Conspiracy theories about Japan’s approach to the coronavirus (COVID-19) are beginning to spread online, as people find it very difficult to believe that the country still has only 1000 cases of the virus even though it has not been testing a great deal. This has led to suggestions that Japan is covering up the true number of cases, and the epidemic is out of control in Tokyo.

This isn’t true: Japan has actually tested quite a lot of people, the epidemic is not out of control here as it is in so many other countries, there is no cover up, and what is happening in Japan is an example of what can be achieved with careful, early interventions. I will explain this here a little.

What is Japan’s epidemic situation?

According to the Ministry of Health, Labour and Welfare there were 1193 confirmed cases of COVID-19 on 25th March, of whom 272 had recovered,  43 had died and 57 required ventilator support. Japan’s first death from COVID-19 occurred on 13th February, about 41 days ago, a lot earlier than in other countries such as Germany (15 days ago), Italy (34 days ago) or the USA (25 days ago). For a disease as infectious as this one, these small differences in number of days should lead to huge differences in case numbers: Japan has had 16 days more than the USA to see this epidemic grow, but on day 9 the USA had only 645 cases – now it has 64,661 cases. It is obviously mystifying to many people that the US could see a 100-fold increase in the number of cases in the same time period that Japan saw only a two-fold increase. The obvious suspicion is that since Japan hasn’t tested that many cases, they must be hiding something. There are two reasons this theory doesn’t work: 1) Japan is actually testing more than people recognize and 2) you would definitely be able to tell if there was a 50-fold undercount of cases.

What is Japan’s testing situation?

Testing data can be obtained here. Japan has tested about 22,000 people, of whom 1193 have been confirmed positive. In contrast Germany has tested 167,000 and the UK has tested 65,000. This certainly seems like a lot of missed tests in Japan, but it is worth bearing in mind that the number of tests per positive person is actually about the same in these countries: 18.4 per positive in Japan, 19.7 per positive in the UK, and 25.5 per positive in Germany. In South Korea the number is unusual: 350,000 tests for about 9,000 cases, or 38.9 tests per positive case, but South Korea was dealing with a unique situation where a particular population group was known to be at risk (the weird religious group) and an aggressive testing policy could be targeted based on a social identity. In other countries the number of tests has approximately mapped the scale of the epidemic. This strangely stable ratio of tests to positive patients arises from the limitations on the test: it can only work on people who currently have the virus (it’s a PCR test) and it is expensive and still limited, so population-level testing cannot yet be conducted, and if done partially would miss cases. Basically every country is using passive case-finding to identify the disease, and only using the test where the symptoms suggest it, in order to conserve tests and avoid the social consequences (isolation and clinic shutdowns) associated with false positives. Japan is doing no differently here than Germany or the UK, it’s just that there are less people with symptoms, and less people to test as a result.

It’s worth noting that Japan set up a call centre for people with COVID-19 concerns on the 28th January, and since the middle of February it has been receiving about 3000 calls a day (also, somewhat cutely, 0-2 faxes per day: don’t ever change, Japan!), so there have been about 150,000 calls over the period of testing. In a country of 120 million this doesn’t seem to be a sign of a massively out of control epidemic. I can’t find statistics on the NHS 111 line but there are many stories out there about how it is congested with calls.

Why is Japan following this policy?

There are several levels of testing that can be conducted for any disease, ranging from population screening (seen in breast cancer programs) through voluntary testing (seen in HIV prevention programs), active case finding (where community health organizations target particular groups known to be at risk of a disease, usually used for TB) to passive case finding, which is used in almost all non-fatal sexually transmitted infections, influenza, and other infectious diseases. Screening is usually only conducted if the disease course can be changed by early detection. Passive case finding is useful when there is no identifiable group to target, or the disease prevalence is low so the chance of a positive test is low, or the test is rare/expensive/invasive. In this case the test is still restricted in availability, and the disease prevalence is low so you need to use a lot of tests to find one case. This is complicated in the case of COVID-19 by the possibility that the testing process itself will infect the tester, and so it’s better not to go charging out into the community exposing testers to large amounts of potentially infected people. South Korea conducted a kind of active case finding program, but that is because they knew where to look.

