7 ms·

The riddle of Japan's dramatic drop in Covid numbers

38 points by SQL2219 5y ago

kranke155 5y ago
- Jeema101 5y ago
  That rumor seems to have originated with a right-wing American broadcaster, but more importantly, ivermectin isn't approved for use as a Covid treatment in Japan: https://www.newshub.co.nz/home/world/2021/11/coronavirus-fact-check-did-mutations-or-ivermectin-help-stamp-out-delta-in-japan.html https://www.newshub.co.nz/home/world/2021/11/coronavirus-fac...
- bsaul 5y ago
  Please people, don't downvote this. We all know ivermectin has been "debunked" a lot of time, and yet others people keep reporting that "it works". And among those people a lot of them will indeed point out a few videos from japan (and other times india) with "doctors" (don't know who they are) advocating for ivermerctin. So yes, it would be a very interesting data point to know for sure what's the real situation there regarding treatments like ivermectin.
  - dogleash 5y ago
    >it would be a very interesting data point to know for sure what's the real situation there regarding treatments like ivermectin. The efficacy of ivermectin is a proxy war for something that has zero to do with treating a disease. As such, by the time you find a satisfyingly-conclusive answer, you won't actually care anymore.
  - adevx 5y ago
    Clearly there are a lot of doctors that have good experiences with ivermectin. On an FDA approved dosage, it is one of the safest drugs available. Yet there seems to be a crusade against it. It is beyond me why such cheap and safe drug that has helped many, especially in the early stages of a covid19 infection, is being so strongly censored. In the Netherlands, we advise those coming down with covid19 to wait until things get so bad one needs to go to the hospital. Why not try ivermectin at this stage.
    - epakai 5y ago
      It has been tried. There are still ongoing trials. The evidence so far points to ivermectin being beneficial for people with parasites suppressing their immune systems. Studies in areas without common parasitic infections tend to show no effect. Basically we have better treatments both in-hospital (remdesivir), and out (monoclonal antibodies, new Pfizer pill soon). Nevermind prevention of serious symptoms with vaccine is our best tool.
      - bsaul 5y ago
        i thought remdesivir has been proven totally useless a while ago ?
        epakai 5y ago
        It's the treatment my family member received in November. https://pubmed.ncbi.nlm.nih.gov/34331674/ https://pubmed.ncbi.nlm.nih.gov/34331674/ 2021 July. Seems like a reasonable treatment by these measures.
  - kranke155 5y ago
    I don't know what's true or not - one side insists on it, while large scale trials seem to be ongoiong, some have failed, some trials appear to have been fraudulent. Yet some people, including some physicians, seem to insist on it so I'd like to know what's going on. But it's difficult through the fog of misinfo.
b0sk 5y ago
The Japanese religiously follow the 3 C's (https://www.mhlw.go.jp/content/3CS.pdf https://www.mhlw.go.jp/content/3CS.pdf) which happens to be the major way the virus spreads.
- marcan_42 5y ago
  They actually started certifying venues for air exchange rate early on in the pandemic, there's hand sanitizer pretty much at every shop, everyone wears a mask, plexi panels and other barriers are common, people get told to check their body temperature and not attend events if >37.5, many places actually have thermal cameras or other measurement devices at the entrance, etc. Add the vaccination rate to all that and it's not hard to see how the R number dropped to <1 (and stayed there). Though we may be rebounding slightly in the last few days, so we'll see whether it's the start of a new wave or not. Whether we get a significant year end wave like we did last year will tell the story.
  - everybodyknows 5y ago
    > certifying venues for air exchange rate early on in the pandemic The wisdom of this as a public investment in health seems so obvious that I keep wondering why there's been no similar progress discernible here in the States, followed up with tighter HVAC requirements in building codes.
  - deleted 5y ago
    [deleted]
derbOac 5y ago
Does anyone know what reporting practices are like in Japan? I'm definitely not meaning to cast aspersions but I remember early in the pandemic there were concerns cases were being underreported, in part due to issues related to the Olympics. The Olympics have passed but was there truth to any of it and if so is it still an issue?
geofft 5y ago
> The vaccine is one barrier keeping the virus at bay. Oka says that it's a social norm in Japan to keep another kind of barrier over people's mouths and noses. > "Even though I keep having no COVID patients, I haven't seen anybody on the street in Japan not wearing masks," observers Oka. "Even though they think it may not be necessary, there is pressure for people to do the same as everyone else." This is probably not sufficient, as the article points out South Korea has much the same culture. But it seems definitely necessary.
boeingUH60 5y ago
