Sunday, 12 April 2020

"It's just Behaviour": How Acting more Japanese Could Help Defeat the Coronavirus

In my earlier post on the coronavirus situation in Japan (updated daily!), I suggested that one of the reasons that the virus may not have spread to the extent it has in Western countries could be cultural. I wrote that Japan is a hygiene-obsessed country at the best of times and hand-washing, gargling, masks, and hand-sanitiser - not to mention social distance and bowing instead of hand-shaking and hugging - are part of everyday life (especially during the influenza season which coincided with the start of the crisis). I also mentioned the plethora of anti-bacterial or kōkin (抗菌) goods on sale, from pens and slippers to bags and leg-warmers.
While it is true that Japan has conducted fewer tests than most other countries – at the time of writing WHO data gives a figure of 1.03 per thousand in stark contrast to its neighbour South Korea with almost 11.22 per thousand – it is also true that the number of deaths has remained extremely low: Japan's mortality rate was 2.5% as of April 23rd compared with 13.56% in the U.K. Moreover, hospitals have not been overrun. So could adopting Japanese cultural traits help us defeat the Coronavirus - and save lives? This seems less of a stretch if we remember that culture is simply the customs and behaviour of a particular people or society. Indeed, governments across the world have been encouraging us to change our daily habits. "It's just behaviour," said Dr Deborah Birx, the coordinator of the White House coronavirus task force, "each of our behaviours translating into something that changes the course of this viral pandemic."

Starting with the ideas and values that drive behaviour let's look in a little more detail at the Japanese focus on cleanliness and hygiene in Japan. In one of my earliest posts, I discussed Japanese high-tech toilets and the "clean/pure" inside (uchi =内) vs "dirty/polluted" outside (soto =外) divide. In the home, for example, this is evidenced by both the genkan (porch or entrance hall) where shoes are removed before stepping up into the house and also the toilet itself where household (often anti-bacterial) toilet slippers need to be worn. The distinction between clean and dirty is rooted in Japan's indigenous religion, Shinto; the torii gate to the shrine, often festooned with shide purifying paper, marks the boundary between the sacred (pure) and the profane (impure).

Overall and hat for school lunch duty
One consequence of this concept of the outside as dirty (kitanai=汚い) is that the importance of removing shoes, hand-washing, and gargling is drilled into youngsters from an early age. In schools, children change into indoor slip-on shoes (uwabaki=上履き) at the entrance. In public schools, school lunch (kyūshoku) is typically provided and everybody washes their hands thoroughly before eating. Students take turns to dish out the food and the student on duty (tōban) for that day will typically wear an overall or apron, hat, and mask (pictured). Given this cultural background, recent songs by Arashi  and (below) Pikotaro imploring everyone to wash their hands seem unnecessary.

Another Japanese (indeed Asian) habit that can save lives is the wearing of masks. As I discussed in detail here, Japanese wear masks for a variety of reasons, from covering the face when there was no time to make-up and preventing a sore throat to stopping hay fever and the spread of cold/flu. Part of the culture of mask wearing is consideration for others: it is safe and reassuring for others if you are wearing a mask. This is a point that was not well understood by WHO and most Western governments who initially said that masks were not recommended. In contrast, countries such as Korea strongly recommended masks as a way to limit the spread of infection. In other words, the Western perspective was that masks were unlikely to prevent an individual catching the virus; in contrast the Asian perspective was that masks were effective in stopping the spread of the virus to others (especially relevant since around 10% of cases are asymptomatic). Belatedly, we are now seeing a change in the WHO position to one condoning the wearing of masks.

In conclusion, there is a lot of evidence that acting more Japanese can help protect both ourselves and others. In Japan, as outlined in this Japan Times article, there has been a flood of tweets and blog posts arguing that Japanese cultural practices have contributed to the low number of infections. Cell biologist Hironori Funabiki, for example, mentions washlets on high-tech toilets, lack of speaking on public transport and at ceremonies, few religious assemblies, and the fact that few foods are eaten with bare hands (most snacks are individually wrapped). The article cited above does finish with a word of caution, though, introducing one Japanese cultural trait that could actually increase the spread of the virus: shame. Japanese are for the most part very sensitive about causing trouble or inconvenience for others (the word for this, meiwaku, is frequently used to admonish adults and children alike) and this could make people reluctant to get tested for fear of embarrassing their company or in-group. Indeed, there is a underlying feeling that health is "all in the mind" (yamai wa ki kara) and anybody who has fallen ill must be at least partly to blame for not taking proper care of their health (kenkō kanri). Of course this can also work to encourage people to take more care. In the final analysis, whatever culture we hail from we all need to take a little extra care - and be a little more considerate - if we and those around us are to survive these difficult times.