The Washington PostDemocracy Dies in Darkness

Anatomy of Japan’s joyless Olympics: A hyper-cautious bureaucracy and slow vaccine rollout

Protesters march in front of the metropolitan government building in Tokyo during a demonstration against the Tokyo Olympic Games on Sunday. (Yuichi Yamazaki/Getty Images)

TOKYO — There will be joy and drama, glory and grief, among Olympic competitors. But this summer's pandemic-era Games in Tokyo are destined to go down as the most joyless of modern times, with athletes sequestered and cheering banned.

In the past few weeks, Japan's government has dramatically accelerated its slow coronavirus vaccination program. Confidence is growing that at least some domestic spectators might be able to attend events.

Yet this awakening appears to have come too late to alter the lockdown atmosphere. As other rich nations move closer to a return to pre-pandemic normalcy, Tokyo is still laboring under a state of emergency.

Instead of basking in anticipation of the Opening Ceremonies on July 23, the buildup to the Games sees Japan mired in blame, recriminations and laments that it didn't have to be this way.

Some people point the finger at former prime minister Shinzo Abe, who pushed for an Olympic postponement of just one year from last summer, gambling that coronavirus vaccines would be widely available in Japan and he would still be in office. He was forced to resign because of ill health last year.

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More complaints target the International Olympic Committee for resolutely pushing ahead with the Games despite widespread public opposition in Japan — including appeals by medical professionals to call off the Olympiad.

And then there is Japan’s inability to rise to the moment, led by a deeply cautious and inflexible bureaucracy, and the lack of urgency in the government’s response to the coronavirus crisis.

“The government and the Ministry of Health didn’t consider this covid pandemic as a wartime emergency, rather they considered it like a medical, public health issue,” said Ken Ishii, a professor and vaccine expert at the University of Tokyo.

Keep quiet and then go home

It all has the makings of an Olympics like no other.

There won't be any fans from overseas, and probably not many domestic ones. If people are allowed into stadiums, they will be told not to cheer or shout, not to eat snacks or drink alcohol, and to go straight home afterward.

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Journalists coming from abroad will be told to avoid public transportation and steer clear of Tokyo’s many wonderful restaurants.

Fun, too, is also largely off the agenda for the athletes. They will be confined to the Olympic Village and training camps and told to return home right after their participation is over.

Sponsors, who have paid tens of millions of dollars each to support the Olympics, won’t be entertaining clients from abroad, and maybe not even Japanese ones. Many are quietly seething.

A vaccination drive in Japan has suddenly sprung to life in the past few weeks. Mass vaccination centers opened in Tokyo and Osaka, the military and the private sector are getting involved, and more than 650,000 jabs are being delivered most days.

Prime Minister Yoshihide Suga pledged Wednesday to vaccinate everyone by October or November. But while most people over age 65 will have been given two vaccine doses by the time the Games begin, most people under 65 won’t be covered at all.

Japan has delivered a first dose of a coronavirus vaccine to around 10 percent of its population, one of the slowest rates among wealthy industrialized nations.

Japan has been struck less severely than many Western nations by the pandemic, but it has suffered vast economic damage and close to 14,000 deaths, a high total for East Asia.

Still, the government kept to the normal way of doing things: procedural, methodical and, above all else, risk-avoiding, experts said.

There is a proverb in Japan that people here are so cautious they even knock on a stone bridge before crossing it, to test its strength. But, a joke goes, so many people knock on the bridge that they break it. 

“Japanese people don’t want to fail, and that’s why they fail,” said Ishii.

Vaccine 'yattafuri'

Japan has a history of vaccine hesitancy among the general public because of several past vaccine safety scares. But the skepticism is no greater than in France, which has rolled out coronavirus vaccines much faster.

Japan also demands that vaccines undergo trials within the country before being approved, and the Health Ministry ignored widespread warnings that applying this rule to coronavirus vaccines would dangerously delay inoculations.

Japan insisted on trials with fewer than 200 participants, delaying approval of the Pfizer-
BioNTech vaccine until February and Moderna’s vaccine until May. In contrast, both coronavirus vaccines received emergency authorization in the United States in December.

