Precautions help Japan control flu

Regional News
Typography
  • Smaller Small Medium Big Bigger
  • Default Helvetica Segoe Georgia Times

TOKYO — If there is a positive impact of the coronavirus epidemic, look for it in Japan, where people are observing better hygiene, and the number of influenza cases is far below a typical year.

The trend hasn’t been clearly seen in Europe or the U.S., where the threat of the epidemic has begun to hit home only in recent weeks, but if people elsewhere begin to take flu-prevention measures, thousands of lives could be saved.

Minako Ohashi, a family doctor for more than two decades, said the shift at her Tokyo clinic was unmistakable.

“It was business as usual toward the end of the year,” she said. Then, as publicity spread in mid-January about the viral outbreak in the Chinese city of Wuhan and cases started emerging in Japan, the number of flu patients suddenly declined.

“I believe the coronavirus affected it in a good way, because people have become more careful about washing hands and wearing masks,” Dr. Ohashi said.

The typical clinic among 5,000 surveyed by the Japanese government saw only six flu cases in the fourth week of February, compared with nine in the year-earlier week and nearly 23 in that week of 2018. Through early January, cases had been running ahead of earlier years.

The numbers each week recently have been lower than at any time since 2010, when Japan and other countries were worried about the H1N1 swine-flu virus.

Whether those favorable numbers will translate into fewer flu deaths has yet to be seen. In Japan, 3,300 deaths were attributed to the flu in 2018. A small percentage reduction in that number would exceed the deaths in Japan so far from the disease caused by the new coronavirus, Covid-19, which on Sunday stood at 12, including victims from the Diamond Princess cruise ship. An additional cruise passenger died in Australia.

The government said it hoped stepped-up hygiene and emergency measures would halt the novel coronavirus in March and allow Japan to resume normal life in April.

Shigeru Omi, a former World Health Organization official helping the Japanese government’s virus response, said the connection between the public’s heightened hygiene awareness and the drop in flu cases was plausible but not proven. Many parts of Japan have had a warm winter, which tends to tamp down the flu.

Around mid-January, television programs, newspapers and online media started offering frequent advice on how to prevent infection with the novel coronavirus. They typically stressed that the most effective measures were the same ones for flu prevention.

Minoru Fukuda, a 51-year-old engineer, said he regularly washed his hands but was doing so more thoroughly now and used soap so frequently that his hands had dried out. He also started wearing a mask on the train and at work. “I have not had even a single cough this year so far,” he said.

On a subway in the southern city of Fukuoka in mid-February, when a passenger coughed without wearing a mask, an outraged neighbor pressed an emergency buzzer. Station personnel pulled the quarreling men off the train and gave the cougher a mask, an official of the subway company said.

Research has long shown that hygiene measures can have an effect on infectious diseases. One 2002 study in Pennsylvania had classrooms in a test group receive hand sanitizer and training on hand-washing and found that absences fell by half compared with classrooms that didn’t get any intervention.

Infections “are basically spread by poor hand hygiene,” said Svenn-Erik Mamelund, a research professor at Oslo Metropolitan University who has studied epidemics.

The limits on public gatherings introduced in several countries including Japan are also likely to have an effect, Dr. Mamelund said. In the 1918 flu epidemic, one of the deadliest in modern history, flu infections jumped roughly a week after mass rallies to celebrate the end of World War I, and flu deaths surged a week after that, he said.

China has introduced the most draconian restrictions on public gatherings, with people in the outbreak center of Wuhan mostly confined to their homes for more than a month. In Hubei province, of which Wuhan is the capital, 2,682 deaths from the novel coronavirus were reported as of Friday, representing more than 95% of the total in China.

The effect of China’s restrictions on diseases such as the flu isn’t known because the country has reported health statistics only through December 2019.

In the U.S., flu activity remained high but decreased in the two weeks that ended Feb. 22, the Centers for Disease Control and Prevention said. The CDC’s European counterpart also said flu activity was easing off in those two weeks and was roughly in line with last year’s trend. The CDC estimates that 18,000 Americans have died of the flu so far in the 2019-20 season.

Robin Chater, the secretary-general of the London-based Federation of International Employers, said he believed more lives have been saved by the precautions people are taking than have been lost to Covid-19, the disease caused by the coronavirus. But the economic slowdown triggered by the epidemic could hurt public health, he said.

Shadow
Slider