NZ Herald
  • Home
  • Latest news
  • Herald NOW
  • Video
  • New Zealand
  • Sport
  • World
  • Business
  • Entertainment
  • Podcasts
  • Quizzes
  • Opinion
  • Lifestyle
  • Travel
  • Viva
  • Weather

Subscriptions

  • Herald Premium
  • Viva Premium
  • The Listener
  • BusinessDesk

Sections

  • Latest news
  • New Zealand
    • All New Zealand
    • Crime
    • Politics
    • Education
    • Open Justice
    • Scam Update
  • Herald NOW
  • On The Up
  • World
    • All World
    • Australia
    • Asia
    • UK
    • United States
    • Middle East
    • Europe
    • Pacific
  • Business
    • All Business
    • MarketsSharesCurrencyCommoditiesStock TakesCrypto
    • Markets with Madison
    • Media Insider
    • Business analysis
    • Personal financeKiwiSaverInterest ratesTaxInvestment
    • EconomyInflationGDPOfficial cash rateEmployment
    • Small business
    • Business reportsMood of the BoardroomProject AucklandSustainable business and financeCapital markets reportAgribusiness reportInfrastructure reportDynamic business
    • Deloitte Top 200 Awards
    • CompaniesAged CareAgribusinessAirlinesBanking and financeConstructionEnergyFreight and logisticsHealthcareManufacturingMedia and MarketingRetailTelecommunicationsTourism
  • Opinion
    • All Opinion
    • Analysis
    • Editorials
    • Business analysis
    • Premium opinion
    • Letters to the editor
  • Politics
  • Sport
    • All Sport
    • OlympicsParalympics
    • RugbySuper RugbyNPCAll BlacksBlack FernsRugby sevensSchool rugby
    • CricketBlack CapsWhite Ferns
    • Racing
    • NetballSilver Ferns
    • LeagueWarriorsNRL
    • FootballWellington PhoenixAuckland FCAll WhitesFootball FernsEnglish Premier League
    • GolfNZ Open
    • MotorsportFormula 1
    • Boxing
    • UFC
    • BasketballNBABreakersTall BlacksTall Ferns
    • Tennis
    • Cycling
    • Athletics
    • SailingAmerica's CupSailGP
    • Rowing
  • Lifestyle
    • All Lifestyle
    • Viva - Food, fashion & beauty
    • Society Insider
    • Royals
    • Sex & relationships
    • Food & drinkRecipesRecipe collectionsRestaurant reviewsRestaurant bookings
    • Health & wellbeing
    • Fashion & beauty
    • Pets & animals
    • The Selection - Shop the trendsShop fashionShop beautyShop entertainmentShop giftsShop home & living
    • Milford's Investing Place
  • Entertainment
    • All Entertainment
    • TV
    • MoviesMovie reviews
    • MusicMusic reviews
    • BooksBook reviews
    • Culture
    • ReviewsBook reviewsMovie reviewsMusic reviewsRestaurant reviews
  • Travel
    • All Travel
    • News
    • New ZealandNorthlandAucklandWellingtonCanterburyOtago / QueenstownNelson-TasmanBest NZ beaches
    • International travelAustraliaPacific IslandsEuropeUKUSAAfricaAsia
    • Rail holidays
    • Cruise holidays
    • Ski holidays
    • Luxury travel
    • Adventure travel
  • Kāhu Māori news
  • Environment
    • All Environment
    • Our Green Future
  • Talanoa Pacific news
  • Property
    • All Property
    • Property Insider
    • Interest rates tracker
    • Residential property listings
    • Commercial property listings
  • Health
  • Technology
    • All Technology
    • AI
    • Social media
  • Rural
    • All Rural
    • Dairy farming
    • Sheep & beef farming
    • Horticulture
    • Animal health
    • Rural business
    • Rural life
    • Rural technology
    • Opinion
    • Audio & podcasts
  • Weather forecasts
    • All Weather forecasts
    • Kaitaia
    • Whangārei
    • Dargaville
    • Auckland
    • Thames
    • Tauranga
    • Hamilton
    • Whakatāne
    • Rotorua
    • Tokoroa
    • Te Kuiti
    • Taumaranui
    • Taupō
    • Gisborne
    • New Plymouth
    • Napier
    • Hastings
    • Dannevirke
    • Whanganui
    • Palmerston North
    • Levin
    • Paraparaumu
    • Masterton
    • Wellington
    • Motueka
    • Nelson
    • Blenheim
    • Westport
    • Reefton
    • Kaikōura
    • Greymouth
    • Hokitika
    • Christchurch
    • Ashburton
    • Timaru
    • Wānaka
    • Oamaru
    • Queenstown
    • Dunedin
    • Gore
    • Invercargill
  • Meet the journalists
  • Promotions & competitions
  • OneRoof property listings
  • Driven car news

