TOKYO — Japan had only some dozen confirmed coronavirus infections when the 30-something nurse with a slight sore throat boarded a bus to Osaka, the nation’s third-largest metropolis, to attend a Valentine’s weekend efficiency by pop bands at a music membership.
Less than two weeks later, she examined constructive for the virus, and the authorities swiftly alerted others who had been on the membership. As extra infections quickly emerged from three different music venues within the metropolis, officers examined concertgoers and their shut contacts, and urged others to remain house. All advised, 106 circumstances have been linked to the golf equipment, and 9 persons are nonetheless hospitalized.
But lower than a month after the nurse examined constructive, the governor of Osaka declared the outbreak over.
Ever for the reason that first coronavirus case was confirmed in Japan in mid-January, well being officers have reassured the general public that they’ve moved rapidly to stop the virus from raging uncontrolled. At the identical time, although, Japan has puzzled epidemiologists because it has averted the grim conditions in locations like Italy and New York with out draconian restrictions on motion, economically devastating lockdowns and even widespread testing.
The puzzle could also be about to achieve some readability. On Thursday, Katsunobu Kato, Japan’s well being minister, mentioned he had knowledgeable Prime Minister Shinzo Abe that there was proof that Japan was now at a excessive danger of rampant an infection.
On Wednesday evening, only a day after Japan and the International Olympic Committee agreed to delay the Tokyo Summer Games for a 12 months due to the coronavirus pandemic, the governor of Tokyo, Yuriko Koike, warned residents that the sprawling metropolis of near 14 million individuals was in a “critical phase before a possible infection explosion.”
Cases in Tokyo spiked this week, setting information for 4 days working — together with an announcement of 47 circumstances on Thursday — as vacationers returned from abroad. The restricted testing for the virus has raised fears that many extra are going undetected.
Ms. Koike implored the individuals of Tokyo to do business from home, keep away from pointless outings and keep inside over the weekend. On Thursday, governors from 4 neighboring prefectures additionally requested that residents chorus over the weekend from going exterior for something aside from pressing wants.
“If we go without doing anything now,” Ms. Koike mentioned, “the situation will worsen. I ask for everyone’s cooperation.”
The public up to now has not taken such warnings severely. Although schools have been closed for a month and the federal government has requested that enormous sports activities and cultural occasions be canceled or delayed, the remainder of life has returned to regular. People have been using crowded subways, congregating in parks to view the cherry blossoms, purchasing, ingesting and eating, comforted by Japan’s comparatively low variety of confirmed coronavirus circumstances and deaths.
Even at one of many Osaka golf equipment the place the outbreak occurred earlier this month, a gaggle of 40 younger ladies attended a efficiency by a boy band on Wednesday, leaping and waving their arms in a small, unventilated house for shut to 2 hours.
As different components of the world fall right into a spiral of infections, hospital overflows and deaths, Japan, a rustic of just about 127 million individuals, has reported just one,300 circumstances and 45 deaths, with one of many slowest-progressing death rates on the planet regardless of its aging population.
“It’s either they did something right,” mentioned Dr. Peter Rabinowitz, co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security, “or they didn’t, and we just don’t know about it yet.”
As Japan has appeared to tug off a feat of an infection containment, it has introduced an intriguing distinction to different international locations in Asia, the place the pandemic started. It didn’t put cities on lockdown, as China did. It has not deployed modern surveillance technology like a rising variety of international locations, together with Singapore. Nor did it undertake the form of wholesale testing that helped South Korea isolate and deal with individuals earlier than they might unfold the illness.
While South Korea, with a inhabitants lower than half the dimensions of Japan’s, has carried out assessments on near 365,000 individuals, Japan has examined solely about 25,000. Japan now has the capability to conduct about 7,500 assessments a day, however its each day common is nearer to 1,200 or 1,300.
Dr. Tomoya Saito, director of the division of well being disaster administration on the National Institute of Public Health, mentioned the restricted testing was intentional. Those who’re examined are referred by docs, normally after sufferers have had fevers and different signs for 2 to 4 days. Japan’s present coverage is to confess anybody who assessments constructive to a hospital, so officers wish to keep away from draining well being care sources with much less extreme circumstances.
Dr. Saito mentioned that a part of Japan’s seeming resistance to an infection might end result from measures widespread within the tradition, together with frequent hand-washing and bowing as a substitute of shaking arms. People are additionally more likely to put on masks on trains and in public areas. “It’s a kind of social distancing,” Dr. Saito mentioned.
But Jeffrey Shaman, an epidemiologist at Columbia University and the senior creator of a report that projected 5 to 10 undetected circumstances for each confirmed an infection of the coronavirus primarily based on information from China, mentioned Japan’s method was a “gamble.”
“The risk is that things may be brewing underneath the surface that you don’t recognize until it’s also a little bit too late,” Dr. Shaman mentioned.
In Osaka, a report ready for the well being ministry this month projected that by early April, the town may have shut to three,400 infections, 227 of them critical. “It’s possible that provision of medical treatment to seriously ill patients may become difficult,” the report mentioned.
On Wednesday, Osaka’s governor, Hirofumi Yoshimura, mentioned he was working to safe an extra 600 beds in hospital isolation wards that might accommodate sufferers with probably the most extreme infections.
Dr. Masaya Yamato, chief of infectious illnesses at Rinku General Medical Center in Osaka, mentioned the area was transferring towards a mannequin the place coronavirus sufferers with gentle signs may keep at house in an effort to save hospital beds for the severely sick.
In Tokyo, there are solely 100 beds designated to deal with these with critical infectious illnesses. On Wednesday, the town authorities pledged to safe 600 extra.
The request by Tokyo’s governor to remain inside this weekend, Dr. Yamato mentioned, could also be too weak to defer a disaster.
“It’s better that Prime Minister Abe decisively declare a lockdown in Tokyo,” Dr. Yamato mentioned. “The economic impact should not be a top priority. Tokyo should lock down for two to three weeks. Otherwise, Tokyo’s medical system could collapse.”
Mr. Abe’s administration has appointed a job pressure to find out whether or not he ought to declare a state of emergency, a measure that he mentioned was pointless earlier this month.
For now, the general public is essentially unmoved. Although some grocery retailer cabinets in Tokyo have been cleared out on Wednesday evening after the governor’s request, it was enterprise as typical on Thursday.
Near Shinbashi Station in central Tokyo, males in black fits sat elbow to elbow at a counter in a restaurant providing a fried noodle lunch particular for 500 yen, about $4.50. A protracted line fashioned exterior a McDonald’s, and people who smoke crowded a small pen close to the station entrance.
In Shinjuku Gyoen park in western Tokyo, the place cherry blossoms have been close to peak bloom, an indication on the entrance knowledgeable guests that, as a part of antivirus efforts, picnic blankets and alcohol have been banned. Security guards with megaphones wandered by way of teams of people that have been taking photographs with the flowers, warning them to clean their arms.
At a retailer not removed from the park, Kazuhisa Haraguchi, 36, stood in a protracted line for an opportunity to purchase a limited-edition pair of Nike Air Max sneakers.
Mr. Haraguchi mentioned that he was apprehensive about how the virus was spreading within the United States and Europe, however that he wasn’t too involved concerning the scenario in Japan.
“It’s scary, but it doesn’t seem like there’s much of it here right now,” he mentioned. “If I die, at least I’ll die with my sneakers.”
Ben Dooley and Makiko Inoue contributed reporting from Tokyo, and Hiroko Masuike from Osaka, Japan.