 Thank you everyone for joining us for this year's A&U Japan Update Conference. My name is Shiro Armstrong, I'm the Director of the Australia Japan Research Centre here at the Crawford School of Public Policy in the A&U's College of Asia and the Pacific. The Japan Update is convened with the A&U Japan Institute and my colleagues Lauren Richardson and Ipe Fujihara. As we commence, I'd like to acknowledge that I'm joining you from the A&U campus in Canberra on the traditional lands of the Ngunnawal people and recognise that many of you are joining us from across Australia. I want to acknowledge and celebrate the first Australians on whose traditional lands each of us meet and pay my respects to elders past and present. This year we're joining you online across three days instead of our one-day symposium in Canberra. It's a pity of course that we can't meet in person with many of our regular audience and have our expert colleagues from Japan join us in Canberra, but this is an opportunity to reach an audience beyond Canberra. We'll be recording the update, all of it, and we'll make those recordings available soon and let everybody who registered know about those recordings. Each year with the Japan Update we have sessions on the economy, politics and foreign policy and society. This year we'll kick off with a panel on Japan's handling of the coronavirus pandemic, including the health response and the politics. The big news, of course, is a resignation of Prime Minister Abe Shinsor and that's a topic that'll be discussed on some of the panels. Prime Minister Abe brought political stability to Japan after revolving door of Prime Ministers, so including his time as Prime Minister for one year in 2006, he overlapped with all of Australia's six Prime Ministers since John Howard. Much is being written on Abe's legacy. His resignation may have received a mixed response domestically in Japan, but internationally the response has been a significant outpouring of praise. And that's because it's in diplomacy that Abe shone. Under his leadership Japan was able to conclude the Japan-Australian Economic Partnership and the Trans-Pacific Partnership Economic Agreement and those connected domestic reform to trade policy for the first time. Later Japan concluded an economic partnership with the European Union and importantly took a leadership role in concluding the CPTPP, the Comprehensive Progressive Agreement towards the TPP after the United States withdrew. Prime Minister Abe built a close personal relationship with President Trump and handled him as well as any international leader. Managing the economic, political and security relationship with the Trump Administration is not for the faint hearted and Abe managed to secure Japan's interests. Japan also repaired and improved the China relationship under Prime Minister Abe, President Xi Jinping and Abe came to power only months apart with the bilateral relationship at a low point. Gradual improvement in the China-Japan relationship saw Abe visit Beijing for a state visit in October 2018 and announced 50 joint infrastructure projects in third countries. President Xi was due to visit Japan for a state visit in April this year. That's been postponed due to the pandemic. Japan as many know also concluded a successful G20 summit as president last year and that was in the midst of a worsening China-US trade war. Under Abe, Japan has been a leader and defender of multilateralism as uncertainty has risen globally. The record isn't spotless though. Japan's important relationship with South Korea is at its lowest point since relations were normalized in 1965. They've not been able to escape history and Japan deployed highly politicized trade restrictions on South Korea. Those trade measures relate to new economic security policies of export controls and restrictions on foreign investment in Japan that seem to place narrow security interests ahead of economic interests. That's of course in response to much to a much more complicated and uncertain external environment that Japan and many of our countries all face. So Abe's successor has his work cut out for him. And yes, all the candidates for the next prime minister of Japan are men. Japan has made some progress in improving gender equity in recent times, but from a pretty low base. Female labour force participation has increased, but much of it non-regular or insecure employment. And the gender wage gap remains really large. The changes to how people have, how people, people work have accelerated due to the coronavirus pandemic. And that could remove some of the barriers for women. Japan's able to take, take advantage of some of those changes. Because progress is urgent, not just for society, but because Japan continues to face huge demographic challenges. For Australia, Japan has become a closer political and security partner. What was a strong economic relationship and close people to Japan. And that is why we are so much stronger. We are stronger and more organized and strengthened and deepened. And under Abe, the political and security relationship has deepened. Australia and Japan are anchors of stability, security and openness in our region as the United States and China continue to be sources of instability, both in their own right, but also as their strategic competition makes things much harder for others. How we are building our security. So today as we start the Japan update, we launched the latest version of the East Asia Forum quarterly publication on Japan's choices. That discusses some of the big choices for Japan. So a link has been sent to all of you who registered. Should be in the chat function now and we'll make sure that it's linked in the YouTube description. The update will cover more issues, of course. Many more issues, but Japan is managing the economic shocks from the coronavirus pandemic. I want to thank our speakers for making the time to share their expertise with all of us. And I want to thank Marie Armstrong, No Relation, and Naomi Oxenham for organizing the update for us and doing all the behind the scenes work and the excellent work they've done. So let me now hand over to Associate Professor Sanjay Sanayaka from the ANU Medical School to chair the first panel and introduce the speakers. Sanjayaka is an infectious diseases specialist and has been providing much needed adults with a vision on the global response to COVID-19 here in Australia. Over to you Sanjayaka. Thank you Shiro for that introduction and talk. I am privileged to be chairing this session on Japan's choices beyond COVID-19 and we have three excellent speakers who are sure are going to generate a lot of discussion. We're going to leave questions, please generate questions on this webinar as you normally do, but we'll try and answer them at the end of the three talks. So rather than after each talk, at the end of the third talk we'll start to answer those questions and hopefully there'll be a lot to discuss. I think there will be. So we are now, could eight months or so, eight or nine months into this outbreak, almost six months since the pandemic was declared. We've got about 27 million confirmed cases worldwide in a geographically wide area. I think almost every country in the world has experienced COVID now. We've got almost 900,000 deaths and having said that and despite the fact that COVID is in our minds, in our thoughts every day because of the wide media exposure and just day-to-day conversations with everyone else, there is still a lot we are learning about this virus and how it behaves in different populations. And I think it is really important to see how different countries have responded to the challenges that COVID has posed to them. And today we're going to hear about Japan from a medical, economic and political point of view. So Japan at the moment has about 72,000 confirmed cases for a population of about 126 million people and there have been different waves or surges if you want to call it that. So without further ado I will introduce our first speaker. Haruka Sakamoto is an assistant professor at the Department of Health Policy and Management at Keio University. She has working experience at the Department of International Cooperation, Ministry of Health, Labor and Welfare of Japan where she was deeply involved in health policy activities in Japan. She is also currently working at the Gates Foundation, Tokyo office and the World Health Organization as a consultant. Thank you. Thank you very much for your kind introduction. So my name is Haruka Sakamoto, assistant professor at the Department of Health Policy and Management at Keio University in Japan. Thank you very much for giving me such a great opportunity today and it is my great pleasure to be here today to present Japan's COVID-19 strategy. I am an expert in the public health and then in my presentation slide I mainly explained the current COVID-19 situation in Japan and then Japan's strategy for COVID-19 from a public health perspective. So this figure shows Japan's current situation. The left figure shows a daily number of confirmed cases whereas the right shows a daily number of this due to the COVID-19. We experienced the first wave of the COVID-19 in early March to April mainly caused by the lidar need from European countries and the United States. And two to three weeks after the first wave we experienced the increase in deaths due to the COVID-19 in mid to late April. Then the government announced the state of emergency on the 7th April and we then succeeded in decreasing in post-COVID-19 case and the deaths. However, since early July we have experienced the resurgence of the COVID-19. This resurgence is mainly because people restarted their daily activities and as seen in many other countries, younger generations are the main source of spreading infections. I will explain the details about the PCR testing policy in Japan later but this resurgence is also due to the PCR testing's increasing capacity. So the government expanded its testing capacity compared with that in March and April and thus we could capture more more positive case compared with that in the first wave. The main difference between the first and the second wave is that this time in the second wave we do not experience much deaths due to the COVID-19. The number of the case reported yesterday was 293 nationwide and then assuming the second wave of infection is now converging. So here is the comparison of the number of deaths per 100,000 people worldwide. As of September 6th, Japan's destory per 100,000 people was 10.73, a far lower figure than in western countries. Although some have pointed out that Japan may be high in Asian countries. However, considering the Japan's overwhelmingly high proportion of the older people, I think it can be said that Japan has been successful in limiting the number of deaths compared to other Asian countries. The proportion of the elderly those who are aged 65 years in the order is currently 28% in Japan, which is the highest in the world. In addition, the population density is not very high in the metropolitan areas in Japan such as Tokyo and then