Japan Case Study: Balancing saving lives and livelihoods: Three painful years under the COVID-19 pandemic in Japan

The COVID-19 pandemic brought colossal disruption to everyday lives and massive destruction of health and wellbeing worldwide, including millions of deaths.This study presents an overview of how the pandemic developed in Japan.Specifically, it discusses the number of cases of and deaths from COVID-19, the governments countermeasures, the transformation of the health care delivery system, the broader health impacts of the pandemic, and the economic impacts on society.During a period of approximately three years following the first confirmed case of COVID-19 (reported on January 15, 2020), there were eight waves of COVID-19 and about 34 million confirmed cases.Eventually, the Japanese government downgraded the legal status of COVID-19 on May 7, 2023.The governments measures to combat the pandemic included the so-called "soft lockdown," active surveillance, providing evidence-based messaging for the public, and delivering various economic stimulus packages for individuals and businesses.Overall, government measures together with the public's concerted efforts were effective; the death toll relative to the population was quite low compared to that in other developed countries.Nonetheless, there were frictions between the government, businesses, and individuals.During the soft lockdown, national and local governments imposed various constraints on businesses and residents to limit the spread of infection; many bars, restaurants, karaoke bars, and tourism and event businesses suffered damages, which were relatively severe for small businesses.There were also frequent tensions between infection control and peoples livelihoods among medical professionals, scholars, economists, and politicians over the course of the pandemic, which potentially delayed decisions about starting or ending specific COVID-19 countermeasures.Another concern is that the governments massive spending to alleviate the economic impact of the pandemic has increased the government debt in Japan.This study identifies that a comprehensive evaluation of how the Japanese government's COVID-19 policy balanced saving lives and livelihoods is necessary but has yet to be conducted.