Drawing on an essay by House of Councillors member Rui Matsukawa published in Hanada Selection under the title “The International Information Battle: Now Is the Time for a Counteroffensive,” this article examines Japan’s COVID-19 response, the importance of mortality rather than case counts alone, universal healthcare and medical access, public hygiene, diversification away from China-dependent supply chains, and reforms Japan should pursue in the post-COVID world.

This article was originally published on August 10, 2020.
The passages below are drawn from an essay written by Rui Matsukawa and published at the time in Hanada Selection.
Figures and assessments concerning mortality, medical access in the United Kingdom, and other aspects of the early pandemic should therefore be understood in their 2020 context.
In particular, the reference to mortality exceeding 15 percent among certain infected populations was not a universal infection-fatality estimate for COVID-19.
Likewise, the statement that appointments under Britain’s public healthcare system could often require a wait of one or two months represented Matsukawa’s comparative assessment at the time, rather than a statistical description applicable to the entire NHS.
The broader argument, however, extends beyond those early figures.
It concerns whether Japan should have emphasized deaths and severe illness rather than case counts alone; whether Japan should have communicated the strengths of its healthcare system and public hygiene more effectively; whether supply chains should be diversified away from excessive dependence on China; and whether the pandemic should be used to accelerate digitalization and structural reform.
The following preserves the substance of that argument.
【Text】
August 10, 2020
The following is drawn from an essay by House of Councillors member Rui Matsukawa entitled “The International Information Battle: Now Is the Time for a Counteroffensive,” published in the then-current Hanada Selection.
Introductory section omitted.
【Deaths Matter More Than Case Numbers】
There was considerable criticism of the nationwide school-closure measure.
Yet Matsukawa argued that it had a major shock effect in changing the perception of the Japanese public across the country.
Naturally, such measures would inflict severe economic damage.
But even if the economy suffered temporarily, bringing the outbreak under control as early as possible would ultimately benefit public health, the economy, and Japan’s international reputation.
She argued that the Japanese government should conduct an international communications campaign emphasizing that mortality, particularly deaths relative to population, mattered more than infection numbers alone.
The virus was highly transmissible.
Young and healthy people could carry the virus without symptoms and unknowingly transmit it to others.
At the same time, it posed much greater danger to older people and those with underlying medical conditions.
Matsukawa referred to data available at the time suggesting very high mortality among certain high-risk groups.
Japan, she argued, possessed a high standard of medical care and therefore had significant capacity to prevent infected patients from progressing to death and to help them recover.
She also emphasized the number of patients who had already recovered and been discharged during the early stage of the Japanese outbreak.
This, she argued, was something Japan should communicate much more actively to the world.
She suggested that unexpectedly high mortality in parts of Europe might have reflected several factors, including differences in access to medical care.
Advanced countries may possess broadly comparable medical technologies, but Japan, under its universal health-insurance system, had particular strengths in the quality and accessibility of community medical care.
That accessibility has also contributed to concerns about rising healthcare expenditure, but it remains one of the important strengths of Japan’s system.
【Japan Among the World’s Leaders】
Matsukawa contrasted Japan with the United Kingdom.
She described Britain’s publicly funded healthcare system as providing care with limited direct patient charges while also imposing greater constraints on access.
She argued that some patients could face long waits for routine appointments and that those seeking faster treatment might choose private medical care.
That comparison represented her assessment of British healthcare at the time.
She also emphasized what she regarded as Japan’s exceptionally high standards of cleanliness and public hygiene.
Even children routinely learn practices such as handwashing and gargling.
Matsukawa expressed renewed respect for Japan’s healthcare workers.
Japan’s relatively low number of deaths, she argued, reflected the dedicated efforts—day and night—of doctors, nurses, caregivers, local-government officials, and everyone else working on the front line.
Few countries, she argued, could completely prevent a virus with such strong transmissibility.
Even highly authoritarian China had required considerable time to bring its outbreak under control, assuming its claims of control were accurate.
Democratic societies that respect human rights cannot easily employ the coercive measures available to an authoritarian state.
But they can reduce deaths and severe cases through high medical standards, accessible healthcare, strong public hygiene, and stable governance.
For that reason, success in suppressing deaths should be a major international benchmark.
More fundamentally, preventing death should be the central objective.
If Japan continued to keep mortality low relative to countries in Europe and elsewhere, Matsukawa argued, then once the pandemic ended Japan might recover from its earlier reputational difficulties and ultimately be judged to have managed the crisis well.
【What Will the Post-COVID World Look Like?】
Once the pandemic ended, countries could be judged by whether they had demonstrated effective crisis management and by how much economic damage they had sustained.
That, she argued, could significantly alter the international standing of nations.
【Will the Sun Rise Again for Japan?】
Depending on how long the crisis lasted, the world might become more closed.
Business could move away from unquestioned globalization toward regional economies.
Supply chains could move away from excessive dependence on China toward diversification and domestic production.
If the crisis persisted, the global economy could become more fragmented into blocs, accompanied by a major restructuring of supply chains.
That restructuring might involve a Chinese bloc, a U.S.-centered bloc, and economic relationships spanning both.
At the time, China was actively proclaiming that it had succeeded in controlling the virus.
Yet a virus recognizes no ideology, political system, or national border.
COVID-19 was also spreading throughout the democratic societies of Europe and North America.
If the eventual conclusion were that authoritarian states handled infectious disease more effectively than democracies and restored their economies more rapidly, Matsukawa warned, the consequences for the international order could be considerable.
Conversely, if Japan succeeded in limiting deaths and severe illness, controlling economic damage, and achieving a strong post-pandemic recovery, Japan’s international standing could rise.
She believed that outcome was entirely possible.
Fortune favors those who seize the moment.
Japan should use the crisis to correct long-standing weaknesses.
Digitalization, work-style reform, the My Number system, and other changes that had proved difficult during ordinary times should be accelerated during the emergency.
The COVID-19 crisis appeared, in her view, almost like a counterreaction against excessive globalization.
The U.S.–China struggle for supremacy—a new Cold War.
The resurgence of power politics.
And a pandemic that froze the movement of people across the world.
Historical turning points of such magnitude and fluidity are rare.
Japan must reform itself now.
Now is the time for a counteroffensive.
To be continued.