Osaka, which is also a disadvantage in terms of the COVID-19 measures. So we are considering these unfavorable conditions such as population aging and then high density populations. It can be said that although the number of deaths per population is certainly higher than in other countries in Asia, but we have succeeded in keeping the number of deaths low on the whole. So what works well in Japan? The Prime Minister Shinzo Abe announced in July that the Japan model was the key to success for the COVID-19. There's no clear definition of the Japan model, but its main component is the cluster-based approach, which I will explain later, and then no lockdown measures. So unlike other countries, Japan did not introduce a lockdown. The government encouraged people to stay home, avoid crowded areas, and then work remotely. These were the voluntary basis, and then there was no legal penalty. However, according to the data, most people followed the government's request, and in that in the epidemic period, the proportion of people going out were more than 80 percent forward than normal period, especially in urban areas. Here I'd like to explain about the cluster approach, which was the main approach about the Japan's COVID-19 strategy. The first, the importance is to know about the difference between the size and the COVID-19. So in such case, in 2003, most of all infected became severely ill or had any symptoms, and then it was easy to detect infected. Also, the patient did not have infectivity before the symptom onset. That is why by tracing the severely ill patient and their close contact, we could contain cells. However, in the COVID-19 case, there is a larger proportion of asymptomatic or presymptomatic cases that transmit the virus, and it is very difficult to detect and isolate all the patients. So this is the main difference between the COVID-19 and the previous pandemics. And then another characteristic of COVID-19 is that about 80 percent of infected does not further infect others. Instead, rest of the 20 percent further infected others, and then among them, only a few causes the severely infected, so-called in the cluster. So in Japan, we did not emphasize sporadic case, as they usually do not further infect others. Instead, we emphasized super spreaders, which cause in the cluster. And so after the careful investigation of the clusters happened in Japan in early February, we identified the possible condition that the cluster happens. So clusters were found to be more likely to occur in closed space with poor ventilation, crowded place with many people nearby, and then close contact settings such as in cross-stage conversation. Therefore, avoiding these 3C conditions has been a national slogan in Japan since the beginning to reduce cluster occurrence. And then next, I'd like to explain more details about Japan's strategy, namely testing, contact tracing, and isolation policy. So about testing, the testing policy is rooted in the aforementioned cluster approach that is emphasizing the preventing clusters happening and does not care about sporadic cases. So in Japan, initially, PCR testing was only conducted at the local public health centers and not conducted at clinics and in hospitals. This is based on the 2009 novel influenza pandemic experience that many people rush to hospitals seeking for testing and then cause nosocomial infections. So to avoid this situation and then protect healthcare professionals and then personal protective equipment, the government limited testing place only for the local public health centers. The government also encouraged the general public to stay at home at least four days unless they are old, have underlying conditions, and have severe symptoms such as shortness of please. Instead, the main focus was to capture results who are the part of the cluster and their close contact. The public greatly criticizes this approach. First of all, it would not be easy to understand the cluster approach. So as what's done in most countries, expanding the testing capacity is easy to understand and then gives the impression that government is taking measures against infectious disease. On the other hand, Japanese approach of limiting the scope and the location of testing is not easy to understand and maybe perceived as not taking any measures. Of course, the testing system which focus on the clusters also had its challenges. The primary reason is that Japan did not have sufficient PCR testing capacity to begin with and then expansion of the testing system is not progress quickly enough. So as a result, it was sometimes impossible to test people who needed to be tested. For example, those who are part of the cluster or who had been in close contact with infected or those with a symptomatic condition, even if a physician judges that the test was necessary. Besides, as mentioned earlier, local public health center in Japan conducted the testing, but initially they had limited staff and were unable to respond quickly when there wasn't such inpatient. For example, it took time to establish and drive through a testing system as seen in some countries. So in the future, we need a system that enables rapid testing of healthcare facilities and clinics other than local healthcare centers. Here's another point I'd like to make about the testing policy for the asymptomatic patient. So in some countries, large-scale testing for asymptomatic people is conducted, but large-scale testing for the asymptomatic patient is not recommended in Japan. This rule is because the number of people infected in Japan is assumed to be very small compared with the western countries. Just the prior probability is low in Japan and then there is a concern of the false negative results and then the cost-effectiveness issues. On the other hand, in early July, for example, there were the signs of the spread of the infection in Tokyo areas, particularly among the young people working in nightclubs and pubs, and then some mass screening was carried out on this high-risk population. While we do not test asymptomatic individuals with the aim of containing the epicenter, in those who seem to have a high preprobability, we do not recommend testing the wider public. In the future, for example, I think there is a room for the further constellation of group testing targeting at the high-risk population and testing in places where the mortality rate increasingly significantly when cluster occurs, such as healthcare facilities and nursing homes. On the other hand, I think testing itself does not decrease the number of infected people. The suppression of the infection is only a matter of enforcing individual preventing measures and then preventing clusters from occurring. In Japan, as with the masks in the United States, the testing system has been a political issue, but I like to emphasize here that the testing system is just one part of the comprehensive measures against the infectious diseases. Next, I'd like to explain about the contact tracing policy. Unlike other countries in the Asian region, there was a strong concern over the privacy issues and then did not introduce any application gathering information about the infected and their close contact by the middle of June. Instead, the staff at the local public health centers asked the infected individually over the phone call when met who and where, and then the public center did not disclose any information regarding the infected. However, as the number of infected people increased, there was a limit to public health center's ability to collect information by human resources alone. So, the finally, Ministry of Health, State, and World Affairs developed an introduced application named COCOA for collecting contact information. So, the Bluetooth is used to detect and record contact between users of this application. It would notify users if he or she had close contact with COVID-19 positive. Users who are notified by the application will be able to voluntarily live in isolation or consider seeking medical attention on their own. Still, this application does not gather any personal information. Lastly, about the isolation policy, by the infectious control law in Japan, the infected has been hospitalized at an initial stage which put Biden on healthcare facilities. So, concerns were expressed about the mild or asymptomatic patient occupying a healthcare facility bed. The government then changed the policy that these mild and asymptomatic should be isolated in hotels or other isolation facilities, rather than admitted to the hospital, except for cases that were already seriously ill or those are at high risk of becoming seriously ill as in older people. In some areas, it was impossible to provide a sufficient number of facilities for the mild case and they were forced to treat them at home. So, they are considering the risk of home infection. It is desirable to isolate people, especially those living with high risk individual in principle in hotels. So, here is the summary of the Japan's approach for the COVID-19. As mentioned many times in this presentation, the cluster approach has been the main focus in Japan. And then focus inspection were carried out on the people who made up the clusters and then their cross contact to prevent to the first cluster happening. And then we did not introduce the lockdown, rather the government encouraged people to change their behavior in to stay at home and work remotely. Okay, so next I'd like to explain about how Japanese health care system contributed to the COVID-19 control. So, last let me briefly explain about the Japanese health care system. So, in 1961, although Japan was not in high income country at that time, we were able to establish a universal health insurance system. This system covers an entire population living in Japan and secure access to health care service and affordable cost. In order to ensure cost containment, Japan also introduced a uniform fee schedule alongside establishment of the universal health insurance system. Like most of the European countries, the government of Japan determines the price of health care services which are revised once every two years. This publicly defined fee applies to the private health care facilities and are not limited only to the public health care facilities. The uniform fee schedule enables us to contain the total cost of health care even though the majority of health care facilities in Japan are privately owned. So, by combining the universal health insurance scheme and the uniform fee schedule, Japan has secured access to health care service for all people regardless of their socioeconomic status, while at the same time, they're controlling the total health care expenditures. In addition to our universal health insurance system and the uniform fee schedule, public health centers have also played an essential role in improving population health in Japan in the history. So, for example, Tebeki Roshis was one of the leading course of this in Japan during the post-war period. All costs related to the TV management such as screening and treatment are covered by public health financing through