Anecdote here. I live in Nigeria, what you'll call a third-world country, and our Covid journey has been funny. We basically took much precautions earlier in the pandemic but later on reverted to life as usual. Markets, restaurants, offices, et al are wide open and people are going about their lives pre-pandemic, however our Covid rates are relatively low; barely 3,000 deaths from a population of 200 million+ if we're to believe the data from our health agency [1]. More so, we're only about 2% vaccinated [2] (I'm included in this group), but with that quite dire rate, I don't really observe a gloomy pandemic around us. I honestly can't point to anyone in my social circles who died of Covid, but there are a few infections whom all recovered quickly. I'm still trying to understand why, because my common sense expects that Covid should be dealing with us due to our very low vaccination rate. Are the numbers forged? Are we just ignoring the misery around us? I can't tell but I'm hoping for a scientific explanation. Perhaps, if there's an expert immunologist around here should please give me an opinion, I'm all ears and asking in good faith. 1- https://covid19.ncdc.gov.ng/ https://covid19.ncdc.gov.ng/ 2 - https://ourworldindata.org/covid-vaccinations?country=OWID_WRL https://ourworldindata.org/covid-vaccinations?country=OWID_W...
- blitzar 5y ago
  1) Age. 2) Obesity rate. 3) Climate.
- mrtnmcc 5y ago
  Susceptibility to severe Covid-19 disease is linked to Neanderthal genes, which Africans wouldn't have? https://www.nature.com/articles/s41586-020-2818-3 https://www.nature.com/articles/s41586-020-2818-3 (I'm interested in this, as I had severe covid with no prior health problems, but do have these N genes).
em500 5y ago
It's not just Japan, we've seen this pattern in various countries in many phases of the pandemic, like the Delta wave in spring India and the recent Omicron wave in South Africa which seems to have peaked. For some reason, we see waves that appear to crash and recede long before the majority of the population is no longer succeptible (either through vaccination or infection). I believe the reason(s) are still largely unknown. There are multiple plausible explanatory factors, but nothing be really validated. And especially structural explanations (local age distribution, underlying comobidities, population genetics) seem inadequate to account for the huge time variation in cases/deaths. To the point, nobody can confidently predict if Japan, India or South Africa won't have another huge wave 3 or 6 months from now.
vibrato2 5y ago
mensetmanusman 5y ago
Japan has an order of magnitude lower obesity, surprised that isn’t mentioned in the article. If you are exposed to the virus and are obese you are far more likely to experience covid.
- melling 5y ago
  People often overlook that Japan has had fewer than 2 million infected people. If you don’t get infected, you don’t get sick https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
- fomine3 5y ago
  Comparing with Korea would be interesting. Similar culture and health.
- dham 5y ago
  You'll never hear that from any news outlet or government unfortunately. One size fits all
  - dang 5y ago
    Can you please stop posting unsubstantive/flamebait comments like this to HN, and also, can you please stop posting primarily for ideological battle? Your account has become close to a single-purpose account (arguing about one thing) which is not allowed on HN—it goes against the intended spirit of this place, which is curious conversation on unpredictable things. If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
- guiriduro 5y ago
  Irrelevant to the figures for covid contagion, though.
  - prepend 5y ago
    I don’t think so. High viral loads lead to more spread, right? So if people have less comorbidities and that contributes to both less spread and less severe infections it should reduce contagion. Or I suppose contagion is still occurring but isn’t detected because the infections are subclinical and the host never even tests.
jacknews 5y ago
It's a dramatic drop in reported numbers. Perhaps occam's razor applies.
- GameOfFrowns 5y ago
  >Perhaps occam's razor applies. Which means what exactly within this context?
  - geofft 5y ago
    Somehow I get the feeling that what was intended was "A shadowy global cabal is trying to steal freedom from America and is suppressing reports in Japan," but I do agree Occam's Razor applies and yields the result "People in Japan wear masks in public and have been used to wearing masks in public for years every flu season and don't whine about it."
    - xboxnolifes 5y ago
      There doesn't require a shadowy, global cabal for a single country to tamper with their own reports.
      - geofft 5y ago
        But why would one single country tamper with their own reports - that is, what would motivate Japan, more than other countries, to tamper with their reports? Like I see the argument for why all countries would want to make themselves look good. (It's weak, because if people start dying in ways they're not tracking they have bigger problems, but I can see the argument that the motivation exists.) And I can perhaps see the argument that the more autocratic a country is, the more likely they are to do so. But none of that explains the observation "Japan is reporting a low number of covid cases compared to other similar countries" - and especially not "Japan is reporting a sudden drop in covid cases compared to other similar countries." You need to multiply a lot more entities to get there.
rich_sasha 5y ago
> Yet another theory, she adds, holds that the delta variant in Japan has mutated so that it has lost the ability to replicate, pushing itself toward extinction. How does that work? A single mutation that decreases transmissivity (anywhere between 0-100%) presumably loses out to the regular variant. So did any such mutation develop spontaneously in many viruses? Can't see how that could happen.

