I am in Japan.
The number of CASES has always been far, far higher than the official stats--people seldom test here. Very very different to South Korea.
The low number of SEVERE CASES and FATALITIES is very real, though. If something were being covered up or if they were just failing to correctly diagnose the COVID fatalities, we'd be seeing big excesses in the total mortality figures, as most countries have. But we haven't. Total deaths from all causes in Japan have been lower than usual, for most of the pandemic. The lack of deaths and serious cases does appear to be genuine.
Those of us who live here are also slightly baffled and there are a lot of different theories, but a few ideas:
- The population has very low rates of obesity - this is a huge factor, without any doubt. It's also not a policy that you can just export to other countries
- Japanese doctors are very good at treating pneumonia in the elderly
- (Speculative) Smoking has been the norm in public indoor spaces in Japan until VERY recently - only just getting curbed these last few years, and still so many smoking restaurants. Restaurants etc. are in the habit of ventilating these spaces well and have some heavy duty ventilation equipment going - probably reduced severe cases, esp in first wave.
- The universal masking probably did quell both case numbers and severe cases (by reducing viral dose) in the initial phase of COVID, when we had variants that were easier to control. Not much good with omicron - but by the time we got to omicron, most people were vaccinated.
- Japanese habits are probably conducive to less spread and reduced viral doses, esp in the early stages with less contagious variants. People live alone in large numbers, tend to have a lot of physical distance from each other, seldom touch, don't hug often, don't often talk to strangers, and are just very risk averse and "safety-ist" by nature - they adapted habits even without a formal lockdown.
By the way, what I mean is that these are good cultural traits for suppressing a pandemic, not that they are good cultural traits in general.
They are bad traits if you are a demographically declining and isolationist power with a rapidly aging and shrinking population which desperately needs people to start being more spontaneous, hooking up, forming families and having more kids, taking risks, going overseas, doing new stuff, accepting immigrants into their country, encouraging foreign tourists to bring in revenues and doing a whole bunch of stuff like that - stuff which the Japanese now seem less likely to do than ever, now that COVID has cemented people's ideas that overseas and foreigners are dirty/dangerous and that the best life is one where you are terribly safe and quiet and interact with others as little as possible. The birthrate has continued to plummet and is showing no signs of the recovery that has been seen in many western countries.... I am grateful in many ways for having a fairly normal life here for the past couple of years. But the Japanese response to COVID and the hardening of attitudes towards outsiders, innovation and risk makes me really pessimistic about the future of this country.
Forgive me for going off at a slight tangent; it's just I feel like at the moment, people are often tending to assume that cultural practices that are good for reducing COVID risks must be good practices to adopt in the long run, and do not really think about the fact that trade offs are common in life.