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“Japanese bodies are different”. Why exceptionalism can be fatal.

Updated: Nov 23, 2022

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What’s gone wrong in Japan? I wrote four articles* between June last year and January this year comparing the Japanese management of the Coronavirus pandemic with what was happening in Europe, especially the UK. Japan, like so many east and south-east Asian countries, had coped far better. On January 7, almost a year after Covid-19 had arrived in Japan, I noted that there had been only 3,655 deaths from the disease out of a population of 127 million. At that point the UK had had 76,305 deaths out of a population of 67 million. In the fourth article, a week later, I explained why Japan had done so much better than the UK.

Yet since mid-January Covid cases in Japan have shot up, some hospitals have come close to turning patients away, and the number of those who have died from Covid-19 had reached over 12,819 on 29 May. Meanwhile, the significant minority of Japanese who a year ago were wanting the Tokyo Olympics to be cancelled rather than just postponed have been joined by most of their fellow citizens in wishing them scrapped. Why open Japan’s borders and allow tens of thousands of athletes, support staff and officials to come in and potentially infect a mostly unvaccinated Japanese people with Covid-19?

Okay, a death toll of 12,819 is still tiny compared to the UK’s 127,768. Moreover, whilst the number of Covid deaths per day in Japan is around 100 at present compared to the UK’s 10, the number of daily cases in Japan – 3,708 on 29 May and dropping – is lower than those in the UK – 4,182 and rising. Even so, the Japanese can no longer quietly boast that they, unlike us selfish, ill-disciplined Westerners, have handled the pandemic well. At least not in its later stage.

The chief reason for these recent failings was hinted at by me in my second article, written on 11 June last year, though I can’t claim to have recognised it at the time. I was commenting on a Japanese TV show which demonstrated how speaking English was one of the reasons non-Japanese were dying in much greater numbers than Japanese. This claim was one of forty-three reasons given by Japanese respondents to a widely-publicised survey. I wrote:

It’s a fascinating list, even if you ignore those which Google Translate fails to turn into comprehensible English. What’s more, many of the reasons given are echoed by Japanese infectious disease experts. All are agreed that there is no single over-riding explanation, except perhaps Taro Aso, the Finance Minister, who said late last month that it was because of the “superiority of the Japanese people”. Actually, that is probably a very common belief among ordinary Japanese, raised from birth to believe that they and their society are exceptional.

Japan started its roll-out of Covid-19 vaccines in mid-February, over two months after the UK did. Japanese officials said the delay was because not enough of the only vaccine approved by their drug regulator – the Pfizer-BioNTech one – had been sent from Europe. This was half-true at best. Stocks of this vaccine were indeed low. But that was because Japan only approved the vaccine in early February, more than two months after countries like the UK and USA. Why was Japan so late to the vaccine party? Because Japanese bodies are different to all other bodies on this planet. Surely, you knew that.

“Japanese bodies are different” was the official explanation given for the Japanese government’s refusal to accept help from American medical teams aboard US Navy ships stationed off Kobe after the Great Hanshin earthquake hit the city on January 17, 1995. I had spent a weekend in Kobe a few months earlier, staying with Swiss friends who had moved from Tokyo to Kobe partly to live in a place which had no history of serious earthquakes. They survived, though their house, high above Kobe’s harbour, did not. I took a particular interest in how the Japanese authorities dealt with this unexpected quake. The answer is badly. Over 6,400 people were killed and around 40,000 injured. The local yakuza (gangster) syndicate, Yamaguchi-gumi, one of the largest in Japan, did far more to help Kobe’s people in the first hours and days after the earthquake than did the government. But politicians, officials and gangsters were united on one thing: don’t let the gaijin (foreigners) in. And so American doctors and nurses with their life-saving equipment, drugs and skills were told to stay away because they would, apparently, not understand Japanese anatomy. Saving face was one reason. But so was the widespread belief among Japanese that their biology is different from everyone else’s. How many of those 6,400 might have lived if the American medics had been allowed ashore?