Puzzles & Quizzes

  • Puzzles
    • All Puzzles
    • Sudoku
    • Code Cracker
    • Crosswords
    • Cryptic crossword
    • Wordsearch
  • Quizzes
    • All Quizzes
    • Morning quiz
    • Afternoon quiz
    • Sports quiz

Regions

  • Northland
    • All Northland
    • Far North
    • Kaitaia
    • Kerikeri
    • Kaikohe
    • Bay of Islands
    • Whangarei
    • Dargaville
    • Kaipara
    • Mangawhai
  • Auckland
  • Waikato
    • All Waikato
    • Hamilton
    • Coromandel & Hauraki
    • Matamata & Piako
    • Cambridge
    • Te Awamutu
    • Tokoroa & South Waikato
    • Taupō & Tūrangi
  • Bay of Plenty
    • All Bay of Plenty
    • Katikati
    • Tauranga
    • Mount Maunganui
    • Pāpāmoa
    • Te Puke
    • Whakatāne
  • Rotorua
  • Hawke's Bay
    • All Hawke's Bay
    • Napier
    • Hastings
    • Havelock North
    • Central Hawke's Bay
    • Wairoa
  • Taranaki
    • All Taranaki
    • Stratford
    • New Plymouth
    • Hāwera
  • Manawatū - Whanganui
    • All Manawatū - Whanganui
    • Whanganui
    • Palmerston North
    • Manawatū
    • Tararua
    • Horowhenua
  • Wellington
    • All Wellington
    • Kapiti
    • Wairarapa
    • Upper Hutt
    • Lower Hutt
  • Nelson & Tasman
    • All Nelson & Tasman
    • Motueka
    • Nelson
    • Tasman
  • Marlborough
  • West Coast
  • Canterbury
    • All Canterbury
    • Kaikōura
    • Christchurch
    • Ashburton
    • Timaru
  • Otago
    • All Otago
    • Oamaru
    • Dunedin
    • Balclutha
    • Alexandra
    • Queenstown
    • Wanaka
  • Southland
    • All Southland
    • Invercargill
    • Gore
    • Stewart Island
  • Gisborne

Media

  • Video
    • All Video
    • NZ news video
    • Herald NOW
    • Business news video
    • Politics news video
    • Sport video
    • World news video
    • Lifestyle video
    • Entertainment video
    • Travel video
    • Markets with Madison
    • Kea Kids news
  • Podcasts
    • All Podcasts
    • The Front Page
    • On the Tiles
    • Ask me Anything
    • The Little Things
  • Cartoons
  • Photo galleries
  • Today's Paper - E-editions
  • Photo sales
  • Classifieds

NZME Network

  • Advertise with NZME
  • OneRoof
  • Driven Car Guide
  • BusinessDesk
  • Newstalk ZB
  • Sunlive
  • ZM
  • The Hits
  • Coast
  • Radio Hauraki
  • The Alternative Commentary Collective
  • Gold
  • Flava
  • iHeart Radio
  • Hokonui
  • Radio Wanaka
  • iHeartCountry New Zealand
  • Restaurant Hub
  • NZME Events

SubscribeSign In
Advertisement
Advertise with NZME.
Home / World

Covid 19 coronavirus: Testing is key to beating coronavirus, right? Japan has other ideas

By Ben Dooley and Makiko Inoue
New York Times·
2 Jun, 2020 12:21 AM8 mins to read

Subscribe to listen

Access to Herald Premium articles require a Premium subscription. Subscribe now to listen.
Already a subscriber?  Sign in here

Listening to articles is free for open-access content—explore other articles or learn more about text-to-speech.
‌
Save

    Share this article

    Reminder, this is a Premium article and requires a subscription to read.

