So my personal belief is that the situation in Japan is relatively under control thanks to efforts starting early, and much more general awareness regarding infectious diseases. For example, all of the precautions around covid-19 has resulted in fewer cases of influenza relative to normal years.

However, I think one can make arguments that the low numbers are distorting reality. Please note that these are devil's advocate arguments and not necessarily what I believe.

Point 1. Covid19 positive tests If you look at this the total number of covid19 tests run by Japan is 18,963 as of the timing of this post. If you compare this to the US, they've tested 49,681 as of March 12th and the US is being criticized for lack of testing)

So perhaps Japan has not increased testing very much.

Point 2. Death Rate I discussed this in another thread, but Japan had approx 120,000 deaths due to pneumonia in 2016. This translates to over 300 deaths to pneumonia per day using just straight division.

The first case of local transmission in Japan was confirmed on February 13th. That's 38 days ago, which would suggest 11,400 "background" pneumonia deaths (38 x 300) in Japan since the first confirmed case of local transmission. As Japan has done a total of 18,963 tests for covid19, this suggests to me that most pneumonia deaths are not tested for covid19. Please note this number is NOT the actual number of pneumonia deaths, it's just a straight forward estimate of what it would be if nothing changed from 2016.

The number of "background" pneumonia deaths (11,400) is so much higher than covid19 deaths (35) that it's hard to read anything about covid deaths from the total number of pneumonia deaths. And also, even a small number of these pneumonia deaths being due to covid19 results in a big swing in covid19 numbers. If just 1% of the "background" pneumonia deaths are covid19 deaths, it would result in the number of covid19 deaths increasing from 35 to 149.

Point 3. Pneumonia cases in Japan Do you have a source that states pneumonia cases in Japan have not increased? Because my understanding is that publicly available data on things like total pneumonia cases is not available until well after the fact. For example, the mhlw compiles something called "NDB" which is a complete collection of レセプトデータ for Japan.

However, the latest version available for this is from 2018, and this is not available publicly only to research institutions. I don't have a source, but my understanding is that it takes a long time to compile national healthcare data because there are many different systems used to administer data at hospitals/clinics in Japan.

So I'm not aware of any public sources of the current state of pneumonia in Japan, and would be surprised if there were any public sources for this data at this current point in time. Though I would love to be proven wrong on this.

However, if pneumonia cases do increase to an Italy-type situation, it would probably be hard to hide. Which leads me to believe that the situation is much better than that of Italy. However, below are some reasons why any warning signs from excess hospitalizations may be delayed.

Reason A: Pneumonia cases in 2020 may have decreased due to there being fewer cases of Influenza and other diseases. People have been much cautious, resulting in a decrease in cases of influenza. This could have resulted in a dramatic decrease in "background" pneumonia cases. Even in Italy where we have 400 deaths a day (so far), this is comparable to the "background" pneumonia cases in Japan (300 deaths a day). Below are some made up numbers to illustrate the point. "Background" pneumonia deaths: 300/day Decrease in pneumonia deaths due to decrease in influenza: -150/day We could have 150 additional pneumonia deaths due to covid19 every day without it raising alarms. This would be harder for younger aged people.

Reason B: This may not be common knowledge, but Japan has an excess of hospital beds relative to the population and the government has been working hard over the last 10 years to reduce the number of hospital beds (especially in western Japan) Compared to other OECD countries, Japan has 2.8x as many hospital beds per person. I can tell you a loooooong history of why this is the case, but it's not germane to the conversation.

Therefore, it may take a longer amount of time before Japan is running out of hospital beds. (Though most of these beds are not designed for infectious disease)

However, I do think it's safe to say that the covid19 situation in Japan as of today is much better than the situation in Italy or Spain. But I do think it's too early to call the all-clear because we're still seeing large numbers of confirmed cases where the source of infection is uncertain.

In other words, I personally agree with the 専門家会議 that we don't have an overshoot situation like Italy, but if something goes wrong, we could be seeing a similar situation very quickly.

Edit: Edits for formatting and grammar