Oshitani says riders are usually alone and not talking to other passengers. (Reassuringly, they did not trace any clusters to Japan's notoriously packed commuter trains. But, "This has been the most important component of the strategy," Oshitani says. This led them to urge people to avoid what they dubbed the "three Cs"-closed spaces, crowds, and close-contact settings in which people are talking face-to-face. "It is impossible to stop the emergence of clusters just by testing many people," Oshitani says. They also concluded that most of the primary cases that touched off large clusters were either asymptomatic or had very mild symptoms. Not surprisingly, they found that most clusters originated in gyms, pubs, live music venues, karaoke rooms, and similar establishments where people gather, eat and drink, chat, sing, and work out or dance, rubbing shoulders for relatively extended periods of time. "We try to identify the clusters and their common characteristics." Then, whereas much of the rest of the world built its response to the pandemic on widespread contact tracing, isolation, and testing, Japan adopted a "quite different" strategy, Oshitani says. Eventually, 712 of the 3711 people on board tested positive for the novel coronavirus 14 died. Japan got off to a bad start dealing with the pandemic when it quarantined the Diamond Princess cruise ship for 2 weeks in Yokohama after passengers were infected with COVID-19. Although the government may consider reimposing restrictions, he believes "we can manage these smaller outbreaks." "I'm expecting small outbreaks from time to time," he says. He credits the public's cooperation with stay-at-home directives and the fortuitous timing of the emergency.ĭespite the lifting of the emergency, the outbreak "is not over," says Hitoshi Oshitani, a virologist and public health expert at Tohoku University. Japan has prevented an outbreak "on the scale seen in many Western countries," says Kenji Shibuya, a global health specialist at King's College London who previously warned of undetected community spread. The positive outcome has even convinced some skeptics of the nation's cluster strategy. At yesterday's press conference, Abe noted the number of hospitalized COVID-19 patients has dropped from 10,000 about 1 month ago to 2000.
The number of daily new cases peaked at 743 on 12 April but has varied between 90 and 14 for the past week, according to the World Health Organization. "With this unique Japanese approach, we were able to control this trend in just 1.5 months I think this has shown the power of the Japanese model," Prime Minister Shinzo Abe declared at a press conference yesterday evening announcing the lifting of the state of emergency. Instead, the country focused on finding clusters of infections and attacking the underlying causes, which often proved to be overcrowded gathering spots such as gyms and nightclubs. It drove down the number of daily new cases to near target levels of 0.5 per 100,000 people with voluntary and not very restrictive social distancing and without large-scale testing. Japan yesterday declared at least a temporary victory in its battle with COVID-19, and it triumphed by following its own playbook. Science' s COVID-19 reporting is supported by the Pulitzer Center.