'Japan’s Virus Success Has Puzzled the World. Is Its Luck Running Out?' diff viewer (5/6)

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Japan’s Virus Success Has Puzzled the World. Is Its Luck Running Out?	Japan’s Virus Success Has Puzzled the World. Is Its Luck Running Out?
2020-06-16 17:52:22 UTC	2020-06-16 23:00:32 UTC (about 5 hours later)
TOKYO — Japan had only a few dozen confirmed coronavirus infections when the 30-something nurse with a slight sore throat boarded a bus to Osaka, the country’s third-largest city, to attend a Valentine’s weekend performance by pop bands at a music club.	TOKYO — Japan had only a few dozen confirmed coronavirus infections when the 30-something nurse with a slight sore throat boarded a bus to Osaka, the country’s third-largest city, to attend a Valentine’s weekend performance by pop bands at a music club.
Less than two weeks later, she tested positive for the virus, and the authorities swiftly alerted others who had been at the club. As more infections soon emerged from three other music venues in the city, officials tested concertgoers and their close contacts, and urged others to stay home. All told, 106 cases were linked to the clubs, and nine people are still hospitalized.	Less than two weeks later, she tested positive for the virus, and the authorities swiftly alerted others who had been at the club. As more infections soon emerged from three other music venues in the city, officials tested concertgoers and their close contacts, and urged others to stay home. All told, 106 cases were linked to the clubs, and nine people are still hospitalized.
But less than a month after the nurse tested positive, the governor of Osaka declared the outbreak over.	But less than a month after the nurse tested positive, the governor of Osaka declared the outbreak over.
Ever since the first coronavirus case was confirmed in Japan in mid-January, health officials have reassured the public that they have moved quickly to prevent the virus from raging out of control. At the same time, though, Japan has puzzled epidemiologists as it has avoided the grim situations in places like Italy and New York without draconian restrictions on movement, economically devastating lockdowns or even widespread testing.	Ever since the first coronavirus case was confirmed in Japan in mid-January, health officials have reassured the public that they have moved quickly to prevent the virus from raging out of control. At the same time, though, Japan has puzzled epidemiologists as it has avoided the grim situations in places like Italy and New York without draconian restrictions on movement, economically devastating lockdowns or even widespread testing.
The puzzle may be about to gain some clarity. On Thursday, Katsunobu Kato, Japan’s health minister, said he had informed Prime Minister Shinzo Abe that there was evidence that Japan was now at a high risk of rampant infection.	The puzzle may be about to gain some clarity. On Thursday, Katsunobu Kato, Japan’s health minister, said he had informed Prime Minister Shinzo Abe that there was evidence that Japan was now at a high risk of rampant infection.
On Wednesday night, just a day after Japan and the International Olympic Committee agreed to delay the Tokyo Summer Games for a year because of the coronavirus pandemic, the governor of Tokyo, Yuriko Koike, warned citizens that the sprawling city of close to 14 million people was in a “critical phase before a possible infection explosion.”	On Wednesday night, just a day after Japan and the International Olympic Committee agreed to delay the Tokyo Summer Games for a year because of the coronavirus pandemic, the governor of Tokyo, Yuriko Koike, warned citizens that the sprawling city of close to 14 million people was in a “critical phase before a possible infection explosion.”
Cases in Tokyo spiked this week, setting records for four days running — including an announcement of 47 cases on Thursday — as travelers returned from overseas. The limited testing for the virus has raised fears that many more are going undetected.	Cases in Tokyo spiked this week, setting records for four days running — including an announcement of 47 cases on Thursday — as travelers returned from overseas. The limited testing for the virus has raised fears that many more are going undetected.
Ms. Koike implored the people of Tokyo to work from home, avoid unnecessary outings and stay inside over the weekend. On Thursday, governors from four neighboring prefectures also requested that residents refrain over the weekend from going outside for anything other than urgent needs.	Ms. Koike implored the people of Tokyo to work from home, avoid unnecessary outings and stay inside over the weekend. On Thursday, governors from four neighboring prefectures also requested that residents refrain over the weekend from going outside for anything other than urgent needs.
“If we go without doing anything now,” Ms. Koike said, “the situation will worsen. I ask for everyone’s cooperation.”	“If we go without doing anything now,” Ms. Koike said, “the situation will worsen. I ask for everyone’s cooperation.”
The public so far has not taken such warnings seriously. Although schools have been closed for a month and the government has requested that large sports and cultural events be canceled or delayed, the rest of life has returned to normal. People have been riding crowded subways, congregating in parks to view the cherry blossoms, shopping, drinking and dining, comforted by Japan’s relatively low number of confirmed coronavirus cases and deaths.	The public so far has not taken such warnings seriously. Although schools have been closed for a month and the government has requested that large sports and cultural events be canceled or delayed, the rest of life has returned to normal. People have been riding crowded subways, congregating in parks to view the cherry blossoms, shopping, drinking and dining, comforted by Japan’s relatively low number of confirmed coronavirus cases and deaths.
Even at one of the Osaka clubs where the outbreak occurred earlier this month, a group of 40 young women attended a performance by a boy band on Wednesday, jumping and waving their hands in a small, unventilated space for close to two hours.	Even at one of the Osaka clubs where the outbreak occurred earlier this month, a group of 40 young women attended a performance by a boy band on Wednesday, jumping and waving their hands in a small, unventilated space for close to two hours.
