THE DOCTOR IS IN / OP-ED By Adil Manzoor
Virtually every corner of the world has been introduced to the coronavirus. Some countries have felt it more than others, but no country is a stranger to the worst pandemic in more than a century.
SARS-CoV-2, the virus responsible for the pandemic, is a novel virus, which essentially meant we had to figure out most things about the virus as we went. This, combined with the nonchalance of several people regarding pandemic guidelines and vaccine regulations, is chiefly responsible for the struggles of even the most medically-advanced countries (whispers… the United States).
One common trend among the countries most affected is high population numbers. It just makes sense when you think about it – the more people there are in a country, the higher the chances of a principally air-transmitted infection spreading. This applied to Japan, too, as it is one of the world leaders in coronavirus cases.
Then, when countries started regaining their footing, even gaining the upper hand in the war against the pandemic, new variants emerged. The most significant of these variants is the Omicron variant.
However, this is where things get interesting. In Japan, despite emerging variants, cases were plummeting at some point late last year. This unsurprisingly raised a few eyebrows in the medical world.
Perhaps the most obvious suspect for the drop in cases was vaccinations. But Japan’s vaccination wasn’t anything extraordinary. In fact, neighbors South Korea had even greater vaccination numbers but contrasting cases records.
While vaccinations have definitely played their part in the drop in cases in Japan, it would be very bold to attribute the drop in cases to just vaccinations, considering Omicron’s ability to evade the vaccines’ defensive efforts.
Now, to the next suspect for the drop in cases – adherence to COVID guidelines. According to various reports, Japanese people are quite religious with mask-wearing, which is the most basic of COVID guidelines. There, even people who don’t believe masks are working wear them just not to be outliers in society.
When you compare this to what we have in America, where people even go as far as organizing protests against masks, you just shake your head. This article is not in any way trying to talk down on how we have handled ourselves as a nation – which is dreadful for the record – but to try and understand what Japan possibly did differently from the rest of the world.
It is not rocket science that getting vaccinated and following COVID guidelines will reduce the chances of transmission of the virus. So, Japan doing this and getting encouraging results shouldn’t surprise anyone, yet the whole of the medical world was surprised, particularly with the emergence of the Omicron variant.
Don’t get it wrong – following COVID guidelines and getting vaccinated will definitely lower COVID cases, but not when a new variant emerges, especially one as transmissible as the Omicron variant.
The variant showed vaccine-evading properties, making it harder to contain than previous strains. While booster doses exist now, only 35% of Japan’s population have taken them. And other countries with even more impressive vaccination numbers, like South Korea, saw cases skyrocket when Omicron first broke loose in early 2022.
Therefore, Japan’s drop in cases hugely surprised many experts. It was definitely a pleasant and very much welcome surprise, but the question of why it happened is not going away any time soon. What makes Japan so different? What is the unknown factor for this drop?
While everything we have considered thus far has been pretty generic, there is an interesting argument for a genetic feature in Japanese people. This genetic feature – HLA-A24 – is common in East Asian countries and has been found in many countries with milder coronavirus experiences, including Japan and Korea. There hasn’t been much research about it, but it is certainly a promising concept.
However, that’s not the whole story. This genetic feature is observed in Japan and Korea, making it surprising that Korea didn’t have a similar drop in cases like Japan. Quite the opposite, in fact, with cases reaching record highs in South Korea.
What then makes Japan special? I don’t know, and the science world doesn’t either. We will have to conduct more extensive studies, but for now, nothing concrete.
I admit that it is quite unfortunate to conclude today’s article without giving any solid answers, but that’s literally all we know about it right now. Something serious will come up later, I’m sure, but for now, stay safe.
This article was written by Dr. Adil Manzoor DO, a Board Certified Internist & Board Eligible Pediatrician, who works as a Hospitalist, and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice Mobile Medicine NJ.
References
- https://www.washingtonpost.com/world/2021/12/22/japan-covid-omicron-falling-cases/
- https://www.npr.org/sections/goatsandsoda/2021/12/20/1065159384/the-riddle-of-japans-dramatic-drop-in-covid-numbers
