In the current pandemic of COVID-19, though Japan was one of the earliest affected countries, with its first case reported on 16th of January 2020, the containment of the infection in Japan has surprised the world. As of March 27th (Stage 3), only a total of 1387 confirmed cases of COVID-19 has been reported in Japan, which includes 712 passengers and crew of the Diamond Princess Cruise ship [Ref no.1].

Dr. Samuel JK Abraham, a cardiothoracic surgeon of Indian origin who works at the Yamanashi University in Japan, who is also the Director of NCRM, India, shares his perspectives on how Japan could control the infection while the spread in countries like Italy and Spain is exponential with very high mortality.

1. In Japan people are well disciplined especially during natural disasters such as earthquake and Tsunami, and the same spirit, grit and determination stood its ground against the scourge of “Corona attack” as well.
2. In Japanese schools, right from primary levels, children are taught to clean their desks, classrooms and toilets by themselves, so for them following the government’s instructions to fight against Corona virus was quite easy.
3. In offices, the staff as soon as they report to work, they first clean their desks, office and their surroundings before starting to work.
4. Japanese do not shake hands while greeting each other. Rather, bowing is their custom which is another important aspect. When SARS affected Japan in 2003, right from that time, it has become a custom for the Japanese to wear masks and to use sanitizers in all entry points of buildings, schools, offices, etc., and this further intensified after the NORO virus outbreak in 2013. It may be interesting to note that our team has earlier reported on Clinister (www.nichiclinister.com) [Ref No. 2-5], an alcohol- free citric acid-based sanitiser and disinfectant from Japan which has been effective even against H5N3 Avian Influenza virus.
5. Also, even before the COVID-19 outbreak, when having cold or cough, all Japanese people wear masks to prevent spread to others and hand washing often is another most prevalent custom in Japan
6. With doctors, nurses and paramedics, after their work are over, they mandatorily gargle and cleanse their nostrils with appropriate disinfectants, which I feel should be mandatorily practiced by all healthcare workers in India.
7. Another important fact as mentioned before is the people of Japan follow rules and regulations very meticulously and have a very high level of civic responsibility. When the Government issued a guideline, not even a rule that people should stay indoors especially the elderly, each citizen of Japan followed it to their maximum extent and stayed indoors cancelling all social gatherings and meetings. In my family, my mother-in-law, who is 85 years-old and stays in a nursing home due to her health condition. We were instructed not to visit her from February itself and her needs from our house are carried by a nurse who follows all sanitation protocols meticulously.
8. In fact, All Nippon Airways had stopped serving meals and drinks in its flight right from the outbreak and the tokyo metro trains and taxis keep the windows partially open to allow a better ventilation.

We can observe how each citizen or organization have tried their maximum best to do their part in containing the outbreak.

Dr. Samuel Abraham completed his primary medical degree in Tirunelveli Medical College in 1992, India. After a year in Paediatric surgery training, joined Yamanashi Medical University, Japan in 1993. Finished postgraduate training in Cardiac surgery in 1999 and got PhD. He is a faculty, Centre for Advancing Clinical Research (CACR), Yamanashi University till date, working on Regenerative Medicine and Founder & Director, Nichi-In Centre for Regenerative Medicine (NCRM), India; 2005~ till date. Currently pursuing clinical translation of regenerative medicine in Japan with the Edogawa Evolutionary Laboratory of Science (EELS), Edogawa Hospital, Japan. He may be contacted through e-mail: drsam@nichimail.jp ; and +91- 9444083550/+91-9444927694 (NCRM Chennai, India office contact mobile numbers)

References:

1. https://www.statista.com/statistics/1096478/japan-confirmed-cases-of-coronavirus-by-state-of-health/
2. Venkatesa K, et al. Efficacy of an Alcohol - Free, Citrate based Agent 'Clinister' as a Surface Disinfectant agaist Common Bacterial and Fungal Contaminants. Current trends in Biotechnology and Pharmacy. 2013; 7(2) :592-96
3. Abraham S, et al. Control of airborne pathogens in hospital and laboratory environments by continuous spraying of an alcohol free disinfectant: Clinister. 15th International Congress on Infectious Diseases (ICID). June 13-16, 2012. Bankgok, Thailand
4. Sasikala R, et al. Safe and efficient alcohol-free disinfectant ‘Clinister’ for control of pathogens including Avian Influenza. IFICON 2012, Chennai, India
5. Kubota S et al. Effects of powdered Bio-Io Nurse on Highly Pathogenic Avian Influenza Viruses. Food Industry 2012.