taxation with no out-of-pocket payment to the patient. While the public health centers have been in charge of the public health management of TV, including mass screening, health care facilities have also played an important role. So, the individuals who have any symptoms that indicates the possibility of TV infection such as fever or cough can access health care facilities at affordable cost thanks to the universal health insurance system. So, by combining tax-based public financing and the universal insurance scheme, as well as in the public health centers and health care facilities, Japan was able to rapidly decrease the deaths by Tebeki Roshis in the country. The effective combination of the policies and health infrastructure is also thought to be one of the main factors underlying the Japan's success so far in tackling the COVID-19 pandemic domestically. So, during our initial response, already public health centers played a central role in the COVID-19 management, including the context tracing, and the public financing has covered all the costs for test and treatment. In addition, thanks to the Japan's health care systems universality and the no-gatekeeping system, any person who had any symptom, whether it be fever or cough, had access to health care facilities without worrying about the cost, which resulted in early detection, isolation and treatment of the COVID-19 patient. So, we need to note the negative aspect of the no-gatekeeping system in Japan. So, because individuals can easily and affordably go to health care facilities, there wasn't a concern that people would rush and master health care facilities seeking COVID-19 tests out of fear. So, accordingly, as I mentioned in the previous slide, the government set the screening criteria to prevent the spread of the main spread of the infection within the public health centers. But again, Japan's health care system, such as the universal health insurance system and the public health centers, together with the Japan's COVID-19 approach, Japan's COVID-19 cluster-based approach contributed the success in the COVID-19 outbreak in Japan so far. So, another key success factor is how we manage the aging population. As I mentioned, Japan is one of the oldest countries in the world. So, proportion of the elderly is almost 30% in Japan. And then, as we already know, that elderly is the highest risk for the COVID-19. So, if the cluster occurs at nursing facilities, it poses severe burden on the local health care facilities. So, how to prevent the cluster happening in the nursing home is one of our main issues. So, there is no official data is not coming yet, but compared to the European countries, the number of the clusters happening in the nursing home and in the health care facilities is much lower here in Japan. And then, I think, which is one of the main successful factors we can decrease the number of the COVID deaths. While we also need to the negative impact of the social distancing among the older people during the COVID-19 pandemic. So, now, the older people are encouraged to stay at home and then do not meet people or friends or do not participate in any social activities. However, compared with the older people, previous research shows that compared with the older people who meet their friends at least once a month, those who do not have 1.3 to 1.4 times higher risk of dementia requiring long-term care. Or another research shows that compared with the older people doing a physical exercise alone, the elderly doing a physical exercise within the group have a lower risk of nephering. Like we, at least the COVID-19 may last for one or two more years. I think how we can treat older people, not just in isolation, but how we can manage their well-being is another concern here in Japan. Okay. So, this is the new normal for the elderly. So, the older people with a lack of social participation and then social isolation are at a higher risk of depression, that's cognitive impairment, and then the carenees. And the carenees are predicted to be more severe. So, going out, working, interacting with people and then participating in a society is a significant opportunity to reduce the risk of force, hypertension, diabetes, and any other health conditions, including the carenees, and this among seniors and to improve the health of the seniors throughout the community. So, destroy the use of the ICT. It is possible to reduce the risk of infection among the elderly while enabling them to participate in social activities. So, of course, we need to protect them from the COVID-19, but at the same time, we also need to think about how to secure the well-being during the COVID-19 pandemic. Okay. Thank you very much. This is the end of my slide. Thank you very much. Thank you very much, Sakamoto-san, for a very lovely talk. It covered many aspects of the outbreak in Japan, and I wrote down lots of questions, which we can talk about, and we've already had five or six questions from the listeners as well. So, now we will move on to our second speaker. So, Hiromi Murakami is a visiting scholar at Global Health Innovation Policy Program at the National Graduate Institute for Policy Studies, or GRIPS, prior to joining GRIPS. Oops, excuse me. I've just had a technical difficulty here. Sorry. There we go. Prior to joining GRIPS, he was involved in various projects in U.S.-Japanese institutions. Including the Center for Strategic and International Studies, the Health and Policy Institute, and Economic Strategy Institute. Her expertise includes state industrial relations, and global health policies. Thank you. Thank you very much. I'll be starting my slides first. Okay. Thank you very much for kindly invitation to speak at this ANU Japan Update series. I'm very honored to be here. And just before starting, this is solely my own view, and I'm not representing GRIPS or any other institutions. So, let me share my view why Mr. Abe's approval rating have been low, so low, and how the government measures have been perceived in the eyes of Japanese citizens. First of all, I'd like to show this graph, that Japanese people are very concerned of COVID-19. And if you see it, 87% of people are concerned, have anxiety that either himself or his family member might get infected. So, very conscious about the situation in COVID-19. And having said that, here's the approval rate of other administrations response to COVID-19. Majority, 60% disapprove of his response to COVID-19. If you look at the breakdown, of course, the LDP supporter would approve, but if you look at the other party supporters and non-partisans, they're consist of around 60%. They are mostly not approving other administrations responses to COVID-19. And I know Australian Prime Minister Mr. Scott Morrison has been enjoying high approval rating because of his response to a pandemic. In time of crisis, usually it should be a great opportunity for leaders, political leaders, to show his or her political leadership, strong leadership. And not only Mr. Morrison, but Mrs. Jacinda during of New Zealand, or Mrs. Markle of Germany, but also many other democratic leaders in the world, the approval rating have been soared during this pandemic era. However, there are only a few leaders whose rating have been substantially dropped, namely Mr. Trump and Mr. Johnson and Mr. both of Brazil and Mr. Abe. Mr. Abe's point is not here, but he's definitely in this group of red group. So if you look at the Mr. Abe's approval rating, it has been declining, but because you know, Shirosan mentioned in the very beginning that Abe's just announced declining from his Prime Minister ship. I don't know why, but his approval rating suddenly jumped 20 points. So it's quite interesting phenomena that maybe, I don't know, I have to ask other panelists what they think of it, but it's interesting to see that the quite jumping of approval rate end of his era after announcing that designation. So what do people expect from leaders in time of crisis? Is a bold leadership or decisiveness or proactive measures or continuous effort to tackle issues? Or maybe honesty, because I remember Governor, New York Governor, Mr. Cuomo, he had broadcasted almost every day about telling us this is situation today and this is what we have done and this is what we're shortcoming of and then this is what we need help us. It was so direct, the message that you get from those leaders and then you almost feel like there's anything I can do. So I can get the sense of trustworthy leadership. Unfortunately, in case of the Prime Minister Abe, he didn't deliver them effectively unlike the other reputation overseas, but domestic reputation is not as much as high as overseas. So for many of you, Japan seemed to handling the crisis very well and combating disease wisely and because of the relatively low number of reported cases in death, but the truth is that Abe administration has fumbled the ball. For many of our Japanese fellow's eyes, Japanese leadership have been mostly indecisive, reactive and invisible. Let me explain. First point, indecisiveness. I'll be making comment about looking at timeline here. During February and March, Mr. Abe was trying to move forward with hosting the Tokyo Olympic Games, which viewed as an important part of his legacy. And so as Mr. Shijin pins visit to Tokyo, they're supposed to have a meeting. By then it was increasingly unlikely that Tokyo Olympic Games will not be held. Unlikely that it will not held in the summer, but the decision came very late, which is in March 24. Until the decision is made, there were awkward period existed. One hand schools are asked to close. On the other hand, TVs are promoting Tokyo Olympic Games or athletes. And we're in the limbo and the government kind of play low key for COVID-19. The decision for a cancellation of Tokyo Olympic Games should have made earlier. And also seeing all the global lockdowns elsewhere. And Mr. Abe made the national emergency declaration in early April. But it was rather late. Our perception was that this should have come much earlier. So that seems to, from our eyes, the leadership was very hesitant to make decisions. And looking at the reactive portion of Japanese leadership, that we had the first patient found in January 16. And no one was in charge of the coronavirus response until March 6, when economic minister Mr. Nishimura was appointed. And on March 13, the emergency bill was passed, which is two months after the first patient was found. And when Abe officially postponed the Tokyo Olympic Games on March 24, Japan was already in the next phase of its health crisis. We're no longer possible to track down when and where patients had contracted the disease. You know, the successful strategy that Masakamoto-san talked about. By then, you know, those cluster-based strategies don't look effective. So at the peak of first wave, health facilities were filling up quickly and coming to a verge of collapse. You know, if Japan was hit by a much larger wave, it could have been a disaster because Japan's intensive care unit bed capacity is only half of Italy's. So if the Italian scale hit Japanese soil, then