Printer-friendly version

Fighting the virus: The Asian model – Interview with Ludovico Ciferri

Fighting the virus: The Asian model – Interview with Ludovico Ciferri


The West should observe the strategies and technologies being used by some Asian countries such as Singapore, South Korea, Taiwan, for example, that have managed to stem the tide of contagion without suspending the economy. Things are not going so well in Japan, which does not appear to be in the avant-garde in confronting this crisis. Ludovico Ciferri, president of Advanet, a Japanese company specialised in the manufacture of miniature computers and professor at the University of Japan, is interviewed again (on March 29th) on the situation in Southeast Asian.

Successful battles against the virus in Asia: what have been the gains and at what cost?  

If confirmed, the data emerging from those regions’ experiences show that when preventive risk containment plans include drastic measures such as those implemented in that part of the world for years now, it can greatly reduce the consequences of an epidemic. As of 29 March, Singapore was reporting 802 cases and 2 deaths in a population of over five million; Taiwan: 283 cases and 2 deaths, population nearly 25 million; South Korea: 9,583 cases and 152 deaths in a population of 52 million. Italy has recorded over 90,000 cases and more than 10,000 deaths with a population of 60 million.

The United States – and we are only at the beginning – already has 125,000 cases and more than 2,000 deaths out of a population of nearly 330 million. Apart from detection systems and case counts, which could differ substantially, the figures show differences too glaring to be attributed merely to statistical error. The issue of being prepared for this type of risk for facilities and perhaps to the population itself is going to have to be taken into consideration from now on.

On the other hand, it should also be considered that the need to curtail individual freedoms carries the risk that those methods could eventually be used for purposes other than safeguarding health. Let me offer two recent examples: giving local police helmets equipped with thermometers that work at a distance, allowing for identification of a person with a temperature higher than 38°C (100.4°F) at a distance of up to five feet; or, crossing a facial ID system with 95% accuracy – despite the person’s wearing a mask – with the local police data base, thus permitting the identification of 30 persons per second. These are measures already adopted that need to be very carefully assessed. Governments must be held to a responsible use of surveillance technologies during a pandemic, otherwise we risk exposing those already emarginated today to the further threat of regulation, repression and persecution of their activities – if not of their very lives – tomorrow.

Could you be more specific?  

In South Korea, where there have been some very large outbreaks, technology has played a decisive role, albeit at the expense of privacy. First in the diagnostic phase, with the adoption of a widespread drive-through testing system for all persons who could have come into contact with a confirmed case. According to some observers, making a public website available where the movements of the initial infected persons were tracked (cell phones, credit cards, etc.), was an abuse of personal freedoms. This has, nevertheless, placed data at everyone’s fingertips and made people aware that they must be proactively responsible for evaluating the possibility of having encountered someone infected. This application is an example of Big Data use that has played a decisive role.  

Technology has also been used in Singapore, where it seems the threat will soon be raised to “red” alert – the highest level – with school and university closings, and in this case to disseminate information of the spread of the pandemic to all citizens via mobile devices as well as to keep infected persons in quarantine under control. There are serious sanctions in many cases: for instance, any foreigner who violates compulsory home quarantine will be subject to loss of their job and immediate expulsion. One Singapore resident is risking six months’ prison detention.

In my opinion, the case of continental China has to be left out for now, since it is going to take time to figure out what really happened: despite the current good news coming out of the country, there are still too many grey areas, for example concerning the delay in adopting the Wuhan measures and the city’s continued industrial activity during the embargo. I find the experience of Taiwan interesting: a nation that seems to have best handled the risk of epidemic by adopting, from January onward, a mix of measures, fruit of previous SARS and MERS experiences, that were based on moderate limitation of personal freedoms (among which simple mask distribution quotas) and the use of technology, which made it possible to keep the country going – a sort of world factory that never shut down. Unfortunately, there is little mention of this experience in the West, while, instead it would seem to merit further study in for the purpose of coming up with a blueprint.

Olympic Games postponed: what’s happening in Japan? 

We have a very unusual situation here in Japan. I have the impression that the Japanese authorities have, for various reasons, decided to keep a low profile on the spread of the virus. Some heads of Western states have made an almost arrogant show of being out of harm’s way, as though the virus wouldn’t have been able to reach their countries, to then hastily order a national state of emergency and consequent lockdown. By contrast, Japan’s prime minister and his government have avoided making a commotion. This explains why the framework of the epidemic remains indefinite and no one – except for many of the national media – seems surprised about why this has happened. However, now that the Olympics have officially been pushed back, the Japanese infection curve has “suddenly” become a topic of public discussion. The media have jumped on the few – and still small –numbers available. The governor of the region has asked Tokyo for a voluntary lockdown of the city on weekends, while closure is being considered for the entire region of Tokyo, which has lost approximately 50% of GDP.

Is the Japanese healthcare system equipped for the emergency?

According to some observers, Japan’s healthcare system is not up to handling an epidemic of this nature, Based on the data as of 2016, the 653 intensive care units approved include 5603 beds for a population of nearly 127 million, only 12% of which are categorized as high intensity units. The ratio of IC beds to population is thus the lowest for any developed country after the UK, while the total number of hospital beds is the highest.

Moreover, only 244 ICUs (about 40% of the total) are certified by the Japanese Society of Intensive Care (JSICM) for providing subspecialist training. In addition to the decision not to give much visibility to the development of the epidemic, is the difficulty in performing swab tests on a large scale. The official explanation from the Japanese counterpart to the US’s CDC, is that fewer swab tests have been done in Japan because their purpose – by choice – was epidemiological (to track contagion) and not medical (to understand the origin of the disease). In other words, if Japan still has a low rate of infection and few deaths traced to the coronavirus that is probably owing to the lack of searching out cases. We can only hope that Japan is able to avoid going through what Wuhan did, because the result could be tragic here too.

How do explain such a situation so different to other Asian countries?

That is the big question at the moment. As I have said, the contagion curve is information that – given that the Japanese government actually has it – is still not available to the public. There are therefore various hypotheses on the apparent trajectory that, if confirmed, would result in few cases in Japan (as of 29 March, the number of infected persons confirmed stood at 1693.52 out of a population of 127 million) owing to a lifestyle involving a low rate of interpersonal contact, the widespread tradition of wearing facemasks and the habit of frequently washing hands.

If should also be pointed out that using facemasks and social distancing are things that anyone who has experienced living in an Asian country knows are part of the urban landscape; not to mention that sometimes those masks even have designer labels to make them more psychologically acceptable.

Japan was among the first nations to promote the use of facemasks for both personal protection and with regard to others. We have all experienced the derision of those in the rest of the world who had the impression that there was some kind of epidemic underway here. The truth is, according to the local health authorities, that despite the WHO’s not advising the use of facemasks, logic indicates otherwise: 1) the virus is conveyed by saliva; 2) infection takes place via air passages and eyes; 3) no one can know if they are positive or not, and even what they may know will only be valid for a limited time; 4) the mask reduces the possibility of active and passive contagion by any pathogen, not only the corona virus. In brief, given that the mask can’t hurt, the case scenario is that it doesn’t do anything: the Japanese find it hard to understand the WHO’s reluctance to recommend its use. Social distancing is also an interesting element of consideration.  Proxemics has long identified a marked tendency in Japan to avoid not only physical and visual contact, but also to maintain a comfort zone around oneself free of other people.




Ludovico Ciferri is President of Advanet, a Japanese firm specialized in the development and production of high-performance miniature computers. He also teaches Mobile Business Strategy and Private Equity & Venture Capital at the Graduate School of Management of the International University of Japan