The Japanese coronavirus story

You may recall that some time ago MR posted an anonymous account of how the coronavirus problem actually was much worse in Japan than was being admitted by the Japanese government and broader establishment.  It is now clear that this Cassandra was correct.

I can now reveal to you the full story of that posting behind the first link, including my role in it.  Here is the opening excerpt:

By March 22nd, I strongly suspected there was a widespread coronavirus epidemic in Japan. This was not widely believed at the time. I, working with others, conducted an independent research project. By March 25th we had sufficient certainty to act. We projected that the default course of the epidemic would lead to a public health crisis.

We attempted to disseminate the results to appropriate parties, out of a sense of civic duty. We initially did this privately attached to our identities and publicly but anonymously to maximize the likelihood of being effective and minimize risks to the response effort and to the team. We were successful in accelerating the work of others.

The situation is, as of this writing, still very serious. In retrospect, our pre-registered results were largely correct. I am coming forward with them because the methods we used, and the fact that they arrived at a result correct enough to act upon prior to formal confirmation, may accelerate future work and future responses here and elsewhere.

I am an American. I speak Japanese and live in Tokyo. I have spent my entire adult life in Japan. I have no medical nor epidemiology background. My professional background is as a software engineer and entrepreneur. I presently work in technology. This project was on my own initiative and in my personal capacity.

I am honored to have played a modest role in this story, though full credit goes elsewhere, do read the whole thing.  Hashing plays a key role in the longer narrative.

Comments

The day you posted the Anonymous account, I posted in that post:

"You can see they are coming to this realization by regions if you read Japan Times. https://www.japantimes.co.jp

Lead article in today's newspaper is how they are inching towards a lockdown.

You could also see that some prefectures were resisting and then got slammed."

This was not a secret to the Japanese, or its media. It was a government and local persons dragging their feet.

Give credit to the JapanTimes article and reporting.

Hmm. Is there really a big problem in Japan ? . Cases have declined since April 15. Did they lower the testing rate?

Not to date, but acknowledging that is emotionally unacceptable to the moderators.

According to the post:

‘Monday April 20th: Increasingly specific and repeated calls to strengthen social distancing measures are beginning to show some objective improvement, though the situation is incredibly complex and in different phases throughout the nation. The number of infections continues to increase rapidly.

There are increasing reports of difficulties in accessing medical care.

The number of acknowledged coronavirus cases exceeds 11,000. The number of acknowledged cases requiring the highest level of care is approximately 230.’

According to the Covid 19 tracking project, the US had some 772K positive tests as of yesterday. Was he giving a count just for Tokyo? What am I missing?

The 11k cases are for the whole of Japan. The deaths total 263 to date.
This is 3 months 5 days after the first case. The new daily cases have been declining 5 days in a row. I don’t see a huge problem here on the contrary.

Assuming the official stats are correct there isn't an issue. Is the referenced source saying the official stats are bunk?

I'm astounded by people panicking over Japan. Total deaths are UNDER 300 for a country with a population of 100 million!!!! That's half of what NYC gets in one day. What is the issue here? It's unbelievable.

Maybe people should not be talking about *just* deaths:

"After examining a small group of patients who recovered from Covid 6 weeks ago after only mild symptoms, the doctors reported that 'The damage to the lungs is irreversible.'"

https://twitter.com/erikbryn/status/1252601195731906563?s=19

If you read the article, which Brynjolfsson apparently did not, you would see this quote:

"To what extent long-term effects remain on the lungs is unclear according to the doctor and is currently speculative. "We don't know how much of the changes will last," said the doctor. When looking at the findings, however, it is difficult "to believe in complete healing".'

Hilarious that people criticizing antibody studies are quoting a sample of 6 divers based on a month.

The precautionary and anticautionary arguments are not symmetrical!

Precaution may indeed be driven by uncertainty.

I would imagine Tyler would counter that Japan has only been able to achieve this by locking down and risking catastrophic economic loss, just like the rest of the world.

Nothing is "not an issue" if you're locking down you entire population.

Before this, some had used Japan to argue that it was possible to keep deaths low while keeping a (mostly) normal economy going, even in the absence of the very high test-trace-etc. that's going on in SK, Taiwan and Singapore.

Except Tyler would be wrong if he said that since the request to stay at home order happened only a few days ago and the cases/deaths increases haven't changed much. Three days before the order, cornavirus cases were increasing 6% a day; since April 16th, the increase in cases has declined 5% a day.

Deaths were increasing at about 5% a day for a week before the national emergency was declared but then crept up briefly to 7%, 10% and then 16% increase a day on April 15th. That is when the Japanese government freaked out instead of waiting a day to find a decline of 12%, 6%, 7%, 6%.

"The new daily cases have been declining 5 days in a row"

Are they testing the same or greater people daily for the last 5 days in a row?

You can see in English the daily trend of number of people tested in Tokyo (stable at the very low level of around 300-400 people per day) at https://stopcovid19.metro.tokyo.lg.jp/en One of the mysteries is why Japan is testing so few by setting overly strict requirements to test, which at first was presumed to be driven by the Olympics and later by the rule that all people testing positive must be hospitalized.

So the gov't is not testing many people. Published cases seem to be flatish but this represents what was happening two weeks ago, not today. The gov't, though, is expanding its emergency declaration.

Likely conclusion: Shit is coming down the pipeline and the gov't is obscuring the data that is indicating that (for example, perhaps hospitalizations are increasing).

Did the Japanese government cover up data in 2010 about having 100 deaths from H1N1? Has the South Korean government been hiding thousands of deaths from H1N1 and covid -19?

