As the United States begins to see light at the end of the tunnel with COVID-19, Japan remains locked in its struggle with the pandemic. On May 24, 2021, the Biden Administration raised the travel advisory for U.S. citizens to level four, a “do not travel” alert. To be sure, Japan’s case numbers have been far below that of the United States and European nations, and yet the government’s management of the pandemic has set its citizens’ teeth on edge.
The prime minister’s office has failed to win public confidence, and the approval ratings of first Prime Minister Abe and then Prime Minister Suga have fallen as a result. Three states of emergency have been proclaimed since the pandemic started. The first was in April 2020, the second was in January 2021, and the latest began on April 23, 2021, but has been extended to June 20. This is not a draconian lockdown, however, and the national government has been at pains to get citizens to comply. Initially, then Prime Minister Abe closed schools, and corporate offices followed suit. Japanese office workers adapted to telework and curtailed after work socializing. But according to the Mainichi Shimbun, fewer and fewer residents of the Tokyo metropolitan area were complying with Prime Minister Suga’s latest appeal for those who did not have compelling business to stay at their homes.
Three issues have drawn criticism. The first is the complex guidance issued by the Prime Minister’s office. It has been unclear what indicators the government has used to issue its on again, off again states of emergency. According to the Prime Minister’s Office (Kantei) website, the main factors are the prevalence of a mutant strain and a spike in rates of infection. Second, the national government has asked local governments to determine whether they need to implement a state of emergency. Major metropolitan centers of Tokyo and Osaka, and their surrounding prefectures, have gauged their responses differently. Tokyo has, since the beginning of the pandemic, had about 20% of the national cases of COVID-19. Osaka’s case numbers, meanwhile, have gone up and down. Thus, these two highly populated urban centers, the first the nation’s capital and the second home to a significant concentration of Japanese commerce and industry, are not always synchronized.
Finally, the COVID-19 pandemic has revealed longstanding weaknesses in Japan’s health care system. Here there are a host of issues that have frustrated Japan’s public health response to the pandemic. Access to emergency care has been problematic, especially in urban centers where people work by day but where the residential population is thinner. Similarly, Japan’s rural areas are also thin when it comes to emergency care facilities, and with 28% of the Japanese population today above the age of 65, the coronavirus has threatened to overwhelm the Japanese hospital system. But perhaps the most glaring inefficiency during the pandemic has been Japan’s restrictive process of approving foreign pharmaceuticals. Despite early development of a COVID-19 vaccine by Pfizer, Moderna and other companies, the Japanese government insisted on independent clinical trials, slowing down the process of importing vaccines. The Pfizer vaccine wasn’t approved until February 2021. According to the Yomiuri Shimbun, as of the end of March, only 20% of Japan’s health care workers were vaccinated and only 1% of Japan’s elderly.
But the government’s insistence that the Tokyo Olympics, postponed from the summer of 2020 to this July, go forward has angered the Japanese public. Citizen activism against the Olympics is growing, including an online petition that garnered 350,000 signatures. At an estimated cost of $15.6 billion, the Tokyo Olympics and Paralympics are an expensive investment. The early promise that they would rejuvenate Japan’s global image has dissipated, and now there is a sense that Japan will be lucky if they can avoid a super spreader event. With COVID-19 variants increasing, and new resurgences emerging in countries where the corona virus seemed to have been brought under control, the idea of bringing global athletes together to compete in the Olympics seems highly risky to many. The CEO of SoftBank, Son Masayoshi, is but one of a number of corporate leaders who have called on the government to reconsider, arguing that the costs are far too high to risk holding the games. According to the International Olympic Committee, however, even if the Japanese government continues to declare a state of emergency, the games will go on.
There are some positive signs on the horizon, however. The Suga Cabinet has made some progress recently with vaccinations. The Japanese government just approved the Moderna and AstraZeneca vaccines on May 21 in an effort to speed up distribution. The Self Defense Force has been charged with operating mass vaccination sites in the major metropolitan centers of Tokyo and Osaka. The SDF’s medical teams may also be deployed in support of the Olympic Games.
Elections loom at the end of the summer, and Prime Minister Suga will need all he can muster to garner public support for his Liberal Democratic Party. His approval rating this year, according to the Yomiuri Shimbun, went from 39% in January to 43% in May. Polling by the Asahi Shimbun, usually more critical of the government, showed Suga’s approval rating steady at 33% in both January and May. Much will depend on two outcomes: the rate of vaccinations and the number of COVID-19 cases after the Olympics. The former may be easier to control than the latter.
Already the political implications of this summer’s COVID-19 tensions are visible. With a Lower House election looming, the Liberal Democratic Party must consider its future electoral prospects. Will Prime Minister Suga be able to navigate these pressures successfully? Can he sustain support within his party? Former Prime Minister Abe, a staunch supporter of the prime minister, was invited in a recent interview to suggest his “post-Suga” lineup. It included three current or former Cabinet ministers: Foreign Minister Motegi Toshimitsu, Chief Cabinet Secretary Kato Katsunobu, and former Foreign Minister Kishida Fumio as well as one LDP policy heavyweight, Policy Research Council head Shimomura Hakubun. None of these names were on the April Nikkei Shimbun poll that asked its readers for their preferences. That line up in rank order was: Minister for Administrative Affairs Kono Taro (24%) and perennial party favorites Ishiba Shigeru (16%) and Koizumi Shinjiro (14%).
Prime Minister Suga may still pull a rabbit out of this difficult summer’s hat. But pressures are mounting and the variables are difficult to corral. So much is at stake: public health during an unpredictable pandemic, considerable public and private investment, and the confidence of the Japanese people in their government’s ability to protect their well-being.