As early as December 6, based on a grim worst-case scenario, Japan’s Prime Minister Fumio Kishida vowed strict measures to defeat the Omicron variant.
Japan had but 25 critical cases of Covid-19 nationally and only five had died from the virus in November. Nonetheless, the word was out from the top.
Prime Minister Shinzo Abe’s white whale had been the Olympics; Yoshihide Suga’s, to carry out whatever his master Abe had left undone. For his own obsession, PM Kishida had chosen to keep Japan free from the dreaded Omicron.
The new variant has since been widely acknowledged to be rather milder than all its Covid-19 predecessors. But the prime minister was on the warpath, and Japan’s bureaucrats had their marching orders.
On December 20 my son Ryo, a Japanese-American dual citizen, arrived at Tokyo’s Narita Airport to spend Christmas and New Year’s with us. Armed with two negative pre-flight PCR test results from the United States, he was flabbergasted when he tested positive on arrival.
He protested and demanded a retest, but the staff at Narita were unsympathetic. “This happens every single day,” they said, “people come in from the US or Europe with negative results, we test them, and they’re positive. The tests overseas are very poor. Our Japanese tests are very exacting and very accurate.”
Needless to say, there was no re-test.
Free nights at an exclusive resort
Ryo, 26, was whisked to the Marroad International, a large resort hotel a few miles from Narita offering a pool, a gym, a spa and fancy restaurants with gorgeous views of Chiba Prefecture. But if you look at the website, it says “Temporarily Closed” in English, and all the choices of language have been disabled except for Japanese. The “News” section of the website displays just two words: “not applicable.”
In fact the entire hotel has been taken over by the government to house those unfortunate returning Japanese and permanent residents who test positive on arrival.
At the Marroad today, “guests” are prohibited from leaving their rooms, with the exception of a once-weekly pre-reserved trip to the washing machines. No one may visit the pool, gym or spa. The bars and restaurants are shuttered. Instead, packed meals are left outside the guests’ rooms three times a day, followed by a piped announcement that they may now open their doors long enough to bring the meal inside.
Using government-issued pulse oximeter and thermometer, they are instructed to record their statistics on a web form several times a day until their mandatory six-day quarantine has run its course. This entire operation, run with military precision and thousands of staff, is provided free of charge at the expense of the Japanese taxpayer.
Ryo started his stay totally asymptomatic, with no fever, aches or pains, not even a sniffle – but on the third day he did experience the telltale loss of his sense of taste, so at least we knew it was probably true that he had Covid-19.
On December 23 he received a call from a tense-sounding staffer: “Pack your things, you’re leaving in 90 minutes.” The impact of two days of solitary confinement in a small hotel room had compromised his ability to carry on a conversation. Perplexed, he just managed to ask, “Where am I going?”
“You’re going to the hospital – because you have Omicron!”
Ryo was shuttled into town to a room in a special, locked wing in a big Tokyo Metropolitan hospital in Sumida Ward. Soon he was missing even the very basic, stripped-down comforts of the Marroad.
Since Japanese tend not to take sick days, when they actually do end up in the hospital they’re so exhausted they can’t do anything except lie in bed. Perhaps this is one reason why Japanese hospitals are so spartan. Patients are expected to provide their own towels and drinking cups. Luxuries like a box of tissues or a bar of soap are not provided.
There is no desk or chair as the patient is expected to stay horizontal. This was a challenge to Ryo, who had brought his computers and a pocket-wifi for use in finishing off lots of year-end work.
A further challenge for Ryo was that he typically spends two hours a day in the gym to maintain his remarkable set of muscles. Part of this discipline involves eating five carefully planned meals a day. As his sense of taste had returned and the provided meals are tiny, we began delivering packed meals and snacks. We took him a workout mat and a couple of sets of dumbbells, which the ward nurses received with many giggles.
Quantitative antigen testing 1, 2, 3
On Christmas Day a doctor came into Ryo’s room and shoved a swab up his nose for his first quantitative antigen test. Japan uses the Lumipulse SARS-CoV-2 Ag test kit manufactured by Fujirebio, an inconspicuous but Tokyo Stock Exchange Section 1-listed pharma company with more than 70 years of history.
The test employs a technique that goes by a mouthful of a name: chemiluminescent enzyme immunoassay (abbreviated as CLEIA) – and how very precise it is. Ryo’s Christmas Day result was 9, which the hospital explained to the bewildered and asymptomatic patient was “neither negative nor positive.” Apparently, a reading of less than 10 is below a cutoff level that makes it statistically almost equivalent to zero.