You and me both, Rich. I'm baffled by the persistence with which Tyler and some comments are pushing this narrative, when the facts on the ground just aren't there.

Even if the answer is, "wait and see, it's coming," that still leaves unanswered the question of why the disease has spread so much more slowly in crowded, subway-riding Japan than in western Europe or New York City.

I think TC needs to inject a bit more skepticism to counterbalance his desire for a "scoop".

I agree, Tom.

It suggests that some cultural/behavioral factors - I would bet on widespread wearing of masks in public spaces and overall attentiveness to infectious disease hygiene - make a massive difference.

Yes, this is the important question. Genetic factors?

Have you all been following the story about the TB vaccine? It's standard to receive in Japan. Some of my Japanese friends have been talking about this.

Re: Genetic Factors?

Oh, you just want to be Asian.
Ask the Chinese.

Doubt it’s genetic.

But who’s gonna break it to Bill the Boomer that not all Asians are the same? Jesus lol.

Who's going to break it to you that you have no sense of humor or irony.
Must be genetic.

A Boomer making racial jokes and insults.

Quelle surprise

I guess you don't get the joke: Chinese are Asians. The Chinese sucked wind.

I guess I will have to spell it out for you.

But, on top of that, you could see, but apparently not, that I was criticizing the genetic argument by pointing out that the Chinese, who are Asian (really, believe me) had a serious epidemic and their genes did not save them.

You are not blind, you just want to keep your eyes closed.
Sleep.

Tyler is a boomer to, and probably proud of his experience as well.
"Baby boomers were born between 1944 and 1964. They're current between 55-75 years old (76 million in U.S.)" per wiki.

What a ridiculous answer, Bill.

I asked the Chinese authorities, and according to their official figures, China has been spared by the coronavirus. Italy or Spain have 100 times as much deaths per capita as China. Even if the official figures are off by a factor 10, that still makes China in much better shape than Western European countries or the US. In fact, so far, all East Asian countries have done much much better, in terms of official counts of death due to Covid-19, than Europe and North America. I have no idea why is that. Policies adopted by those countries have been very diverse.

So either the official figures are completely false, both in China and Japan and other east-asian countries, which is a real possibility. Or there is some factor we do not understand that is going on. TB vaccination maybe, genetic factor perhaps, or many other things I haven't thought of.

I am sure the Communist Chinese Party was telling you the truth.

And, I am sure that inexorably leads to the conclusion that it was genetics, and not forced lockdown.

You are so smart to jump to the genetics without any evidence.

What parts of the chromosomes do you think we can find this evidence? Is it a protein

Or, is it, in your own words, "many other things I haven't thought of."

Maybe it's that they eat bats and unicorn horns.

I think it was more ridiculous to call it genetic without evidence.

Guess I was wrong. Boo Hoo.

I have never said that the conclusion was "genetics". I have asked if genetics could be a factor. My exact sentence was "Genetic Factors?". It was just a few lines above. Try to be a better troll.

You said what you said, and everyone can see it.

It's not genetics but some people in Japan and an Australian researcher have remarked that everybody in Japan gets the improved BCG vaccine for tuberculosis. Does that have an impact on COVID-19? Who knows but they believe it.

Pacific rim countries and western states/provinces seem to have different characteristics of spread. Maybe we have been exposed to a similar virus due to proximity. Or maybe a different variant of the virus.

Still Tyler persists. We all know that he *never* would have predicted Japan would be doing this well right now. They still aren’t “locked down”.

And like Sweden they’re probably well on their way to herd immunity.

Just baffling.

I live in Tokyo and intentionally took a road trip to Ise and Kyoto on March 18-21 (social distancing completely except for hotel check-in) thinking at the time that it would probably be my “last chance” to leave Tokyo or perhaps even my home before a lockdown was announced as early as the following week. My colleague at work similarly thought around March 21-22 that a lockdown was a strong possibility as soon as the Olympics postponement decision was done. So I’m not sure if the publicity campaign materially helped push the government or was just coincident with widespread frustration among people here. I believe Tokyo governor Koike was strongly in favor of much stricter measures in the week of March 23 but was overruled by the national government. It’s a similar debate as one can see in the US between California/NY vs Arkansas/Nebraska. Ultimately it’s a political decision, and people put different monetary value on saving one statistical life-year and have different levels of risk aversion. There are obviously many times more active cases in Japan than reported but given the low death rate relative to officially reported deaths, the situation still seems somewhat well contained relative to the disasters in the US and some European countries. Of course, it’s still early days but I wouldn’t exaggerate the degree of risk of a breakdown in the health system.

Why is it early days ? The first case was on January 16, 3 months and 5 days ago. New York’s first case was mid February.
If there was really a problem there should be thousand of deaths by now.

For example, if a recurrence in autumn is mismanaged, or if undetected cases in emerging markets are imported into Japan in a similar fashion to the way cases were imported from Italy, Spain and elsewhere in early March even after the initial cases from China had been basically contained already. There’s so much we still don’t know about the COVID-19 virus so I wouldn’t be surprised to get further curveballs ahead, which could be mismanaged due to government incompetence, bad luck or a combination thereof

Yup, If you read the https://www.japantimes.co.jp you could see it coming.
I particularly like the Japantimes perspective on US economy and politics. You see things reported there about the US that you see little coverage of in the US.

What's interesting now is that they are trying to deal with how they can withdraw a little from China (paying their companies to leave and return to japan) and paying for the costs of locking down and stimulus when they already have high debt.