In this sense Japan’s policy is really no different to that in other countries. Japan has focused its efforts up until now on finding cases through cluster investigation: a lot of cases in Japan up until recently have arisen from cluster’s connected to specific events, and finding the people connected to these clusters and isolating them is super important. A single live music event in Osaka, for example, was responsible for 48 cases (about 5% of all the cases in Japan!), and had those cases not been tracked they would have turned into a huge outbreak. You can see the effect of this cluster approach in the statistics: often new cases (particularly in rural Japan) are asymptomatic, which indicates they were caught as part of a contact tracing effort; and even today with 40 new cases in Tokyo about half have a known contact already, which suggests they were tracked down (or their contacts will be). Quite a few cases are also imported: 5 of today’s 40, for example, have an overseas travel history. Focusing on clusters means targeting testing at people who need it, which avoids clogging up testing facilities and ensures that the test follow up is good quality.

Another reason for Japan’s low number of tests is its basic advice to people with suspected COVID-19. The advice from the government to citizens and medical institutions alike is: don’t come in for a consultation unless you have a fever >37.5C and coughing/chest tightness for at least 4 days (unless you’re pregnant or otherwise at risk). Until then you should self-isolate and avoid travel. This advice is super important in Tokyo, where most people travel by public transport, and ensures sick people aren’t infecting others on the train, and it avoids over-burdening health facilities with people who just have a cold. Two of my role-playing group have gone through this process; one went to the doctor after 4 days and was diagnosed with a cold based on x-ray and influenza tests, and the other self-isolated until her symptoms faded after 3 days. We’ll never know if she is immune to the virus now, but it doesn’t matter because she wasn’t at risk and she did not infect anyone else by getting on a train. Given that a lot of cases in Italy are now being  reported as hospital-acquired, this is good advice – but it also leads to the use of less tests.

So how do we know the size of Japan’s epidemic?

If we aren’t testing, how do we know what’s happening? First, we can assume given the ratio of positive results to tests is the same as in other countries that the process is working the same way here, and less tests are needed because less people have the virus. Second, though, we can look at the state of hospital emergency and intensive care wards, and make a judgment about the epidemic from the burden those wards are facing. In New York, for example, we now have horrifying accounts of emergency wards overflowing with cases and doctors working without breaks as their hospitals become basically COVID zones. In Italy new triage guidelines are being released for rationing ventilators. I am sure that is not happening (yet) in Japan, for two reasons: I work with doctors at a major hospital, and I am regularly visiting that hospital for medical care.

I have worked in and around hospitals for my whole career, doing data management and research, including in Japan, and I am familiar with how a hospital feels when it is working well and when it isn’t. You can tell from the way the doctors and nurses are working, the state of the physical environment, and what they complain about when they talk to you during your work day, whether they are struggling. Doctors are often wrong about epidemiology but they have an eye for when things are changing in their case load, and when they talk to you about it you can tell if things are going wrong. I don’t get that impression from my day job, or from any of my research colleagues from other hospitals here. There is not yet any pressure on emergency or intensive care services. I also receive the circulars for the medical staff in my work email, and so I can see how they are preparing for a surge that has not yet happened (today for example I received reassuring news about the stockpile of emergency equipment that my hospital has, the kind of news that would probably make an American very angry at how ill-prepared their system was). It’s not complacency or a lack of care: the wave just hasn’t hit yet.

The second reason I know this is that I have had to visit a lot of different parts of this hospital for medical care for my stupid knee, which I dislocated at kickboxing four weeks ago and have subsequently discovered has been missing some major components for the past 30 years. I only discovered this through multiple x-rays, MRIs, and CT scans (which I guess Aussie doctors didn’t feel I deserved over the first 30 years of my life!) As we all know, X-rays play a very important role in COVID-19 care since they enable doctors to see what kind of damage is going on. There is no way I would have sat just 10 minutes in the x-ray queue, watching orthopaedic patients hobble in and out calmly, if my hospital were overrun with COVID patients – I would probably be sent off to an external private provider or forced to wait all day. There’s also no way the CT scanner would be available for me to use 15 minutes before my appointment.