Ryo was told that if his test on December 26 was negative he would be discharged. Sadly, the reading the next day was 65. The doctors told us that people who are actually infected have readings in the thousands.
Symptom-free days continued. Ryo had finished all his work and sent it to his clients in the USA for feedback but, of course, they were all out for the holidays. My wife and I continued to deliver meals and snacks. Ryo craved sushi, but the nurses had told us they couldn’t accept raw foods because of the health risk they pose – strange for a country that gorges on sashimi every day. No matter, I hollowed out a loaf of bread and hid some of Ryo’s favorite maguro inside, no wasabi.
On the subsequent four days, Ryo’s test results were 65, 50, 85, and 3.8 — all of which are levels which both Dr K and Dr S of the hospital agreed were statistically hardly distinguishable from negative. But as much as they felt sorry for us, they could not possibly allow Ryo to check out. The Kishida Cabinet had instructed the Ministry of Health, and the Ministry of Health had instructed the Quarantine Office, that no one with Omicron could be released until they had utterly negative tests two days in a row.
Jailbreak, or Go To Jail?
By now my wife and I were beside ourselves. I took some unofficial legal advice that a hospital did not have the right to physically detain a patient, and we plotted a jailbreak.
Ryo had been forced on arrival at Narita to sign a pledge to the Ministry of Health that he would quarantine for a full 14 days, not use public transport, avoid going out and not come into contact with other people. He was allowed to ride in a private car and to quarantine at home. We prepared a spare room at home for him and we laid our plans.
Our ruse involved taking a care package to the hospital so we would be admitted to the door of the ward. Once at the door of the ward, we handed the nurses a note saying that we had decided of our own accord that Ryo would leave the hospital. He would quarantine safely at home and honor his pledge. He would stay in an isolated room in our house and not come in contact with others.
Finally, we assured the hospital that we would never hold them responsible for any negative consequences of our own violation of the rules.
Our scheme seemed to be going well. The doctors and nurses had been assuring us all along that they were on our side — they were just unable to go against government guidance. We thought they might somehow let him slip out. Instead, a nurse brought us two stools to sit on and Dr S came out to the hall to give us a little pep talk.
“Don’t do it”, he said, “you’re going against the government, and the government isn’t known for their sense of humor. We doctors have been telling them for two years that their rules are scientifically and medically spurious, but this is political, not medical. Please, let me have the Quarantine Officer from Narita call you. Please.”
After a few minutes, Ms Y from Narita Quarantine called. Starting with a few pleasantries about how she felt sorry for us, she then put on her most severe bureaucrat tone. Legalese was not far behind. Should we persist in our scheme to bust Ryo out of the hospital, we would be in violation of Japanese Quarantine Law Sections 9 and 15, and if found guilty could be subject to punishment by a fine of up to one million yen and up to one year’s imprisonment.
Not only might we parents end up in jail, but our son might too. As we digested this new wrinkle, Ms Y entreated us as nicely as a bureaucrat can to wait just a few more days until Ryo had the requisite two negative tests in a row.
Resignation, then rays of hope
On December 31st, Ryo’s test result came back as 1.25. After the previous day’s 3.8 we begged the hospital to spring him. All the doctors knew Ryo by now — he was the young man who was always dripping with sweat from working out with weights in his room. The nurses knew him as the polite young man whose mother brought packed dinners to him every day.
One of the nurses had even come into his room before dawn to examine him while he was asleep and commented when he awoke with a start, “You’ve got great muscles!” One doctor hinted in jest that perhaps he could apply the swab lightly to get a sample with an even smaller viral count.
But no one was going to go against the government. We were up against the unquestioning acceptance of authority and dogged adherence to rules that are at once the best and the worst Japanese traits.
The prime minister of Japan was elected in a democratic process and his policies reflect the will of the people. His policy is that Omicron must be stamped out at any cost. The ministries report to the prime minister. Quarantine reports to the ministry.
Omicron has now been contracted by dozens of Japanese in 23 cities and prefectures, and not one of the infected has been abroad or has disclosed any idea of how the infection occurred.
These people are hospitalized too, as soon as they are diagnosed, and the hospitalizations will continue until the policy changes. The policy is that the tests must be negative. Negative is defined as a test result of zero. There can be no ambiguity.
As I type this closing paragraph, Ryo’s January 1, 2022, test result just came back as negative. If he can stay that way tomorrow, he will come home, and the Year of the Tiger at the Jaeger home will begin with the retroactive celebration of Christmas 2021.
Educated as a Japan scholar, New York native Peter Jaeger is a writer, translator and veteran of 30 years in Tokyo financial markets.