Simon Denyer

Pulitzer Prize-winning journalist and author. Former bureau chief with The Washington Post and Reuters.

Aug 6, 2021
Published on: Washington Post
2 min read

TOKYO — Japan’s capital logged a record number of coronavirus cases this week, burdening the hospital system amid a slow vaccine rollout, an increasingly apathetic public and the government’s unsuccessful efforts to restrict the rapid spread of the delta variant.

On Thursday, Tokyo reported 5,042 new coronavirus cases, its highest daily count and nearly double the record set nine days before. The virus is spreading quickly beyond the Olympic host city: Japan’s positive daily cases exceeded 15,000 for the first time Thursday.

While the case count is far below that of some countries that are registering tens of thousands of infections per day, the surge in Japan is probably an undercount of positive cases because of a lack of widespread testing availability, public health experts say.

Prime Minister Yoshihide Suga last week extended a state of emergency throughout Tokyo and surrounding prefectures. And Thursday, the government’s coronavirus advisory panel extended a “quasi” state of emergency to more prefectures through the end of the month. But Suga said a more strictly enforced lockdown wouldn’t “really suit Japan,” and it was not under consideration.

Many experts say the government’s appeals for self-restraint are falling on deaf ears, especially among young people, and warn it may be running out of ideas on how to contain the surge in cases.

Under the latest measures, the government is asking people in and around Tokyo to stay home and refrain from gathering in large groups, and urging restaurants and bars to stop serving alcohol after 8 p.m. to deter crowds.

But after having such an emergency declaration in place for most of the year so far, the sense of urgency around the warning has drastically waned, public health experts say.

“People are so tired of the repeated state of emergency declarations,” said Kenji Shibuya, the former founding director of the Institute for Population Health at King’s College London who recently moved back to Japan and is helping with mass vaccination efforts here. He warned that transmission may increase with Japanese summer holidays next week.

The government’s request has been ignored in many parts of Tokyo, with large numbers of people going out to bars and restaurants beyond the suggested end time. Although spectators are not allowed in most Olympic venues, droves of people have gathered nonetheless to catch a glimpse, taking photos at the Olympic rings and the Olympic torch, and watching competitions from afar.

This week, Suga asked those with moderate coronavirus symptoms to isolate at home rather than go to the hospital, because medical staff are overwhelmed. Tokyo Gov. Yuriko Koike then made the same request to residents of the capital.

“We decided on the policy to protect people’s lives and health amid rapidly surging infections from the delta variant strain,” Suga said in a briefing on Wednesday. “The policy is meant to respond to emergency cases by reserving a certain number of hospital beds.”

Japanese lawmakers and voters have sharply criticized efforts to restrict hospitalizations, and members of the ruling party on Thursday called on the government to retract the policy. At least eight people, all aged between 30 and 50, have died in their homes this month without being taken to a hospital, according to media reports.

One man in his 50s who had difficulty breathing was reported to have been refused help by 100 medical institutions in Tokyo last week, with an ambulance crew only finding a hospital to help him after eight hours of searching. In the southwestern island of Okinawa, a shortage of test kits meant some people were told they would need to wait a month before they could learn whether they had been infected, local media reported.

Officials “are throwing away the responsibility of taking care of people. That is really shocking,” Shibuya said of the government’s policy. “It’s serious, because they increasingly acknowledge that the health system has started to collapse.”

After a slow start, Japan’s vaccination program finally ramped up in May. So far, just over 40 million people, or 31.7 percent of the population, have received two doses of a coronavirus vaccine, most of them over age 65.

Inside the Olympic bubble, the situation has remained largely under control, even as the number of positive cases rose over the past three weeks. Since July 1, there have been a total of 380 positive Games-related cases.

Some public health experts say the messaging and atmosphere around the Olympics have undermined public understanding of the severity of the virus.

“When you turn on the TV, many athletes are actively participating in the Games and the announcers and commentators are smiling and celebrating … while we are sweating and accepting new infected people right now,” said Kentaro Iwata, a physician and infectious-disease expert at Kobe University. “We can see the gap between the euphoric atmosphere inside the TV and the very pessimistic real world inside the hospital.”

“I can’t see whatever happening inside the TV is occurring in Japan. It feels like it’s occurring somewhere outside of this country,” Iwata added.

Japan would almost certainly be experiencing a surge in cases even without the Olympics, but some experts still question the wisdom of holding the event during a health crisis.

The International Olympic Committee has maintained that it is not aware of any cases of direct transmission from inside the bubble affecting the general Japanese public. Still, it acknowledges that half of the Games-related positive cases are reported by Tokyo Games contractors who are local residents of Japan.

Tokyo Olympics spokesman Masa Takaya said in a briefing this week that one Games-related person had been hospitalized among the people who came from abroad. But he had no data on how many Japanese residents connected with the Games had been hospitalized or whether any had died.

“You’ll see not only when they become positive for covid-19, they will most likely be isolated at home. If that person’s conditions worsens and becomes hospitalized, the reports to the organizing committee would not actually come,” Takaya said. “Therefore, when you ask how many hospitalization [cases are] happening for those who are living in Japan, I would say it’s very hard to answer that question.”

Between 80 and 85 percent of Olympic Village residents, and 70 to 80 percent of media and officials from abroad, have been vaccinated against the coronavirus. But Takaya said he had no data on how many Japanese residents connected with the Games have been inoculated.

A study by Hiroshi Nishiura, an epidemiology professor at Kyoto University, released this week predicted the number of new cases in Tokyo could top 32,000 by Aug. 26, two days after the Paralympic Games start.

But Olympic officials say they are committed to ensuring the Paralympics go ahead. IOC spokesman Mark Adams said Games officials will continue to “have a very, very clear process” for how to respond to positive cases and test all visitors and personnel regularly.

“We’ll continue to do that and work with the local health authorities, whichever Games we’re talking about, to make sure that we deliver safe and secure Games because they have to be safe and secure, not just for the athletes, but for everyone involved,” Adams said in a briefing Thursday.