"There are obviously many times more active cases in Japan than reported but given the low death rate relative to officially reported deaths, the situation still seems somewhat well contained relative to the disasters in the US and some European countries."

Right, the post by Patrick McKenzie seems rather puffed up. On the good side, he was skeptical of public pronouncements, did a good amount of research, and collaborated with others to do the same.

But was he more prescient, and giving more warnings, than other groups were?

He says his "exact moment" of worry about disastrous outcomes happened March 9. Heck on March 6 I was getting nervous about a planned trip to watch baseball spring training games starting on March 13 (several days later we cancelled the trip). Granted that's in the US, which had more cases and more reason to worry than Japan did at that point.

But he himself notes that on March 26 Motoko Rich published that influential article asking if Japan was really doing as well as it claimed. (And Japan had already decided to postpone the Olympics by that date.)

So I don't see him doing much more much earlier than what the rest of us were doing: looking at Japan's numbers and wondering is it really the case that they're doing so well and if so, why?

Moreover his explanation for what happened in Japan seems to amount to: they had low numbers because they didn't do much testing, so their true numbers were and are much higher than what they're reporting.

Well yeah but that was true -- and probably still is true -- for every country in the world.

Japan's reported deaths are still low; if we had correct numbers, is Patrick McKenzie saying they would total say 16K deaths as Britain has had?
He seems instead to be claiming that eventually their deaths will be as bad (or maybe worse) than what other countries will have suffered. And that remains to be seen (I'm not saying that I don't believe that forecast, it's just that we don't know yet).

Japan's numbers presented us with three questions: are their numbers correct? If their deaths and infections are low will they stay that way, and if so why? If their numbers eventually rise to levels similar to the rest of the world's, why did they rise more slowly in Japan?

And I don't see McKenzie's research as moving us very far ahead on those questions. He has strong evidence that their numbers are undercounted; that's a real contribution but AFAICT still leaves Japan with interestingly low numbers. He says they will not stay that way, which is a solid forecast but as mentioned above one whose accuracy we do not yet know, and people were publicly wondering that same question a month ago. And if Japan in the end will does the same or worse problems as say Britain or even Italy, we still have the question of why did it take longer in Japan?

McKenzie had good solid thinking and organized a nice set of research. But did it change our perceptions or the questions that we ask about Japan? I'm not seeing that it made big changes. (OTOH, if e.g. Motoko Rich's article was directly influenced by McKenzie's research, that'd ben an example of such influence. He did directly influence Tyler's post, but coincidentally that was also March 26 so it was merely part of a set of voices asking if Japan's numbers were for real. If McKenzie's group was behind most of those voices, then yes that would be real influence.)

And so another 'alternative story' falls. The response to the pandemic it seems is just about every country begins with denial, half-measures, until it ends up in more or less lockdown of one sort or another. The search for alternative models to me appears to be an exercise in putting wishful thinking in place of well rounded thinking (for example, holding Sweden up as an alternative path when in fact they are doing a type of lockdown as well and probably no other nation on earth could replicate the factors that cause their outbreak (for now) to be more modest than other nations.)

Things are horrific in Sweden. Per capita they have over 30 times the deaths per capita of South Korea. It only looks good in comparison to countries like Spain and Italy.

Horrific? 17 dead/100k is horrific?

That’s less than traffic accidents.

@Reason - traffic accidents is not the right metric. More people die of traffic accidents in Africa than of malaria. So malaria is not a problem? Ask lockdown Bill Gates that question.

Bill Gates knows he can’t fix the traffic accident death rates in Africa. Malaria is what he can address. Like the drunk who looks for his keys under the lamp post.

He could fix traffic deaths too if he invested massively in self-driving cars. The challenges are on the same scale financially and time-wise as ending malaria.

You could probably make it work fairly soon as long as you do a hard switchover and ban all human-driven traffic overnight. Surely saving lives at the cost of personal freedom is the new normal?

The lockdown-till-vaccine enthusiasts tend to be the same crowd that deeply mistrusts Big Tech, but they would instinctively welcome a top-down government-imposed driving ban.

Mosquito nets are cheap, lockdowns are not.

The deaths were senseless and easily avoidable. That's why they are horrific. There is nothing mysterious about stopping a respiratory virus from killing people. It would be like the Swedes ignored the benefits of seat belts and left them out of their cars.

And yet it's undeniable that the disease has followed an alternative path in Japan (even if only "much more slowly"). It really would be more valuable to explore why that is, than to keep trying to force the suspect narrative that Tokyo is experiencing the virus just like New York City, Madrid, and Milan.

Maybe, maybe not.

Japan: 263 deaths
Taiwan: 6 deaths

Unless they’re hiding thousands of bodies.

+1, there's no way to make the case that Japan has a significant Covid19 caseload in the background without a large spike in deaths.

Using 0.5% as a IFI, 263 deaths implies at least 5,260 infections in Japan. Are they identified and isolated or not? If not that seems like an ample critical mass for continued spread unless these deaths were clustered weeks ago.

BTW, isn't this the country where we heard their high number of people who've lived to absurd old ages (150 or whatnot) were really cases of people hiding deaths from the gov't to keep their version of Social Security coming in? How good are Japan's death statistics? Are pneumonia deaths tested for Covid-19 as a matter of policy or put in as presumed Covid-19 deaths or written up as just pneumonia?

Boonton - and that low of a number of infections so long after introduction into Japan is still a surprisingly low number, especially in light of factors like dense cities and extensive use of crowded public transport.

