How have we curbed Covid-19 in Japan? – Why does a crow sing? –

A well-known Japanese comedian with a long career on TV was recognized again during the spread of coronavirus, however not on any TV screen but in an obituary. We were shocked with deep sadness to encounter the news that Ken Shimura, an influential and beloved comedian for decades in Japan, suddenly passed away due to Covid-19 despite the fact that we were about to watch a new TV drama with him cast as one of the primary characters.

Loss of beloved comedian during pandemic

Well-known comedian for his career on TV was recognized again during days of the spread of coronavirus, however not on TV screen but in obituary on this occasion. We were shocked with deep sadness to encounter the news that Ken Shimura, an influential and beloved comedian for decades in Japan, suddenly passed away due to Covid-19 despite that we were going to watch new TV drama casting him as one of the primary icons in the story. 

I watched a TV show in which Ken Shimura played funny roles very often when I was a child. He taught us on TV how to tease school authority while we were taught in schools how to follow social rules and keep morals in unified manner in daily life. School taught us in class of music a song which all Japanese kids should be familiar with. It sings in a way; “Why does a crow sing there in the mountain? Because, my dear, she sings to love seven kids at home there”. It was a song composed in early 20th century by a famous composer and lyricist and has been treated as a song suitable for education. School teachers and officials in local educational committee were all satisfied with the learning of the song. But, Ken Shimura sang it on TV show with surprising alteration which raised eyebrows of those officials in a way; “Why does a crow sing there in the mountain? That’s none of your business, Huh?” It sounded very funny to kids including me and we repeatedly sang it in the same way in school defying bitterness on teacher’s faces. All in this way, I grew up with a lesson I learned both from school teachers and Ken Shimura that it is vital to obey to social norm in general but occasionally a fun to tease it.

SU with KenShimura

Shin Ushiro holding a photo of Ken Shimura

Low death figure on Covid-19 in Japan 

The announcement by the Japanese government yesterday (1st June) again told about the death poll as low as 892 among 126 million population. This figure is small enough compared to the US, UK and other European countries. It is recently reported in several international media that Japan has been successful in curbing death toll of coronavirus infection. Some Japanese media welcomed message from WHO that hailed our success. 

One of the reasons on the low death toll is probably found in the last one month and a half in which we tried to stay at home as possible as we can under the government request. 

The declaration of state of emergency worked well, but why?

Death toll due to Covid 19 in Japan

In response to accelerated increase of contracted patients, the Japanese government declared the state of emergency on 7th Apr to continue until 6th May. The state of emergency in Japan is a mild legal order not to mandate but strongly request the nation, shops, restaurants, bars, night clubs, live-music house, athletic gyms, pachinko parlors etc. in private sector to exert self-restrain on their social and economic activities. Accordingly, there was no penalty such as fine as we see in lockdowns in other countries. This may seem weak and ineffective measures during pandemic, but from the retrospective viewpoint, it worked well. It covered only 7 prefectures e.g. Tokyo, Osaka, Kanagawa, Fukuoka (where I live) in the beginning, however, only a few days later, other 40 prefectures were successively covered when the government considered their willingness to join in the group. One may think that individuals and local governments originally do not like to be covered under the state of emergency which impose huge restriction on personal and regional activities. However, prefectures favored to be a part of it in similar way that we learned to follow rules by authority in school days. The preference was more explicitly recognized when they accepted the extension of the state of emergency to 14th-25th May. We seriously followed a particular rule provided by the government which requested us to avoid 3 “Mitsu”s (it means “Dense” in Japanese) i.e. “Misshitsu (Closed spaces)”, “Misshuu (Crowded places)”, and “Missetsu (Close-contact settings). At this point, one may be aware of our unique sense of loving to follow rules and trying to avoid being “exceptional” as a member of our society. Even “Iwate” prefecture with 1.2 million population in which no patient has been identified so far showed willingness to be a part of the group. The epidemiologist, the government committee member and advisor to the government, repeatedly claimed in a press conference that we should reduce 80% of close person-to-person contact to finally see dramatic decrease in the number of new patient. We followed his instruction as a sort of authority calling him “Uncle 80%”. Then, virtually, we have observed dramatic decrease of the new patients probably due to the unified action by the nation in spite of suffering loss of economic activities. 

Different view Ken Shimura brought to social rules

I admit that we devoted our time to curb coronavirus spread by obeying the rules and achieved a lot under loose lockdown, but it is of note that we also incurred bitter experiences caused by the life during pandemic. I would say we obviously have smaller number of fatal cases in comparison but neither necessarily took correct way to attain it nor deserved international admiration. To be frank with my friends in international community on quality and safety, I cannot accept without being ashamed words and phrases which international organization and media praised Japan with. I have seen hundreds of overly criticism, harsh words and messages to the government and TV pundits, discrimination to medical professionals and their family members, harassment to small shops and restaurants in operation for daily money under the state of emergency in the past months. I observed people who rigorously try to obey rules and never allow others who like to behave in slightly different way. I thought that Covid-19 was infecting not only with our organs but our generosity to others in our society. In times of bitterness I felt in my mind, I occasionally tried to recall what I learned from Ken Shimura and his altered “crow song (“Seven kids” as the correct title)”. We like to have and follow rules in unified fashion given by authority because they effectively bring us to the success in most of the time as seen in school days long time ago and in pandemic nowadays. However, Ken Shimura taught us that we were allowed to challenge the authoritative rule anytime in ways people are in favor of. It would eventually foster generosity in our society to the difference, the diverse and the uniqueness of individuals. Application of rules in concerted manner with generosity is what we should achieve and will deserve international admiration. I believe that teachers in my school days would not raise their eyebrows to our efforts on attaining it but move them in a way to form warm smiles to us.

Shin Ushiro, MD, PhD

Professor and Divisional Director, Kyushu University Hospital

Executive board member, Japan Council for Quality Health Care (JQ)

ISQua Board Member

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