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Understanding Japan’s response to the COVID-19 pandemic
  1. Satoshi Kodama1,
  2. Michael Campbell1,
  3. Miho Tanaka2,
  4. Yusuke Inoue3
  1. 1 Department of Ethics, Kyoto University Graduate School of Letters, Kyoto, Japan
  2. 2 Graduate School of Core Ethics and Frontier Sciences, Ritsumeikan University, Kyoto, Japan
  3. 3 Department of Public Policy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
  1. Correspondence to Dr Satoshi Kodama, Department of Ethics, Kyoto University Graduate School of Letters, Kyoto 606-8501, Japan; kodama.satoshi.4v{at}

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Jecker and Au’s paper raises important issues concerning health equity in pandemic responses, and the importance of considering the long-term effects of pandemic strategy on population health and well-being.1 We welcome their focus on the experience of Asian countries, including Japan. However, we have some concerns with both the distinction which they draw between elimination and mitigation, and their account of the nature and origins of the Japanese response to the COVID-19 pandemic.

First, we believe that the distinction between elimination and mitigation is not fine grained enough to capture the various strategies which countries have taken towards the pandemic. Many of Jecker and Au’s criticisms of the elimination strategy relate to specific policies such as lockdowns, travel restrictions and restrictions on businesses, which have been employed by numerous countries irrespective of their end goal. By contrast to the simple elimination/mitigation dichotomy with which Jecker and Au work, Baker et al have identified five separate COVID-19 strategies, namely: exclusion, elimination, suppression, mitigation and no substantive strategy.2 Baker et al define an elimination strategy as ‘maximum action to exclude disease and eliminate community transmission’ with the goal of reaching ‘zero [disease] transmission in the community’.

On this account, Japan’s strategy does …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.