COVID-19 : the “Sweden of Asia”

Jean-François Cliche
The Sun

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17 June 2020 11: 03

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COVID-19 : the “Sweden of Asia”

SCIENCE DAILY / “Why Japan has there been so few confirmed cases and deaths linked to the COVID-19 compared to Canada, yet has only one-third of the population of Japan ?”, request Michel Jacob, of Trois-Rivières.

The last I heard, Japan had not yet reached the cap of 18 000 cases and 1000 deaths. It is actually much less than the approximately 100 000 confirmed cases and over 8000 deaths were reported in Canada. Pro-rata to the population (127 million in Japan, $ 38 million in Canada), the contrast is even more striking : 141 cases and 8 deaths per million in Japan, compared to 2630 and 210 here. And this is without saying anything of Quebec : 6350 confirmed cases and 616 deaths per million.

As we have already seen in this topic, it is always difficult to compare statistics between different countries or provinces because the screening efforts and the definitions of “death-related/caused by the COVID-19” are not the same everywhere. Moreover, the prime minister of japan Shinzo Abe has been criticized in the beginning of the pandemic because his country was relatively little testing, “beyond” and many cases. Then it is possible that a part of the outbreak, has passed unnoticed since the latest available data about mortality (from all causes) were approximately 1,000 more deaths than usual, just in the capital, Tokyo, reported the agency Bloomberg last week. Wherever the epidemic has struck, there has been a significant increase in general mortality. So maybe, well, yes, that the extent of the damage was a little under-estimated in Japan.

But there was clearly not just dealing with a sleight-of methodology, here. The excess mortality from April to Tokyo, yet the city of the hardest hit areas of the country, was only about 12 % above the average of the last four years, and 7 % higher than the number of deaths occurring in April 2019. It is much, much less worse than in countries that have been hardest hit by the COVID-19. In England and Wales, for example, the excess mortality exceeded 100 % in the second half of April, at the height of the epidemic. If Japan had “looked elsewhere” by limiting the testing, the stats in general mortality would have easily revealed the entourloupe. You can see here that this was not (or little) the case.

So why the sars coronavirus has there been so much evil to spread there ? Japan is a case very intriguing, it must be said : a kind of “Sweden of Asia”, in the sense that the Abe administration has not imposed a containment of solid and mandatory, as it is elsewhere. A state of emergency has been declared, but nothing that approached what we experienced here — no legal restriction in the movements of the population, most of the shops remained open, etc

Except that… After a promising start, Sweden is placed among the countries where there are the most of death each day : it is mounted up to 10 daily deaths per million inhabitants and was always on top of 3 all the latest news. Japan has never exceeded the 0.25 death per million per day, and keeps very close to absolute zero for several weeks.

It will perhaps never be fully certain of the explanation, but we can say two things about it. The first is that we often hear about Sweden, Japan and other countries, “without containment” and as if almost everyone there had continued its daily routines as if nothing had happened. However, this is not true. The Swedes have greatly reduced their movements from mid-march, showed data mobility from Google. Not as much as in other countries (the use of public transit, for example, has decreased by approximately 40 %, whereas it was 80 % in Quebec) and they resumed normal earlier, but still : they have applied a form of enclosure voluntary.

The second thing to know is that this little “game”, the Japanese seem to have been more disciplined than the Swedish. They have decreased their use of public transport by 50 % and have maintained this behavior for a longer time. Same thing with the attendance of places of “recreation” (restaurants, cafes, shopping centres, attraction parks, etc) : decline of 25 % in Sweden versus 40% in Japan (and for longer). Many businesses have suffered, also.

A study published this month in the scholarly journal PLoS – One has shown that the Japanese have massively changed their behaviour. For example, 70 % of them say “always wear a mask when they leave their homes (the study surveyed the population at the end of march). By comparison, the house of Gallup poll has found that at the beginning of April, only half of Americans had already put a mask (if only once) of leaving the house.

In addition, note the authors of the study, “it is well known that the Japanese greet each other by lowering the head instead of shake hands, kiss or shake in his arms. This cultural habit reduces the frequency of bodily contacts of the Japanese compared to other cultures. During the hayfever season, the Japanese wear regular masks style surgical to prevent the symptoms […]. These practices already in place have been able to help the citizens of Japan to change their behaviours in these times unusual”.

Two observers of japanese politics have come to similar conclusions recently in Tokyo Review : if the COVID-19 is not able to get a foothold in Japan, this is not due to the measures relatively low catches by the central government, but thanks to the behaviour spontaneously and widely adopted by the population.

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