I don't know what Japan would have responded. So before second wave hit, we had the moment to breathe. Japan could have addressed insufficient PCR testing capabilities, but it has kept same strategy. So it made it difficult for Japan to grasp a complete picture of this pandemic. And from my view, if you don't have a complete picture, how can you come up with the right solution to combat this pandemic? And also, you know, Japan's relatively low, a death toll in the first wave gave the Abe administration a false sense of confidence. Even, you know, as mentioned, government officials were saying successful Japan model. And because of the overconfidence, Japan missed a chance to thinking in depth about long-term strategy, how to combat a pandemic. And move on to the invisibility of Japanese leadership. Bureaucratic sexualism were a major bottleneck, and it was very difficult for them to form joint command. And this is not prone to Japanese system. It exists everywhere, you know, but the case of Japan, the sexualism means very strong. So at the national crisis like this, I wish to see nationwide all Japan effort get various experts and best and brightest from various field to get together. However, re-reactance and avoidance to tap into other jurisdictions, intra-agency coordination and cooperation did not materialize. Leadership was invisible. So, and also if you remember, cruise ship diamond princess case, it has a lot of tension of, you know, from foreign media, the health ministry, minister of defense, infectious disease experts, local authorities were there, but every agency acted its own. Minister of defense left relatively early phase because they were not part of the command chain. So the new emergency law that passed in mid-March did not adequately address the problem. It neither provided superseding emergency power over ministers and agencies to overcome bureaucratic stove piping, nor stated where the decision making responsibility was said. And decision process is unclear. This is my next point. Well, we take up this case of PCR testing kit. The health ministry made national institute for infectious disease as a sole designated PCR producer because it was under their health ministry jurisdiction. And there was, you know, but they're not most efficient producer of the PCR and they were so slow to address the chronic shortage of PCR testing kit. In mid-February, the authority could have turned to the private sector for help. And there are many efficient flu diagnosis device makers in Japan who would have responded to incentives for quick and effective diagnosis kit productions. The hesitation to give the antibody to private makers has resulted a severe shortage of testing capacity across the country. In fact, Rakuten, a private company introduced the easy PCR kit in April 20th, but had to stop distribution 10 days after. I don't know exactly the reason, but it says maybe criticism from medical doctors association or some mal procedure, you know, in filing the, you know, enterprises, but I don't know, but it was stopped. I was expecting to see more of those private, you know, companies entering those PCR productions, but it suddenly didn't happen. So another example is drive through options of PCR. The ministry, the health ministry didn't allow drive through testing until April 15th. Two months after, South Korea had launched its very successful testing campaign. We have seen it, you know, neighboring country and have two months. Finally, Japan allowed to have drive through. It's a little late and also because of a face to face visit should be limited for clinics. It is rational to have telemedicine available for any patient visit, but the health ministry and doctors association were very reluctant in making telemedicine widely available for patient for first visit. According to this statement, it is very special allowance and available only crisis period only. And therefore, you know, it will be not allowed once COVID-19 crisis is over. Why? You know, this is a time, you know, chance to, to exploring new ways of health services. And this even, even you have, you know, crisis, but it's also a chance to, to explore new ways, new innovations. So because, you know, fortunate things in, in Japan is that the, because of these decisions were made in this such a way that we're kind of losing opportunity for policy innovations. And also confusion over responsibility. This was witnessed between Abe administration and perfected governor when Prime Minister Abe declared national emergency in early April. The responsibility of the government and perfecture were not so clear. It was up to governors to conform to national emergency, but at the same time, the Abe administration was very hesitant to empower governors. While most of governors was silent, Tokyo Governor Koike Yuriko introduced her own initiative to contain the virus, but her initiative generated friction among and with the Abe administration over which types of businesses should be designated to for voluntary closure under emergency order. Koike desires stricter measures, but Abe pushed her back and included a range of businesses to be remain open because she had no real power to enforce a closure to business owners and she was required to consult with the central government. Koike had initially struggled to minimize the impact of the virus. And another example is when ending the national emergency order in mid-May, the government provided neither clear conditions nor exit strategy. Frustrated with the administration's laidback stance and the rising number of bankruptcies, Osaka Governor Yoshimura fearlessly announced Osaka's detailed own criteria to lift his business suspension request while national emergency order was in still place. So public opinion polls reveal the sharp contrast between the soaring popularity of Governor Yoshimura and widespread frustration with the Abe administration. It is clear that Japanese people wanted decisive leaders. And final point is inconsistent policies. Protocol for securing safety was just lacking, you know, because Abe administration was aimed for, you know, maintain economic activities and try to limit infection as much as possible. So their priority was economic activity, but in order to assure economic activity, you need some kind of protocol, you know, how to secure safety while doing, you know, businesses. What I mean by that is that when you enter, when you fly to Tokyo and then you, you know, you land in Narita and then you immediately got it to a PCR testing booth. And you'll be, you know, you have to take a test and in a couple hours you wait and you get a result these days because it has been, the time has been reduced because they increased the capacity including antibody tests. But if I wanted to go overseas to have a business trip, I have to find a private clinic to do PCR tests. They are not offered in airport. So therefore I need to find myself and it's so troublesome because but it's not offered so easily. And today many nations require a proof of PCR result certified by doctors within 72 hours upon arrival. This is to allow business people to smoothly fly in and out the country to engage more business activities. You need PCR testing with doctor's certificate and when you have a business trip. And I looked for the clinic and then what I found out is that I have to pay 400 US dollars to take a PCR test and to get a doctor's certificate. It's too expensive. So therefore I think in order to promote your economic activity, I think there are a lot of things need to be done. And also go to campaign. Japanese government introduced this campaign to help depressed tourist industry. However it hit just when the second wave was just coming. So it was very confusing message to the public and also the decision to exclude Tokyo came last minute. And so the making very economic impact minimum because people from Tokyo in and out is one of the major resources for the economic activities. So they're sending the mixed message and to sum up. So this campaign was very unpopular among people. They said they should stop. So to sum up if you think Japan managed well of the coronavirus curve but it was not a result of government policy. We will have to wait for the scientific studies to find the real cause. But Japanese public is very diligently following guidelines of social distance wearing masks and washing and that definitely can do to the to the lower number of death in cases. So the criticism disappointment simply aimed to other administration as Japanese see the past government response was not sufficiently met with their expectations. I think because I have time up. So I have listed lessons but maybe we can talk about one panel discussion time and I'll stop here. Thank you. Thank you so much. Again another thought provoking talk generated a number of questions both from me and our listeners. Again we will answer these at the end of the third talk which we will move on to shortly. So our third speaker is Sota Kato the Executive Director of the Tokyo Foundation for Policy Research and Professor at the International University of Japan. He has served as Senior Fellow at the Research Institute of Economy, Trade and Industry. Dr. Kato received his PhD in Political Science from the University of Michigan. Thank you very much. Thank you for coming Bertie for the audience and let's get started with my presentation. And the title of my presentation is Why Is Abeso Unpopular? COVID-19 and Japanese Politics. And I added was a parenthesis was because as Murakami-san mentioned that after Abe stated resignation two weeks ago he's approval rate jumped up. So whether it's is or was there's a puzzle. And I will look at some chart data to see why this is puzzling question and what was wrong with Abe. So this chart is the bar graph is the change of approval rate from February to May. I realized that I saw Murakami-san's data and it was still like August so there was some drop in US and UK but this data is taken between February and May. And you see the blue bar chart shows the change of approval rate. So most of the countries increased in the leaders increased their approval rates of a century and but except for the one country in the far right which is Japan. So this blue bar chart itself is very interesting for Japan why only Japan's are for obvious approval rate decline. But if you also look at this rate or the fertility rate this is the line chart show the fertility rate and Japan is on par with like Australia and South Korea but much smaller than other like European North American countries. So Japan seems to be doing well if you look at the fertility rate but the approval rate as for the approval rate of the leader Japan is the only country which declined up to the May. So this is puzzling and so another reason for this there's a reason for this question is puzzling is that I added the line chart is same as the one before but this blue bar graph shows that how strong the government response was how strong government measures was to restrict people's private life and this bar chart is taken from the data set index called