Did Japan Just Beat the Virus Without Lockdowns or Mass Testing?

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Japan’s state of emergency is nearing its end with new cases of the coronavirus dwindling to mere dozens. It got there despite largely ignoring the default playbook.

No restrictions were placed on residents’ movements, and businesses from restaurants to hairdressers stayed open. No high-tech apps that tracked people’s movements were deployed. The country doesn’t have a center for disease control. And even as nations were exhorted to “test, test, test,” Japan has tested just 0.2% of its population — one of the lowest rates among developed countries.

Yet the curve has been flattened, with deaths well below 1,000, by far the fewest among the Group of Seven developed nations. In Tokyo, its dense center, cases have dropped to single digits on most days. While the possibility of a more severe second wave of infection is ever-present, Japan has entered and is set to leave its emergency in just weeks, with the status already lifted for most of the country and likely to exit completely as early as Monday.

23,790 in U.S.Most new cases today

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-4.​8% Global GDP Tracker (annualized), April


Analyzing just how Japan defied the odds and contained the virus while disregarding the playbook used by other successful countries has become a national conversation. Only one thing is agreed upon: that there was no silver bullet, no one factor that made the difference.

“Just by looking at death numbers, you can say Japan was successful,” said Mikihito Tanaka, a professor at Waseda University specializing in science communication, and a member of a public advisory group of experts on the virus. “But even experts don’t know the reason.”

One widely shared list assembled 43 possible reasons cited in media reports, ranging from a culture of mask-wearing and a famously low obesity rate to the relatively early decision to close schools. Among the more fanciful suggestions include a claim Japanese speakers emit fewer potentially virus-laden droplets when talking compared to other languages.

Contact Tracing

Experts consulted by Bloomberg News also suggested a myriad of factors that contributed to the outcome, and none could point to a singular policy package that could be replicated in other countries.

Nonetheless, these measures still offer long-term lessons for countries in the middle of pandemic that may yet last for years.

An early grassroots response to rising infections was crucial. While the central government has been criticized for its slow policy steps, experts praise the role of Japan’s contact tracers, which swung into action after the first infections were found in January. The fast response was enabled by one of Japan’s inbuilt advantages -- its public health centers, which in 2018 employed more than half of 50,000 public health nurses who are experienced in infection tracing. In normal times, these nurses would be tracking down more common infections such as influenza and tuberculosis.

“It’s very analog -- it’s not an app-based system like Singapore,” said Kazuto Suzuki, a professor of public policy at Hokkaido University who has written about Japan’s response. “But nevertheless, it has been very useful.”

While countries such as the U.S. and the U.K. are just beginning to hire and train contact tracers as they attempt to reopen their economies, Japan has been tracking the movement of the disease since the first handful of cases were found. These local experts focused on tackling so-called clusters, or groups of infections from a single location such as clubs or hospitals, to contain cases before they got out of control.

“Many people say we don’t have a Centers for Disease Control in Japan,” said Yoko Tsukamoto, a professor of infection control at the Health Sciences University of Hokkaido, citing a frequently held complaint about Japan’s infection management. “But the public health center is a kind of local CDC.”

Burning Car

The early response was also boosted by an unlikely happening. Japan’s battle with the virus first came to mainstream international attention with its much-criticized response to the Diamond Princess cruise ship in February that led to hundreds of infections. Still, the experience of the ship is credited with providing Japanese experts with invaluable data early in the crisis on how the virus spread, as well as catapulting it into the public consciousness.

Other countries still saw the virus as someone else’s problem, said Tanaka. But in Japan, the international scrutiny over the infections onboard and the pace at which the virus raced throughout the ship raised awareness and recognition that the same can happen across the country, he said. “For Japan, it was like having a burning car right outside your house.”

For more on Japan’s response to the virus:
  • Japan Could Lift Emergency in Tokyo as Soon as Monday
  • Japan Welcomed Foreign Workers Then Left Them in Covid-19 Limbo
  • Tokyo Mortality Data Shows No Jump in Deaths During Pandemic
  • Tokyo Head Sees Olympics Canceled if Virus Isn’t Under Control
  • Who’s Succeeding Against the Coronavirus and Why: QuickTake

Although political leadership was criticized as lacking, that allowed doctors and medical experts to come to the fore -- typically seen as a best practice in managing public health emergencies. “You could say that Japan has had an expert-led approach, unlike other countries,” Tanaka said.

Experts are also credited with creating an easy-to-understand message of avoiding what are called the “Three C’s” -- closed spaces, crowded spaces and close-contact settings -- rather than keeping away from others entirely.

