Is Eric Topol right about the Japanese and the jabs?

What do you think?

Eric Topol is a big time expert.

He’s the founder and director of the Scripps Research Translational Institute and has published over 1200 peer-review articles and several books. He recently entered my bailiwick to offer his opinions about the difference in Covid outcomes between Japan and the USA. His full post is here for anyone in search of an eye-rolling read.

Eric Topol @EricTopol

How did Japan, with ~40% more of its population age 65+ than the United States, have the lowest Covid death rate of any major country in the world?

erictopol.substack.comThe marked contrast in pandemic outcomes between Japan and the United StatesA piece in The Economist this week about masks, and how at least half of the people in Japan are planning to continue to use masks indefinitely (where there was never a mandate), prompts a deeper look into what has been the secret of Japan’s extraordinary success in the pandemic. Over time it has th…

Topol predictably makes the usual approving noises about masks “which were distributed early on by the government to the population in Japan.” This is a reference to the Abenomask fiasco, which almost everybody in Japan regards as a bad joke.

And the idea that masks explain Japan’s low Covid mortality is an even worse joke, which I’ve dealt with in excessive detail here.

To be fair, Topol briefly touches upon population health differences, but only to dismiss them.

Sure there are differences in co-morbidities like obesity and diabetes, but there is also the tradeoff of a much higher population density in Japan.

I’ve looked at immunological reasons for Japan’s low Covid mortality here and specifically in comparison with America here. TLDR: population health factors matter; not much else does. Topol offers no evidence that population density explains any of the difference between countries’ cumulative Covid deaths rates at this point because there isn’t any.

He also praises the “cluster busting” 3Cs.

I see he chose the old 2020 poster. I can’t imagine why he didn’t choose the 2022 version.

Zoom masking aside, the 3Cs sound semi-reasonable. But in practice, they’re the reason Japan still has pointless capacity limits and the embarrassing chanting ban at football and baseball games, which I’ve detailed here. TLDR: no evidence of any clusters busted.

But what makes Topol’s post unique is that he links Japan’s lower Covid mortality to its higher rates of primary vaccinations and boosters (emphasis mine).

Besides these factors, once vaccines became available, Japan got their population with the primary series to 83% rapidly, even after getting a late start by many months compared with the United States, which has peaked at 68%. That’s a big gap.

But that gap got much worse when it came to boosters. 95% of Japanese eligible compared with 40.8% of Americans have had a booster shot. Of note, that 95% in Japan pertains to the whole population.

Er, that graph does NOT show a 95% booster rate since it includes 4th shots, as made clear by the words “doses administered beyond those prescribed by the original vaccine protocol.” Apparently Eric has poor reading comprehension. Another big clue that Japan’s triple-jabbed rate isn’t 95% is that Topol mentioned immediately before that Japan’s double-jabbed rate was 82%. I guess numbers aren’t his thing either.

Clearly unbeknown to Eric, OWiD has the data for booster rates in Japan by age: 90% for 65+, 65% for 12-64, and 0.8% for 5-11. Definitely not 95% overall then.

Topol then moves on to Covid mortality numbers.

Now let’s turn to cumulative fatalities in the two countries. There’s a huge, nearly 9-fold difference, per capita. Using today’s Covid-19 Dashboard, there are cumulatively 45,533 deaths in Japan and 1,062,560 American deaths. That translates to 1 in 2,758 people in Japan compared with 1 in 315 Americans dying of Covid.

Notice how Topol chose to show cumulative deaths starting from March 2020, 15 months before Japan’s injection campaign properly got going? The jabs are so effective they worked even before the Japanese took them!

If Eric wanted to assess the effect of vaccines on the Japan-America mortality gap, he’d have chosen OWiD’s option to show both cumulative jabs per 100 and daily reported deaths and break the periods apart. But since he didn’t, I will.

Pre-vaccine period

As you can see and were probably already aware, deaths were much lower in Japan pre-vaccination. It’s a shame Topol didn’t mention that Japan reopened schools for in-person learning in May 2020, proving the utter pointlessness of the year-long closures in blue-state America. I’m sure his American followers/readers would’ve found it very informative.

Period of higher/similar dosage in USA

Covid deaths were higher in America than in Japan even during the “happy valley” of 95 days effectiveness pre-Delta. After that, the gap returned to its pre-vaccine size, with the earlier boosters in the US making little difference.

Period of higher dosage in Japan

Since March, Japan has extended in lead in terms of dosage administered and finally reported more daily Covid deaths than the US in August and September. Banzai! Let’s not forget Japan maintained universal masking and some of the world’s strictest entry restrictions during this period too, which is odd because Topol says Japan’s “strict policy for border control, while hard to quantify, may certainly have contributed to its success.” I wrote a post about the effectiveness of border controls here. TLDR: there’s far less evidence than everyone seems to think.

Topol also mentions excess deaths, again using cumulative data starting from early 2020.

And if we look at excess mortality instead of confirmed Covid deaths, that enormous gap doesn’t change.

But when we compare cumulative Covid deaths and excess deaths, the miracle cure doesn’t look quite so miraculous, as discussed in my previous post.

All I’ve done here is use the same data from the same sources as Topol. But he chose to show cumulative Covid and excess deaths, which misleadingly make it look like the Japan-America mortality gap was partly due to the vaccines when the truth is the gap has narrowed as the Japanese have injected more boosters. I guess you could say he presented the data like a true expert.

Towards the end of his post, Topol reminds his readers just how wonderful the jabs have been for humanity.

And please don’t forget that around the world, over 20 million lives were saved, just in 2021, the first year of vaccines.

Sadly, these 20 million saved lives exist only in the fantasy modelling by Imperial College London.

Looks like I was right: numbers really aren’t Eric’s thing.