Unless Japanese people are uniquely able to resist this virus, the surge isn’t here yet, which means the epidemic is still in its infancy here – but that may all be about to change.

Japan’s prevention policy and what is coming soon

Japan has avoided major lockdowns yet, because it acted early and sensibly in light of warnings from China. The Japanese government listened to China, sent help early on, and paid careful attention to what was happening. The first advice from the Ministry of Health, Labour and Welfare was sent early – probably in early February – and the first restrictions on public behavior were instituted probably two weeks after the first death in mid February. My work events were being canceled by the end of February, and instructions were being disseminated throughout Japan to avoid large events. New advice about self isolation was issued early, and the National Institute of Infectious Diseases began its epidemiological investigations early. Japanese companies already have seasonal flu policies in place, and it is quite common for people to self-isolate if they have influenza, and those who don’t self-isolate will wear masks and behave responsibly with their disease. Japan is also not a touchy-feely huggy kind of country, and bowing is the standard greeting. In contrast, the UK was still considering what to do about large events in early March, and hand-shaking was still being discussed. It’s incredible that the day before the UK experienced its first coronavirus death, when Italy was starting to go pear-shaped, and in light of China’s experience, the British government still had no opinion on large events or shaking hands, one of the most disgustingly unhygienic ways you can greet someone.

This early action has served Japan well – even though it at no point closed its border to China! – but it may not be enough. Yesterday there were 40 new cases in Tokyo and 95 new cases in the whole country, and the Tokyo governor asked people to stay inside all weekend and not travel at all unless it was an emergency. There has been general uproar that a large kickboxing event (K1) was held on Sunday, and also consternation at the large numbers of people still going to parks and gardens for ohanami (it’s the season). If counter-measures aren’t stepped up it’s likely that Japan will lose a grip on this. It’s my expectation that by next weekend the Ministry of Health, Labour and Welfare will announce a lockdown, at least of the major cities, and an extended closure of restaurants and bars (to be clear, I have no inside knowledge of this – it’s just my judgment). The 40 cases we saw in Tokyo today were at least partly a result of last weekend’s ohanami madness, and we won’t know the effect of a weekend shutdown until next week, so my guess is the government will increase the restrictions next weekend. Given the small number of cases at present and the slow daily growth they probably only need to maintain a couple of weeks’ shutdown, not the extended horror we have seen in some cities, but my guess it is coming. If the Japanese government does what it’s very good at and dithers, expect Tokyo to become a zombie survival game show within a month. But so far the Japanese response has been measured and careful and effective, so I hope they will continue this and will get this right.

A note on conspiracy theories and racism

It’s worth recognizing that the European and Anglosphere countries (except perhaps for New Zealand) had two months’ warning of what was coming, they watched everything that was happening in China and they basically ignored it. Even Boris Johnson’s rapid turnabout on his irresponsible and inhumane “herd immunity” policy wasn’t driven by the clear knowledge available to the whole world from China; he waited until some white dudes at the University for Killing People and Stealing their Shit had had time to update their model with the Italian experience before he realized what a disaster he was unleashing. It seems that no one in the west at any point considered Chinese experience, Chinese struggle or Chinese lives worth anything, and ignored all the warnings they were being given until it was too late. Japan, on the other hand, listened to China and bought itself a month of slow growth as a result.

The conspiracy theories you see online about China and Japan are grown in the same fertile racist soil as the European policy mistakes. There is a long-standing image of Asians as shifty, untrustworthy, authoritarian and narcissistic, and that is exactly the racist image that drives these conspiracy theories. It’s not possible for white people to imagine that Asians could be doing something better than them, so they simply imagine that Asians are lying and covering up the truth. Inscrutable, untrustworthy and impenetrable societies are hiding the numbers and pretending everything’s okay for their own nefarious ends (or to “save face”).