government response string stringency index created by Oxford University. And as you can see that Japan is the far right one and Japan is the least least restrictive. Japan's COVID-19 response was the least restrictive compared to other country and Japan also managed to suppress this rate rather than most of the countries. So these two like so the fertility rate is pretty low and also Japan managed to accomplish that with relatively restrictive measures. So this restrictive measure means that it gives more freedom to the people and also it's more it's better for the economy. So Japan seems to be doing well in these two data and also as others have mentioned Japan is one of the most aged society in the world so Japan should be more vulnerable than other countries and also the like population density is pretty high but Japan has accomplished this low fertility rate and no infection rate. So why is so so this is why I I question at the beginning so why are these poverty rates pretty low very low and declining and maybe the reason is because it's outside the COVID-19 response. So there are some possible explanations unrelated to COVID-19 and first it might be the political scandals and there were a lot of political scandals for the other initiatives like a year or half a year. So Morika Kechei, Borosan Buying Party, Electoral Fraud Prosecutor's scandals these are all Christie sites for political favoritism and also all of these are rooted in concentration of power to the Prime Minister's office because Abe held office for nearly eight years it's a record for Japanese Prime Minister the power was concentrated in Prime Minister's office and that kind of invited and that became the root cause of these scandals and also these political favoritisms and so there are a lot of scandals and it's sure that these scandals negatively affected Abe's approval rate and also as others have mentioned maybe it's not because of the government response or the government so the government leaders but Japanese people's self-control power is great so that was the reason why Japan accomplished low fertility rate or maybe they're like factors, generic factors, agent factors, cultural factors. So there are other possible reasons why Abe's approval rate is running but having said that because of this high visibility of COVID-19 government response should have said substantial and significant effect on Abe's approval rate and if you go into details of surveys if you look at the question of asking the respondent evaluation of COVID-19 response of the government and it's highly correlated with Abe's approval rate so these non-COVID-19 response factors definitely affected Abe's approval rate negatively but there should be some reasons for why other reasons for why Abe's approval rate is stagnated so we should ask for like particular scientists so and I raise two hypothesis that might explain this approval rate after the COVID-19 outbreak one is retrospect boarding and another is rally down the flag effect. I will just read through these two retrospect boarding. Borders evaluate government performance by focusing on simple performance matrix usually economic indicators such as disposal income or like a GDP growth or unemployment rate and borders bought for the incumbent when those indicators improved while in office and this retrospecting boarding research is recently applied to natural disaster management of government so and it works better than economic boarding so it should this retrospecting boarding should have something to say on this COVID-19 response as well and another is rally around the flag effect and borders increase support for the country's government or political leaders during periods of national crisis and this is repeatedly observed phenomenon in the past and so these are the two possible hypothesis that can explain Abe's approval rate and so so let's start with retrospect boarding so if retrospect boarding works and retrospect boarding is result oriented borders boarding behavior hypothesis so if retrospecting boarding works it should positively affect Abe's approval rate because if like indicators like fertility rate death rate or the infection rate remains favorable both for Abe's and favorable for Japan Abe's approval rate should increase if retrospecting boarding works so so you you can look at this figure below so if the death and the infection rate remains low retrospect boarding if retrospecting boarding works the approval rate should increase and as for the rally round the flags rally round the flag effect it might affect the opposite way with the retrospecting boarding so if this and the infection rate are high people become more people feel more sense of crisis and that should increase the rally round the flag effect and that should increase approval rate of borders so these two might work in the opposite directions and if you look at the data at to this point retrospecting boarding seems not working yet so the typical counter example is Japan right so the simple indicators like death rate infection rate are favorable for favorable for Japan but borders are not evaluating those favorable indicators and also counter examples maybe Italy or France they have some serious conditions but the approval rate is being pretty high and more extreme more extreme example maybe the New York governor Cuomo at the local level the state of New York suffered the most devastating result from the among the US states but the governor Cuomo's approval rate surpassed 80 percent which is more than 80 percent so it's very unusual so retrospecting boarding seems not working yet I suspect it might work in the future but it's not still working and that means that rally round the flag effect seems to be buried to a certain extent so the questions will be the question the initial question was that why are they so unpopular and the question here should be that why retrospecting boarding which should favor are they is not working and why are they could not capture the rally round the flag effect so that's because I mean that and so this is a chart taken from uh you go which is survey institute uh the fear of catching COVID-19 and as you can see Japan is much higher Japan Japanese fear much more than other countries but Japanese citizens fear COVID-19 much more than citizens of other countries except South Korea this is taken from G5 G7 countries and also also Australia and South Korea and so this is this Japanese sentiment is interesting especially you fact in the low fertility rate so Japanese are more fear more than Italy or France where there are a lot of that have fertility rate was much higher but uh Japan fear more and this kind of sentiment of Japanese citizens might have affected negatively for Abe's approval rate because Abe's approach was modest maybe indecisive but in something in certain in some sense you can say was reasonable if you account for the low fertility rate uh you you can say it was reasonable reasonable but uh such a moderate approach might the Japanese citizens who fear a lot about uh COVID-19 might have not welcomed Abe's moderate approach he they might have welcomed most stringent response you can see from this chart and also um you have to um borders if you want to if the political leaders were to uh earn borders support from the rally effect or the retro safety body boarding they have borders need to recognize who was responsible for these majors and and they the leaders need to show that he's the one who should get the credit and in the case of COVID-19 political leaders of a local government have been very active and visible in many countries increasing Japan then like Tokyo Governor Yuriko Koike and Osaka Governor Akira Yoshimura have appeared on national tv almost every day and maybe more than Abe since the outbreak of COVID-19 so if the public recognizes that local leaders are holding the flag they will be the beneficiaries of the rally effect not Abe but they will be the beneficiaries and if you look at the surveys results of surveys uh people respondents generally support local government leaders more than Abe and also they trust more local government leaders more than Abe so that may be the battle for the flags or battle for the credibility COVID was won by local leaders and not by national leader Abe and that might be one of the reason why Abe's uh approval rate is stagnating so these pictures as the left side of Abe and Koike and Yoshimura and these three pictures kind of show their attitude Abe is relaxing this picture was provided in Abe's twitter account and Abe is relaxing in his house drinking coffee but other two governors Tokyo Governor Koike and Osaka Governor Yoshimura their their looks they they have stern locks and they are always cautioning uh citizens and so these are the different attitudes of these three leaders and uh I I kind of suspect that uh attitudes of Koike and Yoshimura have taken more uh was taken more favor in computer Abe uh because Japanese citizens fear a lot over the COVID-19 I'll just skip out the US case so just to wrap up why Abe is so unpopular uh so one the first is in literacy voting we should have favored Abe is not yet working I say not yet working I I suspect he will start working in the future and this is not only in Japan and also Abe failed to capture rally around the flag effect which seems to be working in several countries and low maybe low infection and fertility rates might have prevented him from taking strong measures and that kind of uh led Abe to fail to capture rally around the flag effect and also Abe might have lost the battle for the flag with governors uh and that might be one of the reasons and also there are a lot of non-governmental reason like political scandals and I still think one can still argue that Abe has done really very well against the COVID-19 and his modest and gradual approach might have minimized socioeconomic damage while making the low infection in this day and also he might be uh he might have been uh positively evaluated by the voters if the literacy voting start working but since he designed we cannot test that uh but uh but in the in the conclusion it's not I think it's not reached yet so that's the end of my presentation thank you thank you Katosan for a lovely presentation on those political aspects of the COVID outbreak in Japan so now we've come to the end of our three talks and finished exactly on one hour well done to our three speakers perfect timing and we have got a number of questions from our audience I am going to just open it up and perhaps maybe to uh any of our panelists but maybe Sakamoto-san if I may ask uh with the elderly you said the elderly have been protected in nursing homes could you please tell us a bit more about how that's being achieved and a comment uh just something I've read before uh in in Japan they talk about lonely deaths where there are five million elderly people who live alone and I think 40 000 of them have sort of died alone and they think that will be about 100 000 by the end of the decade and although it's obviously a horrible thing from a social point of view from a COVID point of