38 points by SQL2219 5y ago

Jeema101 5y ago
That rumor seems to have originated with a right-wing American broadcaster, but more importantly, ivermectin isn't approved for use as a Covid treatment in Japan: https://www.newshub.co.nz/home/world/2021/11/coronavirus-fact-check-did-mutations-or-ivermectin-help-stamp-out-delta-in-japan.html https://www.newshub.co.nz/home/world/2021/11/coronavirus-fac...
bsaul 5y ago
Please people, don't downvote this. We all know ivermectin has been "debunked" a lot of time, and yet others people keep reporting that "it works". And among those people a lot of them will indeed point out a few videos from japan (and other times india) with "doctors" (don't know who they are) advocating for ivermerctin. So yes, it would be a very interesting data point to know for sure what's the real situation there regarding treatments like ivermectin.
- dogleash 5y ago
  >it would be a very interesting data point to know for sure what's the real situation there regarding treatments like ivermectin. The efficacy of ivermectin is a proxy war for something that has zero to do with treating a disease. As such, by the time you find a satisfyingly-conclusive answer, you won't actually care anymore.
- adevx 5y ago
  Clearly there are a lot of doctors that have good experiences with ivermectin. On an FDA approved dosage, it is one of the safest drugs available. Yet there seems to be a crusade against it. It is beyond me why such cheap and safe drug that has helped many, especially in the early stages of a covid19 infection, is being so strongly censored. In the Netherlands, we advise those coming down with covid19 to wait until things get so bad one needs to go to the hospital. Why not try ivermectin at this stage.
  - epakai 5y ago
    It has been tried. There are still ongoing trials. The evidence so far points to ivermectin being beneficial for people with parasites suppressing their immune systems. Studies in areas without common parasitic infections tend to show no effect. Basically we have better treatments both in-hospital (remdesivir), and out (monoclonal antibodies, new Pfizer pill soon). Nevermind prevention of serious symptoms with vaccine is our best tool.
    - bsaul 5y ago
      i thought remdesivir has been proven totally useless a while ago ?
      - epakai 5y ago
        It's the treatment my family member received in November. https://pubmed.ncbi.nlm.nih.gov/34331674/ https://pubmed.ncbi.nlm.nih.gov/34331674/ 2021 July. Seems like a reasonable treatment by these measures.
- kranke155 5y ago
  I don't know what's true or not - one side insists on it, while large scale trials seem to be ongoiong, some have failed, some trials appear to have been fraudulent. Yet some people, including some physicians, seem to insist on it so I'd like to know what's going on. But it's difficult through the fog of misinfo.

b0sk 5y ago

The Japanese religiously follow the 3 C's (https://www.mhlw.go.jp/content/3CS.pdf https://www.mhlw.go.jp/content/3CS.pdf) which happens to be the major way the virus spreads.

marcan_42 5y ago
They actually started certifying venues for air exchange rate early on in the pandemic, there's hand sanitizer pretty much at every shop, everyone wears a mask, plexi panels and other barriers are common, people get told to check their body temperature and not attend events if >37.5, many places actually have thermal cameras or other measurement devices at the entrance, etc. Add the vaccination rate to all that and it's not hard to see how the R number dropped to <1 (and stayed there). Though we may be rebounding slightly in the last few days, so we'll see whether it's the start of a new wave or not. Whether we get a significant year end wave like we did last year will tell the story.
- everybodyknows 5y ago
  > certifying venues for air exchange rate early on in the pandemic The wisdom of this as a public investment in health seems so obvious that I keep wondering why there's been no similar progress discernible here in the States, followed up with tighter HVAC requirements in building codes.
- deleted 5y ago
  [deleted]

derbOac 5y ago

Does anyone know what reporting practices are like in Japan? I'm definitely not meaning to cast aspersions but I remember early in the pandemic there were concerns cases were being underreported, in part due to issues related to the Olympics. The Olympics have passed but was there truth to any of it and if so is it still an issue?

geofft 5y ago

> The vaccine is one barrier keeping the virus at bay. Oka says that it's a social norm in Japan to keep another kind of barrier over people's mouths and noses. > "Even though I keep having no COVID patients, I haven't seen anybody on the street in Japan not wearing masks," observers Oka. "Even though they think it may not be necessary, there is pressure for people to do the same as everyone else." This is probably not sufficient, as the article points out South Korea has much the same culture. But it seems definitely necessary.