Needless to say, it’s all bullshit. There is no conspiracy, and nobody is covering anything up. Asia is just doing it better, and the west needs to start listening to what’s happened over here, if they want to escape this with any of their grandparents alive.

Today’s Guardian has some new notes on the ongoing scandal that is the British education system. This time it’s a new OECD report ranking countries by numeracy and literacy, and the United Kingdom has fallen near the bottom. Worse still, the study finds that on average 16-24 year old Britons perform worse on both numeracy and literacy than do 16-55 year olds – that is, educational achievement has gone backwards in recent times. The depth of failure is also astounding:

a quarter of adults in England have maths skills no better than a 10-year-old, a conclusion that also prompted a political row in which the Conservatives attacked Labour’s record in government.

That means an estimated 8.5 million adults are only able to manage one-step tasks in arithmetic, sorting numbers or reading graphs. The same body also concluded that one in six adults could only just decipher sentences and read a paragraph of text – the literacy level of a child in their final year of primary education.

This is a pretty disturbing indictment of the British education system. The rankings also show it is under-performing relative to other English-speaking nations, with Australia and Canada out-performing the UK on every measure and the US close behind the UK. South Korea is top in numeracy and Japan top in literacy, which finding is particularly staggering given that literacy in Japanese requires a huge commitment of time and effort just to learn the vocabulary in comparison with English. The UK government is trying to blame Labour, pointing out that a 24 year old tested by this report would have spent their entire education under Labour, but I think that’s a little simplistic – education systems are slow to shift, and education methods, infrastructure and workforce obviously have legacy affects that would strongly influence outcomes long after the government that set them has disappeared into the trash bin of history. The Guardian is taking a more nuanced approach, attempting to understand what it is about education policy in Japan that makes Japanese students so good. It makes the good and obviously alarming point about differences in attitude towards education between the countries:

Japanese senior high school teachers, and their pupils, are often incredulous when they learn that 16- to 18-year-olds in England can drop maths and literature and study just three A-level subjects of their choice.

Add me to the ranks of the incredulous. When I was finishing high school you had to do five subjects. What else would be reasonable? And to the best of my knowledge I could only drop maths in my final year, and had to do one science and one humanities amongst my five subjects. What do English students do with their time?

This article, however, also brings up the common criticism of Japan’s education system – in fact it brings it up twice – and presents this criticism as some kind of counter-balance to the system’s strong focus on rote learning and hard work. The article states:

Japan’s state education system is often criticised for quashing original thought among pupils in favour of rote learning, and for placing an emphasis on theory rather than practical skills …
The stress on memorising information and passing exams, which begins in primary school and continues through to senior high, has been blamed for stifling critical, independent thought

This is a personal bug bear of mine, and something I find really frustrating about western coverage of Japan in particular and of Asia generally, for two reasons: it exaggerates the extent to which western students learn “critical thought” and it valorizes western “critical thought” as something that somehow counter-balances ignorance, or has some kind of value separate from the basic knowledge and skills required to inform critical analysis.

In terms of exaggeration, I remember growing up in the Australian school system, entering university, and interacting with peers during that period, and I can’t say that between us we had a shred of critical thought. We all failed essays at university and had to be taught a whole bunch of things about analysis and critical thinking skills, and university tutors in the humanities will often talk about how the students they get in first year are just repeating rote what they learnt from parents and peers. So the idea that western schools are a haven of critical thinking strikes me as a little exaggerated. Yes, high school students in the west spend more time spouting their opinions in essays than Japanese students, but so what? I’m sure that lots of British students have spent time in the library photocopying their arsehole, but that doesn’t mean they’re good at art.

