Scientists probe Japan’s remarkable COVID success

Tokyo — the notable of Japan coronavirus pandemic resilience has generated dozens of possible explanations, from the country’s preference for going indoors without shoes, to the supposedly low-aerosol-generating nature of Japan’s silent conversation, to the beneficial gut bacteria of its citizens. Even irreligion – which would have spared Japanese people exposure to crowded houses of worship – has been touted as a virtue in the age of COVID-19.

Despite having the oldest population in the world, with nearly one in three residents aged 65 or over, Japan has had fewer COVID deaths per capita than almost any other developed country. As of Thursday, Japan had recorded just 246 COVID-19 deaths per million population, surpassing even New Zealand (263) which had initially adopted a maximum zero COVID suppression strategy. By comparison, the United States has a cumulative death toll of 3,045 deaths per million population.

But COVID mortality statistics alone, often based on inconsistent and/or incomplete records, don’t tell the whole story. Researchers estimate that Japan has recorded 111,000 “excess deaths”, more than five times the number of reported COVID deaths, when mortality due to disruption of medical care and social dislocation is taken into account.

Japan’s excess mortality rate, at 44 per 100,000, far exceeds that of South Korea (4), Singapore (-15), Australia (-37), New Zealand (-9) ; China (0.6) and Taiwan (-5). Even less wealthy Vietnam and Thailand fared better.

But compared to the United States (179) and Europe (140), Japan remains in the lead. Some experts believe that the congratulations for this relative success belong above all to the citizens of Japan, for their willingness to cooperate with antiviral measures.

“Japan’s approach to COVID response has been primarily based on people’s effort,” not the imposition of mandates, said Kenji Shibuya, research director of the Tokyo Foundation for Policy Research, at CBS News. “These kinds of voluntary efforts, rather than draconian top-down measures, have worked.”

Peer pressure to wear face masks remains such a powerful force in Japan – even as heatstroke season approaches – that the national health ministry has been forced to publish a brochure urging people not to wear masks when walking their dogs, biking, jogging or just commuting to work.

In addition to the almost ubiquitous use of masks, Japan’s vaccination program, which was initially delayed but then quickly implemented, is credited with saving lives. Despite initial fears about vaccine hesitancy, two-thirds of all citizens and about 90% of seniors have now received boosters.

Japan’s generally healthy population has also helped it weather the pandemic. Lifespan continued to increase for four decades, giving Japanese people the highest average longevity in the world, at 87 for women and 81 for men. While the obesity rate in the United States climbed to nearly 42% in 2020Japan has one of the lowest obesity rates in the world, at around 4%.

Thanks in part to its universal health insurance plan, rates of cancer and heart disease are also low. Like obesity, these diseases are major underlying risk factors for complications from coronavirus infection.

Meanwhile, scientists have probed a theory that the Japanese may have an inherent advantage at the cellular level when it comes to fighting COVID.

Researchers at the state-funded RIKEN Center for Integrative Medical Sciences looked at human leukocyte antigens (HLA), proteins found on most cells throughout our bodies, as a potential antiviral defense. HLA markers are well known in the field of organ transplantation, where matching HLA types, not just blood types, is crucial to reducing the risk of organ rejection.

by Riken study found that Japanese subjects with HLA type A24, common here and in some other parts of Asia, develop “cross-reactive” T cells in response to seasonal coronaviruses, or colds, which can redeploy to kill COVID-19 infections much more quickly and efficiently than in those without this specific marker.

Shin-ichiro Fujii, who is leading the study, told CBS News he had asked to conduct clinical trials of a vaccine for immunocompromised cancer patients that would simulate the benefit of having HLA type A24 proteins in people unable to develop neutralizing antibodies. existing vaccines.

“The real hope,” he said in a statement, “is that we will be able to develop vaccines that can stimulate a highly targeted T-cell response against infection. We have demonstrated that this might be possible in this particular HLA group, but now need to look at other types.”