The first two months of 2020 have seen the world gripped by a novel coronavirus, a mysterious and in some cases deadly plague. Each nation has been forced to respond in their own way and as best they can as their populations fall victim to the new virus strain. Japan’s response to COVID-19 has been called into question however, with critics claiming the nation is not doing enough, fast enough. But what makes Japan’s seemingly delayed response to the virus so problematic? As residents of Japan witnessing the situation first hand, we’ve identified 4 risks likely to exacerbate the spread of corona in Japan.

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Risk 1: Government’s Delayed Response to the Virus

The first factor currently problematizing COVID-19’s jaunt through Japan’s national immune system is the government’s delayed response to the outbreak. Slow to conduct tests and provide the necessary resources to do so, Japan has received criticism for allowing the virus to spread out of control, unmonitored. The New York Times reported on March 2nd that whereas South Korea is conducting 10,000 tests per day, Japan has conducted a fraction of this, a mere 9376 in total at the time of writing. This suggests Japan does not have a clear picture of actual number of infections, but the total is likely to be much higher than the current number of 639 confirmed cases.

The reluctance to test people means the risk of the virus spreading in Japan is much higher as those infected cannot be monitored or isolated. Prime Minister Abe has taken stronger measures to combat the virus since March however, closing all schools until April. The efficacy of this move has been questioned though for putting unnecessary strain on working parents and for neglecting Japan’s large aging population who are most at risk. The government's cutious approach to handling the new viral strain is likely to exacerbate a number of other risks in Japan which we discuss below.

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Risk 2: Unhealthy Working Practices

It’s no secret that employees in Japan put in a lot of time in the office. So much so that there’s even a special word in Japanese to describe death by overwork: Karōshi 過労死. Such a concept is indicative of Japan’s rampant overtime culture and highlights the tendency to prioritize one's company over one’s personal life and even health.

In such a culture, it increases the likelihood that people who are sick, especially with mild symptoms, are likely to come to work. One reason for this is a sense of oft-unspoken expectation that even when ill, employees should come to work. On this topic, Hiroshi Ono, professor of human resource management at Hitotsubashi University was quoted in the Japan Times as saying: “they think if they take time off, they’re causing bother to others”. This sense of social pressure has arguably created a working culture in Japan that encourages working through illness.

In this case, many people with symptoms of COVID-19 are more than likely attending work already. This situation is made even easier by medicines in Japan designed for those who intend to attend work while sick, which Twitter user @nitadrikae has mocked on Twitter. This kind of unhealthy working culture makes companies in Japan likely beacons for the disease, as office block upon office block becomes infected by untested, overly committed employees.

Risk 3: Japanese Rush Hour Trains

Japan has some of the busiest rush hour trains in the world. Manin densha 満員電車, the tightly packed subway cars that shunt salarymen across cities every morning and evening in Japan are iconic, especially in Tokyo. They are also ideal environments for a disease like COVID-19 to infect a large number of people.

In response to this many Japanese companies have recently implemented working from home policies and flexible hours to alleviate congestion on trains during peak times. However, Tokyo’s central city subway lines remain crowded at rush hour as few workers take advantage of flexible working initiatives. With one of the best connected metro systems in the world, Tokyo’s rush hour trains remain a risk for increasing the spread of the virus in this densely populated city.

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Risk 4: Unhelpful and Inefficient Cultural Practices

Last week we wrote about how difficult it can be to get a corona virus test in Japan. For the Tokyo resident we interviewed however, the way he was passed around between medical hotlines was a more burning concern than his fever. Similarly, NHK reported that one Hiroshima resident showing corona symptoms was sent to 8 different clinics before he received a test.

Obtuse guidelines for corona tests have left medical clinics unsure who to test. The result is that many are falling back on tarai mawashi たらい回し, or passing patients on to others clinics when they don’t want to deal with them themselves. This indirect approach is common in Japan, a culture that favors a slower roundabout way of dealing with things. Though this may be culturally acceptable, it flies in the face of the kind of prompt response to the corona emergency urged for by the WHO. It also raises questions about the risk of further spreading the disease by deferring sick patients from clinic to clinic.

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What does this mean for Japan and visitors?

The risks discussed in this article likely point to a higher rate of infection in Japan than is currently being reported. Delays in testing for the virus in Japan combined with a corporate culture that encourages enduring through illness to work mean undetected cases of the virus can spread with ease.

But questions are still to be raised about why the response to the virus in Japan has been so slow. The New York Times quoted Masahiro Kami, head of the Medical Governance Research Institute, as suggesting Abe’s slow response was to limit cases in Japan so the Olympics wasn’t cancelled.

However, infectious disease specialist Kentaro Iwata, reported by Japan Today, said “testing as a response to public anxiety would cause the medical system to crumble”. With Japan’s economy in an unstable position already, limiting tests to keep the country working and sure up the economy may prove significant. Though it does raise questions about the governments priorities.

Ultimately only time will tell whether a cautious approach to testing was the right decision. What we know for sure is Japan currently remains open for business and the number of reported fatalities from corona are relatively low. Many tourist attractions remain open and public transport is less busy than normal, along with just about everywhere else in Japan. For any budding traveler with confidence in their immune defenses, now may be an opportunity in disguise for a visit to Japan.