They’re a first world country. How good are their death statistics? Seriously? The answer is: as good as any other first world country.

Jumping to anecdotal social security fraud is... no.

Our death statistics are not great at all. AND this is a sleepy area of statistics where things move slowly. Our system was not designed to rapidly spit out accurate reports day by day but to collect them over nice periods of time and publish them once a quarter or so.

That being said it's a fair question. What *every* developed country just happens to be of equal quality in death reporting?

"We projected that the default course of the epidemic would lead to a public health crisis." I guess crisis is a rather ill-defined word. According to World-o-meter they have had 263 deaths in Japan, sad, but hard to call a crisis.
Isn't every single country in the northern hemisphere showing declining cases? Given the geographic distribution of severe cases in the United States as primarily a northern phenomenon, would it not be reasonable to believe that sunshine and warm weather are not good for the virus? Still, better for everyone to stay inside until we know for sure.

That could be, although if that's the case we should see countries like India, Mexico and others nicely dodging a major crises.

Or we are just seeing luck and randomness. Perhaps Japan is simply late to the party because some super-spreaders happened to land in other countries rather than Japan, a country that's always had a mixed relationship with China at best.

Should policy be based on wishful thinking or balanced thinking? Wishes do sometimes come true.

Where is the balance? I don't see much thinking of any kind, just people rallying around their priors.

You're at a party. Five people eat the potato salad. 30 minutes later 3 people are really sick.

Initial Conclusion: No one eat the potato salad, assume its bad.

Other possibilities (wishful): The 3 people did something else (had sushi at the same place before showing up).
There's nothing that ties them together, just all happened to get sick at the same time for unrelated reasons.
Perhaps the 2 who didn't get sick (yet) share some special trait. Maybe people with black hair can eat the salad and are immune.

These other things are indeed possibilities and we should be open to them but the initial conclusion should stand until a other possibility appears to have sufficient evidence to overturn it.

As far as sunshine and warm weather are concerned, it is possible these are moderating factors since we have yet to see an Italy-New York-Iran-China-style disaster anywhere in the tropics.

On the other hand, Miami-Dade county has 202 deaths from covid-19 while Singapore has 11 and Hong Kong has 4(!). Smart policies clearly play an important role as well.

A policy isn't smart because it decreases the number of death from COVID 19. It is if it decrease the total number of deaths.

Is this a variation of people die when the economy goes down therefore any decrease to GDP = deaths? But aren't the economic responses to a lockdown policies in their own right?

Yes, at least in part. The lock-down causes deaths directly (increased domestic violence, for instance), but the economic disruption it causes will create many many more deaths in the long run, in direct and indirect ways. Hunger is already developing quickly in many parts of the world.
If the lock-down stops now, the consequences will stil bel manageable, but if it lasts in many countries for several more months, they will be huge.

I wouldn't be surprised if the lock-down saves a lot of lives, for now. Less driving, less infectious disease exposure in general, more exercise and cooking at home and less restaurant food...

Interesting, I believe the UK reported a spike in domestic violence complaints but then a huge drop. Sometimes disruption to routine causes people to correct things they were avoiding in the past.

But my point was that economic policies also have to be evaluated. If a shutdown lays off 20M people but 5M people lose their health insurance and 5,000 die prematurely because they skip on insulin or doctors' visits...is that the shutdown or a 'stimulus' policy that tries to shuttle an incomes program only through unemployment bonuses and tax cuts?

I'm not sure you really get bonus points for a March 28th post on how bad coronavirus could be. Stock markets had already crashed to their lowest points a week earlier... this wasn't new information.

So, are Japanese hospitals being overwhelmed? Just curious.
It sure took a long time for it to get this bad, compared to other nations. Doesn't that mean their curve was already substantially "flattened" even without the emergency measures?

I don't feel like this story tells us anything. The stats for Japan don't look bad at all. This looks more like a success story than the doomsayers were correct story. Maybe there's information I'm missing?

If you search Google News for the keyword “病院" (hospital) and then use translation software for articles you can maybe get a feel for the current situation. I don’t think hospitals are being overwhelmed right now but my background isn’t in medicine so I can’t say much myself. There seem to be some shortages of protective equipment, which is a bad thing

Japan apparently has very few critical care beds per capita (surprising for such an aged population), so its health system may be much more easily stressed that that of the US or Germany, even with a much lower prevalence of disease. Still not seeing a crisis, though.

We cannot expect to completely stop COVID infection in a short period of time. Our goal is to lower the peak of infection so we can avoid a collapse of medical systems. With the total deaths of 223, less than 1% of US or Italy, and no sign of exponential growth so far, Japan is managing the situation relatively well, in my view. Japan Times says, "Japan is the girl who stays skinny despite eating junk food and not exercising." Is that the reason for the negative view?

Japan is the country that has had its first case before all western countries ( 3 months and 5 days ago). It has had lax measures from the beginning, didn’t really quarantine anyone, didn’t close shops or crowded subways.
It’s not a disaster waiting to happen, it’s a disaster that didn’t happen. They never got to pandemia-land. Why is what needs explaining.

The why I think is pretty obvious. Japanese people don't touch each other that much. Italians cheek kiss. Why anyone wouldn't think that the whole cheek kissing thing wouldn't lead to a higher rate of spread of this pathogen is a mystery to me. It totally explains the differences between Italy/Spain/France vs Germany/Sweden/Japan. Germans and Swedes shake hands, Japanese bow. Obviously the less physical touching there is when people are saying hello is going to translate into differences in the rate of spread. Duh. Why would you expect otherwise?

