Margarita Estévez-Abe PhD (Maxwell School of Citizenship and Public Affairs, Syracuse University) and Hiroo Ide PhD (Institute for Future Initiatives, The University of Tokyo)

The full report is available here:

Key findings:

• Despite being the most aged society in the world and having a high population density, Japan maintained low rates of deaths from COVID-19.
• Japan locked down long-term care facilities (LTCFs) during the first months of the pandemic, several weeks earlier than in Europe and the United States. This helped protect the most vulnerable elderly population from infection risks.
• The well-established protocols of prevention and control of communicable diseases such as influenza and tuberculosis In LTCFs proved to be effective in containing transmission of SARS-COV-2.  The rate of compliance with the protocols has been high.
• The Japanese government response to the pandemic has been primarily a routine bureaucratic response. The presence of public authorities exclusively devoted to the oversight of LTCFs contributed to swift institutional responses.
• The presence of effective channels of communication between the public authorities and LTCFs contributed to the swift implementation of government guidelines.
• The national government’s unwillingness to make PCR tests widely available to LTCFs and the population at large has been a major obstacle in ensuring safety of residents in LTCFs and users of other LTC services. Japan has almost solely relied on lengthy lockdowns of LTCFs. This is not an ideal solution to a prolonged pandemic.
• The Governmental campaign offer subsidies for domestic tourism (GoToTravel campaign) and eating out in restaurants (GoToEat campaign) led to the worst spikes in viral transmission during the final quarter of 2020
• The pandemic has revealed the most vulnerable aspects of the Japanese LTC system.  In particular, two characteristics of the Japanese LTC system have proved to be highly vulnerable to transmission of SARS-COV-2: Japan’s reliance on daycare and homecare services and the large number of LTC facilities that provide both residential and non-residential care services.