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Olympics reveal 'big hole' in Japan's health crisis policy

Audrey Tang, Taiwan's digital minister, says 'trust' is key to dealing with pandemic

Taiwan's Digital Minister Audrey Tang speaks at The 7th Nikkei FT Communicable Diseases Conference on Nov. 6. (Photo by Kosuke Imamura)

TOKYO -- As the climb in the global count of COVID-19 cases further dampens hopes for a return to normal life, it has underlined a huge challenge facing Japan, which is set to host the Summer Olympics in eight months' time, experts at an infectious disease conference hosted by Nikkei and the FT have said.

In Japan, the number of new infections on Thursday exceeded 1,000 for the first time since late August, as the virus has spread from Tokyo to other major cities such as Sapporo in the north and Osaka in the west. The increase came as the government of new Prime Minister Yoshihide Suga has promoted domestic travel in an effort to offset the loss of inbound tourism.

In Europe, the U.K., France and Germany have introduced new nationwide lockdowns, with bars and restaurants closed and citizens asked to stay at home, in the wake of a second wave of infections since October that is much larger than the first wave in March and April.

Scientists blamed the new outbreak in Europe on a new variant that originated in Spain and has been spread across the region by holidaymakers since the summer months.

Japan's first wave started in March and was caused mostly by travelers returning from Europe, said Yasuhiro Suzuki, adviser to Japan's health minister, during the symposium. One of the questions facing Japanese policymakers was whether that spread could have been prevented, he said, and what needed to be done now as the nation was getting ready for the Olympics.

"The athletes and their coaches and VIPs will be allowed in. The question is [over] international spectators, including those from the U.S. and Europe," Suzuki said. "How many should be allowed in? Will Japan have the capacity to test so many people? Will it be possible to put some limit on their activity while they are in Japan and [to enforce this]?"

One of the new challenges is the emergence of new strains of the virus, such as the one now spreading in Europe. Hiromitsu Tazawa, professor at Kyoto University Hospital, asked whether the current testing equipment in Japan was capable of detecting various strains of the coronavirus and whether more resources should be devoted to research in this area.

As Japan opened up its borders, it would also be important for the country to keep tabs on the health condition of its visitors, noted Nahoko Shindo, a senior adviser at the World Health Organization.

Japan still faces challenges even in collecting basic data, such as the number of cases. The health ministry has been collecting information from municipal governments every day by checking their announcements and by telephoning them. Communications between hospitals and local governments, via public health centers, have also been through analog channels, such as sending faxes.

A new digital system, known as HER-SYS, was introduced in May to share information online, but many hospitals are still not using it, according to Motoi Suzuki, director of the Infectious Disease Surveillance Center at Japan's National Institute of Infectious Diseases.

HER-SYS was designed so that hospitals can enter the health status of each patient, including details such as when they were hospitalized after initially showing no symptoms. However, such detailed information is not yet entered into the system, according to Suzuki. "There is robust epidemiological information at the local level, but [this] cannot be handled systematically," he said.

When it came to Japan opening up its borders for the Olympics, a surveillance system was very important as a backbone of measures to counter the spread of the virus, said the WHO's Shindo.

At the conference, experts who were at the front lines of Japan's coronavirus response shared their suggestions for the future, bearing in mind potential new waves of COVID-19 or outbreaks of other infectious diseases.

"We have to promote social implementation of big data," said Hiroshi Nishiura, a Kyoto University professor known for his recommendations of social distancing based on mathematical modeling. He said it was difficult to persuade ministers or the prime minister to allow his team to use GPS data for analysis of where people were. Even with the new tracing app, which has been downloaded about 20 million times so far, they were still far from seeing the full picture, he said.

Taiwan's digital minister Audrey Tang stressed the importance of cultivating trust between governments and citizens. As early as Dec. 31 last year, there was enough trust to "talk about possible new SARS cases in a public forum ... with the [Taiwan] government trusting citizens enough to take it seriously and treat it as if SARS was happening again", she said.

She suggested that the reason for trust lay in democracy, "with an emphasis on keeping an open mind on novel technologies". "In Taiwan, we are constantly looking at ways to improve democracy at the center of social technologies," she said, referring to online press conferences held by the island's Central Epidemic Command Center, during which anyone could call a toll-free number to ask questions and share thoughts.

There was a "big hole" in Japan's preparedness to tackle health crises, compared to other incidents such as natural disasters, said Hajime Inoue, deputy director general of Japan's Office for Novel Coronavirus Disease Control. "There needs to be a system in place to always be ready [for such a crisis]," he said.

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