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Lessons from Japan on containing coronavirus could help U.S. reopen safely

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Lessons from Japan on containing coronavirus could help U.S. reopen safely
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In many ways, Japan’s experience of the coronavirus pandemic has paralleled America’s.

Americans have been told to wear masks, stay at least six feet apart, and wash their hands. But that’s not enough. People need to hear that, if they are desperate to see friends, they should do so outdoors as much as possible; that adding one other household to their quarantine group is much safer than adding five; that if a single person needs physical intimacy, having one partner — even if neither considers it a romantic relationship — is safer than a series of hookups; that they can stop disinfecting all their groceries while still avoiding higher-risk situations, such as spending time inside with large groups of people.

In the absence of lockdown restrictions, public health guidance will matter more than ever. People want to know what the rules are — and why they should follow them. As for the rules, there are two clear takeaways from Japan. One is to avoid what experts there call the “Three Cs” — closed spaces, crowded places, and close-contact settings in which people are talking face-to-face — rather than staying away from other people entirely. “Social distancing may work, but it doesn’t really help to continue normal social life,” Kazuto Suzuki, a professor of public policy at Hokkaido University who has written about Japan’s response,. “The ‘Three Cs’ are a much more pragmatic approach and very effective, while having a similar effect.” Japan’s Three Cs messaging evolved out of its novel approach to containing the coronavirus. While much of the rest of the world has relied on testing, tracing and isolation, Japan focused instead on identifying so-called “clusters” — groups of infections from a single location — and determining their common characteristics. , the country “found that most clusters originated in gyms, pubs, live music venues, karaoke rooms, and similar establishments where people gather, eat and drink, chat, sing, and work out or dance, rubbing shoulders for relatively extended periods of time. They also concluded that most of the primary cases that touched off large clusters were either asymptomatic or had very mild symptoms,” which means that even widespread testing would miss them. Hence the need for a more sustainable, targeted strategy — one that now seems ideally suited to a post-lockdown world. The other big lesson from Japan is that masks work. Face coverings have been universal there for months, in large part because “Japanese people [already] feel comfortable wearing masks on a daily basis,” as Shigeru Omi, vice chairman of the Japanese government’s expert coronavirus panel, recently. “Many people are allergic to pollen, so they do this during the cedar pollen season from the beginning of the year until spring, as well as to protect against influenza.” As evidence of the efficacy of masks, Japan did not trace any clusters to its notoriously crowded commuter trains, where riders are usually alone and not talking, their mouths and noses fully covered.wearing cloth face coverings in public settings where it is difficult to maintain social distancing, citing grocery stores, pharmacies and gas stations as examples. But like everything else in the U.S., mask wearing is already becoming politicized and polarized. According to, a full 87 percent of Americans who voted for Hillary Clinton in 2016 say they will continue to wear a cloth mask in public after lockdown ends; fewer than half as many Trump voters say the same. Likewise, 34 percent of Trump voters say the CDC’s recommendation is “too strict”; just 5 percent of Clinton voters agree. And , 33 percent of adults who strongly approve of Trump’s job performance now say that masks are not effective at preventing the spread of coronavirus — up from 12 percent in early April.

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