The point is that if just avoiding touching and (say) wearing masks in public is enough to slow down the spread to Japanese levels, then the policy of shutting everything down has to be called into question. And at this point, some people are so married to that policy they have to pretend Japan is having an uncontrolled epidemic in order to ignore the obvious differences in the trajectory.

I think, at this point, if the Democrats/left backed off and said "ok that was a bit of an overreaction, but we didn't have good data a month ago, now we have better data" then they could wind down these restrictions, but the longer they hold onto this position that "WE MUST HAVE A TOTAL LOCKDOWN OR MILLIONS WILL DIE." they are going to start getting locked in more and more. Sunk cost fallacy, we've supported the lockdown thus far and now we can't back off because that would mean admitting we were wrong.

They've got a narrow window in which to say "ok, now that we know what's going on we can ease up on certain things."

Although none of us really have enough data to know for sure, based on the preponderance of evidence I’d agree with you that it seems if the US had adopted the basic practices that led to a slower rate of transmission in Japan (no handshakes, mask wearing by 20-50% of people), probably lockdowns could have been avoided there with an outcome similar to Japan. However, I wouldn’t agree that it therefore follows that draconian lockdowns weren’t needed at all in the US and Europe. The problem was that the US and European countries saw an explosive spread from late February into mid-March that, by the time its extent was detected, made lockdowns unavoidable. The spread occurred at a ~30% daily rate instead of a ~10% daily rate like in Japan so it was too late by the time society realized what had happened. I’m sure dozens or hundreds of pandemic specialists in each country realized the danger in late December but their voices couldn’t penetrate societal inertia quickly enough, whereas in Japan the slower 10% base spread rate gave us a bit more time to slowly wake up to the danger (especially after seeing the disasters in Italy, Spain and NYC)

Doesn't that also imply that now that society has "woken up" so to speak that we can remove the lockdowns since people are going to be more cognizant of the virus and practice more social distancing voluntarily?

It’s a difficult question to answer, which is why it must be a political decision. The fact that the US has a federal system I think is a plus over unitary political systems like Japan because different regions can adopt different policies more fitting their individual preferences. Of course with such high stakes in terms of potential deaths and economic damage it will be a miracle if decisions can be reached without some acrimony

I think yes, their greeting habits must be a factor. I think masks also are very effective. The time lapse camera movie of saliva droplets expelled just talking with and without a mask completely convinced me.

How tedious. Democrats did not create the lockdown. It was bottom up with more and more people distancing, working from home and avoiding going out and the signs kept rolling in. The lockdown as the formalization as the top realized just what we were dealing with.

I suppose the 'kissing Italians' is a hypothesis versus bowing Japanese. But then China and S. Korea also like wearing masks and I'm not sure how common bowing is in each I'm pretty sure the guide books will caution against hugging and kissing everyone you meet.

As for overreaction. We already in about a month have seen more death than a mild flu season. If we optimistically keep this at 60K, we'll have a year's worth of bad flu deaths in two or so months.

There was no over reaction and for that matter no real national lockdown. It wasn't that long ago Florida had its beaches open for Spring Break and GA's governor telling us he 'just' found out that people could spread it without symptoms.

We are on the verge here of keeping this thing going until 2021. China did a national lockdown to clear the virus out of everywhere but Wuhan, the first red zone was the last one to clear. We are about to experiment with keeping multiple red zones going more or less forever because two weeks without professional wrestling is too much.

Of course maybe some of the magical thinking deployed at the start of this will start to work. Maybe the virus will start to hate sun and heat. Maybe one of the multiple treatments will turn out to be a silver bullet. Sadly this would be great but would also be like a drunk driver who doesn't get pulled over or into an accident....rather than telling ourselves we dodged a bullet we'll tell ourselves it wasn't a big deal after all.

Koreans like wearing masks, maybe. And they have pretty good numbrs, no?

China probably stopped the spread from Hubei by requiring the wearing of masks...it not a natural Chinese thing to do.

Chinese like to hawk and spit on the ground, actually.

Ctrl-F "Olympics" 0 results.

That's unfortunate. I admire the work of Patrick in 100% of his endeavors that he has shared online including this one. I do remember his cryptographically hashed tweet on social media. So kudos to him. But perhaps it wouldn't be polite for him to speculate but it should be somewhat obvious to others that the 2020 Tokyo Olympics played a role in the thinking of the country's decision makers. The money and prestige was too hard to let go.

That's because he wrote "sporting event" and not "Olympics."

https://reason.com/2020/04/20/l-a-county-antibody-tests-suggest-the-fatality-rate-for-covid-19-is-much-lower-than-people-feared/
Preliminary results from antibody tests in Los Angeles County indicate that the true number of COVID-19 infections is much higher than the number of confirmed cases there, which implies that the fatality rate is much lower than the official tallies suggest. "The mortality rate now has dropped a lot," Barbara Ferrer, director of the Los Angeles County Department of Public Health, said at a press briefing today. In contrast with the current crude case fatality rate of about 4.5 percent, she said, the study suggests that 0.1 percent to 0.2 percent of people infected by the virus will die, which would make COVID-19 only somewhat more deadly than the seasonal flu.

Based on a representative sample of 863 adults tested early this month, researchers at the University of Southern California (USC), working in collaboration with the public health department, found that "approximately 4.1% of the county's adult population has antibody to the virus." Taking into account the statistical margin of error, the results indicate that "2.8% to 5.6% of the county's adult population has antibody to the virus—which translates to approximately 221,000 to 442,000 adults in the county who have had the infection." That is 28 to 55 times higher than the tally of confirmed cases at the time of the study.