A doctor demonstrates collecting a nasal swab sample for a Covid-19 test in Tokyo. Photo / Getty Images

A doctor demonstrates collecting a nasal swab sample for a Covid-19 test in Tokyo. Photo / Getty Images

The country has reported fewer deaths than other major nations and ended a state of emergency even while maintaining a low testing rate.

As the world tries to get a handle on the coronavirus and emerge from paralysing lockdowns, public health officials have repeated a mantra: "test, test, test."

But Japan went its own way, limiting tests to only the most severe cases as other countries raced to screen as many people as possible. Medical experts worried that the approach would blind the country to the spread of infection, allowing cases to explode and swamping hospitals.

It hasn't happened. Japan — the greyest country in the world and a popular tourist destination with large, crowded cities — has one of the lowest mortality rates from Covid -19 among major nations. The medical system has not been overwhelmed. And the government never forced businesses to close, although many chose to.

READ MORE:
• Covid 19 coronavirus: Zero new Covid-19 cases for 10 days in row
• Covid 19 coronavirus: Town's anger over dead man's wrong Covid-19 diagnosis
• Covid 19 coronavirus: NZ could be at level 1 by June 10
• Covid 19 coronavirus: Police apologise after failing to act on protection order

Advertisement
Advertise with NZME.

This week, Prime Minister Shinzo Abe declared Japan's battle against the outbreak a resounding success, taking the country off an emergency footing — a sort of "lockdown lite" that lasted only a month and a half.

"By doing things in a uniquely Japanese way, we were able to almost completely end this wave of infection," Abe said, adding that what he called the "Japan model" offered a path out of the global pandemic.

It's still unclear, though, exactly what accounts for Japan's achievement and whether other countries can take lessons from its approach. Critics say Japan undercounted coronavirus deaths. And some warn that further waves of infection could undermine the government's self-congratulatory pronouncements.

Advertisement
Advertise with NZME.

Instead of testing widely to understand and limit the virus' spread through the general population, Japan has focused on quickly containing small outbreaks through contact tracing. Instead of dictating strict constraints on daily life, it has focused on educating people about measures like social distancing and gently prodding them to follow along.

A station passageway is crowded with commuters wearing face mask during a rush hour in Tokyo last week. Photo / AP
A station passageway is crowded with commuters wearing face mask during a rush hour in Tokyo last week. Photo / AP

Theories for the country's relatively low mortality rate run the gamut from cultural attributes — widespread mask wearing, a practice of regular hand washing, a near absence of physical greetings like hugs and handshakes — to just plain luck.

Discover more

World

Tokyo, in a state of emergency, yet still having drinks at a bar

19 Apr 11:45 PM
World

Inside the fringe Japanese religion that claims it can cure Covid-19

22 Apr 08:21 PM
World

It took a pandemic, but 7-Eleven in Japan is letting stores take a break

20 May 07:00 AM
New Zealand

Defence Force deployed 700 personnel in Covid-19 lockdown response

02 Jun 01:34 AM

A combination of many other factors, including government measures and changes in behaviour among a public that feels strong pressure to follow the rules, could also be at work.

Individual actions "may seem small or mundane," said Keiji Fukuda, an epidemiologist who directs the School of Public Health at the University of Hong Kong. But, he added, "the cumulative impact of all of those efforts across the entire country to really implement some kind of distancing" may have been substantial.

Whatever the formula, Japan has so far succeeded in keeping deaths low. The country has recorded fewer than 900 deaths even as the United States and European countries have reported tens of thousands.

Epidemiologists say widespread testing for the virus is important because it allows officials to isolate those who test positive and to track trends in infection rates to help determine when it is safe to reopen schools, businesses and other places where people congregate.