And so too with the Covid-19 vaccines. How many Japanese may have lived if the Japanese government had not delayed approving and rolling out the Pfizer-BioNTech vaccine? Pfizer-BioNTech conducted clinical trials of their vaccine between April and November 2020 on 46,331 people in six countries – Germany, USA, Turkey, South Africa, Brazil and Argentina. Apparently, there were about 2,000 “Asians” among these 46,331. I’m guessing but I’d be prepared to bet that some of those “Asians” were Brazilians of Japanese descent. Brazil has the largest population of Japanese origin outside Japan itself. Whatever the truth about these 2000 “Asians”, the fact is that as far as the Japanese drug regulator was concerned no Japanese were tested. Ergo, the vaccine could not be approved for use on Japanese bodies.

Instead, the Japanese regulator insisted that additional trials be conducted on 160 Japanese people. The reaction inside Japan to this decision was mixed. Some medical experts said this extra testing involved too few people to be conclusive and would only delay the roll-out. But they were a minority. Many demanded that the trial be conducted on a much larger number of Japanese bodies before approval should be given. The regulator stuck with the 160. And until a few days ago had approved only one vaccine – the Pfizer-BioNTech one. Do I need to tell you why the Oxford Astra Zeneca and Moderna vaccines have only just got the nod from the Japanese regulator?

Result? Only 1.5 % of the population have so far received two doses of the Pfizer-BioNTech vaccine, while 4.5% have had the first dose. Only a third of the 4.8 million medical workers who have been designated as top priority have had both doses. Only 500,000 or so of the 36 million elderly (those aged 65 or older) had had their first shots by mid-May.

Is this glacially-slow roll-out due to a shortage of supplies? No. Japan has placed orders for 364 million doses, all of which are supposed to arrive by the end of this year. According to The Economist there are currently 10 million doses in freezers waiting to be used. Why aren’t they being used? Because there are too few people qualified to administer the vaccine.

Meet another Japanese obsession: quality. This, of course, is normally considered a great strength. Whatever it is, if it’s been made in Japan it must be of the highest quality. But this strength becomes a fatal weakness in an emergency. Quality to the Japanese is only achieved after a lot of hard work and only by people with the right qualifications. Want to administer a life-saving vaccine in the correct way to be certain of avoiding any mishaps? Only let qualified doctors and nurses do it.

The Japanese ministry of health has now authorized dentists to administer the vaccine. But they have yet to be called on to do so. How about pharmacists, as in the US and France? No way. What about volunteers without any medical knowledge or qualifications, as in the UK? As a Brit who lived and worked in Japan, it’s not hard for me to imagine the Japanese disbelief, expressed in the politest possible way: “Ah, yes. UK quality. Very interesting.”

Any foreigner who has spent any time in Japan will be able to tell you a story of Japanese exceptionalism. The one that I can remember best also concerns Japanese anatomy. A Japanese scientist working as a researcher for Nippon Lever, the Japanese subsidiary of Unilever, was doing a one-to-one course at my company’s training centre in Tokyo. Her Australian trainer asked me to act as her British boss in a presentation she was about to make to him. I listened as she did her best to explain to me the difference between Korean hair and Japanese hair. She had a swatch of Korean hair and compared it to her own hair. I could see no difference and have since been told by someone who should know that there is no difference. But she was clearly convinced that there was. In a way she was right to think so. No Japanese consumer of shampoo will use a product which has not been specifically designed for Japanese hair. Unilever was asking its Japanese subsidiary to market a new shampoo which had been successfully sold in several Asian countries, including Korea. The researcher had been given the task of showing that it would work equally well at cleaning Japanese hair. She could not accept that. Japanese bodies are different.

The Japanese authorities have failed the Japanese people badly in their approval and administration of the Covid-19 vaccine. Many Japanese have needlessly died as a result and I fear many more will do so. But we Westerners should not crow. The incompetence of many of our politicians and officials has been far more lethal.

The failing that too many countries share is a belief in their own superiority and, consequently, that they have nothing to learn from others. How many of you Brits laughed scornfully when you read that the Japanese Finance Minister last June thought the Japanese had had so few deaths from Covid-19 because of the “superiority of the Japanese people”? Have you forgotten what the British Secretary of State for Education, Gavin Williamson, said on 3 December 2020? He claimed that the reason that the UK was the first to approve a coronavirus vaccine and roll out a vaccination programme was because “we’ve got the very best people in this country... Much better than the French have, much better than the Belgians have, much better than the Americans have… we’re a much better country than every single one of them, aren’t we?”

Not with people like you, Mr Williamson, we aren’t.



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