In February, there was another month-long delay as the Pfizer-BioNTech vaccination campaign kicked off with a sample of 40,000 health workers, effectively a second domestic trial.

Kentaro Iwata, a professor of infectious diseases at Kobe University, calls it an example of what is known here as “yattafuri,” showing you are doing something without actually doing anything: a superficial approach that values procedure over outcomes.

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In late April, Suga acknowledged that the domestic trial requirement isn’t appropriate in an emergency and should be dropped in the future.

“Even though we are in a state of crisis, we’re still using the same rules to approve vaccines that we do under normal times,” the minister in charge of vaccines, Taro Kono, said in a May television interview, clearly frustrated by his inability to change the system.

Japan struggled to secure enough Pfizer-BioNTech doses at first, as vaccines were directed toward countries experiencing worse outbreaks. But when vaccines did arrive, tens of millions of shots piled up in refrigerators without being administered.

That’s partly because municipalities were largely left to decide when and how to administer vaccinations. Many waited until the supply pipeline had been fully established before starting inoculations, and they were not ready to receive and administer doses on a more ad hoc basis.

'Abnormal' Games

While other countries prioritized getting shots into arms, Japan favored control and ­record-keeping. But attempts to parcel out appointments fairly and methodically, and create master lists of the vaccinated, only slowed down the process.

An effort to base delivery on the My Number personal identity card system had to be abandoned when the obvious glitch was pointed out: Most people don’t even have My Number cards, which are voluntary.

Then, municipalities switched to posting vouchers for the elderly. The cumbersome system prevented a swift response when appointments were canceled or slots were not booked.

One of the biggest problems has been a shortage of personnel to deliver the shots, with doctors already struggling to cope with the pandemic.

Makito Yaegashi, chief of general medicine at Kameda Medical Center, who trained and practiced in the United States, said it was “super obvious” that Japan should harness its 310,000 pharmacists to administer vaccines, as the United States and about 25 other countries have done. Yaegashi organized an online petition that attracted more than 24,000 signatures and presented it to vaccine minister Kono last month.

Shhh: No cheering or chanting at Japan’s torch relay. But clapping allowed.

Authorities rejected the proposal to train pharmacists to carry out the simple procedure.

“There is an extreme aversion to risks,” Yaegashi said. “If there is a risk, we tend to avoid it, whereas in fact we should compare the risk to the benefit, and then decide what to do.”

There was also a lack of vision, experts said, and a failure to develop a Japanese coronavirus vaccine despite having one of the world’s largest pharmaceutical industries.

Public opposition toward holding the Games appears to have softened in recent weeks, as the pandemic’s grip has lessened and the pace of vaccinations has picked up.

Yet doctors and medical associations have called repeatedly for the Olympics to be postponed or canceled.

The government’s most senior medical adviser, Shigeru Omi, joined the chorus this month, arguing that it was “abnormal” to hold the Games during a pandemic, an extraordinary intervention from a man who tends to defend government policy in public.

“To keep arguing the Games is safe does not mean anything,” Hitoshi Oshitani, a virology professor who has also played a leading role in the government’s covid response, said in an interview.

“We have to do a proper risk assessment,” he said, echoing a call made in the New England Journal of Medicine. “They should have started this process a year ago.”

Already, at least 10,000 out of the 80,000 Olympic volunteers have pulled out, with organizers finally promising this past week to look into obtaining vaccines for those who stay.

Sponsors have given up on receiving any returns on their investment, says Robert Maes, a sports marketing expert in Tokyo.

Kaori Yamaguchi, an executive board member of the Japanese Olympic Committee, said it was “truly a shame” the government’s vaccination effort did not begin two months earlier, arguing that Japan had been “cornered” into going ahead with the Games despite widespread misgivings.

“What will these Olympics be for and for whom? The games have already lost meaning and are being held just for the sake of them,” she wrote in an op-ed for Kyodo News. “If we push on like this, even if the Olympics stir our emotions we will be left with a bitter aftertaste.”

Julia Mio Inuma contributed to this report.

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