People enjoy food and drink at an izakaya bar in Shinjuku district after the state of emergency ended. Photo / Getty Images
People enjoy food and drink at an izakaya bar in Shinjuku district after the state of emergency ended. Photo / Getty Images

Researchers at Harvard have said the goal should be to test nearly everyone who has at least mild flulike symptoms, as well as an average of 10 contacts for each person who tests positive.

Countries like South Korea and China that faced fast-growing outbreaks early in the pandemic quickly ramped up testing. China performed more than three times as many tests in Wuhan in a single day than those Japan has conducted nationwide since February 18 — about 455,000 tests on around 278,000 people.

Advertisement
Advertise with NZME.

Japan initially told people who suspected they were infected with the virus not to seek help unless they had experienced a fever for four days, or two days if they were over 65. Even some people with seemingly severe symptoms were refused, provoking theories that the government was trying to hide the true extent of the problem.

Medical experts said the guideline was intended to conserve hospital resources. A national law on infectious diseases mandated that anyone who tested positive, even those who were asymptomatic, had to be placed in one of the country's few isolation wards, creating a strong disincentive for doctors to test patients with milder symptoms.

The Japanese government also said early on that test kits must be rationed because they were in short supply. That argument has since faded, however, as Japan has never used even half of its testing capacity on any given day, and it has increased its testing capacity to just over 24,000 a day.

Cleaning escalators in Tokyo. Photo / AP
Cleaning escalators in Tokyo. Photo / AP

Japan has since eased its rules to allow those who test positive but are asymptomatic to stay in hotels. It is preparing to begin limited testing for antibodies, hoping to get a better grasp of the number of people who have been infected. It also plans to introduce a smartphone app to help with contact tracing.

Despite the constrained testing for the virus, the rate of positive results has dropped below 1 per cent, a fact that the government's expert panel on the virus says demonstrates that current testing levels are sufficient.

But a group of prominent Japanese academics, businesspeople and other figures has called on the government to take a much bolder step: build a capacity of 10 million tests a day and offer testing to anyone who wants it. Consecutive negative results, the group argues, could allow people to fully resume social and economic activities.

As the country has seemingly defied the odds, many public health experts, including some in the government, have warned against drawing any definite conclusions from Japan's experience.

They caution that Japan is not in the clear yet and that a second or third wave of infections could strike at any time. As more data on deaths from this year becomes available — there are indications that Tokyo has undercounted dozens of coronavirus deaths — the picture may not look quite as good.

Social distancing at a bank in Tokyo. Photo / Noriko Hayashi, The New York Times
Social distancing at a bank in Tokyo. Photo / Noriko Hayashi, The New York Times

Some say Japan may have a large hidden population of asymptomatic cases. Shigeru Omi, deputy head of the government's expert panel on the coronavirus, told lawmakers that the real number of infections could be as much as 10 or 20 times as high as currently believed. Japan has reported fewer than 17,000 cases, versus more than 1.7 million in the United States.

Norio Sugaya, an infectious diseases expert at Keiyu Hospital in Yokohama, noted that Japan's mortality rate, while vastly lower than those in hard-hit countries like Spain or Britain, is one of the worst in Asia.

In February, an outbreak of the virus aboard the cruise ship Diamond Princess left officials scrambling. The response was widely seen as a disaster, but health experts turned it into a learning opportunity.

Epidemiologists and public health experts used the data from the ship to help develop a framework for stopping the virus' spread in Japan.

The approach emphasised reducing people's exposure to the conditions that led the pathogen to spread on the ship. A public education campaign urged people to avoid the "Three C's" — closed spaces with poor ventilation, crowded places and close contact.

Protective sheeting at a 7-Eleven store in Tokyo last month. Photo / Noriko Hayashi, The New York Times
Protective sheeting at a 7-Eleven store in Tokyo last month. Photo / Noriko Hayashi, The New York Times

On TV talk shows, hosts took a "no question is too stupid" approach to talking about the virus, assuaging viewers' anxiety and stressing the basic science of prevention: wash your hands, wear a mask, keep your distance from others.

