<![CDATA[Avoid crowds, wear a mask and isolate: how Japan's coronavirus response echoes Spanish flu guidelines]>
As Japan deals with a coronavirus outbreak and uncertainty over whether it will be able to host this summer's Tokyo 2020 Olympic Games, interesting parallels are being made with a previous deadly pandemic: the 1918 Spanish flu.
In much the same way as they did a little over a century ago, many Japanese people are wondering when the pandemic will have run its course and when their lives might return to normality.
It is believed that the Spanish flu was brought into Japan in the spring of 1918, when three sumo wrestlers returned to Tokyo from Taiwan, which was a Japanese colony at the time. A second outbreak was reported that May, with a sailor on a warship anchored at the naval base in Yokosuka diagnosed with what was initially called the "epidemic cold".
Japanese people wear face masks as they picnic under cherry trees in bloom at Shinjuku Gyoen National Garden in Tokyo. Photo: Bloomberg
By the autumn, the scale of the crisis had become clearer, with the headline in the October 26, 1918, edition of The Japan Times & Mail proclaiming: "Thousands dying from influenza throughout the world."
"There is hardly a school in Tokyo but from which dozens or scores of students and teachers are absent and it is spreading to offices and factories," the report stated. "The disease has become known as the 'Spanish influenza'."
By the end of the pandemic, in the latter months of 1920, communities across Japan had been decimated. Some villages lost all their inhabitants, while there was a similar impact on people living in built-up urban areas.
A book written by Yuu Hayami and published after the crisis had passed gave graphic accounts of the devastation.
"One village was destroyed by colds," he reported, with 970 of the 1,000 residents of Omotani, in Fukui Prefecture, dying. Hospitals were full, Hayami recorded, and the sick were turned away at the door.
Two children at Kurikawa Elementary School in Morioka City, north of Tokyo, died on November 5, 1919, and every store and business in the city was shut down. The only two crematoria in Kobe were overwhelmed and more than 100 bodies were stacked up awaiting cremation, he wrote.
Records are incomplete, but academics estimated that between 257,000 and 481,000 Japanese died from the Spanish flu, although a study by US academics published in Emerging Infectious Diseases journal suggested the real figure may actually be around 2.02 million deaths.
That figure would account for 3.71 per cent of the population at the time of 56 million, and put Japan's experience on a par with other parts of Asia.
If that percentage is applied to the current Covid-19 outbreak, the death toll would be 1.2 million people in Japan.
In January 1919, the Ministry of Home Affairs issued a public notice on how to avoid catching the disease, which health authorities at the time still believed was a bacteria.
The notice " which is largely being repeated by Japanese officials today " said the disease spread when those infected with it coughed or sneezed, and people should stay at least 1 metre away from each other. Citizens were told to avoid large gatherings and to wear a "respirator" or a mask when they had to use a train or bus. If a mask was not available, they were told to cover their mouth and nose with a handkerchief.
Similarly, anyone who felt unwell was advised to go to bed, consult a doctor and isolate themselves from anyone else.
In another parallel with today, the production of face masks could not keep up with demand, while the government ordered schools to close and cancelled political rallies, stage performances and movie screenings. Even sumo tournaments were called off.
And just as rumours claiming the discovery of cures to the coronavirus are readily found on the internet today, desperate Japanese 100 years ago sought out treatments, no matter how unlikely they appeared. Some people were convinced that drinking water at between 57 and 60 degrees Celsius would protect them, others bought amulets or badges that they were promised would keep them safe, while another cure was apparently created by "burning a rat", Hayami recorded.
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This article originally appeared on the South China Morning Post (SCMP).
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