view it's probably protecting them protecting those five million people from COVID so do you mind just commenting on on that and just how the elderly have been protected because as you know in Australia in Victoria we've had a big problem with deaths arising from residential aged care facilities getting uh washed with COVID cases okay thank you very much for the question so the how to protect an older older population my point is that how do you protect older population at the nursing facilities not at home so the uh compared with the case in the some European countries more than half of this are occurred in nursing facilities in some countries however in Japan very few died in the nursing facilities due to the COVID 19 I think this is not because the frontline workers like the caregivers made the effort to prevent the elderly people are getting infected so for example these some facilities close the family or friends are visiting the nursing facilities in the very early stage of the COVID 19 pandemic like the very early February or end of the even end of the January or the healthcare workers working at nursing home themselves and trying to be not infected like not wearing the masks correctly or always washing the hand and personal hygiene and do not going out or they do not do this kind of the high-risk activities so I think the ages and the personal effort contributing a lot to our occurring the cluster happening in the nursing home however as you mentioned from the our social aspect the protecting the elderly isn't sometimes sometimes very controversial so of course we need to protect the older people but at the same time we need to how we can are secured opportunity that these older people are still making a connection with their family members and the friends or as a part of the social activities however there's no are a good answer for this question because the people in the valley struggling how to keep the social activities while protecting older people from the COVID 19 so some day or the nursing facilities introduce an ICT device like an iPad or mobile phone or mobile tablet in order to keep communicating with the family members but majority of the older people are not really familiar with this kind of the ICT device so the uh in that person I think the ICT device does not really replace the real contact with the family members and the friends so like the uh how we can keep the social activities and social connection with the family members and friends while they're protecting the older people from the COVID 19 there's still a very big issue however when they're seeing the our national debate about the our national debate I think they are already just not much debate isn't happening this kind of the issue so now the more focus is only to go to help protect the older people from the COVID 19 and then doesn't really care about the social aspect so I think this is in the current situation in Japan thank you very much we've by the way we have got a lot of time for questions so uh don't don't be worried we've got plenty of time to go through I think we've got uh more than 10 questions 10 to 15 questions from our audience the first one I'm going to read out names because I think if this was a real live session the person would come to the microphone and say their name and their affiliation so Kim Hale has said uh hi panelists she's asking about the Japanese attitude to working from home which I guess we're seeing a lot in Australia and in a lot of western countries was this a difficulty in transition and does Japan envision any opportunity for foreigners to be able to work remotely to assist Japanese organizations and businesses whoever would like to answer that from our panel please go ahead well can I ask is is do a lot of people work from home in Japan at the moment hi okay yeah all right so this is my personal view that I think it depends on the generation so like the younger generation like in the 20s and 30s because they are not very familiar with the working remotely by using the mobile phone and a pc and other devices so like the younger generation are very positive for the working remotely however in the older generation or senior management class I think this is just my personal impression but I think these older senior generations are not really positive for the working remotely so once the state of emergency lifted I think the especially for the big companies where the senior class is in the 50s and more than 60s they encourage the employees and come to the office physically this is my view sure thank you uh then we have a question from Carol Lawson who asks can you comment on the role of shame and stigma in Japan in infectious diseases management both historically and in the COVID era this has been seen in medical facilities refusing to admit COVID patients medical staff resigning under family pressure in order to avoid treating COVID patients children and spouses have known recovered COVID patients being excluded from school and workplaces patients avoiding diagnosis and treatment etc and that that is true I think uh in every country in the world there is a different cultural approach and understanding and acceptance of disease how has COVID-19 been reflected on in Japan hi okay so again all right so I think this isn't a very huge issue in Japan both among for the healthcare professional and then also among the general public so for the healthcare professional they sometimes refuse to take the bus taxi or public transportation because they are recognized as the source of infections and then the kids of the healthcare workers sometimes refuse to come to the nationally or elementary school so because of the stigma of fear of the COVID-19 and then among the general public as well because they are here in Japan we have a very strong pressure each others so like they are in my presentation I mentioned that we did not introduce in the lockdown measures instead the government encouraged people to stay at home and working remotely and then the reason of success is that one of the reasons of the success is that we have the very strong pressure among the each others so the darling the state of emergency you have people in the working around or going far places says in the kind of the very negative pressure from the other state neighbors so the especially for the remote areas in Japan the where the number of infected in the belly low if the someone or their family are a diagnosis in the COVID-19 positive they have the experience the stigmatization or prejudice nor it's kind of a negative experience and then the our government also showed a concern of this situation and then the several weeks ago government established an expert committee on these issues and then the how to tackle the prejudice and then this kind of the yeah these issues okay okay thank you and now there's one I think for Murakami-san a comment regarding that I think it was in your talk you talked about the increase in Prime Minister Abe's approval rating since he announced his retirement I think you you mentioned that didn't you the comment is perhaps it's a case of better the devil you know and this is from Louis Sweeney I should say the comment and now the Japanese people are uncertain about his successes ability to deal with COVID and the economic crises so that's Louise's comment I mean I also when you mentioned that I I always find that once he hasn't retired yet but once a politician retires and they're out of the public eye everyone forgets why they were angry with him or her and they look at them more fondly maybe that's what we're starting to see with Mr. Abe Murakami-san would you like to comment? Sure um so uh I'm really a little bit un not understandable of the the the devil uh phrase but is it mean that um it's it's uh sorry yeah it's it's what it's really saying better the devil you know means that someone no matter how bad they are at least you know them whereas the next person you don't know so they could even be worse ah okay so but uh the current situation I think Kato-san may have much better idea but the current situation is that we almost know who is going to succeed Mr. Abe and he said he's continuing Abe's policy including COVID-19 so what I think uh and then I think that the rate uh went up 20 points uh meaning that I think the public would satisfied with the continuation of Abe's policy even though you know I I said many things uh that uh frustrated but I think as you said you know people forget you know okay he's quitting because he's ill so that I feel sorry for him right he did a great job if you look at the eight years you know just COVID COVID-19 is only past eight months but the rest of if you look at the rest of his his term maybe he did a great thing just to accept this COVID-19 so um for I think public general public it's just uh the way that they think that continuation is much more likely and they like to see new faces and uh for that reason I think even uh we don't know who what kind of policy the next success is going to take but generally know the same as the current situation so therefore I think people are not really looking for a big change but maybe a continuation of the current status okay thank you thank you for that cut cut or some do you have anything to add to that or this is puzzling but um I think wrong is that uh the news conference uh he when he announced the resignation was taken very favorably by the favorably of the Japanese citizens uh and I I I also watched that and he answered each question very sincerely and uh took a long time to answer each question and I think that was accepted very favorably and also I think that uh Japanese citizens are thanking him for uh doing a pretty good job in eight years in total so that's my guess but I'm not sure okay thank you uh be laloa asks or notes that in Australia a growing issue is confusion between the states and the federal government for key responsibilities which responsibilities do you think are currently ineffectively allocated between prefectural governments and federal governments in Japan and uh yes that's a big issue here in Australia where uh particularly over borders uh which which states should states have the ability to close political borders I think it's frustrating the federal government at the moment because they want to open up the country the the economy etc and it really has uh brought up the issue of what should states control what should the federal government control so here in Australia the economy defense the federal government looks after but the states look after health uh primarily in a number of other things and a former premier of one of the states was just saying of the public servants in Australia 78 percent of them are state public servants they're not federal so he was arguing that the states should have more power because they've got more people on the ground but uh obviously you've talked you've touched on the issues between the prefectural governors in Japan and the prime minister uh what what is your comment on this is it me oh it can be anyone okay should I be responsible yeah cut us down please