There’s no perfect solution to suppress the pandemic, but careful study and communication are key.
Through six waves of COVID-19 in Japan, the number of cases and deaths per capita has been significantly lower than in other G7 countries. This is despite having the world’s oldest population, and being densely packed. Yes, Japan has high vaccination rates, especially for older people, and masking is common. But neither of these is a full explanation. Deaths were low even before vaccines were available, and masks are common across Asia.
In 2003, I was the officer responsible for emerging diseases at the World Health Organization Western Pacific regional office when the outbreak of severe acute respiratory syndrome occurred: it was contained within eight months, with fewer than 1,000 deaths. When I first learnt of a similar coronavirus identified in China in people with pneumonia — SARS-CoV-2 — I thought perhaps the outbreak would follow a similar path.I soon realized otherwise. With SARS, most people became severely ill.
By the end of February 2020, scientists had identified many clusters of transmission and realized that most infected people did not infect anyone else, but a few infected many. From my past work, I knew that respiratory viruses are mainly transmitted through aerosols. My colleagues and I looked for common risk factors among superspreading events to come up with a more effective public-health message for the public. It incorporated early indications that SARS-CoV-2 could spread through aerosols.
The situation is becoming more complicated. People are reluctant to accept strict measures, even with the upsurge of cases, because vaccine coverage is high and Omicron fatality rates are lower. There are more interventions available, especially in a high-income country such as Japan: booster vaccinations, antivirals, better clinical care and public-health measures, such as COBut there is no one silver bullet that can eliminate the virus.
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