But more importantly – and the reason this annoys me – critical thinking is a complete waste of time, and can even be counter-productive, if it is alloyed with ignorance and an inability to read. Let’s review the facts about one in six adults in the UK, who could “only just read a paragraph of text.” Why don’t we slap down the IPCC summary for policy makers in front of one of these adults and ask them to critically analyse it. Are they going to produce an analysis with any critical value, no matter how well they learnt to spray their opinions at school? I don’t think so – especially if they have maths skills no better than a 10-year-old. Perhaps it might be better if these adults were first able to understand the IPCC summary, before they embarked on a critique. Indeed, it might be better if these adults refrained from criticizing things they can’t read, because if you don’t understand something it’s likely your critical thinking about it is going to be of little value. You cannot present “independent, critical thought” as a boon independent of the skills that underlie basic comprehension, because one depends on the other. This isn’t to say that both can’t be taught in school, but it’s clear that the UK and US are not doing that. If you teach “critical thought” without teaching the skills it depends on, what you are actually teaching is rhetoric: the ability to bend facts to support your pre-conceived ideological goals. That this is taught in UK schools is not a positive thing.

Critical, independent thinking is not actually a hallmark of western culture: spouting opinions is. If we are such good critical independent thinkers, how come we got lied into a war in Iraq, participated in the massive con that was the housing bubble and the GFC, still haven’t come up with a solution to global warming, and managed to wage the biggest and most disastrous war in human history (WW2). Is it possible that what we see is a virtue is actually a flaw? Or, more likely, we aren’t doing it at all? After all, the land of limited independent thought, Japan, has a low crime rate, high employment, little inequality, and has a strong opposition to engaging in any form of war. They have an economy much larger than their population would be expected to have, exert a significant positive influence in the world, and make all the stuff you use even though they have no resources to speak of. Perhaps an education system that doesn’t focus on “independent, critical thinking” is more beneficial to society than one that does? Or perhaps the West is so full of its own opinions that it mistakes ranting for thinking?

This article’s platitudes about critical thought might go down well with educated British readers, but to me they’re just another example of the standard rhetorical footwork employed by journalists about Japan: on the one hand, a weak and stereotypical assessment of Japanese as conformist; and on the other, a triumphalist reassurance that westerners are all free-thinking individuals. Both of these two steps in the movement are wrong, and the underlying assumptions about the value of critical thinking to a functioning society, as well as the facts about how prepared western school leavers are to engage in such thought processes are also deeply flawed. A little more nuance would be nice.

Also of passing interest in this debate that the UK will now have with itself over its education policies is the role of inequality, and the relative benefits of development compared to birthrates in preparing for the future. How can the education levels of young adults in the UK be going backwards at the same time as average GCSE scores are going up? One answer, readily deployed by conservatives, is “grade inflation.” The other answer is inequality: that if you looked into the background of that “one in six adults” you would find they were much more likely to be poor and from certain areas. Japan, of course, has very little inequality compared to the US and the UK, and Australia and Canada are much more equal than the US and the UK. Interesting how the rankings seem to reflect the inequality within these countries. Also, if one in six of your young adults lack basic literacy and one in four of your adults lack basic numeracy, I think it’s safe to say that you have a problem with your workforce, and no industrialized, developed nation can hope to maintain its economic and cultural development with this kind of lack of investment in its workforce. Although England has a higher birthrate than Japan or South Korea, which country has the larger number of suitable new entrants to its workforce? Who is better placed to maintain a high-skilled pool of workers? The UK with something like 20% of its workers incapable of even basic office duties, or Japan and South Korea? Maintaining birth rates is not the be-all and end-all of maintaining a sustainable social order, especially if a large minority of all those born are going to grow up to be completely unable to contribute to the economy. British policy-makers need to be looking at the long-term implications of their education and industrial strategies (such as they have any) if they want to maintain anything resembling the quality of life that modern industrialized economies have come to expect.

