Tokyo – Japanese remarkableThe resilience of the pandemic has provided numerous possible explanations, from the country’s preference for going indoors without shoes, to the supposedly low aerosol-generating nature of Japan’s quiet talk, to its citizens’ beneficial gut bacteria. Even irreligion — which is said to have spared the Japanese from exposure to crowded places of worship — has been touted as a virtue in the era of COVID-19.
Despite having the oldest population in the world, with nearly one in three residents aged 65 or older, Japan has fewer COVID deaths per capita than almost any other developed country. As of Thursday, Japan had registered just 246 COVID-19 deaths per million people, more than even New Zealand (263), which initially adopted a zero-COVID strategy with maximum suppression. By comparison, the US has a cumulative number of 3,045 deaths per million people.
But COVID death statistics alone, often based on inconsistent and/or incomplete data, don’t tell the whole story. Researchers estimate that Japan has had 111,000 “excessive deaths”, more than five times the number of reported COVID deaths, when including deaths from impaired medical care and social disruption.
The high death rate in Japan at 44 per 100,000 is much higher than that of South Korea (4), Singapore (-15), Australia (-37), New Zealand (-9); China (0.6) and Taiwan (-5). Even less prosperous Vietnam and Thailand fared better.
But compared to the US (179) and Europe (140) Japan is still ahead. Some experts believe that the credit for that relative success belongs primarily to the Japanese citizens, for their†
“Japan’s approach to COVID response is based primarily on people’s efforts,” not on the imposition of mandates, Kenji Shibuya, research director for the Tokyo Foundation for Policy Research, told CBS News. “This kind of voluntary effort, rather than draconian measures from above, has worked.”
Peer pressure to wear face masks remains such a potent force in Japan – even as heatstroke season looms – that the national health ministry has been forced to issue a brochure urging people not to wear masks when walking their dogs, cycling, jogging or just walking to work.
In addition to the nearly ubiquitous use of masks, Japan’s vaccination program, which was initially delayed but then quickly implemented, is credited with saving lives. Despite initial fears of vaccine hesitation, two-thirds of all citizens and about 90% of seniors have now received booster shots.
Japan’s generally healthy population also helped the country withstand the pandemic. Lifespans have continued to increase for four decades, giving Japanese people the highest average lifespan on Earth: 87 years for women and 81 years for men. While the U.S. obesity rate rose to nearly 42% in 2020, Japan has one of the lowest obesity rates in the world at about 4%.
Thanks in part to universal health insurance, cancer and heart disease rates are also low. Like obesity, these diseases are important underlying risk factors for complications from a coronavirus infection.
Scientists, meanwhile, have explored a theory that Japanese people may have an inherent advantage at the cellular level when it comes to fighting COVID.
Researchers at the state-funded RIKEN Center for Integrative Medical Sciences have delved into human leukocyte antigens (HLA), proteins found on most cells throughout our bodies, as a potential antiviral defense. HLA markers are well known in the field of organ transplantation, where matching HLA types, not just blood groups, is crucial to reduce the chance of organ rejection.
Riken’s study found that Japanese subjects with HLA type A24, which is common here and in some other parts of Asia, develop “cross-reactive” T cells in response to seasonal coronaviruses or colds, which can re-engage with COVID-19. -19 infections much faster and more effectively than those that do not have that specific marker.
Shin-ichiro Fujii, who is leading the study, told CBS News that he has signed up to conduct clinical trials of a vaccine targeting immunocompromised cancer patients that would simulate the benefit of having the A24-type HLA proteins in people who are unable to develop neutralizing antibodies from the existing vaccines.
“The real hope,” he said in a statement, “is that we can develop vaccines that can stimulate a highly targeted response of T cells against the infection. We showed that this could be possible in this particular HLA group, but now we have to look at other species.”