Lessons from the COVID-19 pandemic: strategies and challenges for an aging society in Japan

PurposeThis article analyzes the challenges of infectious disease control under a super-aged society through Japan's experience with COVID-19.Design/methodology/approachThis article provides an overview of Japan's COVID-19 measures and their characteristics, discusses their successes and failures, and identifies future challenges.FindingsJapan's basic strategy for COVID-19 consists of three parts: the border defense (Stage 1), slowing down the spread (Stage 2), and damage control (Stage 3). One key policy feature in Stage 2 and Stage 3 is based on "voluntary restriction". It had a certain effect, but it was prolonged with each recurring "wave of infection", resulting in economic exhaustion and people's dissatisfaction. Thus, the effect of the voluntary restriction has weakened, while the percentage of people who have been vaccinated is improving, making it difficult to predict the damage of the next "wave". Under the hyper-aged society, it was necessary to identify and protect particularly vulnerable areas, i.e., psychiatry hospitals, chronic care hospitals, and long term care (LTC) facilities. On the other hand, secondary impacts extend to young people. The most serious one is the decrease in births which further accelerates the aging of society.Originality/valueThis study is original as it investigated why Japan's unique countermeasures against COVID-19 without mandatory lockdown worked well for a considerable period. It also revealed that secondary impacts of the COVID-19 epidemic are broader and more significant than the direct loss of life, and that the social system, especially super-aged society with many vulnerable areas should be reformed in consideration of the threat of infectious diseases. Lessons from the Japanese case may contribute to other countries.