Calls are emerging in Japan to consider Covid-19 as endemic, joining a global chorus calling for a return to normalcy as people get tired of pandemic restrictions, vaccines become more widely available, and virus deaths stay low.

On the basis of research indicating that omicron poses a less severe risk than previous variants, public leaders from Tokyo’s governor to former Prime Minister Shinzo Abe have expressed support for the virus’s legal status being downgraded in Japan. Changing the rules would make it easier for people to get health care, making the virus seem like the flu.

It’s a discussion that’s burning all around the world, but especially in the West. In a recent interview with the radio station Cadena Ser, Spanish Prime Minister Pedro Sanchez called on Europe to treat the virus as a staple of everyday life. And, despite the rapid onset of omicron, countries from India to the United Kingdom are avoiding going to lockdowns, as politicians lose appetite for widespread disruptions.

In many ways, Japan is the most likely to shift in Asia, which has been significantly harder on virus containment since the pandemic began. Officials never used obligatory lockdowns, in part because the authority to use emergency measures during crises is not included in the constitution. Even as the number of infections climbed, Japan’s policies stood apart from those in places like China. Many calls for businesses to limit their hours of operation or mandate vaccinations can simply be ignored.

Downgrading Covid’s status would also have the immediate effect of freeing up medical resources for Japanese patients in hospitals that are currently refusing to treat Covid patients due to a lack of infection-control equipment.

Even so, Prime Minister Fumio Kishida has urged caution and blasted his predecessor for advocating for endemic status in an interview with a local news source earlier this month. Given the omicron caseload, Kishida told reporters last week that it’s still too early to downgrade the virus.

Japan reported more than 30,000 new cases on Tuesday, though “severe” ones rose by just 18, according to national broadcaster NHK. And broadly speaking, the public has also supported efforts to keep the virus out: After the government barred new foreign arrivals in November, an opinion poll found that almost 90% of people supported the measure.

Nevertheless, the topic has growing resonance in Japan, with Abe one of the highest-profile backers of softening curbs.

“Why don’t we go further this year and change the legal position of the coronavirus,” he said in an interview with Yomiuri. “As hospitalization is the principle treatment, the burden on medical institutions and health centers is heavy. We need to be cautious of omicron, but if drugs and vaccines can prevent the disease from becoming severe, we could treat Covid like seasonal influenza.”

A bigger shift in how Japan treats the virus may change public perception about the threat of infection, as well as help to diffuse the impact of future mutations.

Currently, Japan draws on 450 or so public health centers to contact trace and hospitalize people with the virus. Space is limited because hospitals, especially small or privately owned ones, can refuse to take patients unless they are severely ill.

Members of the public visit a PCR testing site in the Akihabara district of Tokyo, on Jan. 18.
Though deaths have remained low in Japan throughout the pandemic, despite the country’s large elderly population, scores of people have still been turned away from hospitals during previous waves. Hundreds were left to die at home without seeing a doctor.

Some countries have already started to see omicron waves peak. In South Africa, where the variant was first reported almost two months ago, the omicron death rate topped out at 15% of the delta wave, according to the National Institute of Communicable Diseases. The strain causes less severe disease, even in those who are unvaccinated or who haven’t had a prior infection, according to the latest South African research.

‘State of quasi emergency’

Japanese officials seem aware that forcing the infected into hospitals or quarantines might do more harm than good. As health facilities continue to fill up, Japan plans to impose a state of quasi emergency in Tokyo and several other parts of the country starting Friday, but requests for bars and restaurants to shorten their hours are still non-compulsory.

“We will stop the infection. We will not stop the society,” Yuriko Koike, Tokyo’s governor, told reporters last week. “We have to do both.”

Financial woes have weighed on Japan. The country’s economy was projected to grow by 1.8% in 2021, compared to 5.9% globally. Over the course of the pandemic, Japan has declared a state of emergency four other times, slowing the recovery of the world’s third-largest economy.

Japan has sent mixed messages about a broader relaxation, partly because the previous administration was ousted for a slow response to tackling infections. Kishida’s administration may be worried that downgrading the legal status of the virus could be perceived as weak. The dilution would also free the government from covering the cost of Covid hospital stays, putting the burden of payment on patients, a potentially unpopular proposition.

The government banned all foreign arrivals until the end of February — one of the most aggressive travel responses enacted globally due to omicron — but also cut the self-isolation period for close contacts to 10 days from 14 days. For medical workers, the rules were scrapped entirely last week.

While Western countries worry that removing the Covid stigma will discourage people from taking precautions like mask-wearing, that’s unlikely in Japan: Broad public cooperation and cultural norms have meant that people never stopped sanitizing their hands or wearing masks in public, even when new cases dropped.

During virus surges, many people canceled travel plans voluntarily, perhaps partly explaining why the country has escaped high fatalities. Almost 80% of residents are fully vaccinated with two shots, making Japan one of the most immunized among developed nations.

As Japan weighs its next move, Kishida has signaled that his government’s priority is finding a middle ground.

“The virus repeatedly mutates and we must take that into account,” he told reporters last Thursday. “We can’t keep changing the status every time the virus changes its form.”

Image Credit: Getty

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