I think this the COVID-19 issue has spotlighted this fundamental issue of division of tasks between national and local government and I think I'm I'm not sure about other countries but in Japan I think that borders or the citizens realize that local government has much to do in this situation but they don't have the uh enough this uh enough uh right to do that and so um borders kind of attributed attributed the responsibility to local government that's my take on this like thing but uh the decision power uh is not delegated enough to the local government that and this should be discussed any more in the future and this that's this is a really fundamental question and this course COVID-19 has spotlighted this and this should be discussed further can I add one comment in addition to Mr. Kato's um also the Japanese case is that uh we don't have state tax it's it's all federal taxed so therefore the the prefectures are getting money from the central government so this is the like a hierarchical situation so therefore sometimes that will limit limit you know governors or it gives a lack of budget they can't really have a say and have to obey what the federal government says so you know there are a lot of discussion that the state tax should be allowed or you know what decentralization uh should be promoted and but still that federal government has not given up the taxation policy toward the local government so that's one of the main issue okay and uh I was going to ask a question but uh Shiri has asked a question which leads on to the question I was going to ask which are the most affected areas in Japan is it a fairly uniform level of infection throughout Japan or have some areas been more affected than others we kind of charted graph um taking the relationship between population density and death rate and there's very very clear uh proportional relations so the areas that were affected most were areas with population high population density which means like Tokyo Osaka and Nagoya and those those prefectures has any local governor or local political leader as in Australia tried to close their prefecture or their their area from areas with high levels of disease if they've had low levels of disease or do they not have that power they don't mostly they don't have like um formal power but they try to kind of do those kind of things and they yes and yes okay okay and so is that is there a particular area which has been closed down for a long time to people from outside the area or they haven't been able to sustain that it's not really legal they could not close the shutdown the border of prefecture legally but they the governor's asked people to not come in or come in so that kind of informal restriction were made can I add one point of course okay uh I think there are there's a no uh official I mean official limitation for the geographical area but instead are the uh there's a kind of the high-risk place like nightclub on the bars so they are both the prime minister and the cabinet secretary and also the metropolitan governor are encouraging people to not go to this kind of a high-risk areas not in geographical areas but in the encouraged people to not to go to the bars and the club or a night night pub this kind of the areas okay great thank you uh Declan O'Hare has written quite a long question so Declan I hope you don't mind if I paraphrase it I think essentially Declan is asking says that China's response to the uh to COVID hasn't been ideal should has COVID-19 affected Japan's relationship to with China so maybe Murakami Sano Kato-Sano would you be in a position to answer that so if I understand the question correctly so COVID-19 situation affected the Japan-China relations yes in any way okay the same I guess it has in the United States they're trying to distance themselves from China and blame etc okay um a Japanese leader especially Abe was very um conscious about you know not damaging relation with China so that's why he waited last minute he didn't close down from entry from Chinese uh China tourist he only Japan only limited particular provinces not like entire China like US did so very carefully um you know limiting particular areas and because he wanted to see the success of Shijipin summit and also Japan is really closely related to uh you know Chinese I mean economic activities in Chinese markets so therefore as Japan's position you don't want to miss miss you know relation with China so that kind of portrayed as much and then therefore um especially when US and China is having really you know harsh uh relations so therefore Japan as like a more Christian we want to kind of you know elevate yourself to be a good friend of China so Japan is trying to be you know much more friendly basis with China not damaging any Japan-China relationship that's that's what I see so so if anything the relations the strength of the relationship has increased through COVID um maybe neutral though um there are many uh you know like schools or uh some factories sent masks to you know the children so they're like the like local level so Japan sent like mask to the particular province and then the province also sent back masks to the schools in Tokyo so it's sort of um a much more of a grassroots of relations but they're trying to be more helpful each other and that's what I don't see any confrontation uh you know in terms of uh limiting Chinese don't come Chinese we don't have that sort of thing um evidently you know okay thank you the other thing I want to do ask uh is the the implications of canceling the Olympic Games because I think we all know I mean having had it in 2000 here we know it was such a big deal so much money so much time invested in trying to win the Olympics competition there's so much prestige for the country for the political leader it's uh it's win win win and then having to cancel it must have been devastating I guess did do the people did the people at the time accept that it had to be done or was that regarded as a failure of Japan's response to COVID and how are they dealing with it now I think the situation is pretty obvious um they thought they could handle a very beginning because you know in Japan that the the patient the number was not so high but if you look at China's rising all the number of patients and also European you know nations so even Japan is able to keep itself as uh you know the better environment but all the rest of the world people coming from you know the various places so it's the question of can you do you know within this situation where a lot of you know the COVID-19 elsewhere so you can't really have just own you know your own country but how do you deal with when did the rest of the world people coming to Japan and can you deal with it can you deal with the safety and it was pretty obvious that it's it's not maybe a possible so people feel like it's well you know you can't help it uh if you know it's not the failure of Japanese policy but it's more of the the overall situation developing elsewhere and worldwide yeah thank you thank you for that now someone labeled as Stevenson asks and this may be one for Sakamoto-san could you tell us more about in-car testing for COVID in Japan what extent is it being used my understanding is that it's not comprehensive so introduced independently by prefectures or cities and only covers very small numbers of people I think the testing center in Nagoya which was opened in May only took about 15 people a day two days a week this is different to other countries such as the US, Australia and South Korea okay yeah thank you for that question so like after the 2009 novel influenza pandemic the expert committee recommended to have the capacity to do the car testing or car PCR testing and then the staff at the local government most of the old local government have an experience of training when they're conducting the car PCR testing however in my presentation because of the initial phase the local public health center overwhelmed by the response for the COVID-19 case so it took time to set up the car PCR testing however the in some municipalities and the local government started doing the PCR testing however the government does not does not recommend a nationwide car PCR testing like the South Korea or Germany so it doesn't car PCR testing but here in Japan the government does not recommend the nationwide car PCR testing and then the main reason is that it's related to the previous question about the relationship between the central government and local government but the situation of the COVID-19 is not very different among the prefectures so for example like in the Tokyo metropolitan areas the number of the positive cases is totally different from the Tokyo and other areas so like the government say it does not recommend any nationwide testing testing policies so it totally depends on the local government so the local government decided that it is very useful to introduce the car PCR testing in that case some local government does okay thank you and I was talking about the testing do I do you agree with this approach to just testing for clusters or do you think testing should be performed a bit more widely I think they are a bit more widely because in the only a cluster approach we cannot avoid the state of emergency and then we experience that are such increasing the end of the March to the early April so we need to expand to the PCR testing capacity not only for the cluster approach however I do not agree with the RMS screening for the asymptomatic cases instead like in the early July the Tokyo metropolitan government decided to contact the PCR testing for the those who are working in the nightclub and the bars because they are very high risk of the infected correctly I think they are focused on the target group with a high-risk population like this someone who are working in healthcare facility when I think home or it's those who are working in the nightclub and the party nightclub and the bars I think this kind of the place is I think we need to expand the PCR testing capacity but for example in some prefectures we does not experience in any positive COVID-19 positive case recently so like I do not really agree within the conduct this kind of the areas where the very few positive case positive COVID-19 case and then they barely few yeah in that kind of the preprobability is not very low in that kind of places so I do not agree to expand the PCR testing capacity for those who are symptomatic cases okay thank thank you very much for that and a question from Christian Magnus Halkin I hope I've pronounced that properly a question for Katosan you mentioned that the higher sense of fear among the Japanese population is a reason for the decreasing support for Abe during the COVID-19 pandemic there is some indication in research that fear responses in voters generally favors the right or the conservative political spectrum what would set the fear factor in Japan apart apart from that in Britain Australia US in short why hasn't the fear factor helped the LDP or Abe okay um I yes I think it's generally true that this kind of fear kind of