As Cases Mount, Japan Rapidly Becomes a Coronavirus Hotbed

While the hundreds of cases aboard the ship have grabbed the world’s attention, they are not counted among Japan’s total.

As Cases Mount, Japan Rapidly Becomes a Coronavirus Hotbed
Workers in protective gear prepare to board the Diamond Princess cruise ship, operated by Carnival Corp., docked in Yokohama, Japan. (Photographer: Toru Hanai/Bloomberg)  

(Bloomberg) -- Japan is emerging as one of the riskiest places for the spread of the coronavirus, prompting criticism that Prime Minister Shinzo Abe’s government has misfired on its policies to block the outbreak.

The number of infections in Japan has more than doubled in the past week to 84, tying Singapore as the country outside mainland China with the most cases. The government is being faulted for being too slow to bar visitors from China and too lax in its quarantine of the Diamond Princess cruise ship, where infections surged during two weeks docked in Yokohama.

While the hundreds of cases aboard the ship have grabbed the world’s attention, they are not counted among Japan’s total. What appears to be more troublesome is that Japan is starting to see a surge in cases in multiple areas across the country – sometimes with little to link the outbreaks.

As Cases Mount, Japan Rapidly Becomes a Coronavirus Hotbed

Adding to the worries is that passengers began leaving the quarantined vessel Wednesday amid concerns some might later test positive and take the virus to more parts of Japan. The situation is growing more alarming as Japan’s elderly population and work ethic present high-risk scenarios for the outbreak’s spread.

‘Second Wuhan’

Professor Kentaro Iwata, a specialist of infectious diseases at Kobe University Hospital who said he boarded the Diamond Princess, posted a video to YouTube that went viral in Japan in which he slammed infection control aboard the boat as “completely inadequate.” He later deleted the videos and apologized, without elaborating.

As Cases Mount, Japan Rapidly Becomes a Coronavirus Hotbed

In an interview with Bloomberg News before deleting the videos, Iwata said Japan now faces a crucial period in its handling of the outbreak to prevent a “second Wuhan.”

“It’s a really critical moment to see whether Japan is going to see the containment of the disease or really suffer from the spread,” he said, adding that he rated the government’s response apart from the handling of the Diamond Princess. “I don’t know which way to go. I think it will be decided in the next couple of weeks.”

As Cases Mount, Japan Rapidly Becomes a Coronavirus Hotbed

While a handful of the cases in Japan are evacuees from Hubei province – the epicenter of the disease where Wuhan is located – the vast majority are Japan residents, many with no history of traveling to China. Among those have been several taxi drivers, suspected of having extensive interactions with the public before their diagnoses.

A party on board a pleasure boat for a group of taxi drivers is believed to be at the heart of one cluster of cases in Tokyo, spreading to at least 11 people. Among those infected was the mother-in-law of one of the drivers, who became Japan’s only confirmed domestic death from the virus to date. Three more cases were confirmed in Tokyo Wednesday, Kyodo News reported, including the case of a couple which authorities could not trace to another infection.

Health experts warn that the countries with the greatest public risks for the virus are poor states with few resources to fight the disease, such as China’s neighbor North Korea. Developed states with advanced health-care systems like Japan are best suited to treat patients and conduct tests to find those infected.

As Cases Mount, Japan Rapidly Becomes a Coronavirus Hotbed

However, a Bloomberg survey released Wednesday showed that economists see Japan falling into recession as the coronavirus pummels an economy already weakened by a sales tax hike.

“The Japanese government’s decision to wait for the China-friendly WHO to make its much-delayed declaration of a global health emergency led to the first cases of domestic person-to-person transmission and tarnished the country’s international reputation,” Richard Koo, chief economist at Nomura Research Institute, wrote in a report.

“The coronavirus will probably cause a substantial amount of economic damage in Japan,” Koo wrote. The Abe administration, he says, “managed to completely drop the ball on this issue.”

Rare Rebuke

As the threat of the coronavirus became apparent in January, Japan’s stance of rejecting travel bans for Chinese tourists stood in stark contrast to nations such as Australia, which barred entry. Chinese tourism to Japan hit a January record high, with Tokyo’s travel curbs only taking effect on Feb 1.

And while businesses in Hong Kong and Singapore implemented work-from-home experiments on a scale never before seen, Abe merely acknowledged telework as “one effective strategy.”

While a growing number of companies are banning events and allowing employees to work from home to contain the spread, there has been little push to implement a wide-scale lockdown. Tokyo rush-hour trains remained as packed as ever, leading Abe to call on Japan’s famously hard-working residents to stay home from work or students from school if they suspect they have a cold.

With the cases mounting internally, Japan received a rare rebuke from the U.S. Centers for Disease Control and Prevention over the way it managed the quarantine on the cruise ship, saying “it may not have been sufficient to prevent transmission.” The U.S. and others placed a 14-day quarantine on repatriated nationals, but about 500 people cleared by Japan left the ship Wednesday to go about their normal lives, and were told to call authorities if they feel ill.

The government has defended its policies and may have been stretched to find a facility on land to place the 3,700 people aboard the cruise ship in quarantine. Its National Institute of Infectious Diseases said the quarantine program on the Diamond Princess “was effective in reducing transmission among passengers.”

Infection Path

As Cases Mount, Japan Rapidly Becomes a Coronavirus Hotbed

Away from the Diamond Princess, an admission by the nation’s Health Minister Katsunobu Kato on Sunday that Japan had lost track of the route of some of the cases of infection in the country shocked many, and has led to increasing criticism of the government’s control efforts.

“It’s not correct to say they lost the path of infection,” Kazuhiro Haraguchi, a politician with the opposition Democratic Party for the People and former minister, said on Twitter. “By taking steps like only checking people from Hubei, they didn’t try to understand the full infection, or the dangers.”

A mass outbreak native to Japan is something the nation can ill afford, with two of its top economic standouts – a booming tourism sector and the 2020 Olympics – potentially under threat from the outbreak in China.

In the absence of travel bans, visitors to Japan fell only 1.1% in January, a drop that was mainly due to an ongoing spat with South Korea, with tourists from China lodging a surprising 23% increase compared with the year earlier. Meanwhile, the World Health Organization and the International Olympic Committee have refused to countenance any cancellation of the Olympics, set to begin in July. Others have said there is little that can be done to prevent the eventual spread of the disease.

“This virus spread very, very fast. Not only China, not only Japan, but also many other countries cannot catch up with the speed of this virus,” Hitoshi Oshitani, a professor of virology at Tohoku University, told reporters in Tokyo. Oshitani also sits on the government panel tackling the virus. “Even if they implemented a travel ban to all of China, it was too late.”

--With assistance from Isabel Reynolds.

To contact the reporter on this story: Gearoid Reidy in Tokyo at

To contact the editors responsible for this story: Gearoid Reidy at, Jon Herskovitz, Jeff Sutherland

©2020 Bloomberg L.P.

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