So far we are twice as bad as he 2009 flu which we hardly remember.

1 month ago: So far, it's not as bad as the flu.

2 weeks ago: So far, it's only as bad as the flu.

Today: So far, it's only twice as bad as the flu.

See the pattern? Flu people forget that viruses spread.

There's been more debunking of that study than actual reporting of the study. In short, it's obviously flawed due to a bath false positive rate. Had it been true, it would imply that literally every New Yorkers has the virus.

I don't think this is accurate. While it's true that high false positive rates could certainly skew the study (Baye's Theorem), I don't think it's reasonable to assume that the model implies every New Yorker has the virus. That is a linear extrapolation of what the model, which is inaccurate because we know second order effects make the infection function concave at some point due to herd immunity. People are taking one correct criticism of the study and substituting it with another mathematical fallacy in my opinion. I've also see no proof of what the false positive rate is (not to say there isn't any), but just stating that it could exist and account for the results is not enough in my opinion.

The study says the fatality rate is .1%. That means to get 11,000 deaths you need 11,000,000 infections.

In a simple linear extrapolation, yes. But we know the fatality rate varies significantly by age. Completely possible to have fewer infections with the same fatality rate in NY if the age distribution of infection is different...

I see this same response from other Americans I know living in Japan. Utter panic. And I know this type very well, the guy who thinks that by speaking Japanese well they have some kind of inside knowledge of how the country works. Japanese people are rightly dubious of these panicking foreigners. Let Japan figure out what's best for Japan for pete's sake! Abe is falling for it, but people are still out and about.

These emergency orders are not

He does come off as having a "Western Savior" complex in his writing.

"Humanity’s response to coronavirus implicates almost everyone. We live in imperfect, divided, fractious, and hurting world, as we always have. We will comfort the afflicted. We will mourn those who pass. We will learn. We will beat this thing, with high science and with hand soap."

Jeez, he's like a social justice warrior without social justice or a war.

Yep.

If you live in Japan you meet these kind of guys all the time. They've devoted they're life to learning Japanese and now want to show it off. They'll fly off the handle if a japanese bartender dares speak to them in English or if someone asks if they'd like a fork and knife with their dinner.

I'm afraid Tyler is getting played here.

Was thinking more about this, and if you look through history it's actually a common response of the Japanese government to announce "very strict measures" when pressured by foreign governments that aren't actually that strict at all. Right now all these 'emergency' measures by the central government are just suggestions. They don't carry much legal weight. From what my friends in Japan are telling me, it's mostly the multiinational chains like Starbucks that are closing up. I'm sure there's less street traffic than normal, but it's hardly like what's going on in London or New York.

Having said all that, in our globalized world, world opinion plays a bigger part in decision making than it did in the past, even in Japan, so I suspect you'll still see a generalized slowdown of life over the next month.

I have a friend who works at a restaurant in Tokyo and that has closed because so few customers had been going last week. It plans to open in three weeks.

The U.S. embassy in Tokyo advised Americans to return home because the U.S. government doesn't think Japan's testing is accurate. The Obama administration made several major errors when the Fukushima accident happened in 2011, so I'm not surprised at pressure that is happening now.

But .... buut MR kept telling me that the Japanese were special. They have amazing cleanliness habits and they wear masks and practice social distancing to a degree that would give kissy-faced Italians mental health issues. It was all about their amazing culture. All lies that MR told me.

Tyler says that the Casandra's anonymous email to him was correct on March 26th:

"Accordingly, Japan will face a national-scale public health crisis within a month, absent immediate and aggressive policy interventions."

It is almost a month later and covid-19 deaths in Japan have gone from 46 on March 26th to 186 to 263, depending on the source, on April 20th. That is a national-scale public health crisis? The national emergency was declared on April 16th, 3 weeks after the anonymous writer insisted "immediate and aggressive policy interventions."

Japan recorded 100 deaths after the H1N1 pandemic in 2009/10 while the U.S. had 12,500 deaths. South Korea recorded about 200 deaths that year and has 250 deaths after the pandemic has essentially ended there for now. Isn't 2009/10 a clue as to what is happening now in Japan and South Korea compared to the U.S. and Western Europe?

... while the U.S. had 12,500 deaths.

Citation?

Wikipedia indicates the U.S had only 3433 deaths not 12,500, and the pandemic started in the U.S.
https://en.wikipedia.org/wiki/2009_swine_flu_pandemic_by_country

Googled it again and "Biosphere" states:

"The CDC estimated that from April 12, 2009 to April 10, 2010, there were 60.8 million H1N1 cases, with 274,304 hospitalizations and 12,469 deaths in the U.S. alone.

Would be interesting to compare Japan and Sweden.

Japan declared a state of emergency and while some things closed most are still open and people are still doing their thing but with more masks and social distancing. Unlike Sweden, they don't have to face the more lethal Spanish/Italian strain of COVID-19 but likely the more mild South Korean version. Similar to the other Asian countries, this isn't their first pandemic. They've seen this before.

https://www.japantimes.co.jp/news/2020/04/20/national/crowds-japan-shopping-arcades-coronavirus/

https://www.nytimes.com/2020/04/19/world/asia/tokyo-japan-coronavirus.html

60% of Korea's cases are among people under 50 but only 30% of Italy's were. Additionally, we know testing is much more extensive in South Korea than it is in Italy. These two facts seem adequate enough to explain differences in death rates. Virus genetics as well as population genetics could still play a role but South Korea is really not an anomaly once you take age and testing into account. What is impressive is how they managed to almost completely stop the virus dead in its tracks.

