COVID19 update, October 15, 2020: Israel reopening on Sunday; the Japanese paradox

(1) The epidemiological criteria laid out for Israel’s “exit plan” from the 2nd lockdown apparently have been met:

  • 2,000 or fewer test positive out of at least 30,000 (yesterday we had 2,009 positive out of 38,073 tested, and numbers for today are on track to be even better;
  • our positivity rate has dropped to 5.3% (from 15% at the peak) yesterday, and just 3.9% today until 6pm;
  • the “reproductive number” R is down below 0.8 (in fact, the public health head, Prof. Sharon Alroy-Preis, reported 0.63, which is great news)
  • moreover, severe hospital cases are down to 730 today (from a high of 930), the lowest since late September

Hence the cabinet approved Phase 1 of the return to normality, effective Sunday:

  • the 1 km (0.6mi) limit on nonessential travel is rescinded. (This limitation anyhow carried so many exceptions that one could always come up with an excuse.)
  • non-customer facing businesses can return to normal operation. (Sales of food, medicines, essential household necessities, and telecom equipment were never locked down.)
  • restaurants can offer takeaway (deliveries were already allowed), still no sit-down service
  • national parks and beaches are reopened to the public
  • kindergartens and preschools reopen
  • social meetings between family and friends are now permitted up to 10 people indoors or 20 people outdoors.

In addition, the airport will reopen for outgoing flights starting tonight at midnight.

Customer-facing businesses (e.g., clothing shops, furniture stores, …) and personal care (hairdressers, manicurists,…) will have to wait for future reopening stages. While I completely understand many small business owners are at the end of their tether, and am even more sympathetic to those who say they don’t want government handouts but the chance to earn an honest buck, I also understand concerns that an overly hasty reopening might lead to yet a third lockdown, which would be a death blow to many parts of the economy.

Interior Minister Aryeh Deri, from the Shas (“Sephardi Torah Guardians”) party, “reportedly left the ministerial meeting angrily, after his proposal to allow weddings with up to 200 guests was rejected.” He was being accused of “wanting to drag the country down to a third lockdown” under pressure from his chareidi (“ultra-Orthodox”) constituents.

In unrelated news, the Knesset approved the peace agreement with the United Arab Emirates 80-13, with the 13 “no” votes coming from the Joint Arab[ and Communist] List. Former defense minister (and erstwhile Chief of the General Staff) Lt.-Gen. Moshe “Boogie” Ya`alon boycotted the proceedings, saying the ‘secret’ parts of the agreement should have been presented to the Knesset before the vote.

In other unrelated news, the Attorney-General closed one of the corruption cases against PM Netanyahu (the “submarine case”) for lack of evidence.

(2) Dr. John Campbell, in a video, looks at what I would call “the Japanese paradox”.

Unlike South Korea and Taiwan, which nipped the epidemic through early implementation of contact tracing (capitalizing on their experience with the 2002-3 SARS and [in South Korea] 2015 MERS outbreaks), Japan did have significant outbreaks — and serological data in Tokyo indicate that close to half (!) of the population was exposed. (It is pretty hard to get tested in Japan, unlike South Korea where testing centers are open to walk-ins, so the official case number of under 91,000 is a gross underestimate.) https://www.medrxiv.org/content/10.1101/2020.09.21.20198796v1.full.pdf

Yet mortality from the epidemic is enviably low: just 1,646 out of a population of 126.5 million! And that with one of the world’s “oldest” age pyramids.

Nor did Japan resort to extreme lockdowns: it has applied a light touch. (At present, large gatherings are limited to 5,000 people (!). (“Masgramondou” has told me life in rural Japan is pretty much “business as usual”.)

Dr. Campbell tries to come up with various explanations:

  • widespread, deeply ingrained mask wearing culture going back for decades
  • “non-tactile” culture, keeping physical distance, bowing instead of greeting
  • not a “loud” culture: shouting or speaking loudly is highly frowned upon. (This aspect is extremely unlike Israel.)
  • very low rates of obesity
  • a diet rich in seafood of all kinds, and hence rich in vitamin D and zinc. (I looked for studies on vitamin D deficiency in Japan: one study found a figure as low as 5% (!) among active elderly people.

