and logistics, and some professional societies still argue that self‐isolation at home must be prioritized compared with early testing (Table 1).…”

“…Nevertheless, negative results were excessively conceptualized as whether investing in public health infrastructure and bolstering COVID‐19 tests will bring several disadvantages. Lack of knowledge and critical thinking among some HCWs, absence of their independent drive to learn from the multidisciplinary science, insufficiency of scientific journalism, and weakness in health communication 2 perplexingly brought the distorted science to the public.…”

“…The ongoing COVID‐19 pandemic explicitly suggested that policymakers and even some scientists sometimes ignored, cherry‐picked, and distorted science. Japan has been no exception 2 . Without examining previous errors and getting appropriate feedback, the same mistakes will be repeated, thus magnifying patients’ risk.…”