There isn't a "more lethal" Spanish/Italian strain of COVID-19. The difference is just that Italians and Spanish have a higher viral load because they project saliva onto eachother's face when they say hello.
Swedes and Germans do not do the cheek kiss thing. Japanese people don't even touch.

In addition to the numbers people quoted above, here is what a BBC article has to say, "A nationwide state of emergency has been declared in Japan due to the country’s worsening coronavirus outbreak. The move allows regional governments to urge people to stay inside, but without punitive measures or legal force. The state of emergency will remain in force until 6 May."

I'm missing the part where we show that the doo-doo has hit the fan. Japan has a number of deaths comparable to Miami-Dade county alone and seems to have cases growing at a low, stable rate of growth. And it is taking the drastic, path-breaking step of politely and voluntarily asking people to kindly remain indoors. Got to love the Japanese.

In the earlier thread, it was suggested there was a government cover-up and that the country was just several days away from seeing hundreds of people dying everyday from the disease. We still have no evidence of that. Past trends have continued up until the present.

This is from the linked post:

"If government infection counts were accurate, but containment has failed, and we use optimistic doubling rates observed in peer nations taking aggressive measures, we would expect to see on the order of 3,000 cases, including more than 200 severe cases, in each of Nagoya, Osaka, Tokyo by the end of April.

If we do not use peer nations’ experience for doubling rates, and instead rely upon the estimates of the cluster identification working group who prepared the report for Osaka, and we do not implement aggressive measures to slow the spread of disease, we could see more than ten times to one hundred times that number."

If I read this correctly, if Japan does not adopt severe personal contact restrictions, it could see, by the most pessimistic projection, 60,000 severe cases in these three large cities (200 x 3 x 100). Assuming that 1 out of every 2 severe cases succumb to the virus, that would be 30,000 deaths. Worst case. No restrictions. Total population base of 14.2 million. That looks like the heavy restrictions outcome in NY State, with a roughly comparable population. Of course, if it is not the worst case projected of 100x, it will be fewer. The author suggests between 3,000 dead and 30,000 dead (on the foregoing assumptions, all of which presume the worst possible outcome).

Sorry, but this doesn't seem all that apocalyptic. This does make me wonder about the value of the extreme restrictive measures.

https://www.statnews.com/2020/04/21/he-ran-marathons-why-did-coronavirus-almost-kill-him/
Among the many mysteries of Covid-19 is why relatively healthy young people suddenly become critically ill — or die.

One answer is what was happening to Fiske. His body had begun to fight the coronavirus with the immune system’s equivalent of thermonuclear weapons — proteins so powerful they risk annihilating the body they are supposed to protect. This massive over-reaction, known as a cytokine storm, is believed to be a major reason that a growing number of exceedingly fit people find themselves fighting for their lives.

Immune cells release cytokines as part of the normal response to infections, but in many Covid-19 patients, this process gets out of hand, leading to inflammation and fluid buildup in the lungs. The storms pose a dilemma for doctors: Prescribe medications that tamp down the immune system at the wrong moment, and the body will be defenseless against the coronavirus or any opportunistic infection that’s taken root. Do nothing, and there’s a good chance the massive attack will shut down the lungs and other vital organs.
----
The victim is allergic to the virus. This is the great curiosity as we may be able to test for the allergy. But what we will need is a targeted treatment for cytokine storm, directly kill the macrophaes. The docs need this targeted killer for a bunch of diseases and allergies. It is a bit of last resort as the text indicates.

https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm

Where are these young people dying without comorbidities? Please, without the anecdotes.

Nope, not yet. Still waiting for the exponential apocalypse you promised.
https://toyokeizai.net/sp/visual/tko/covid19/en.html

I would delete all posts about Japan and hope no one finds them on the way back machine.

I have the Japan posts on file. Trust me, they are secure and aren't going anywhere.

260 deaths in 3 months!!! How can you possibly ignore this number?! It's unbelievable. Not even remotely close to NYC even. A million miles away. It's straight up BS to claim Japan is in any trouble at all.

This guy is definitely taking TC for a ride.

A lot of people aren't thinking clearly right now, and it isn't just Tyler.

NYT analysis compares historical death count with current death count in a variety of countries (though not including Japan) and suggests the higher death count now likely resulted from unaccounted for covid related deaths. https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html

The New York times is trash.

http://euromomo.eu/

They are not just always wrong. But intentionally so.

Tyler Cowen in this Covid period looks like the pollen particles pushed randomly around by invisible molecules that Brown observed when he discovered the Brownian motion. Yesterday TC expressed his skepticism towards overreacting policy response, and today he glorifies someone for having "predicted" that the official figures of infected cases in Japan were a gross underestimate (as if it was not the case in every country, and as if not everyone knew that), and pushes for a much stronger policy response.

I've read Patrick McKenzie for a while. I was reloading his Twitter eagerly to see what he was going to say.

I read the entire thing, Tyler- how could anyone be proud of being involved in this? I didn't find a single data point that actually supports the assertion that Japan is worse than the official numbers indicate.

The writer needs actual data that contradicts the official data- absent that, why would I believe him? It is one thing to be skeptical of the numbers, but you have to offer me a reason to believe the skeptic is, in fact, correct to be so. That is completely missing here.