“Social distancing may work, but it doesn’t really help to continue normal social life,” said Hokkaido University’s Suzuki. “The ‘Three C’s’ are a much more pragmatic approach and very effective, while having a similar effect.”

Different Strain

Infectious disease experts also pointed to other determinants, with Shigeru Omi, the deputy head of the expert panel advising the Japanese government and a former chief of the WHO Western Pacific office, citing Japanese people’s health consciousness as possibly the most important factor.

The possibility that the virus strain spreading in Japan may have been different, and less dangerous, to that faced by other nations, has also been raised.

Researchers at the Los Alamos National Laboratory in the U.S. studied coronavirus variants in a database and found one strain of the virus spreading through Europe that had several mutations distinguishing it from the Asian version, according to a paper put in early May. Although the study has not been peer-reviewed and drawn some criticism, the findings point to a need to more thoroughly study how the virus changes.

Large questions still remain over the true extent of the pathogen’s spread. In April, a Tokyo hospital conducted tests on a handful of non-Covid patients and found that around 7% had the coronavirus, showing the danger of missing asymptomatic or mild carriers that can become the source of an outbreak. An antibody test on 500 people in the capital suggested the true outbreak could be nearly 20 times larger than figures have shown. Analog contact tracing breaks down when infection numbers are high, and reports of people unable to get tested or even medical treatment for Covid-like symptoms peppered social media during the height of the outbreak.

And the fact remains that Japan’s response was less than perfect. While the overall population is much smaller, Asian neighbors such as Taiwan had just seven confirmed deaths from the virus, while Vietnam had none.

“You can’t say the Japan response was amazing,” said Norio Sugaya, a visiting professor at Keio University’s School of Medicine in Tokyo and a member of a World Health Organization panel advising on pandemic influenza. “If you look at the other Asian countries, they all had a death rate that was about 1/100th of Western countries.”

Buying Time

While Japan may have avoided the worst of the health outcomes, the loose lockdown hasn’t protected the country from the economic impact. Its economy, already dealing with the impact of a sales tax hike in October, officially slid into recession in the first three months of the year. Economists have warned the second quarter will be the worst on record, and the specter of deflation, which haunted the economy for decades, once again looms. Tourist numbers plummeted 99.9% in April after the country shut its borders, putting the brakes on a booming industry that had promised to be a growth driver for years. As in other countries, bankruptcies have risen sharply.

Even with the end of the state of emergency in sight, authorities are warning that life will not return to normal. When case numbers slowed in early March, there was public optimism that the worst was over -- only for cases to spike again and trigger the emergency declaration.

If a deadlier second wave does follow, the risk factor in Japan, which has the world’s oldest population, remains high. The country has speedily approved Gilead Sciences Inc.’s remdesivir and is now scrambling to allow the use of still unproven Fujifilm Holdings Corp.’s antiviral Avigan. There are calls for the country to use the time it has bought itself to shore up its testing and learn in the way its neighbors did from SARS and MERS.

Officials have begun to speak of a phase in which people “live with the virus,” with a recognition that Japan’s approach has no possibility of wiping out the pathogen.

“We have to assume that the second wave could be much worse than the first wave and prepare for it,” said Yoshihito Niki, a professor of infectious diseases at Showa University’s School of Medicine. “If the next explosion of cases is worse, the medical system will break down.”

— With assistance by Gearoid Reidy, and Marika Katanuma

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Italy’s Next Opening Step May Not Include Northern Areas

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The next phase in Italy’s relaxation of emergency measures to combat the coronavirus may proceed at different speeds in various zones, with some northern areas temporarily excluded from a reopening of borders between regions, la Repubblica reported.

It may prove “difficult” for northern territories — particularly the hard-hit Lombardy region around Milan — to be allowed to open their borders on June 3 as planned, the newspaper reported, citing government views on the most recent figures from public health authorities.

A decree from Prime Minister Giuseppe Conte that allowed a wide range of businesses to reopen on May 18 stated that Italians will be allowed full freedom of movement within the country on June 3, though health experts warned from the outset that differences in regional infection levels could make that problematic. Some governors have lobbied Rome to avoid different opening dates by region.

The economic situation is particularly dire in the north, the epicenter of the Italian outbreak. About half of all small businesses in Lombardy are at risk of collapsing, business lobby Confcommercio has said.

Lombardy and some neighboring northern areas could be made to wait until June 10 to open borders with other regions, Repubblica said.

