Last year, Asia — especially East Asia — was often touted as a model of effective pandemic response. While Western countries endured harsh lockdowns, and soaring infection and death rates, Asian countries largely kept COVID-19 under control. The tables have since turned, with East Asia lagging far behind the US and Europe on vaccinations. This does not bode well for this summer’s Olympic and Paralympic Games in Tokyo.
As of Tuesday last week, Japan had the second-worst vaccination record among the 38 Organisation for Economic Co-operation and Development (OECD) countries, with 20.9 doses per 100 people. Contrast that with the UK’s 106.1 doses per 100 people, and the US rate of 93.3 doses per 100.
Why is Japan lagging so far behind the rest of the OECD? For starters, the government was late in securing purchase agreements with vaccine producers, not least because the Ministry of Health, Labor and Welfare was reluctant to provide rapid emergency approval to new vaccines.
Japan has a history of controversy over vaccine side effects. For example, the government approved human papillomavirus vaccines in 2009 and listed them for regular administration in 2013. Just two months later, the government withdrew its recommendation to use the vaccine in girls, after a series of alleged adverse post-immunization events stoked public concerns about the vaccine’s safety.
During the COVID-19 crisis, the authorities insisted that a clinical trial for vaccines be conducted in Japan before approval, even though large-scale randomized controlled trials, involving more than 40,000 people, had already been undertaken elsewhere. The Japanese clinical trial provided little useful information: It involved only 160 people and researchers checked only for antibodies, not asymptomatic infections. Yet it delayed the immunization drive by three months.
Another obstacle for Japan’s vaccination program is the rule that only medical doctors and nurses may administer doses. The US began with a similar rule, but municipalities quickly expanded eligibility to include dentists, veterinarians, emergency medical technicians and clinical laboratory technicians. In New York, pharmacists, dental hygienists, podiatrists and other medical workers and medical students are eligible to administer jabs.
So, while New Yorkers return to pre-pandemic life, Japanese are facing a new surge of COVID-19 infections and lockdowns. On April 25, the government declared a state of emergency in Tokyo and the Osaka area — the third since the pandemic began.
The state of emergency — which requires, for example, that restaurants close at 8pm and prohibits the sale of alcohol — was subsequently expanded to encompass 10 prefectures. Eight more are under a softer lockdown.
While the state of emergency was lifted for nine prefectures on Sunday, it could be reinstated, given the painfully slow decline in COVID-19 infections. There is no guarantee that another wave would not demand new lockdowns soon. With the Olympic Games scheduled to be held from July 23 to Aug. 8, and the Paralympic Games from Aug. 24 to Sept. 5, such a wave could be more like a tsunami.
During the Games, a significant share of Tokyo’s medical resources would be diverted from the COVID-19 response, to meet the needs of competitors and their supporting staff. Moreover, a huge number of people from around the world would travel to Tokyo — potentially bringing dangerous coronavirus variants with them. It should come as no surprise that 83 percent of Japan’s residents oppose holding the Games as scheduled.
Japanese Prime Minister Yoshihide Suga’s administration has attempted to assuage people’s fears, pledging to bring in additional medical resources and keep all visitors in a “bubble” that covers hotels, event facilities and transportation between them.
Opposition parties accuse the government of failing to produce a convincing safety plan, and, after more than a year of strict rules and sharp reversals, the public is unconvinced.
The Suga government’s best hope for regaining the public’s trust is to scale up its vaccination drive rapidly.
This would require, among other things, expanding significantly the number of people permitted to administer doses. Even if Japan follows the trajectory of the US, which was in the position Japan is in today four months ago, it would not achieve widespread vaccination until about mid-October — long after Olympic and Paralympic athletes have gone home.
Without herd immunity (or something close to it) in Japan, hosting the Tokyo Games is a risky bet. Suga could win big: If the Games are a success, and infections do not rise, he is more likely to be re-elected as the leader of his Liberal Democratic Party, at which point he might even call a snap general election. That does not change the fact that he is willing to gamble with people’s health, livelihoods, and lives.
Takatoshi Ito, a former Japanese deputy vice minister of finance for international affairs, is an economics professor at Columbia University’s School of International and Public Affairs, and a senior professor at Tokyo University’s National Graduate Institute for Policy Studies.
Copyright: Project Syndicate
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