Japan’s Coronavirus Response: Sometimes Less is More

By: Andrew Malec

As life goes on and 2020 nears closer and closer to its end, the world is still struggling with the ongoing problems surrounding the coronavirus pandemic.[1] Japan is an example of one country around the world that has always taken a novel approach to handling the implications associated with this deadly virus.[2] To begin, when Japan saw its first glimpses of the coronavirus within its communities, it delegated authority to local health centers to handle the spread of the disease within small localities.[3] These local health centers were tasked with placing patients in various hospitals according to need[4] and contract tracing.[5] However, this streamlined process only lasted for a limited period of time: patients became sicker and hospitals began overflowing.[6] The government was forced to refer patients to different hospitals in less ideal locations, such as hotels converted into hospital spaces.[7] Patients who showed mild or no symptoms were urged to stay home and self-isolate rather than burden the health care system.[8]

Despite the many concerns about Japan’s struggling health care system, the country was able to reduce the number of cases of coronavirus.[9] Despite the problem Japan faced during the early months of the pandemic, the government did not seek to impose strict stay-at-home orders, like those imposed throughout other countries and the United States.[10] The self-isolation measures that the government recommended were only voluntary and there was no economic shut-down in the country.[11] Governors in the country can “strongly request” staying at home, but it was not mandated.[12]

The relaxed stay-at-home order was due, in part, to legal complications concerning the constitutionality of mandated self-isolation.[13] The pertinent constitutional issues are Articles 21 and Articles 22, freedom of assembly and association and freedom of movement, respectively.[14] Article 21 states:

Freedom of assembly and association as well a speech, press and all other forms of expression are guaranteed. No censorship shall be maintained, nor shall the secrecy of any means of communication be violated.[15]

Further, Article 22 of Japan’s constitution reads:

Every person shall have freedom to choose and change his residence and to choose his occupation to the extent that it does not interfere with the public welfare. Freedom of all persons to move to a foreign county and to divest themselves of their nationality shall be inviolate.[16]

While Articles 21 and 22 are viewed as reasons for opposing mandatory stay-at-home orders, Article 13 has been viewed as supporting mandatary orders by the government.[17] Article 13 reads:

All of the people shall be respected as individuals. Their right to life, liberty, and the pursuit of happiness shall, to the extent that it does not interfere with the public welfare, be the supreme consideration in legislation and in other governmental affairs.[18]

Despite the ongoing debate over the constitutionality of mandated stay-at-home orders, the Japanese did not take such actions and instead chose to promote self-isolation.[19] Additionally, the government declared a state of emergency but otherwise lacked any authority to take bold actions.[20] A formal declaration of national emergency is not within the authority of the Japanese government.[21] There is an ongoing debate as to whether Japan’s constitution should be expanded to tip the balance of power in favor of Japan’s government, rather than with individual rights as it is currently written.[22] Either way, because of the self-isolation of Japanese citizens, a mandatory order was not needed and coronavirus rates in the country were much lower than anticipated and, indeed, much of the rest of the world, despite its large elderly population.[23] Overall, Japan’s localized measures to combat the virus seem to have been successful for the needs of the country.

Now, the Japanese government, under the realm of “public welfare” as discussed in Article 13 of Japan’s constitution, seeks to provide free coronavirus vaccines, free of charge, to its citizens.[24] The Japanese government is set to spend over $6.3 billion dollars on providing the vaccine to its citizens. [25]

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[1] See Rolling Updates on Coronavirus Disease (COVID 19), World Health Organization (last updated July 31, 2020) https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen.

[2] Lawrence Repeta, The Coronavirus and Japan’s Constitution, Japan Times (Apr. 14, 2020) https://www.japantimes.co.jp/opinion/2020/04/14/commentary/japan-commentary/coronavirus-japans-constitution/.

[3] Ryoko Hamaguchi et al., Lessons from Japan’s COVID-19 Response, Harvard T.H. Chan, https://www.hsph.harvard.edu/news/hsph-in-the-news/lessons-from-japans-covid-19-response/.

[4] This process is called “patient triaging,” the process of “sorting people based on their need for immediate medical treatment as compared to their chance of benefitting from such care. MedicineNet.com https://www.google.com/search?q=what+is+patient+triaging&rlz=1C1CHBF_enUS894US894&oq=what+is+patient+triaging&aqs=chrome..69i57.3514j1j7&sourceid=chrome&ie=UTF-8.

[5] See Hamaguchi, supra note 3.

[6] Id.

[7] Id.

[8] Id.

[9] Id.

[10] Rupert Wingfield-Hayes, Coronavirus: Japan’s Mysteriously Low Virus Death Rate, BBC (July 4, 2020) https://www.bbc.com/news/world-asia-53188847.

[11] Id.

[12] See Repeta, supra note 2

[13] Id.

[14] Id.; See also The Constitution of Japan [Constitution], art. 21-22 (Japan).

[15] The Constitution of Japan [Constitution], art. 21 (Japan).

[16] Id. at art. 22.

[17] See Repeta, supra note 2.

[18] The Constitution of Japan [Constitution], art. 13 (Japan).

[19] See Repeta, supra note 2; see also Wingfield-Hayes, supra note 10.

[20] See Wingfield-Hayes, supra note 10.

[21] Id.

[22] See Repeta, supra note 2.

[23] Id.; see also Wingfield-Hayes, supra note 10.

[24] Japan to offer Free Coronavirus Vaccinations to All Citizens¸ The Japan Times (Oct. 1, 2020) https://www.japantimes.co.jp/news/2020/10/01/national/science-health/japan-free-covid-19-vaccinations/.

[25] Id.