Fighting COVID-19: It’s the story, stupid

Fighting COVID-19: It's the story

The war against the new coronavirus is being fought on three fronts: medical professionals are on the front lines working to beat the infections; governments are trying to secure domestic public support for difficult measures; and those same governments compete in the court of international public opinion for credibility and leadership. Japan should be winning all three fights; instead the government is struggling, failing to effectively combat the infections and unable to win the confidence of publics at home and abroad.

In some senses, Japan’s failures are inexplicable. This government has had ample experience with contagious diseases and should have anticipated and planned for this type of contingency. According to a 2019 OECD analysis, Japan suffers on average four times more human casualties per inhabitant from disaster risks than other OECD members. Home to five of the 20 most dense metropolitan areas in the 300-city OECD metropolitan database, Japan’s high population density and international exchanges increase the risk of infectious disease outbreaks.

And, indeed, Japanese authorities have prepared. The OECD credited them with evaluating the main risks and their public health consequences with a scenario-based approach that combined “elaborate modeling and solid databases, the association of its world-class scientific research and the application of international guidelines,” which allowed Japan to identify a series of major risks and estimate their public health impacts.

Specific contagions might be unknowable — tests would have to be developed — but transmission vectors are predictable and protocols should have been ready to deploy. The OECD report concluded that “capabilities for public health preparedness and response in Japan are fairly robust.”

Real-world experience has driven home the need to be prepared. National emergencies — the 1995 Great Hanshin Earthquake, the 1995 sarin attack on the Tokyo subway system and the 2011 Great East Japan Earthquake — made plain the need for crisis planning. The 1995 sarin gas attack was a terrorist incident, but it underscored the need for health care surge capacity. The OECD concluded that it did: “Specific exposure to hazards has led Japan to make preparedness of public health emergencies a key priority, both internationally and domestically, and a strong set of policies are in place.”

The government understood the risks. In 2015, Japan hosted the U.N. World Conference on Disaster Risk Reduction. The meeting produced the Sendai Framework on Disaster Risk Reduction, which recognizes the need to enhance the resilience of health systems. A year later, Prime Minister Shinzo Abe chaired a Group of Seven summit in which global health topped the agenda. The group adopted the G7 Ise-Shima Vision for Global Health.

Yet, a failure to respond to crises, especially to learn from experience, is also expected in Japan. Responses are overly bureaucratized, which the OECD also recognized when it highlighted “overreliance on pre-planned emergency scenarios (that) revealed the limit of this approach in time of complex disasters such as the Great East Japan Earthquake. The lack of quality assurance of the implementation at the local level, the limited collaboration across ministries and levels of governments, and the insufficient number of real-condition exercises prevent Japan’s preparedness level from reaching its full potential.”

Some argue that Japan learned the wrong lessons from past crises, suggesting that the key takeaway from the 2009 influenza pandemic was fear that patients with mild symptoms would overrun medical facilities and high-risk cases would be denied treatment.

Whatever its capabilities, the consensus view is that Tokyo has mishandled the COVID-19 crisis. That contrasts with increasingly positive assessments of China’s reaction.

China should have been prepared for infectious diseases: It has had lots of practice. In 1956, an Asian flu outbreak killed between 1 million and 4 million people worldwide; in 2002, SARS claimed 774 lives in 17 counties; and in 2012, H7N9 infected over 1,200 people and killed 40 percent of them: All these diseases started in China.

To their credit, Chinese medical authorities identified the coronavirus outbreak by the end of 2019 and notified the World Health Organization. Yet whatever preparation and protocols may have been in place were undermined by the dictates of a political system that subordinated truth telling to the imperatives of Chinese Communist Party rule. Bad news was silenced because it was politically inconvenient.

After concealment became impossible, the Chinese authorities mobilized all their resources to change the narrative from one of catastrophic failure to heroic efforts to fight the outbreak. As important as the extraordinary measures Beijing used to counter the disease — locking down entire cities, forcing millions of people to stay in their homes and mobilizing the extensive national surveillance apparatus, using artificial intelligence, the social credit system, drones and CCTV systems to ensure compliance — was the marshaling of propaganda machinery to blast a message of competence and leadership to the Chinese people and the world.

The WHO applauded, calling the Chinese response “perhaps the most ambitious, agile and aggressive disease containment effort in history.” What many in the West consider draconian has inspired no small envy. The WHO concluded that the rest of the world “urgently needs access to China’s experience in responding to COVID-19, as well as the material goods it brings to the global response.”

Chinese officials acknowledged the endorsement; Vice Foreign Minister Ma Zhaoxu noted that “China’s vigorous efforts in virus containment and contribution to global public health has won worldwide recognition.”

Elsewhere, the messaging was louder, prouder and more demanding: A commentary in Xinhua, the official Chinese news agency, said “the world owes China a ‘thank you’ because without China’s great sacrifice and contributions, we could not have won valuable time for the world to fight against the novel coronavirus epidemic.”

China’s efforts to shape the narrative and use it to advance the CCP’s interests, both domestic and foreign, are smart. There doesn’t have to be a Sun Tzu aphorism about turning adversity into advantage to recognize its strategic value. What is remarkable is Japan’s failure to utilize its considerable strengths and advantages to advance its standing in the world.

Japan’s story would build on the country’s technological and planning skills, but even more significantly the society’s resilience, preference for order and ability to work together for a single purpose. Those features of national character stood out in earlier crises, and perhaps never more so (in the modern era) than after the 2011 “triple catastrophe” of the Great East Japan Earthquake, tsunami and the Fukushima nuclear disaster. Engaging in a genuine dialogue with the public and appealing to these attributes would galvanize society and help forge a better response.

China’s heavy-handed policies are required precisely because there is no trust in government or society. Japan’s sense of shared purpose and the resulting ability to mobilize with few resources are potential sources of soft power.

Of course, actually managing a crisis helps, but the Chinese case shows that a government can play catchup; initial mistakes don’t have to define perceptions of a country. But Tokyo must get on track — and fast.