Japan’s state of emergency is coming to an end as new cases of the new coronavirus barely reaching the dozens. The country reached this point despite largely ignoring measures applied in other nations.

There were no restrictions placed on the movements of residents and businesses, from restaurants to hair salons, they remained open; high-tech applications that tracked people’s movements were not implemented, and despite the recommendation of the health authorities to “do and test” to detect the SARS-CoV-2 virus, Japan has only examined 0.2 percent of its population, one of the lowest rates among developed countries.

However, Japan flattened the contagion curve, with the death toll below 800, the lowest number among the nations that are part of the G7. In Tokyo, its dense capital, cases have been reduced single digit on most days.

Although the possibility of a second wave of more severe infections is always present, Japan entered and is ready to emerge from its emergency in just a few weeks, with the state already raised in most of the country and with a view to completing the exit as soon as next monday.

Analyzing how Japan defied the odds and contained the virus without implementing the guidelines that other countries have followed has become a national conversation. The conclusion shows that in the nation it was successful, but not only for a single factor.

“Just looking at the death numbers, it can be said that Japan was successful, pbut even the experts don’t know the reason“said Mikihito Tanaka, a professor at Waseda University specializing in scientific communication and a member of a group of public advisory experts on the new coronavirus.

A widely shared list detailed 43 possible reasons cited in media reports, ranging from a culture of wearing masks and a low obesity rate until the relatively early decision to close schools. Among the more fanciful suggestions is a claim that Japanese speakers emit fewer potentially laden drops of the SARS-CoV-2 virus when they speak compared to other languages.

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

However, these Japanese measures still offer long-term lessons for countries in the midst of a pandemic that can last for years.

An early response to the growing infections was crucial. While the central government has been criticized for its slowness in political affairs, experts have praised the work of contact trackers from Japan, which kicked in after the first infections were confirmed in January.

The quick response was made possible by one of Japan’s inherent advantages: its public health centers, which in 2018 employed more than half of the 50,000 public health nurses with experience tracking infection. In normal times, these nurses would be tracking more common conditions, like influenza and tuberculosis.

“It is very analogous, it is not an application based system like in Singapore,” he said. Kazuto Suzuki, a professor of public policy at Hokkaido University, who wrote about Japan’s response. “But, nevertheless, it has been very useful.”

While countries like the United States and the United Kingdom are just starting to hire and train their contact trackers as they try to reopen their economies, Japan has been tracking the movement of the disease since the first cases were found. These local experts focused on addressing outbreaks originating from places like clubs and hospitals. to contain the contagions before they got out of control.

“Many people criticize that we do not have Centers for Disease Control (CDC, as they are known in the US) in Japan,” said Yoko Tsukamoto, professor of infection control at Hokkaido University of Health Sciences, citing a frequent complaint on infection management in Japan. “But the public health center is a kind of local CDC.”

The early response was also fueled by an unlikely event. Japan’s battle against the SARS-CoV-2 virus drew international attention with its highly criticized response to what happened on the cruise Diamond Princess in February, it caused hundreds of infections. Still, that experience provided invaluable data to Japanese experts on how the pathogen spread, as well as & # x27; catapulting & # x27; to the new coronavirus within the public consciousness.

Other countries still viewed the virus as “someone else’s problem,” Tanaka said, but in Japan, international scrutiny of infections and the rate at which the new coronavirus spread throughout the ship raised awareness and recognition that the same can happen throughout the country.

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“For Japan, the cruise was like having a burning car right outside their home,” he said.

Although the political leadership was criticized for its absence, that allowed doctors and experts will take the crisis management, which is generally considered a best practice in managing public health emergencies.

“You could say that Japan has had an expert-led approach, unlike other countries,” said Tanaka.

Experts are also credited with creating an easy-to-understand message to avoid closed spaces and crowded spaces instead of staying away from others entirely.

“Social distancing may work, but it doesn’t really help continue normal social life,” said Suzuki.

Infectious disease experts also pointed out other determining factors. Shigeru Omi, deputy head of the expert panel advising the Japanese government and a former head of the World Health Organization (WHO) office in the Western Pacific, highlighted the Japanese health consciousness as arguably the most important factor.

The possibility has also been raised that the spread of the strain of the new coronavirus in Japan it has been different and less dangerous than that faced by other nations.

Researchers at the Los Alamos National Laboratory in the US studied the coronavirus variants in a database and found a strain of the virus that is spreading across Europe that had several mutations. that distinguished it from the Asian version, according to a document released in early May. Although the study has not been peer-reviewed and has drawn some criticism, the findings point to the need to further study how the virus changes.

There are still big questions about the true extent of the spread of the pathogen. In April, a Tokyo hospital tested a handful of patients who were not infected with COVID-19 and found that about 7 percent did have the new coronavirus in their bodies, showing the danger of not registering asymptomatic carriers. or mild that can later become the source of an outbreak.

An antibody test on 500 people in the capital suggested that the true outbreak could be almost 20 times higher than the figures show. Analog contact tracking is affected when the number of infections is high.

The fact is, Japan’s response was less than perfect. Although the general population is much smaller, neighbors like Taiwan only had seven confirmed deaths from the new coronavirus, while Vietnam had none.

“You can’t say that Japan’s response was surprising,” said Norio Sugaya, a visiting professor at Keio University School of Medicine in Tokyo and a member of the WHO panel advising on pandemic influenza. “If you look at the other Asian countries, they all had a death rate that was about one percent from Western countries.”

While Japan may have averted the worst of health outcomes, the nation has been no stranger to the economic impact of the pandemic. Its economy, which was already grappling with the impact of a sales tax increase in October, officially fell into recession in the first three months of the year. Economists have warned that the second quarter will be the worst on record and the specter of deflation, which has plagued the economy for decades, is looming once again.

The number of tourists plummeted by 99 percent in April after the country closed its borders, holding back a booming industry that had promised to be a growth engine for years. As in other countries, bankruptcies have increased considerably.

Even with the end of the state of emergency in sight, authorities warn that life will not return to normal. When the numbers of cases declined in early March, there was public optimism that the worst was over, only to have the cases rise again later and trigger the emergency declaration.

If a more deadly second wave of infection follows, the risk factor in Japan, which has the world’s oldest population, still high. The country has quickly approved the use of Gilead Sciences’ remdesivir and is now fighting to allow the use of Fujifilm’s antiviral Avigan. There are calls for the country to use the time it has purchased to shore up its evidence.

Authorities have begun talking about a phase in which people will “live with the SARS-CoV-2 virus”, acknowledging that Japan’s approach has no chance of eliminating 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, professor of infectious diseases at Showa University School of Medicine.” If the next explosion of cases is worse, the medical system will break down. “