There is an eerie sense of safety here and one wonders why Japan is an outlier given that it has the world’s largest older population, densely populated and crowded cities, a very high smoking rate, and massive Chinese tourism––all factors attributed to COVID-19 vulnerability.  The schools were closed and many events canceled, but with no quarantine or enforced closures, much of Japan continues as normal compared to what is happening in the United States.

Three theories are prevalent––conspiracy, good fortune or effective government policies.

The conspiracy theory is rooted in Japan’s restricted testing and consequent low number of reported cases.  Many in Japan and in other countries attribute this to a government effort to protect the 2020 Tokyo Olympics by downplaying the extent of the COVID-19 infection particularly after the highly criticized handling of cruise ship incident.  While there may be some truth to this thought it is very unlikely that it was an organized conspiracy.  The Japanese medical community has been quite outspoken and critical of lax government policies.

The good fortune theory is based on cultural conditions such as relatively less social intimacy (e.g., bowing instead of shaking hands), a wide and accepted use of masks when feeling sick, an existing high rate of isolation among the elderly, and the obedient voluntary observance of a government requested two-week containment period of self-isolation and social distancing.  All true but IF Japan has indeed dodged a bullet, the element of luck alone may be a greater factor than cultural behavior.

The efficacy theory supports the government’s restricted testing policy and intense efforts focused on identified infection “clusters.”  So far it appears to be working but experts here and around the world question if the policy is sufficient and will continue to be effective with the two-week containment period ending.

Some of those experts predict that Japan has not yet seen the worst of COVID-19.

Indeed, along with the start of the new school year in April, they point to the start of hanami (cherry blossom viewing) season that includes large picnics and parties in Tokyo’s beautiful parks as a critical event.  Early evidence strongly suggests that Tokyoites will abandon self-restraint.  The Japanese love to party and the experts wonder if this may be a catalyst that brings Japan to a tipping point.