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Japan's COVID-19 death toll relatively small, but basic measures still necessary: experts

A doctor checks images of a chest scan at St. Marianna University Hospital in the city of Kawasaki, Kanagawa Prefecture. The hospital remodeled its ICU into a unit exclusively for severe COVID-19 patients. Photo partially modified. (Mainichi/Junichi Sasaki)

TOKYO -- The first death from COVID-19 in Japan was confirmed in February after the new coronavirus started to spread in China, but several experts admit that they did not even initially imagine that the death toll in Japan would increase. Contrary to the initial optimistic views, however, the number of deaths surged beginning late March as infections spread.

At the same time, compared to the United States and countries in Europe, the number of COVID-19 deaths has been smaller in Japan, even though it now has over 1,000 fatalities. According to Our World in Data published by researchers from the University of Oxford and other institutions, the number of deaths per million people as of July 19 was 666.9 in Britain and 423.32 in the U.S. In Japan, meanwhile, the figure was 7.79.

The Japanese government's expert panel suggested that countermeasures against cluster infections had been effective in a report released in May. Tokyo Medical University's professor Atsuo Hamada, who is knowledgeable about infectious diseases, points out differences in medical systems in each country.

"There is no universal health care in the U.S. and those who are not insured hesitate to see a doctor. Furthermore, unlike Italy and other countries where medical spending financed by tax revenue has been cut, Japan's public medical insurance system is supported by businesses and insurance users, allowing for stable financial resources. As the medical system in Japan is well-supported, we were able to deal with the increasing number of cases," Hamada said.

Meanwhile, Japan's death toll per million is higher than seen in its neighbors such as Taiwan (0.29 per million) and South Korea (5.75 per million). Professor Kazuhiro Tateda at Toho University, who also serves as director of the Japanese Association for Infectious Diseases, said, "Taiwan and South Korea had called for people to remain indoors from the early stages and that probably was effective."

Those infected with the new coronavirus are known to develop a cytokine storm syndrome in some cases, in which their immune system that is supposed to protect the body from a virus overreacts. Tateda points out that many patients with severe COVID-19 cases develop cytokine storm complications. In such cases, immune cells attack normal cells in organs such as the lungs, kidneys and liver, triggering serious diseases. When cells of the interior walls of blood vessels are damaged, it creates blood clots, causing heart attacks, stroke and organ failures, which could lead to death. Underlying conditions, including cardiovascular diseases and conditions such as obesity and smoking, are thought to contribute to the worsening of COVID-19 cases.

Of some 26,000 people infected in Japan, about 20,000 have already been released from hospitals and facilities for recuperation. Tateda says, "If basic measures are taken, such as wearing masks, washing hands frequently and avoiding the '3Cs' (of confined spaces, crowded places and close-contact), there is no need to fear excessively."

(Japanese original by Yuki Ogawa, Lifestyle and Medical News Department)

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