Flexible democratic societies can cope with infectious diseases, expert says

The Yomiuri Shimbun

2:00 JST, May 13, 2022

How can society live with the novel coronavirus? The Yomiuri Shimbun interviewed Nagasaki University’s Taro Yamamoto, a professor at the Institute of Tropical Medicine, to find out his thoughts. The following are excerpts as told to Yomiuri Shimbun staff writer Kayo Goto.

‘It’s like an arms race’

As long as humans are part of the ecosystem, infectious diseases will continue emerging with a certain frequency. Every virus needs a host for its replication, and there are always a variety of viruses attempting to enter and replicate in their hosts. It is human society that selects the viruses that are prevalent among them.

Suppose, for example, that a novel coronavirus emerged in the world more than 10,000 years ago, a time when hunter-gatherers lived in groups of 100 to 150 people.

Even if a group encountered the virus and it spread among these people, the virus would disappear as long as there was no interaction with other groups.

Due to the advancement of urbanization, growth in population and development of means of transportation, modern society allows the virus to spread faster, farther and in larger quantities, with the novel coronavirus continuing to mutate and traveling around the world.

What happens if we try to contain the virus completely? The virus will evolve as it escapes containment, and humans will be called upon to take new measures to counter the virus — it’s like an arms race.

‘Be careful with restrictions’

China has implemented a zero-COVID policy, forcibly monitoring society and restricting people’s behavior. I have been uncomfortable with the way experts and the media have praised China’s methods as a success case since the beginning of the spread of the novel coronavirus two years ago.

I believe that a zero-COVID policy is more of a domestic measure than a countermeasure against infection. For China to reverse course on the zero-COVID policy, its supreme leader has to admit to his mistake. I suspect that the country has fallen into a situation in which it cannot do so.

Restricting people’s behavior is a kind of exercise of power. We must be very careful. Not only those with power, but also the “mask police” and “self-restraint police” have emerged. Even if it appears to be correct, we still need to be careful when restricting people’s behavior.

‘The people ultimately decide’

The Spanish influenza caused a pandemic in 1918 while World War I was ongoing. It has been attributed to hastening the end of the war as a result. This time, on the contrary, Russia launched an invasion of Ukraine in the midst of the COVID-19 pandemic. The Japanese economy could also be affected for a long time. We are now faced with the dual challenges of how to deal with the spread of the virus and the invasion of Ukraine.

A democratic society, which is flexible and supple enough to live in gradual symbiosis with the virus, would be able to cope with infectious diseases such as the novel coronavirus, which is highly contagious but has a low rate of serious illness.

Sweden and the United Kingdom were quick to relax behavioral restrictions, thinking that their economies should turn around even if they have to take on a certain degree of infection risk.

Japan, consciously or not, places a little more emphasis on infection control from the standpoint of valuing life. This may require a certain amount of cost, but it is one way of doing things. The deregulated Western approach is by no means the only correct one.

In practice, it is difficult to reconcile regulations on behavior and economics. Of course, there is no right answer as to which society is preferable to the other.

Individuals have different value judgments when the restrictions should be lifted and whether the classification of the novel coronavirus under the Infectious Diseases Control Law should be changed from the level of a disease equivalent to those in Category II [in the five-level classification system] to Category V, which is the same level as seasonal influenza.

Although politicians make policy decisions, we must not forget that in a democracy, we, the people, are the ones who ultimately decide what kind of society we want to live in.

Taro Yamamoto

Professor, Institute of Tropical Medicine, Nagasaki University

Born in 1964 in Hiroshima Prefecture. After working as an assistant professor at Kyoto University and an assistant director of the International Cooperation Bureau of the Foreign Ministry, he took on his current position in 2007. He has experience as a doctor working on infectious disease countermeasures in Africa and Haiti. He specializes in international health and medical anthropology.