Somehow I wonder if something is missing from these explanations. Green tea? A close relative who has lived in Japan told me the Japanese drink copious quantities of green tea — and as covered here earlier, green tea contains a zinc ionophore nearly as potent as hydroxychloroquine, namely, epigallocatechin gallate (EGCG). Could this be a clue? As I discuss there, however, bioavailability from oral ingestion is problematic.

Then again, it’s not just Japan: all the East Asian countries (except for mainland China) seem to have weathered the COVID storm fairly well to very well. And Mrs. Arbel — very familiar with the region — stresses how widely green tea is drunk in all of them.

There is clearly something going on we don’t know here, and the sooner we find out, the better.

3 thoughts on “COVID19 update, October 15, 2020: Israel reopening on Sunday; the Japanese paradox

  1. I wonder if the Japanese paradox is related to Vit K2.

    The japanese love a fermented soy bean dish in their diet high in Vit K2. I think this dish is fairly unique to Japan.

    https://www.theguardian.com/science/2020/jun/05/vitamin-k-could-help-fight-coronavirus-study-suggests

    One of the most popular breakfast dishes in Japan is natto (fermented soy beans). Even Japanese chain restaurants have “Natto teishoku” (natto meal sets) as a breakfast menu. According to the statistics released by the Ministry of Internal Affairs and Communications in 2016, the average Japanese person eats 41 packs of natto every year.

  2. Note that sporting events now have audiences of up to either 15,000, 20,000 (I forget which but I think it’s 15k up from 5k in August/September but I could be wrong and it was an additional 15k). There’s no singing or trumpets/horns and everyone wears masks most of the time kinda sorta. They also (personal experience) limit queues at the entrance/exit so that you aren’t surrounded by 2000 other fans also trying to enter/leave at the same time.

    Also on the “this should be leading to more infections” front, the government has been running its “GoTo Travel” campaign to get people to visit tourist destinations, stay in hotels etc. so as to keep that part of the hospitality sector alive. It’s working. Hotels are busy at weekends, we see lots of cars from other prefectures, we’ve even seen a few tour buses – I saw a flyer for one that made clear they are doing them at 50% capacity and were not operating some of the services like Karaoke that they have in the past.

    Despite all these options for disease spread, we aren’t seeing an uptick in infections or deaths. As Dr Campbell showed for the last month or so the 7 day average infections is ~500/day and the daily number of deaths is mostly in the 1-5 range with the odd day (possibly Mondays, haven’t checked) at ~10

    One thing that is ubiquitous is the alcohol handwash spray bottle in shop entrances. Everyone uses them too. Hotels and other places where customers might share utensils provide disposable gloves (or groves as the Engrish in a Hiroshima hotel informed me) and a lot of shops that used to allow customers to handle fresh food now wrap it or require the customer to ask an employee to select the food. And while people are sloppy about mask wearing in the more rural countryside, urban Japan is far more consistent.

    I do think the diet is a factor. As is the fact that, although the Japanese population is aging, older people are generally fitter than other places. Compared to Europe or N America, Japanese people are thin and active.

    Dr Campbell is slightly wrong about the quarantine for international travellers. From personal experience in June, you could stay in your own home but they did check some things to make sure that you actually stayed there. His guest was also slightly wrong on a couple of details too but they were minor.

    Finally, it is possible to get PCR tested as a walk in. The catch is you have to spend your own money (~$US100) to pay for the test unless the local government / health dept requires you to be tested. Guess what? people don’t want to spend the $$$ and don’t get tested. However Japan tests around 20-25k/day and double that during the summer peak so it’s not like NO tests happened. Currently positives in testing are around 3% of all tests and more recently it seems to be trending lower (~2%, possibly less)

  3. I use the Japanese ‘Three C’s’: avoid Crowds, Closed-in spaces, and Close Up contact. Is that ‘cultural cross-fertilization’? I think I read about them here at this site. I don’t speak Japanese, but I don’t imagine that the Three C’s are “C’s” in Japanese, however are in English (more cultural cross-fertilization?).

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