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To Avoid Burnout, Work Less and Ignore ‘Productivity Propaganda’

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There’s burnout, and then there’s pandemic-induced burnout. For many workers, the professional environment has changed radically since Covid-19 disrupted life—but the intensity of their jobs hasn’t. Juggling full-time responsibilities, family life, and the stress of confinement makes the risk of burnout greater than ever.

Digital anthropologist and author Rahaf Harfoush, whose book Hustle & Float: Reclaim Your Creativity and Thrive in a World Obsessed With Work investigated the epidemic of burnout, says solutions must go beyond treating symptoms such as exhaustion and anxiety. Instead of merely prescribing rest, exercise, and healthful eating, she says it’s time to deconstruct the underlying cultural sources of burnout and do something radical: Work less. Here, she explains how.

In your book, you explore the origins of work burnout. What’s at play?

Since the Industrial Revolution, the dominant philosophy of work has centered around productivity as the only metric that’s important for success. As work culture developed, we’ve internalized the idea that any time that isn’t spent doing something is wasted time. Worse, we’ve been made to believe that if we aren’t struggling and hustling, we don’t deserve our success. And now, our relationship to work has become tied to our sense of self and self-worth. But this ideology runs counter to scientific research that says that in order for knowledge workers to do their best work, they need space and unstructured time.

How does our current health crisis complicate this dynamic?

The structure upon which we’ve built our work expectations has been hurting us for a long time. When you combine our culture of chronic overwork with the distraction inherent to technology and social media, at a time when people are forced to stay at home, you have a recipe for amplified anxiety and shame. This puts people on a fast-track to burnout.

How can working less break this cycle?

We have to build a system of work that reflects how our brains actually function and what our creativity needs. That begins with incorporating recovery into the process of work. You can’t be innovative if you’re not creative, and you can’t be creative if you’re stressed, exhausted, distracted, or sleep-deprived. Resting doesn’t mean diverting from your goals but rather making it possible to achieve them. I’m not saying don’t hustle. I’m saying, whether it’s a pandemic or not, it’s crucial to recover hard when you play hard.

What’s the particular danger of a lack of rest during this period of remote work?

This isn’t a normal time, so it shouldn’t be treated as normal work-from-home time. The lines between home and work, personal and professional, are blurred with an additional pressure to be productive since the thinking is that we all suddenly have more available time. This isn’t the case, and furthermore, working nonstop simply doesn’t work. We have turned busyness into a coping mechanism. Now, people are applying that to their personal time while sheltering at home, filling it with back-to-back Zoom calls, baking, workouts, and more activity. It’s important to use some of this time to process our emotions and reflect on the discomfort from all this productivity propaganda. Operating as usual will not only negatively affect your work but could compromise your health.

So how do we avoid operating as usual? And how do we get our bosses on board?

There are steps we can all take. For example, take 30 minutes to eat lunch without stimulation: no email, no Slack, no distraction. You can even start with 15 minutes! It’s up to us to carve out periods of time to give our cognitive capabilities the chance to unwind. Then consider managing up: Workers can be explicit in asking for expectations from their managers. Move from unspoken rules to written guidelines so everyone understands how to navigate this period of working from home.

Overhauling work culture won’t happen overnight. What do you recommend for those feeling burnout now?

Start by paying attention to discomfort. If you’re feeling restless, anxious, or guilty, sit with it and start to dig deep to understand what’s behind it. We have to give ourselves the time to shift from a more-is-better approach to internalizing the idea that recovery is as valuable as the work. No one can do that for us. Put recovery time in your calendar and stick to it. If you don’t, force yourself to write down why you didn’t. The real exercise in moving past work devotion and burnout is in understanding why we’re not giving ourselves that time. It isn’t due to a lack of knowledge.

I would also suggest timing your tasks to understand how much time you really need. This will allow you to make realistic to-do lists and avoid feeling overwhelmed. Remember: We are constrained by time, and yet we overestimate our self-expectations constantly. This is something that can be fixed.

What’s the hard truth workers need to remember?

If you’re a high performer and recovery isn’t an intentional and strategic part of your time and workflow, you’re only damaging your output in the long run.

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Rishi Sunak backs down and offers small firms 100% loan guarantees

Britain’s smallest businesses will be offered 100% government-backed rescue loans following sharp criticism for the slow take-up of emergency bank lending during the coronavirus crisis.

In a climbdown following intense pressure on the government to improve its loan scheme to support cash-starved companies, the chancellor, Rishi Sunak, said small firms could access the new “bounce back loans” from next week.

