Random comments in this frame of context:
- I've seen/heard some doctors saying publicly, on Japanese TV, mid-March, "I think there are 10 times more cases than reported"
- There's an average of 270 deaths per day from pneumonia on a normal year in Japan (100k).
- The largest number of deaths announced from COVID-19 in a single day was, I think, yesterday, and it was 20.
- Deaths from pneumonia that aren't tested could very well appear to be in the noise of normal pneumonia deaths, easily hiding the real death toll. It doesn't take malicious intent for this to happen, just people following the rules (see below).
- Generally speaking, Japanese institutions have a very difficult time moving outside the box. If they have a written plan that is to be followed, that is what happens.
- The plan was to test people who had 4 consecutive days of fever (2 for older people) and close contact with people already diagnosed, and that's what happened.
- It took prefecture governors starting to do things on their own for the central government to start moving. That happened for school closures (Hokkaido leading the way, then Osaka, IIRC), and sending mild cases to hotels or making them stay at home, rather than occupy beds in hospitals (started in Osaka, IIRC)
- Hospitals have a shortage of equipment, and beds. Some prefectures have ramped up the number of available beds for infectious diseases. The government finally changed the rules to allow mild cases to be isolated out of hospitals (I think about a week ago, but it's hard to keep track of time these days).
- Some hospitals have closed their doors completely. The reason? Clusters of COVID-19 in staff and patients. Not because they were treating COVID-19 patients as COVID-19 patients. But because they were treating patients that turned out to have COVID-19. Or people with COVID-19 going there for consultations. Which is not all that surprising when you know people are reportedly going from hospital to hospital to try to be tested for COVID-19. If anything, I'm surprised there aren't more clusters in hospitals.
- There have been reports of ambulances having to try a large number of hospitals before finding an ER able to attend to their non-COVID-19 patient.
I wrote this on April 4: "the political response to covid-19 in Japan is pissing me off now. It now feels like watching a 100 km/h car running into a wall in slow motion, and the car is already in contact with the wall and absorbing kinetic energy."
Almost 3 weeks later, I think we're seeing the engine entering the passenger cabin.