The book review: “Influenza” -why wearing the mask is critical-
The only book published by Japanese government about 1918 pandemic
I am in the stay-at-home situation now, same as other Californians as do. Thus, there is no excuse for reading a new book. I have just finished reading the Japanese book “Influenza”. It is the only official record by the Japanese Hygienic Bureau of the Ministry of Home Affairs, which was published in 1922, two years after the end of the Spanish flu pandemic. This book has been reissued in 2008, which was after SARS pandemic in 2002-3. Unfortunately, the same as other countries, Japan went into a massive financial crisis in 2008; thus, governments didn’t have so much money and energy to prepare the next epidemic or future pandemic. As a result, a study in this book hasn’t been considered well until we had a pandemic. This book is incredible. It analysis Spanish flu by multiple angles, including its pathology, treatment, and prevention strategies not only of Japan but other countries such as Europe and the USA. I want to share some noteworthy points in the book.
The background in Japan in 1918-20 pandemic
In Japan, at that time, they didn’t have a health insurance system. When Japan had an influenza epidemic in 1889, they have just opened the door for modernization; therefore, their strategy was not built by the newest Western medical science yet. When they had a massive attack of Spanish flu, they had to step up to fight against this unknown disease. Despite tremendous researches on Western medical journals for treatment and prevention, Japan had the deadly second wave attack in the 1919-20 autumn/winter flu season the same as other countries. Thus, even though it took several months to go to abroad, the Japanese government sent people to Europe and the USA to get the newest information about public hygiene and medical research. They focused on saving Japanese citizens as much as possible for the third wave in 1920-21.
Remarkable points
Strategies which the Japanese government took were pretty similar to the Western countries did, such as Isolation, quarantine, disinfectant, and education. However, we can see a few remarkable points in this book. The most significant aspect was Japan didn’t lock down the city while many Western countries did. The Japanese government asked people not to gather, but they didn’t rule people not to go. Instead of the shutdown, Japan took another strategy. The government asked all people to wear the mask when they went outside. They provided the mask with almost free or very affordable low prices to people. The education of the Japanese government was, “although you are asymptomatic, you might be still contagious, or your pathogen hasn’t been outbreak yet. To protect someone who hasn’t sick yet, you should wear the mask and cover your nose”. Even people could go to a theater or use public transportation; however, the government gave an official right to service providers (e.g., theater owner, driver) that they could refuse to offer the service if people tried to get in without a mask. When poor people couldn’t get help, the government provided support that was also a remarkable point when there was no concept for social security.
The primary thought for Japanese strategy
In-shell nuts, the concept of Japanese strategy is “we = the government, provide supports as much as possible, but you = Japanese citizens, should have responsibilities not only for protecting yourself but other people”. Nevertheless, the Japanese medical system was still behind other Western countries; the government tried to get the newest medical information as much as possible such as medicine or vaccine. Vaccination was free for everyone. Doctors and nurses were sent to an isolated area to treat patients. The labor condition of a factory worker wasn’t great; thus, the infectious ratio of a factory worker was higher than a farmer or fisherman. In response to this, the government ordered factories immediate quarantine and treatment when they had an infectious worker. The government arranged extra rooms of other infectious disease hospitals, even city halls, churches, and temples, to convert to temporally hospitals in case Japan had numerous numbers of patients. It was a very advanced policy at that time. Instead of offering these supports, the government required a very high standard of hygiene to the public. Already scientists knew a spit of saliva or nasal discharge was a cause of the infection. Frequent washing hands and gargling, wearing the mask, correct manners for coughing, and disposing of a paper after blowing the nose or spitting in public, these kinds of standards had never existed in Japanese society before. Instead of the shutdown and stopping the Japanese economy, Japan chose to require Japanese citizens to step-up. Therefore, the number of patients dropped significantly in the third year.
“Think about your neighbors.”
I think the at-that-time Japanese government had an “altruism” concept. Again, Japan didn’t stop its economy. The Japanese government educated Japanese citizens to have more imagination to others for working together against the disease. As for Covid-19, the peak of its infection is one or two days before its outbreak. Therefore, wearing a mask is very helpful in preventing disease. In 2020, all processes, such as detecting the cause, finding the treatment, and inventing the new meds or vaccine, are faster than 1918. However, still, it takes some time to figure out the most effective strategy to cure the disease. Yet science and technology have been advanced than 1918, the most basic and essential strategy is “imagination” for others. Imagine the effect of your behavior on others, and then take action. This is the best remedy for prevention and support. The effect of this remedy has been universally and won’t lose its power even in the 21st century.