Designed to provide smoother access to cash for small companies facing difficulty accessing existing government-backed lending, Sunak said businesses would be able to apply for “micro-loans” worth up to 25% of their turnover, up to £50,000.

It comes after the chancellor had faced intense pressure from business groups and Labour to boost the generosity of the government guarantee on its emergency loan scheme during the pandemic. However, Sunak stopped short of providing a 100% guarantee to big firms, saying taxpayers shouldn’t be exposed to the risks of large company failures.

Announcing the scheme in parliament, Sunak said small companies could apply for the new loans from high street banks from as early as next Monday.

“I know that some small businesses are still struggling to access credit. They are in many ways the most exposed businesses to the impact of the coronavirus and find it hard to access credit in the first place. They will need extra support to get through this crisis,” he said.

The new loans provide high street banks with a guarantee that the state will refund the bank for the entire value of the loan if a borrower is unable to repay, up from 80% on the government’s existing coronavirus business interruption loan (CBILS).

Although firms do not get government money if they cannot repay a loan, the scheme is designed to encourage banks to lend to firms when they might ordinarily turn down a loan application, because the state shoulders some of the risk.

The Treasury had previously resisted calls to offer 100% guarantees, believing that banks needed to share the risk with taxpayers. However, thousands of businesses across the country complained that the CBILS scheme was cumbersome and included too many financial hurdles that many businesses were unable to overcome.

Business lobby group the CBI, and the governor of the Bank of England, Andrew Bailey, had also suggested raising the state-backed guarantee to 100% to speed up the lending process.

Sunak dismissed calls for the government to offer a full guarantee on its emergency loan schemes, telling parliament: “We should not ask that ordinary taxpayers today and tomorrow to bear the entire risk of lending almost unlimited sums to businesses who may in some cases have very little prospect of paying those loans back and not necessarily because of the impact of the coronavirus.”

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IRS depositing some coronavirus stimulus checks into wrong bank accounts

How to spend coronavirus stimulus check if you’re struggling financially

Financial expert Chris Hogan says as Americans begin to receive their coronavirus relief checks, we should be in ‘conserve mode’ and avoid ‘any unnecessary spending.’

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Some Americans expressed concern Thursday that the Internal Revenue Service mistakenly sent their stimulus check deposits to the wrong bank account.

The Treasury Department and the IRS launched the "Get My Payment" tool that allowed people to track their payout. About 80 million people were expected to receive the deposit by Wednesday, the Treasury Department said.

But when some people submitted their contact information into the agency’s tracking portal,  results would show that the money was scheduled to be deposited April 15 — even though those individuals hadn’t seen the money arrive yet. In some scenarios, the last four digits of the bank account number associated with the deposit provided by the IRS didn’t match a bank account that people recognized.

HOW TO GET YOUR STIMULUS CHECK

“My stimulus got sent to the wrong account and it won’t let me update it despite you guys saying we could. I guess I’ll just get evicted,” one Twitter user wrote to the IRS on Wednesday.

“You sent my check to the wrong account number! I've had my account for years. Bank says there's nothing they can do. Now what? please advise,” another user wrote.

The IRS has advised those concerned that the payment may have been sent to the wrong account to check with your bank to verify it was received.

An IRS spokeswoman told USA Today, which first reported the news, that she hadn't heard anything about stimulus checks being deposited into the wrong bank accounts and would look into the matter.

If checks are sent to bank accounts that don't match the name of the person who is supposed to receive the money, the check should be rejected by the bank and returned to the IRS, the spokeswoman said.

"The payment isn't going to bounce back and just sit here,'' she said. "We will turn around and cut them a paper check and make sure they get their money.''

CORONAVIRUS STIMULUS CHECKS: WHO GETS MONEY AND WHEN?

The distributions are part of the $2.2 trillion CARES Act signed into law by President Trump at the end of March.

At the heart of the largest relief plan in recent memory is $1,200 checks for individuals who earn less than $75,000 annually, $2,400 for couples who earn less than $150,000 and $500 for every child. The payments are tapered for higher earners and phase out completely for individuals who earn more than $99,000 or couples who earn more than $198,000.

The cash is intended to blunt the financial pain for Americans caused by the coronavirus pandemic, which brought the economy grinding to a halt. In four weeks alone, more than 22 million Americans filed for unemployment, the Labor Department said Thursday. The record-shattering number is a stunning sign of the depth of the economic calamity inflicted by the virus outbreak.

If Americans did not file a 2019 or 2018 tax return, which will be used by the agency to calculate eligibility, the IRS has instructed them to file a “simple tax return,” with basic filing information like filing status, the number of dependents and bank information.

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