Coronavirus, South Korea and Japan: how did they react to the pandemic?

Coronavirus, South Korea and Japan react differently to the pandemic. If Seoul surprised everyone, Tokyo confirmed its bureaucratic immobility

In the mid of February, South Korea (with a population of 51 million inhabitants) appeared very near to an unprecedented health cataclysm. Coronavirus’ cases were rising daily, with a number of outbreaks that were feared to cause a collapse of the health system. When the virus had still not put in knee the world, South Korea presented the major number of cases outside China.

However, at the beginnings of May, South Korea had 1,086 cases in total, 9,333 healed patients, and 255 deceased. Daily life was beginning to start again normally, after several weeks of social distancing, teleworking, closed public spaces. The prompt decision to establish, in the whole country, a system of diffused tests, marking contacts and hospitalizing patients since the first symptoms has payed off.

In any case, it has also been present, as in other regions of Eastern Asia, a very good answer to the measures by the citizenship, which has learned a lot by the pandemics of SARS in 2003, H1N1 in 2009, and even more by MERS in 2015 – that has severely hit South Korea. The face masks, available since the first days and put on by the whole population, together with an increased hands hygiene and other extraordinary measures, allowed the country to avoid a traumatic lockdown. This system didn’t work only in South Korea. Seoul produced so many medical swab kits that it find itself able to send these instruments abroad. Furthermore, these kits proved to be of high quality, and didn’t present any problem to final users.

The result was remarkable. At the end of February, a very dangerous outbreak was born in the Daegu section of a controversial Christian cult called Church of Jesus Shincheonji (acronym for “New Heaven and New Hearth”), established in 1984 by the preacher Lee Man-hee, who is still its spiritual leader. According to the cult, Lee would be the new reincarnation of Jesus Christ.

This led to a high number of contagions, following mass gatherings of the cult adherents, carried on with no protection of sort. In fact, the followers were sure that the Divine Mercy would have protected them from any infection. This put the Korean authorities to face the stubbornness of a group which refused the modern medical science developments, and that did not have any intention to stop the gatherings, or to perform them with social distancing rules or wearing protections.

After an initial refuse to collaborate with the authorities, Shincheonji consented to break its usual secrecy and gave to the government a list of its members. Therefore, the government ordered all the followers to self-isolate them and proceeded to effectuate swabs on thousands of them.

The containment measures proved so efficient to allow South Koreans to participate to the 15^th of April elections, where the good managing of the pandemic has confirmed the popular support to the Democratic Party of Korea of the current President, Moon Jae-in.

In 2015, when the President in charge was Park Geun-hye – who is now serving a 25 year sentence for abuse of power, corruption and other crimes –, the MERS pandemic was undervalued, which in turn made South Korea one of the most hit countries. Moon, then leading the opposition, accused Park of not having been able to face the situation. Since then, South Korea has entirely revised its system to face pandemics, by new laws, by increasing the hospitals’ isolation departments and by building new emergency hospitals. Thanks to these laws made after the MERS’ crisis, it has been possible to proceed with a series of Public-Private Partnerships which in turn made possible the mass production of test kits (fast and free) and of protective instruments. Since the first virus-positive cases, it has been possible to declare a national emergency.

A tracking app has been made for the citizens, a very important measure if we consider that South Korea remains one of the most Internet and mobile phones penetrated countries. Daily text messages informed the population of what was happening and how the government was facing the events. However, one of the most crucial measure was represented by the extremely wide diffusion of tests. In order to not overburden the hospitals, about 600 swab points have been prepared, easily accessible to everyone.

If South Korea has therefore surprised the world for the promptness and the efficiency in its reaction, this was not the case of Japan. In fact, this country demonstrated again the immobility which characterize the Japanese bureaucracy when facing sudden events. A feature that make Tokyo wastes precious time while the command chain tries to stabilise itself.

One of the main reasons that retarded a prompt response was represented by the Olympic Games – which were supposed to be held in Tokyo this summer and are now postponed. Neither Shinzo Abe nor the Olympic Committee had initially intention to suspend the event.

The virus cases are still on the rise but the fact that the population is quite used to the use of facial masks – and is aware of the importance of personal hygiene – has reduced partially the impact of the government hesitations.

The chances of contagion are furthermore by several social habits that limit physical contact, such as: the use of bowing instead of hand-shaking, the lack of displays of affection in public and the considering of being noisy on public transport as bad manners – which reduces the probability of aerosol contagion.

At the beginnings of May, Japan presented 15,374 Covid-19 cases, with 566 deceased, but new cases are reported daily. The state of emergency had to be extended to the end of May, after having been imposed only at the end of April (initially, at the beginning of April, was limited to seven prefectures).

As a result, while Moon enjoyed a rise of the consensus towards him thanks to the answer to the health crisis, Abe is facing a 10% drop of his support. Only the 40% of the Japanese continues to endorse the Prime Minister conduct, especially for not having prioritize to swabs instead of trying to save the Olympic Games at the expense of public health. For these reasons, at the beginning of May, the Japanese health system is facing several difficulties, with crowded intensive care units and a lack of protection instruments for a remarkable portion of the health personnel. The decision to make swabs to everyone arriving in Japan was, again, taken slowly, without any preparation of sufficient structures, which led many travellers to pass up to 2 nights in the airports, sleeping on the floor while waiting for test results.

The rapid collapse of the health system has shown severe structural inadequacies, such as the low number of beds in intensive care units (less than 6,000 in the whole country, which has 126 million inhabitants). Initially the aim was to focus only on the outbreaks, an attitude determined by the cruise ship Diamond Princess case, anchored in Yokohama port with a growing number of contagions. With a long delay, the Japanese government later realized that this kind of approach cannot be implemented without a tracking strategy of the possible contacts of infected individuals and, in particular, without controlling any traveller coming from highly contaminated places.

Abe’s hesitations, furthermore, have impeded the implementation of teleworking. The vast majority of the offices have actually continued to work and the trade unions’ weakness brought many employees to choose, basically, between losing their jobs or risking contagion. However, despite political failures, the contained number of deceased and contagion cases show both the population self-discipline and the capabilities of a health system able to practice respiratory therapies timely, despite the lack of resources.

This article is also published in the June/July issue of eastwest.

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@IlariaMariaSala