Perhaps they could start by reassessing what they consider to be educational priorities, and trying to look beyond party-political point-scoring. “It’s Labour’s fault” is hardly a sterling example of the “critical thought” that UK policy-makers supposedly learnt at school. But then, maybe it’s an alternative when you don’t have the skills to read the report …

On Monday I was required to monitor at the Tokyo University undergraduate entrance exams. I shepherded 60 terrified 17 year olds through a 2.5 hour Japanese language test and then a 100 minute maths test. These tests were part of a two day examination process for those want to enter the humanities faculty of Tokyo University. About the Japanese test I can say nothing, but the maths test interested me, and can be found online (in Japanese) at the Mainichi Shinbun newspaper. In order, based on my feeble attempts at translating the exam, the four questions were:

  • A straightforward but nasty calculation of the properties of a line intersecting with a cubic function, including elucidation of all minima and maxima of the products of the lengths of two line segments
  • A geometry question with two proofs
  • A constrained linear programming problem
  • A simple Markov model with a slight twist

The students had 100 minutes, and to their credit quite a few of the students managed all four, though a lot also stumbled and didn’t get past two. I would say that for a well-trained student with good maths skills, these four questions can all be done inside their allotted 25 minutes, but it’s a pretty risky process – even a small error at the start, or misconception of how to do the problem, and you have basically lost the whole question because you only have time to attack the problem once. And these problems are probably about the same level of difficulty as the questions on a standard year 12 maths exam in Australia – where usually we would have three hours.

But these questions were for the Humanities Faculty of this university. If you want to study Japanese literature at Tokyo University, you first have to get through that 100 minutes of high level mathematics. It says something, I think, about the attitude of Japanese people towards mathematics, and towards education in general, that they would even set a mathematics test for access to a Humanities Faculty; and it says even more about the national aptitude for maths that the students could tackle this exam.

At about the same time as these exams were being held, the Guardian and the Sydney Morning Herald released articles slamming the mathematical and science abilities of the average student in the UK and Australia, respectively. The Guardian reported on a new study that found English star students were two years behind their Asian counterparts in mathematics, with 16 year old English students at the same level as 14 year old Chinese. The study also found that

The research also found England’s most able youngsters make less progress generally than those of similar abilities across the 12 other countries studied. The other countries studied were Singapore, Hong Kong, Taiwan, Japan, Australia, Slovenia, Norway, Scotland, the US, Italy, Lithuania and Russia.

Meanwhile, the Sydney Morning Herald reported on a new study showing that the proportion of students doing mathematics is falling fast, with apparently only 19% of students studying maths, science or technology in their final year of school, and a rapid fall in mathematics enrollments amongst girls especially. The corresponding figure in Japan in 2002 was 64%.

So is this a problem, why is it common to the English speaking world and viewed so differently in Asia, and what can be done about it? Obviously as a statistician I think this is woeful[1], and it certainly is my personal opinion that understanding mathematics is a good thing, but is it bad for a society as a whole to neglect mathematics education? I don’t know if that’s objectively verifiable. So let’s skip that question, assume for now that improving the number of people taking mathematics is good, and just jump onto the question of why it is unpopular in Australia, and why the British are so bad at it.

First, I would like to dispute the possible explanation provided in the Guardian article by “the researchers”:

In east Asian cultures education has historically been highly valued. This can be seen not only in teachers’ high salaries, but also in the heavy investment of families in private tutoring services

While it may be true that “social and cultural factors” affect maths achievement, the idea that Asians are better at maths because they value education more highly is a very weak one. If this were the case, would it not also be the case that Japanese would universally be better at foreign languages than the British or Australians? Japanese get a long exposure to English teaching but are generally woeful at it, despite all the money they sink into private tutoring services. No, there’s something else going on here, something about the Asian approach to maths and the way it is taught that is important.

It is certainly the case that private tutoring services need to be considered in the mix. When comparing a 16 year old English student to a 14 year old Japanese student, for example, you are comparing someone who does a 9 – 5 study day with very long winter and summer holidays against someone who does an 8 – 8 study day with two-week holidays, and who gets 2-on-1 or small group tutoring in key subjects for up to 3 hours a day, and on weekends. This process starts at age 10 and really ramps up at about age 15-16, just when the linked article finds the biggest gap between English and Asian students. It’s also the kind of process that benefits the “brightest” students most, and would explain the gap very nicely.