Yancey,
You might want to read the Japantimes on a daily basis:
"That compared with 102 new cases on Monday and the highest single-day cases of 201 last Friday, according to the metropolitan government data. The new cases brought the overall total in the capital to 3,307, with at least 77 deaths, according to the metropolitan government data.

Japan on Monday reported another 25 deaths caused by the new coronavirus, the country's highest tally for a single day, bringing the total death toll to 276. That comes almost two weeks after a state of emergency was declared for Tokyo, Osaka and five other areas with large urban populations.

The state of emergency was expanded to nationwide last week to curb social interactions by 70 to 80 percent and prevent people from traveling during the Golden Week holidays, which start later this month and run into early May."
It is a very good newspaper and will give you an idea on how they have been dealing with this.

102 new cases is something to worry about??? Bill , you should be reading the Asahi or Yomiuri shimbun newspapers if you want to see what's really happening.

Oh, I read it, Bill. This isn't evidence of the claims made. I don't see evidence of an explosion of cases or deaths. And no evidence that actual cases and deaths are covered up. In short- it sounds like bullshit and looks like it, too.

The first sentence referred just to Tokyo. Here is the link: https://www.japantimes.co.jp/news/2020/04/21/national/tokyo-reports-120-new-covid-19-cases-tuesday/#.Xp8p_C-z1Bw

This is the website you should be using, it has just the data.
The entire country had 15 deaths on the 21st of April (as I post it's the 22nd there). Don't know where the Japan Times is getting their info from, but this is from the Ministry of Health Labor and Welfare

https://toyokeizai.net/sp/visual/tko/covid19/en.html

Another day, another American (non-medical) trying to save the world (if not yet, wait and see, it's coming!) with maths, conspiracy and I-know-deep-how-japanese-think-about-all.

"It is now clear that this Cassandra was correct."

No, it is not. What's clear is that the number of cases increased, but it's not at all clear that the number of cases was high all along-- in fact, there's a fair amount of evidence from genetic analysis of the strains that the cases in Japan now are of more recent origin (and related to some of the mutations in Europe and the US), rather than having been there for months.

It's also very clear that Japan is still doing much better than, e.g., Sweden (which is doing better than southern European countries yet considerably worse than its peers.)

If the Cassandra warnings were "Japan should not be complacent, things can get worse without more action" (something that would apply to Singapore, to Sweden, and many other places), that would be well proven. The claim that the number of cases was understated in the past is not.

Very disappointing thinking from Tyler here, drawing conclusions unsupported by the linked article or the evidence.

This sounded like it might be interesting to me, also a resident of Japan most of my adult life.

But the tone sounded familiar ... and boy is it long ... wait, it couldn't be ...

Yikes, he lives! Mr. "Patio11" McKenzie of bingo game fame, back with another verbose know-it-all screed.

The general tone of what I sampled reminded me of the Adderall-fueled paranoid Fukushima nuttiness from a lot of foreigners (both flyjin and remainers) after the earthquake (Fukushima's death toll is controversial: the mainstream opinion is that zero people died from it, but there is a growing minority who think that one person who died a couple years ago got his cancer from Fukushima).

Yes, the pandemic is going to screw over Japan, as it has and will continue to screw over the whole world. This kind of blow-by-blow could be written for any country.

The worker at Fukushima had leukemia and didn't have nearly enough radiation to increase his risk of getting that 1%, let alone die from it. And one more time, why didn't the H1N1 pandemic screw over Japan with 100 deaths?

This data shows the number of tested COVID positive, active cases, serious have started to decline in the past 10 days or so in Japan. It is unthinkable Japan overstates the death count more than, say, 10 times compared to US, Italy, etc. No one is sure but it is widely suspected that it is the mandatory BCG vaccination of the Japanese type that has saved the lives of a number of Japanese.

Sorry this is the site:
https://toyokeizai.net/sp/visual/tko/covid19/en.html

I follow Libertarian Poll Data on Facebook run by the founder of current Libertarianism, Michael Gilson De Lemos. This was known to participants weeks ago, and they gave the first warning on Coronavirus there in January.

LPD gets info from libertarian fans around the world. Chinese libertarians were saying there were problems in Wuhan a year ago, and Japanese libertarian health workers said that Japan was not really following the protocol created by South Korean libertarians in 2014, just trying to.

I’d like to see an update on this — Japan continues to defy predictions.

The situation in Japan right now is that the number of new cases, like Europe and parts of the US, is coming down, perhaps partly because of weather, perhaps partly in recent days because the Golden Week holiday made the “soft lockdown” more effective in reducing the number of interactions since people weren’t going to work. The national emergency was extended to May 31 but may be lifted early in some areas with few new cases. It’s not a lockdown but many businesses are closed. A typical example would be a shopping mall whose tenants are closed not because the government ordered them to do so, but because the landlord in response to government request shut the whole mall and told the tenants they won’t need to pay rent since it was the landlord’s decision. Unlike in the US, I wouldn’t expect lawsuits from the tenants suing the landlord nor the landlord suing the government. The good thing about the emergency declaration in Tokyo and Osaka continuing until May 31 is it gives some time for Japan to observe how opening up affects the US and European countries. If opening up becomes a quick disaster somewhere overseas, expect the disaster to be a extended again into June. Hospitals were never overwhelmed by sheer number of patients, but rather the nature of Japan’s medical system with many small hospitals with lots of beds but few ICUs meant that many hospitals were loathe to accept COVID-19 patients because if it led to an infection inside the hospital, all the staff would be forced into isolation for 14 days. These problems seem to have been mainly fixed after some chaos a month or two ago.

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