As other parts of the world fall into a spiral of infections, hospital overflows and deaths, Japan, a country of almost 127 million people, has reported only 1,300 cases and 45 deaths, with one of the slowest-progressing death rates in the world despite its aging population.	As other parts of the world fall into a spiral of infections, hospital overflows and deaths, Japan, a country of almost 127 million people, has reported only 1,300 cases and 45 deaths, with one of the slowest-progressing death rates in the world despite its aging population.
“It’s either they did something right,” said Dr. Peter Rabinowitz, co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security, “or they didn’t, and we just don’t know about it yet.”	“It’s either they did something right,” said Dr. Peter Rabinowitz, co-director of the University of Washington MetaCenter for Pandemic Preparedness and Global Health Security, “or they didn’t, and we just don’t know about it yet.”
As Japan has seemed to pull off a feat of infection containment, it has presented an intriguing contrast to other countries in Asia, where the pandemic began. It did not put cities on lockdown, as China did. It has not deployed modern surveillance technology like a growing number of countries, including Singapore. Nor did it adopt the kind of wholesale testing that helped South Korea isolate and treat people before they could spread the disease.	As Japan has seemed to pull off a feat of infection containment, it has presented an intriguing contrast to other countries in Asia, where the pandemic began. It did not put cities on lockdown, as China did. It has not deployed modern surveillance technology like a growing number of countries, including Singapore. Nor did it adopt the kind of wholesale testing that helped South Korea isolate and treat people before they could spread the disease.
While South Korea, with a population less than half the size of Japan’s, has conducted tests on close to 365,000 people, Japan has tested only about 25,000. Japan now has the capacity to conduct about 7,500 tests a day, but its daily average is closer to 1,200 or 1,300.	While South Korea, with a population less than half the size of Japan’s, has conducted tests on close to 365,000 people, Japan has tested only about 25,000. Japan now has the capacity to conduct about 7,500 tests a day, but its daily average is closer to 1,200 or 1,300.
Dr. Tomoya Saito, director of the department of health crisis management at the National Institute of Public Health, said the limited testing was intentional. Those who are tested are referred by doctors, usually after patients have had fevers and other symptoms for two to four days. Japan’s current policy is to admit anyone who tests positive to a hospital, so officials want to avoid draining health care resources with less severe cases.	Dr. Tomoya Saito, director of the department of health crisis management at the National Institute of Public Health, said the limited testing was intentional. Those who are tested are referred by doctors, usually after patients have had fevers and other symptoms for two to four days. Japan’s current policy is to admit anyone who tests positive to a hospital, so officials want to avoid draining health care resources with less severe cases.
Dr. Saito said that part of Japan’s seeming resistance to infection may result from measures common in the culture, including frequent hand-washing and bowing instead of shaking hands. People are also much more likely to wear masks on trains and in public spaces. “It’s a kind of social distancing,” Dr. Saito said.	Dr. Saito said that part of Japan’s seeming resistance to infection may result from measures common in the culture, including frequent hand-washing and bowing instead of shaking hands. People are also much more likely to wear masks on trains and in public spaces. “It’s a kind of social distancing,” Dr. Saito said.
But Jeffrey Shaman, an epidemiologist at Columbia University and the senior author of a report that projected five to 10 undetected cases for every confirmed infection of the coronavirus based on data from China, said Japan’s approach was a “gamble.”	But Jeffrey Shaman, an epidemiologist at Columbia University and the senior author of a report that projected five to 10 undetected cases for every confirmed infection of the coronavirus based on data from China, said Japan’s approach was a “gamble.”
“The risk is that things may be brewing underneath the surface that you don’t recognize until it’s also a little bit too late,” Dr. Shaman said.	“The risk is that things may be brewing underneath the surface that you don’t recognize until it’s also a little bit too late,” Dr. Shaman said.
In Osaka, a report prepared for the health ministry this month projected that by early April, the city could have close to 3,400 infections, 227 of them serious. “It’s possible that provision of medical treatment to seriously ill patients may become difficult,” the report said.	In Osaka, a report prepared for the health ministry this month projected that by early April, the city could have close to 3,400 infections, 227 of them serious. “It’s possible that provision of medical treatment to seriously ill patients may become difficult,” the report said.
On Wednesday, Osaka’s governor, Hirofumi Yoshimura, said he was working to secure an additional 600 beds in hospital isolation wards that could accommodate patients with the most severe infections.	On Wednesday, Osaka’s governor, Hirofumi Yoshimura, said he was working to secure an additional 600 beds in hospital isolation wards that could accommodate patients with the most severe infections.
Dr. Masaya Yamato, chief of infectious diseases at Rinku General Medical Center in Osaka, said the region was moving toward a model where coronavirus patients with mild symptoms could stay at home in order to save hospital beds for the seriously ill.	Dr. Masaya Yamato, chief of infectious diseases at Rinku General Medical Center in Osaka, said the region was moving toward a model where coronavirus patients with mild symptoms could stay at home in order to save hospital beds for the seriously ill.
In Tokyo, there are only 100 beds designated to handle those with serious infectious diseases. On Wednesday, the city government pledged to secure 600 more.	In Tokyo, there are only 100 beds designated to handle those with serious infectious diseases. On Wednesday, the city government pledged to secure 600 more.
The request by Tokyo’s governor to stay inside this weekend, Dr. Yamato said, may be too weak to defer a crisis.	The request by Tokyo’s governor to stay inside this weekend, Dr. Yamato said, may be too weak to defer a crisis.
~~Updated June ~~12,~~ 2020~~	Updated June 16, 2020
	The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.