boeingUH60 5y ago

Anecdote here. I live in Nigeria, what you'll call a third-world country, and our Covid journey has been funny. We basically took much precautions earlier in the pandemic but later on reverted to life as usual. Markets, restaurants, offices, et al are wide open and people are going about their lives pre-pandemic, however our Covid rates are relatively low; barely 3,000 deaths from a population of 200 million+ if we're to believe the data from our health agency [1]. More so, we're only about 2% vaccinated [2] (I'm included in this group), but with that quite dire rate, I don't really observe a gloomy pandemic around us. I honestly can't point to anyone in my social circles who died of Covid, but there are a few infections whom all recovered quickly. I'm still trying to understand why, because my common sense expects that Covid should be dealing with us due to our very low vaccination rate. Are the numbers forged? Are we just ignoring the misery around us? I can't tell but I'm hoping for a scientific explanation. Perhaps, if there's an expert immunologist around here should please give me an opinion, I'm all ears and asking in good faith. 1- https://covid19.ncdc.gov.ng/ https://covid19.ncdc.gov.ng/ 2 - https://ourworldindata.org/covid-vaccinations?country=OWID_WRL https://ourworldindata.org/covid-vaccinations?country=OWID_W...

blitzar 5y ago
1) Age. 2) Obesity rate. 3) Climate.
mrtnmcc 5y ago
Susceptibility to severe Covid-19 disease is linked to Neanderthal genes, which Africans wouldn't have? https://www.nature.com/articles/s41586-020-2818-3 https://www.nature.com/articles/s41586-020-2818-3 (I'm interested in this, as I had severe covid with no prior health problems, but do have these N genes).

em500 5y ago

It's not just Japan, we've seen this pattern in various countries in many phases of the pandemic, like the Delta wave in spring India and the recent Omicron wave in South Africa which seems to have peaked. For some reason, we see waves that appear to crash and recede long before the majority of the population is no longer succeptible (either through vaccination or infection). I believe the reason(s) are still largely unknown. There are multiple plausible explanatory factors, but nothing be really validated. And especially structural explanations (local age distribution, underlying comobidities, population genetics) seem inadequate to account for the huge time variation in cases/deaths. To the point, nobody can confidently predict if Japan, India or South Africa won't have another huge wave 3 or 6 months from now.

vibrato2 5y ago

mensetmanusman 5y ago

Japan has an order of magnitude lower obesity, surprised that isn’t mentioned in the article. If you are exposed to the virus and are obese you are far more likely to experience covid.

melling 5y ago
People often overlook that Japan has had fewer than 2 million infected people. If you don’t get infected, you don’t get sick https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
fomine3 5y ago
Comparing with Korea would be interesting. Similar culture and health.
dham 5y ago
You'll never hear that from any news outlet or government unfortunately. One size fits all
- dang 5y ago
  Can you please stop posting unsubstantive/flamebait comments like this to HN, and also, can you please stop posting primarily for ideological battle? Your account has become close to a single-purpose account (arguing about one thing) which is not allowed on HN—it goes against the intended spirit of this place, which is curious conversation on unpredictable things. If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
guiriduro 5y ago
Irrelevant to the figures for covid contagion, though.
- prepend 5y ago
  I don’t think so. High viral loads lead to more spread, right? So if people have less comorbidities and that contributes to both less spread and less severe infections it should reduce contagion. Or I suppose contagion is still occurring but isn’t detected because the infections are subclinical and the host never even tests.

jacknews 5y ago

It's a dramatic drop in reported numbers. Perhaps occam's razor applies.

GameOfFrowns 5y ago
>Perhaps occam's razor applies. Which means what exactly within this context?
- geofft 5y ago
  Somehow I get the feeling that what was intended was "A shadowy global cabal is trying to steal freedom from America and is suppressing reports in Japan," but I do agree Occam's Razor applies and yields the result "People in Japan wear masks in public and have been used to wearing masks in public for years every flu season and don't whine about it."
  - xboxnolifes 5y ago
    There doesn't require a shadowy, global cabal for a single country to tamper with their own reports.
    - geofft 5y ago
      But why would one single country tamper with their own reports - that is, what would motivate Japan, more than other countries, to tamper with their reports? Like I see the argument for why all countries would want to make themselves look good. (It's weak, because if people start dying in ways they're not tracking they have bigger problems, but I can see the argument that the motivation exists.) And I can perhaps see the argument that the more autocratic a country is, the more likely they are to do so. But none of that explains the observation "Japan is reporting a low number of covid cases compared to other similar countries" - and especially not "Japan is reporting a sudden drop in covid cases compared to other similar countries." You need to multiply a lot more entities to get there.

rich_sasha 5y ago

> Yet another theory, she adds, holds that the delta variant in Japan has mutated so that it has lost the ability to replicate, pushing itself toward extinction. How does that work? A single mutation that decreases transmissivity (anywhere between 0-100%) presumably loses out to the regular variant. So did any such mutation develop spontaneously in many viruses? Can't see how that could happen.