Colegio de los Ángeles #10

Laura Carolina Hernández Betancurt Grammar 11° 29-01-2023

Low immunity, overwhelmed hospitals fuel Covid-19 deaths in

ageing Japan
Low immunity against Covid-19 and a growing population of frail elderly is driving a surge in
coronavirus deaths in Japan which had, for a long time, upheld some of the strictest pandemic
restrictions.
Japan once boasted one of the lowest Covid mortality rates, but the figure has been trending
upwards since the end of 2022.
It hit an all-time high on 20 January this year, surpassing the UK, US and South Korea, according to
Oxford University's Our World in Data.
Japan was largely closed to foreign visitors from 2020 till mid-June last year. It opened its borders
cautiously - at first, travellers had to be part of a package tour, buy medical insurance, and be
masked in all public places.
Some schoolchildren had meals in silence for over two years as schools imposed bans on
lunchtime conversations.
As restrictions are eased, however, the population's low Covid immunity may be causing infections
to spike, local health experts told the BBC.
Most of the latest Covid fatalities are elderly people with underlying medical conditions, experts
said. This contrasts with the initial spate of deaths that were due to pneumonia and were often
treated in intensive care.
"It is also difficult to prevent these deaths by treatment," says Hitoshi Oshitani, one of Japan's
leading virologists, adding that Covid was only the trigger.
"Due to the emergence of immune-escaping variants and sub-variants and the waning of
immunity, it is getting more difficult to prevent infections," he says.
"Immune escape" is when the human host's immune system becomes incapable of responding
against an infectious agent. New versions of the Omicron variant are known to be masters of
immune evasion.

Before the Omicron variant struck, Covid deaths mostly occurred in cities like Tokyo and Osaka,
but there are now cases across the country, said Dr Oshitani, who was once regional adviser to the
WHO on communicable disease surveillance and response.
"In smaller prefectures and rural areas, the proportion of the elderly population is even higher
than the national average. This changing geographic pattern may also contribute to the increasing
trend of deaths," he said.
Japan is the oldest society in the world by various measures, and its share of elderly people has
been increasing every year since 1950.
Elderly people who are getting infected in nursing homes or in community clusters are not
receiving prompt treatment, says epidemiologist Kenji Shibuya, a director at the Foundation for
Tokyo Policy Research.
Colegio de los Ángeles #10
Laura Carolina Hernández Betancurt Grammar 11° 29-01-2023

Faster treatment can help, he says, but because of Japan's classification of Covid as a Class 2 or
"very dangerous" illness, only government-designated hospitals can treat the infected. And they
have been overwhelmed by the surging caseload.
Dr Shibuya has called for Covid to be downgraded and treated as a form of influenza, allowing all
clinics and hospitals to treat patients who have the virus.
Prime Minister Fumio Kishida announced earlier this month that the classification would be
lowered, but only on 8 May. Experts, including Japan's top coronavirus adviser Shigeru Omi, have
been calling for this since last year.
Dr Oshitani and Dr Shibuya also say that the death rate could have been inflated by under-
reporting of Covid cases due to asymptomatic infections and tweaks to physicians' reporting
requirements last year. That said, Japan is one of few countries still providing daily Covid tallies.
Yasuharu Tokuda, a physician at the Health and Global Policy Institute, noted that the Japanese
population's natural immunity - acquired through infection - had been low before the middle of
last year.
He says natural immunity is stronger than that obtained from vaccination - and so low infection
rates have led to low immunity in Japan, which in turn is causing more deaths.
MAIN IDEA

The article talks about low immunity against Covid-19 and a growing population of frail elderly is
driving a surge in coronavirus deaths in Japan which had, for a long time, upheld some of the
strictest pandemic restrictions.

Japan once boasted one of the lowest Covid mortality rates, but the figure has been trending
upwards since the end of 2022.

It hit an all-time high on 20 January this year, surpassing the UK, US and South Korea, according to
Oxford University's Our World in Data.

Japan was largely closed to foreign visitors from 2020 till mid-June last year. «Due to the
emergence of immune-escaping variants and sub-variants and the waning of immunity, it is getting
more difficult to prevent infections.

POINT OF VIEW

I think the immune escape is when the human host's immune system becomes incapable of
responding against an infectious agent. New versions of the Omicron variant are known to be
masters of immune evasion.

Before the Omicron variant struck, Covid deaths mostly occurred in cities like Tokyo and Osaka,
but there are now cases across the country, said Dr Oshitani, who was once regional adviser to the
WHO on communicable disease surveillance and response.

Prime Minister Fumio Kishida announced earlier this month that the classification would be
lowered, but only on 8 May. Experts, including Japan's top coronavirus adviser Shigeru Omi, have
been calling for this since last year.