A culture of collective responsibility: How Japan has kept COVID-19 numbers relatively low

TOKYO: On Jan 1 at a shrine in the leafy suburb of Asagaya in west Tokyo, Michiko Kubo and her husband, each wearing two face masks, joined a long line of worshippers all standing a metre apart to welcome 2022.

"Last year we stayed at home following official guidelines to avoid crowded places. But this time, we feel protected as we are vaccinated and wearing masks all the time," Kubo, 45, said. Volunteers also walked through the crowd that had gathered under the winter sun, politely reminding everyone to practise safe distancing.

Despite a resurgence of cases driven by the Omicron variant, coronavirus numbers are still low compared to most Western nations. As of mid-January, Japan has reported around 1.9 million COVID-19 cases and close to 18,500 deaths. On the other hand, the United Kingdom - which has a population half of Japan's - has reported more than 15 million cases with 152,000 fatalities.

A MATTER OF ETIQUETTE

Several reasons have been suggested for Japan's ability to keep COVID-19 relatively under control. One factor, experts told CNA, is the likes of the Kubos themselves, for whom mask-wearing is second nature.

"Japanese people are comfortable wearing masks and washing their hands, two crucial factors in virus mitigation. They also tend to follow the rules," said Professor Yoshiaki Katsuda of Kansai University of Social Welfare in Osaka.

"Overall, these habits, ingrained since childhood in schools and at home, have been highly effective."

Katsuda, an expert in travel medicine, added that wearing medical masks when one has the common cold or cough is viewed as good etiquette in Japanese society.

"As children we are taught to protect others from catching our diseases by keeping a social distance. It is almost equated to a civic duty," he explained.

The World Health Organization describes masks as a key measure to reduce transmission and save lives, and that masks should be used as "part of a comprehensive strategy of measures" against COVID-19.

The Japanese public's adherence to mask wearing and social distancing rules has drawn praise from the WHO chief Tedros Ghebreyesus, who in 2020, termed the country's handling of the pandemic a "success".

ROLE OF THE GOVERNMENT

While long-held social habits have played a part, the role of the government has also been key. For example, the Ministry of Health, Labour and Welfare set up a toll-free number to answer queries from the public and has also been promoting a "new lifestyle" to reduce infections.

On the ministry website, people are urged to wear masks as part of three basic preventative measures; the other two being social distancing and frequent handwashing. Government employees at local municipalities have also linked up with medical experts to inform and encourage residents to follow safety precautions.

When Japan experienced a surge in infections involving the Delta variant last year, teams walked through high-risk areas such as shopping streets and red-light districts, urging people to protect themselves by going home.

There have also been numerous media campaigns featuring medical doctors to allay public fears about vaccination. Almost 90 per cent of Japan's population have received two doses of the vaccine and the government announced earlier last week that it would speed up the rollout of booster shots.

The close monitoring has not let up this year. The emperor and family, heavily masked, appeared behind palace windows for their New Year greetings to the public. And for his first press conference of 2022, Prime Minister Fumio Kishida addressed journalists while strictly observing distancing rules and removing his mask only when he spoke at the lectern.

Kishida, surrounded by a phalanx of masked aids, said Japan needed to stay vigilant against the threat of Omicron and pledged to deal with the chronic problem of a shortage of hospital beds that first hit Japan severely in 2020.

According to Katsuda, the professor at Kansai University of Social Welfare, Japan's commitment to battling the pandemic - displayed by top leaders all the way down to regular citizens - illustrates a culture of collective responsibility during times of crisis.

Katsuda himself devotes his time as a volunteer these days, working with the media for the "sole purpose of sharing correct information with the public". But he acknowledged it is not easy to convince everyone.

"This is why I appear with other experts on television broadcasts to stress prevention, especially avoiding cluster infection," he said.

Cognizant of pandemic fatigue, media companies are adjusting the content they put out, for example, by featuring fashion experts giving beauty tips related to mask-wearing.

NATIONAL COLLECTIVE APPROACH

Kazuya Nakayachi, a professor of psychology at Doshisha University, believes the focus on a national collective approach to the pandemic has spared Japan from frequent forced lockdowns and the imposition of harsh penalties. "We have found that leaders play a crucial role in promoting good behaviour," he said.

In February last year, a new law strengthening enforcement of COVID-19 restrictions was passed, allowing authorities to fine businesses that defy closure requests – which were exactly that, requests. Despite that, even before passage of the law, most schools, gyms and restaurants had been compliant, shutting operations when asked to by the government. 

In data compiled by the Tokyo Metropolitan government, even without the threat of fines, 90 per cent of the 300,000 restaurants surveyed had complied with official requests to shut early.

At an individual level, Nakayachi reiterated the importance of cultural, as opposed to medical, reasons for a strong inclination by Japanese people to wear masks. In a paper published in the peer-reviewed academic journal Frontiers in Psychology, Nakayachi said: "Conformity to the social norm was the most prominent driving force for wearing masks."

But this could go overboard, he warned, highlighting what he called the "mask police" - people who pressure and single out those who do not wear masks.

"Non-wearers have expressed indignation and fear about facing criticism," he said.

"But overall, our research does show that Japanese cultural habits of following each other during an emergency has contributed to positive results in the fight against COVID-19."