COVID-19 in Japan: success despite incompetence.

The media has recently highlighted the success of Japan in curbing the threat of COVID-19 infection., This indeed is to be applauded—but was this due to an effective focused national strategy—it seems not. In a thought provoking commentary piece—Crump and colleagues from the Medical Governance Research Institute, Tokyo maintain that this was due more to luck than judgement.

The QJM has highlighted in the past the positive lessons learnt by Japanese authorities after the Fukishima Daiichi nuclear power incident., More recently, we highlighted the management of COVID-19 infections on the cruise liner—the Diamond Princess—but it seems lessons were not learnt with regards to the subsequent management of the epidemic within Japan. In this commentary piece, the authors highlight the unacceptable high transmission of COVID-19 within Japanese hospitals to staff and patients. They describe the dysfunctional national contact tracing system, the lack of personal protection equipment not only within the healthcare settings but also in nursing homes and the fact, that according to Japanese law, all COVID-19 patients must be admitted to hospital—whether they suffer mild, moderate or severe disease.

In learning lessons from history, and in particular the Spanish influenza pandemic of 1918–19, UK and Ireland had three specific surges in infected cases over a 15-month period. When we faces the next surge of COVID-19 patients—will the authorities be prepared and ready to cope?

The elderly and COVID-19: cocooning or culling?

Society is to be applauded for social distancing which led to flattening of the curve and protecting the elderly and the vulnerable during these exceptional times. As we get used to the new norm and adapt to re-engaging with society, opinions have appeared in the media advocating the financial and societal benefits of COVID-19 preferentially targeting the elderly. Therefore, we welcome the commentary piece by Dr Donnelly from Otago Medical School, New Zealand who reminds us of our humanity and our duty to be exquisitely care with the lives of others and in particular the elderly.

With the significant prospect of a second COVID surge later in the year, the prospect of societal distancing fatigue combined with pressure to keep the economy open—we need to find that delicate balance that supports economic activity with protection of the elderly and other vulnerable groups.