US, Japan pay heavy price in 'new war'

The "war" of medical devices in the US

The United States wasted about two months – the “golden time” to prepare for the Covid-19 pandemic. The US response was particularly bad. For weeks, President Trump downplayed the severity of the disease.

It was only when infections and hospitalizations began to rise rapidly that the country found itself facing severe shortages of testing kits, masks, ventilators and other medical supplies.

Doctors and health care workers protest mask shortages in Oakland, California. Photo: Getty

The United States has failed to produce reliable test kits in a timely manner, and President Trump has refused to use his authority to seize medical supplies from private manufacturers.

All of this has pushed the US into a war over medical equipment, fighting and competing to ensure supplies, even bidding like auctions to buy what they need.

“California bids, Florida bids, New York bids, California bids back — that's what all 50 states in the United States are competing to buy.

New York Governor Andrew Cuomo likened the competition to “an auction for ventilators on Ebay” and prices kept rising.

In early March, the US Strategic Stockpile announced it had more than 16,000 ventilators, some of which were purchased 20 years ago and others that were being maintained. Ventilators, essential medical equipment in treating Covid-19 patients, now cost between $25,000 and $45,000.

Face masks have also become scarce, prompting the U.S. Centers for Disease Control and Prevention to recommend that health care workers use homemade masks or scarves in the event of a shortage of protective gear. Hospitals are also urgently seeking volunteers with sewing skills to help.

The US media commented that lack of preparation has pushed the US into a shortage of medical equipment, forcing states to go through a bidding war.

Volunteers sew cloth masks for medical staff in Dorchester, Massachusetts, USA on March 22. Photo: AFP

The US is now rushing to place orders for medical equipment from manufacturers. Private companies have jumped into the fray. Even automakers like Ford have pledged to quickly produce 3D-printed masks for healthcare workers. But scaling up production will take time—weeks or months, during which time the disease will continue to spread.

Others take a more positive view, like Steve Grundman, a senior fellow at the Atlantic Council, who says this is a different kind of crisis altogether.

"Buy the horse only when the barn is lost"

When Prime Minister Shinzo Abe declared a 30-day state of emergency in Tokyo and six other areas on April 7 amid a surge in infections, health experts said it was a tacit admission that Japan’s previous approach had not worked, and that it was now worried about “breaking down” in the face of the pandemic, and starting to “build a barn” after “losing the cow”.

A day after the state of emergency was declared, Japan reported more than 500 new cases - the first large spike in new infections since the Tokyo 2020 Summer Olympics were postponed to next year.

Before the postponement, Japan appeared to have the outbreak under control. Despite the global pandemic, organizers still insisted that the opening ceremony would take place on July 24.

The 2020 Tokyo Olympic and Paralympic Games have been postponed due to the serious outbreak in Japan. Photo: AFP

While declaring a state of emergency in major cities across the country, Prime Minister Abe still tried to paint an optimistic picture, saying that the spread of the disease could decrease within two weeks.

But experts say this assessment is too rosy. “Japan has done a poor job,” said Kenji Shibuya, director of the Institute of Population Health at King’s College London. “The confirmed cases in the country are just the tip of the iceberg.”

The rapid increase in cases has sparked speculation and criticism that Japan has covered up the outbreak in order to allow the Summer Olympics to go ahead. It appears that the Japanese government has been more concerned with “Abenomics” than with measures to deal with the serious spread of the epidemic.

“The Abe government has approached this crisis, first and foremost, as an economic crisis and a public relations crisis, not an epidemiological crisis,” said Koichi Nakano, a professor of political science at Sophia University in Tokyo.

Moreover, the state of emergency declared by the Japanese Prime Minister still has many limitations. It is not a lockdown like that applied in European countries, and public transport will continue to operate.

Japanese Prime Minister Shinzo Abe wears a mask while attending a press conference in Tokyo on April 7. Photo: AFP

Local governors can only require people to work from home and practice social distancing, but do not have the power to impose fines or other penalties. “This means that it depends largely on people’s voluntary compliance, without any incentives or support for them, and importantly, there are no sanctions for non-compliance with government orders,” said Professor Koichi Nakano.

Professor Nakano assessed that Japan's "unique" approach to dealing with the pandemic was the result of a disjointed combination of two factors: weak governance and leadership, and bureaucratic, "risk-taking" experience.

In Tokyo, the number of infections has doubled in the past five days to more than 1,000. Experts fear that Tokyo is entering a phase of exponential growth, requiring the government to impose stronger restrictions to prevent people from going out than to encourage people to comply voluntarily.

Japan has announced it will increase its testing capacity to 20,000 people a day. The country currently has the capacity to test 7,500 people a day, but in reality, it conducts less than half that number.

Some experts have also expressed concern that the Japanese government has focused its warnings on where the virus might spread, while many of the latest cases cannot be traced, meaning officials do not know where the infected person came from.

Professor Nakano said that if the outbreak could be contained by focusing on clusters without widespread testing and people voluntarily practicing social distancing, the state would have enough medical resources to treat seriously ill patients.

“The problem now is that the theory has failed and the Japanese government needs to take steps to strengthen its capacity to deal with the final “explosion”. The government has not been strict, and as a result, so far, there is no solid data to assess the scope and speed of infection,” he said.