How hostess bars and cherry blossoms helped undermine Japan’s coronavirus response

The trouble was: The people at the bars and clubs just weren’t talking to health investigators.

“These night spots have some high-status customers, wealthy people,” Takeaki Imamura, a Tohoku University professor and infection control team member, told public broadcaster NHK in a documentary.

“The staff felt a duty to protect their customers, so they don’t say anything,” he added. “They won’t say who was there, who they were with and so on. It’s difficult to work out what actually happened.”

Wider lessons

This is Tokyo’s sleazy underside: bars where men pay inflated prices for drinks with female “companions” and other venues offering sex services.

Bars, clubs and gambling halls have become weak links in Japan’s efforts to control covid-19, but they are only one part of a much broader story â€" of a government reluctant to impose a blanket lockdown and desperate to minimize the economic pain of its virus response.

The countervailing forces that Japan has grappled with for months â€" economic pain and public health â€" are now at the center of debates in the United States and other countries as leaders try to figure out what to reopen and how fast.

Japan’s response to the coronavirus also has been limited by a lack of testing capacity, and the government’s initial reluctance to allow private-sector screening â€" making it hard to replicate South Korea’s success with mass testing.

So an infection control team headed by Hitoshi Oshitani of Tohoku’s University placed its bets on a cluster-based approach.

It was a strategy backed by research showing that most infected people weren’t passing the virus to anyone. Instead, a small minority were acting as super-spreaders at crowded, enclosed places.

The strategy initially seemed successful: working around-the-clock, tracking down the clusters, the team tamped down the first wave of infections from China and the Diamond Princess cruise ship in February with little social disruption.

But then the approach started to unravel as a new wave of infections entered Japan from Europe and the United States before tougher travel restrictions were put in place.

In mid-March, lulled into a false sense of security by the low official infection count and desperate to return to normal life, the government proposed reopening schools in regions less affected by the virus.

Prime Minister Shinzo Abe warned of the need for “continued caution” â€" but to many critics, the messaging appeared confused and complacent.

Cherry blossom crowds

On March 21, Japan began a three-day weekend to celebrate the spring equinox. The sun was shining, the cherry blossoms were blooming, and Tokyo’s residents poured into parks for picnics, and packed the city’s bars and restaurants.

It wasn’t long before Japan began to pay a price.

More infection clusters began to emerge â€" at a bar in Sendai in northeastern Japan packed with 300 students, at a nightclub in Tokyo’s Shibuya district, at restaurants and bars elsewhere.

Finally, on March 28, Oshitani’s colleague Hiroshi Nishiura appealed to Tokyo’s metropolitan government for stronger action. Two days later, city governor Yuriko Koike called on people to refrain from going to karaoke rooms, concert venues, bars and nightclubs.

“We apologize for this inconvenient request,” Nishiura said at a news conference, explaining that 30 percent of new infections were coming from nightspots. “Many infected people are not fully sharing details.”

But the cluster-based approach also became overwhelmed as the virus spread through Tokyo and the number of untraceable infections jumped.

It became clear that a change in strategy was required, and that the government needed to aggressively expand testing. “This is a clear problem,” Oshitani told NHK.

“The government’s expert panel has repeatedly argued for an increase, and this is now part of the government’s policy,” he said. “But testing centers aren’t being set up quickly or effectively. I believe this has led to the current situation.”

Oshitani said Japan was “on the brink of disaster,” facing a collapse in the medical system.

Nightlife went on

In Tokyo, though, nightlife was still humming.

The idea of Japanese exceptionalism had taken root: Infections were low, people believed, because Japanese people wear masks, rarely shake hands and don’t wear their shoes indoors.

In the documentary, NHK said a “chasm had opened up” between the sense of crisis felt by Oshitani’s team and the public’s relaxed attitude.

The public broadcaster did not say so, but in the middle stood a government and bureaucracy that refused to admit that its initial low-cost strategy was failing.

“Traditionally speaking and historically speaking, Japan isn’t very good at changing strategy,” said Kentaro Iwata, an infectious-disease expert at Kobe University.

“When we begin one strategy, we are very poor at converting it to Plan B, or even thinking of Plan B, because thinking of plan B is a sign of admitting the failure of Plan A,” Iwata said. “And lots of people who are in charge of infection control, particularly the bureaucrats, really dislike the possibility of failure.”

Soon after, the Japanese Medical Association warned that the health-care system was on the verge of breakdown. The Japanese Society for Intensive Care Medicine warned of a critical shortage of ICU beds and nurses.

Finally, on April 7, the government acted. Abe declared a one-month state of emergency covering seven of the country’s 47 prefectures. On April 16, he extended the state of emergency to cover the whole country.

But the measures remain incomplete: Nightclubs have been asked to close, but bars and restaurants are allowed to stay open until 8 p.m.

Not everyone has learned a lesson. On April 9, opposition lawmaker Takashi Takai visited a club offering sex services in Tokyo’s Kabuchiko district. Exposed by a local magazine, he resigned.

The government, too, seemed to have a blind spot. It had ignored sex workers when it initially drew up its economic relief package, and changed course to make them eligible for compensation payments only after an outcry from activists and opposition politicians.

Commuter traffic on Tokyo’s metro system has fallen by 60 or 70 percent, while the number of people at busy spots in the city is down a similar amount. That’s short of the official target of an 80 percent reduction in social contacts.

The daily count of new infections has stabilized but not fallen sharply, and fears are rising that the government will not be able to lift the state of emergency on May 6.

Akiko Kashiwagi contributed to this report.