At the same time, community health centers raced to investigate clusters using a monitoring system that had been developed to trace cases of influenza and tuberculosis.

Another key factor may have been Abe's decision to close schools in late February, well before almost any other country. The decision was hugely unpopular, but it appears to have provoked an almost instantaneous change in behavior, according to polling conducted by researchers at Hiroshima University.

The day after the announcement, the percentage of people who were avoiding crowded places nearly doubled, rising to almost 60 per cent. By mid-March, it was over 75 per cent, the study found.

In April, as cases began to spike, Abe declared a state of emergency. Businesses were requested to close or reduce their hours. People were asked to make only necessary trips. There were no penalties, but many complied anyway.

Makoto Sasho, 50, decided to close his grilled eel restaurant in the Meguro neighbourhood of Tokyo and focus on delivery and carryout, despite assurances from the government that businesses like his could continue table service.

"We conformed to society's expectations of us," he said, adding that "when I thought about the future, I knew we absolutely could not be responsible for a cluster."

As Japan now begins to reopen, some experts fear that people will begin to let down their guard.

In a speech Monday night, Abe emphasised that the end of the state of emergency did not mean a return to normal life.

"What we need to aim for," he said, "is establishing a new normal.

Sasho said that his customers were clamouring for him to reopen but that he was not sure he was ready.

"It's a new way of life," he said. "Maybe I'll just stick with delivery and takeout."


Written by: Ben Dooley and Makiko Inoue
Photographs by: Noriko Hayashi
© 2020 THE NEW YORK TIMES

Save

    Share this article

    Reminder, this is a Premium article and requires a subscription to read.

Latest from World

World

Released protest leader sues Trump Administration for $33m

11 Jul 02:57 AM
World

Bull sharks keep warming to Sydney's waters

11 Jul 02:29 AM
World

In Brazil, Trump faces a country — and a leader — ready for a fight

11 Jul 02:01 AM

From early mornings to easy living

sponsored
Advertisement
Advertise with NZME.

Latest from World

Released protest leader sues Trump Administration for $33m

Released protest leader sues Trump Administration for $33m

11 Jul 02:57 AM

The Columbia graduate was held in an immigration centre despite being a legal resident.

Bull sharks keep warming to Sydney's waters

Bull sharks keep warming to Sydney's waters

11 Jul 02:29 AM
In Brazil, Trump faces a country — and a leader — ready for a fight

In Brazil, Trump faces a country — and a leader — ready for a fight

11 Jul 02:01 AM
Top Ukrainian officer killed in Kyiv

Top Ukrainian officer killed in Kyiv

11 Jul 01:00 AM
Solar bat monitors uncover secrets of Auckland’s night sky
sponsored

Solar bat monitors uncover secrets of Auckland’s night sky

NZ Herald
  • About NZ Herald
  • Meet the journalists
  • Newsletters
  • Classifieds
  • Help & support
  • Contact us
  • House rules
  • Privacy Policy
  • Terms of use
  • Competition terms & conditions
  • Our use of AI
Subscriber Services
  • NZ Herald e-editions
  • Daily puzzles & quizzes
  • Manage your digital subscription
  • Manage your print subscription
  • Subscribe to the NZ Herald newspaper
  • Subscribe to Herald Premium
  • Gift a subscription
  • Subscriber FAQs
  • Subscription terms & conditions
  • Promotions and subscriber benefits
NZME Network
  • The New Zealand Herald
  • The Northland Age
  • The Northern Advocate
  • Waikato Herald
  • Bay of Plenty Times
  • Rotorua Daily Post
  • Hawke's Bay Today
  • Whanganui Chronicle
  • Viva
  • NZ Listener
  • Newstalk ZB
  • BusinessDesk
  • OneRoof
  • Driven Car Guide
  • iHeart Radio
  • Restaurant Hub
NZME
  • About NZME
  • NZME careers
  • Advertise with NZME
  • Digital self-service advertising
  • Book your classified ad
  • Photo sales
  • NZME Events
  • © Copyright 2025 NZME Publishing Limited
TOP