sentiment work positively for right hand right hand conservatives but as I showed audience in the PowerPoint the pictures of Abe and two governors Abe's approach toward COVID-19 was uh kind of moderate and just asking people to be reacts and and those kind of approaches and other like governors um were more uh took more stronger position and more called for more restrictive measures so in this case in this particular case because Abe's approach was moderate the Japanese citizen's fear sentiment negatively affected with approval rate but yes it's true that a fear kind of sentiment will usually support right-hand side politicians and Abe is definitely right-hand side politicians in Japan thank you for that just to follow on in fact from Murakami-san's talk I think when you first showed the approval of for Prime Minister Abe from the different parties you had the bar graph even the LDP 43 percent still disapproved which was which surprised me actually that's his own party even though it was better than the other parties so anyway uh so I have a question from Ari Sharp I guess for any of our panelists Ari says join I'm joining here in a personal capacity my question Japan was already struggling to achieve a female workforce participation what does COVID-19 and the caring responsibilities for children and the elderly that disproportionate the impact women mean for women at work okay maybe I start um at the same survey that I looked at NHK that they have shown you know how much you are salary how much is your income is affected that question like 70 percent is unaffected so like 30 affected and then if you look at woman's pattern of workforce they are mostly you know regular don't regular workers so who happened to be suffering much more than regular workers and then the proportion of the woman is much much higher maybe majority of this don't regular workers are occupied by all women so I think those women have very difficult time these days with this COVID-19 situation because they are laid off or their contract stopped and but I think the government has still lacking to kind of get a sufficient help of those people and so they have to catch up but I think woman at work has very difficult time especially those who are engaged when this non regular as a non regular workers thank you and I think even here in Australia the figures I saw on a news program were suggesting that women were also disproportionate be affected when it came to COVID and work so the consequences of that now we have a question from BE Loloa how has the Japanese governments approached informing migrant worker groups and enclaves so Brazilians and Filipinos where's my question gone about COVID-19 are the federal governments involved in informing these group in any way or is this delegated to municipal and prefectural governments so I guess that we can also think about Singapore where their big I guess second wave or second surge was associated with migrant workers which I think they finally got under control but they're still dealing with how is is are there a lot of migrant worker groups Brazilians Filipinos etc in Japan and how have they been educated about COVID and looked after with regard to COVID maybe Sakamoto-san would you have any thoughts on that or okay thank you for the question actually I do not have the much knowledge about the migrant workers all right but I think there are some nursing care facilities and started to accept the migrant workers mainly from the Asian countries and then because they cannot come to Japan because of the COVID-19 are some nursing care facilities might have a severely effective the short shortage of the long-term care workers and then the even the ordinary time because of the rapid increase of the population older population we are suffering from the chronic shortage of the long-term care workers who are working at a nursing home so the area because of the COVID-19 and then the migrant worker cannot come to Japan all right these nursing home should have the severely affected in these areas and then the also the rural areas some fisheries and agriculture they are also deeply rely on the migrant workers and then the again the RISR industry isn't also affected because of the shortage of the migrant workers thank you would other two panelists like to comment I also don't have much knowledge about this but just to want to a couple points that to start with the Japanese in Japanese working environment not so many migrant labor force and Japan has been really minimum of accepting those immigrant labor so but on the last you know not only this COVID-19 but last disasters and natural disasters we see a problem that communication has been only in Japanese news broadcasting and or you know mainly in Japanese so that those people are left out from you know information necessary information so I think still that the issue remains so therefore not only the federal government but also the local communities we local government has to deal with those things but still a shortage of of having providing such services to non-Japanese workers okay wonderful thank you also a question from me maybe for Sakamoto-san for is Japan aiming to eliminate or control slash suppress this this virus so we're having this debate endlessly in Australia and New Zealand a country like New Zealand has gone for elimination was largely successful until it had a recent outbreak what is Japan's approach okay yeah thank you very much I think this is a very important question so I think they are initial stage I think government try to eliminate the virus virus that's a government strategy I understand but however the after the state of emergency lifted in the end of the May but we still have the our several hundred daily case in Japan which means the government give up to eliminate the virus instead in now I think government sifted the policy from the elimination to the control of the virus yeah yeah I think the initial stage government try to eliminate because they are as the some of the Asian countries and try to eliminate and then in order to come I mean considering the relationship between the neighboring countries I mean the business trip or traveling or also the Olympic game in the next year I think government try to eliminate in the initial stage but I think they are they are shifted their policy not to eliminate but to I mean coexist with the virus I think it is very difficult to eliminate the virus it is it is very hard and if you do it there's always the risk it can come back yeah and then I think they are there's a huge debate between the public health expert and then also the economic expert and then because they are I think the public health expert insisted that we should eliminate the virus first and then after once we succeed in eliminating the virus we can do more actively are reopening the economic activity and other social activities but during the state of the emergency there's a huge debate between the public health and economies and an economy side has a stronger voice than the public health and then they say it's a Japan should be open the social activity and economic activities and then the other decided to support the voice for the economic side which means the government shifted from the elimination to the coexist okay and with with the surge that we're seeing in Japan are there a lot of people being hospitalized or are they mainly in the community I think the initial stage and most of the people even they are mild symptom or asymptomatic case they are hospitalized but the after several months because then there is an I mean asymptomatic case and the mild case is in the burden to the healthcare system so the government and the local government will stay safe in the policy so they encourage these people to stay at home or stay at hotel or other isolation facilities so now only severe case or those who are at high risk like the elderly those who are in underlying condition only those people are hospitalized okay and anonymous attendee asks in Australia the federal government has discussed the idea of a travel bubble that would include Australia and New Zealand so that would mean free travel between two areas with low levels of COVID so anonymous attendee is asking would Japan seek to join this travel bubble if such an idea is consented and endorsed and maybe I guess answer that not necessarily our travel bubble but is there a more another regional travel bubble that Japan is looking at joining maybe I start you know having you know stay home for several months I think people really wanted to go travel and you know having Australia New Zealand is a closer compared to other you know going to Europe or other places so I really wish that Japan would join this travel bubble because you know once you have set a protocol you know the safety and assurance of a floor you may have a certificate or whatever you know to make make it available for people to easily travel that would be very preferable and I hope that would happen soon and so that I really like to join that personally thank you yeah I think we're all getting a bit stir crazy not being able to move very far from our home so that that would be nice now oh the Sakamoto you mentioned Coco the app has there been good uptake or has there been suspicion and issues with privacy etc I think this isn't a good first step because we are I mean the before the cocoa has been introduced the local public health center making the phone call individually and then the sharing the information using the facts I think the facts not the email or digital device but say using the facts so after introducing the cocoa and now I think this is a good timing for the Japan to shift from the kind how to say kind of the or or or the skill like the facts or telephone or this kind of the older skills to the digitalization of course there isn't many challenges about introducing the cocoa application and then there's some of the concern and criticism isn't coming up but I think that's an initial step I think this isn't a good first step look hopefully there have been a few questions I think we've a few more questions I think we've covered everything largely I just wanted to finish on the state of emergency I got the impression even though it was called a state of emergency not many things were enforced by the government is that right it was more just in name only yeah yes yeah okay okay but because of this high fear level that as I mentioned in his his talk people listened okay wonderful look it's 656 I think we've covered a lot both within the talks the three great talks by our three wonderful speakers who've taken time out of their valuable days to to inform us about COVID-19 in Japan and the politics around it so without further ado I would like to thank everyone who's attended and stayed to listen to the questions I thought that there were a number of really good questions from the audience that our panelists answered really well so hopefully this will set the tone for tomorrow's session on the economy but for now I would like to thank our three speakers and all of you for attending this session thank you