Japan's quarantine, immunisation, and infectious disease laws: revised but not improved
The Upper House of the Japanese parliament last week passed revisions to the Quarantine Act (QA), Immunisation Act (IA), and Infectious Disease Act (IDA) in order to ensure Japanese society will more smoothly revolve around the avoidance of infections in the future. So what what do we have to look forward to?
Quarantine Act
The QA already allows quarantine officers to quarantine anyone suspected of being a virus-carrier in a hotel/medical institution. But the new revisions will allow quarantine officers to request suspected virus-carriers to isolate at home or elsewhere and report their health status. If the suspected virus-carriers refuse, the request can be strengthened to an instruction. Noncompliance without a valid reason will then be punishable with either imprisonment for up to 6 months or a fine of ¥500,000 (approx 3,700 USD at current rates).
The real kicker here is the word “suspected”. The below flow chart from the Ministry of Health, Labour and Welfare shows you can still be instructed to isolate under threat of being imprisoned/fined even if you have no symptoms and test negative before/after arrival.
So what could cause you to be “suspected” of being an incoming biohazard? Past episodes of The Covid Show may give us a clue. This is how Japan tried to keep out Omicron in December 2021.
All arrivals to Japan are now considered in “close contact” with the Omicron variant even before tests confirm if an infected passenger on the same flight is carrying that strain, the health ministry said.
These incoming passengers will be asked to quarantine at accommodations designated by local authorities before genome sequencing, which takes four to five days, determines if the fellow passenger is in fact infected with the Omicron variant, the ministry said.
Defining arrivals as “suspected of being infected” is apparently one of the few things the Liberal Democratic Party does liberally.
Thankfully, this borderline-insane policy didn’t last long because 1) most of these close and far contacts ignored the request since it couldn’t be legally enforced and 2) local governments weren’t even able to accommodate the minority who turned up to be quarantined. But the revised QA with its shiny new enforcement mechanisms for home-isolation may overcome these problems. So the next time a scary variant appears, will plane-loads of people arriving in Japan be instructed to quarantine after one of them loses the PRC lottery? Book your tickets to find out!
Immunisation Act
The current IA states that vaccinations should be administered by doctors, nurses, and clinical researchers. The revised IA will allow dentists, radiologists, paramedics, etc. to administer vaccines if the Health Minister asks for their cooperation with the jab campaigns. I would like to say that this is potentially dangerous because vaccines need to be correctly administered to avoid unintended intravenous injections into the blood stream…
…but the Covid jabs are being administered without aspiration anyway, so I guess it doesn’t matter at this point. Hell, they should just let high-school students do it for a part-time job at the weekends.
The government also envisions greater digitalisation. Eligible mRNA consumers will be able to use their My Number Cards (Japan’s digital ID) to verify their identity. Also, information on infections and adverse events (AEs) will be collected in an anonymous database for analysis of vaccine effectiveness and safety. It was the opposition parties that proposed greater surveillance of AEs. It’s just a shame the government itself still couldn’t care less.
Infectious Disease Act
One fundamental cause of Japanese society’s over-the-top response to Covid has been the categorisation of a flu-like illness at the level above Ebola under the IDA. As a result, most private-sector medical institutions have refused to treat confirmed or suspected Covid patients, leading to Covid patients concentrating in public-sector medical institutions and endless panic-inducing media reports about hospitals being overloaded. After cynically creating and maintaining this problem to offer the solutions of anti-Covid measures and mRNA shots, the government has finally decided that it might be a good idea to make private-sector medical professional do their jobs. From Jiji.
Prefectural governments will draw up plans for tackling infectious disease outbreaks, including the numbers of hospital beds that need to be secured. Based on the plans, they will form agreements with hospitals prior to outbreaks.
All hospitals will be obliged to accept talks on forming such agreements, while large-scale hospitals will additionally be required to provide medical services such as fever outpatient services, support for other hospitals and personnel dispatches.
These revisions, which are set to come into effect in 2024, don’t seem particularly unreasonable at first glance. But they mean taxpayers will again be paying hospitals ridiculous sums of money to “secure” beds regardless of whether anyone is in them. So what will happen to hospitals that don’t comply?
Prefectural governors will be able to recommend or instruct hospitals to comply with the agreements and disclose the names of noncompliant hospitals. Advanced hospitals could face a cut in government-regulated medical service fees paid to them if they violate the agreements.
It’s pretty funny that one penalty is to disclose the names of noncompliant hospitals since a major reason most private-sector hospitals declined to take Covid patients was to avoid reputational damage from hysterical media reporting of infection clusters in hospitals. By telling the public which hospitals aren’t taking people carrying the killer virus of the week, governors could end up directing more patients their way.
Now Japan has more legal tools to use so that it’s better prepared for future outbreaks of PCR positives. It’d be even better if Japan had politicians who kept to the spirit and letter of the laws too.
Back around 2006-8 there was much made of the taraimawashi problem. In each article, the reason given for patients being turned away was the lack of beds for that type of patient. At the time, Japan with roughly half the population of the US had double the number of hospital beds of the US. At that time, despite popular misconceptions, it was illegal for hospitals in the US to refuse emergency patients. The problem has never been the number of beds. It has always been a system that creates inefficient use of the insufficient resources it spends too much on.
These reports are absolutely priceless, ty.