The Japan Model: A tricky yet sustainable strategy in the battle against COVID-19

Despite recent criticisms, Japan’s cluster-based approach to combat COVID-19 has some significant lessons to offer, especially to countries struggling with hard lockdown measures.

By Avantika Deb

Since the beginning of the COVID-19 outbreak in early 2020, Japan has adopted some unique measures to prevent the spread of the infection. Contrary to strict lockdown measures like the ones implemented by authorities in China and several European countries, Japan has relied majorly on contact tracing and a cluster-based containment approach. This approach worked well for several months, although a third wave since the end of October has been more difficult to contain. Nevertheless, the so-called ‘Japan Model’ has been mostly lauded as effective and its merits are noteworthy.

The model posits that an increase in the number of infections happens due to the high transmissibility of certain infected individuals (only about 20-30 percent), which forms a cluster. Infected individuals with even higher transmissibility appear from these clusters to form more clusters and infect more people. Japanese authorities have thus undertaken a cluster-based approach where each cluster is tracked to the original infection source and individuals with high transmissibility are isolated. Hence, pin-point testing is carried out rather than mass testings like the ones undertaken by many other countries. A key aspect of this approach is widespread contact tracing; this is carried out by highly trained nurses who have performed tracing for other infectious diseases such as measles and tuberculosis over the years. In several European countries and the United States (US), on the contrary, contract tracing is often done by non-professionals. Moreover, in addition to prospective contact tracing, which is the norm in most countries including the US and India, Japanese officials are also doing retrospective contact tracing in order to identify the source of the infection to understand who else might have been infected simultaneously as part of a cluster. 

Another key feature of the Japanese approach l is a social distancing method which urges people to avoid the ‘three Cs’ – closed spaces, crowded places and close contact situations. Societal norms and practices followed by the Japanese people have contributed greatly to the success of the government’s COVID strategy. Instead of issuing hard lockdown measures, authorities have resorted to advising businesses to close early and for the public to avoid unnecessary travel, and this has largely been adhered to. People are also cautious about wearing masks and maintaining good hygiene. Behaviours like shaking hands, hugging and other types of physical contact are not part of traditional Japanese greetings. Conversing onboard crowded trains is also considered poor etiquette. 

However, despite its initial successes, Japan’s approach has been deemed to have its own set of challenges as pointed out by critics. Some members of the health ministry advisory panel have remarked that the ‘cluster-busting’ approach was nearing its limit following the third wave of infections which saw around 2,000 cases nationwide in late November 2020. The situation differed from the previous two waves as the variety of clusters became much wider. Earlier, most clusters occurred in the night entertainment districts and were easier to detect and contain, but the latest clusters have been found in a variety of places including healthcare facilities, workplaces and foreign communities. According to some experts, the issue is that cluster-busting is mostly effective in containing local outbreaks where infections have not spread widely. Thus the model seems to be working less efficiently amid a great surge in the number of infections. However, it has also been pointed out that the cluster-based approach always assumed that a significant and unaccounted rise in infections would require stronger government measures. The new measures should aim at reducing the number of new hospitalisations so that the cluster-based approach can be reactivated. Perhaps for this reason, the government continues to maintain a state of emergency over Tokyo, Chiba, Saitama, Kanagawa, Okinawa and several other prefectures, as well as tight entry restrictions for returning citizens and residents. Further tough measures may be necessary should the case numbers continue to rise beyond control. 

Although the cluster-based Japan Model has its limitations, it definitely has lessons to offer to countries that are struggling with soaring case numbers and hard lockdowns. Perhaps its greatest achievement is that it allows a decent level of economic activity and freedom of movement which makes it a much more sustainable model than the ones in other countries that have resorted to highly restrictive measures that have triggered economic distress among people. As rightly clarified by the government’s virus expert committee head Dr. Shigeru Omi, Japan has adopted a strategy that requires continuous control rather than pursuing a rushed return to normalcy. 

Avantika Deb is an India-based political and security risk analyst covering East Asia and Oceania.

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