It may be that if the UK wants to compete with the sleeping giants of Asia on basic educational outcomes, it’s just going to have to face up to a simple fact: British students need to study harder. A lot harder.

There are some more nebulous cultural factors that come into play, however, and I am going to go out on a limb here and name a few factors in Japanese society (the part of Asia I am familiar with) that I believe make Japanese so much better at maths than their western counterparts.

  • It isn’t about native talent: A pet hate of mine about western approaches to mathematics is the idea that some people are talented at it, and most people aren’t. I don’t think this is true at all, and I think it’s not something that Japanese believe very strongly. The reality is that getting good at maths is a long, hard slog that involves a huge amount of repetition of basic skills (things like completing the square, substitution, differentiation, interpreting graphs, sign diagrams, etc.) – just like learning a language. Sure, solving maths problems requires creativity and intuition, but these are only of any value if you know the tools you can apply them to, and are familiar enough with those tools to recognize when and how to use them. Mathematics – and especially high school mathematics – is a process of drilling, drilling, drilling, and I think that Japanese recognize this. In Japan the default assumption is that if you pay attention at school and do your homework, you will be good at maths. Sure, they recognize that advanced maths requires extra commitment and talent, but there is a fundamental assumption here that the broad body of maths (up to and including differentiation, integration, limits, and basic probability theory) are things that anyone can learn.
  • The teacher is important: the flip side of the idea that education is important is an increased stress on the value of the teacher, and their role as a guide. The role of the guide is also viewed very differently if they are teaching something that they believe anyone can do, compared to if they are teaching a subject that everyone believes is impossible for most mortals to comprehend. Find me a westerner under the age of 30 who is “terrible at maths” and I will show you someone who was humiliated by an arrogant maths teacher at a crucial time in high school, usually around when they were 14. I was in the bottom class in mathematics when I was 14, expecting to drop out as soon as possible, until a good teacher put some time into teaching me, and I found that I really loved it. In Japan, teachers can be bullies and they can be cold and hard, but I would also argue that they have a much greater burden of personal care and responsibility placed on them compared to western teachers, and the failure of their students is treated more like a professional failure (rather than due to the student’s personal talents) than it is in the west. I think this is especially important with mathematics, because when you don’t get it it really hurts – like a kind of itching in the back of your brain – and the failures pile up rapidly. Just a single year between 12 and 14 in which you give up on maths is enough to make all the subsequent years ever more challenging, meaning the damage and the attendant confidence failures compound.
  • Being nerdy is cool: In Japan, it’s okay to be a nerd, and being good at mathematics is admired and respected. It’s virtually unheard of to find someone here who looks down on a man who can do maths, or thinks that it is beyond the female brain, or thinks that being interested in mathematics is weird. Furthermore, the nerd world in Japan is much more gender neutral than in the west, so there’s nothing unusual about girls doing maths. Good mathematics skill – up to and including being able to rearrange equations or solve systems of equations, for example – is not seen as a weird foible, but as an admirable sign that you are a rounded human being.
  • There is a social expectation of mathematical skill: In addition to nerdiness being much more acceptable, the range of mathematical abilities that qualify you as a nerd in Japan is much more esoteric and advanced than in the west. There is a general expectation that ordinary people can solve maths problems, that they understand the basic language of mathematics so that even if they can’t solve a problem they know roughly what it is and where it sits in the pantheon. Parents assume that their kids will learn mathematics, and don’t dismiss it as the too hard subject that only the special or the weird get ahead in. Whereas in Australia having a kid who is good at maths is unusual, in Japan it is unusual (and embarrassing!) to have a kid who is not good at maths.

I think these properties add up to a society in which mathematical achievement is encouraged and widespread. I think that Australia and the UK need to change some cultural factors so that the intellectual and educational landscape is closer to that in Asia if they want to keep up on mathematics and technology achievement – especially since China’s education system is maturing, and other Asian nations like Vietnam, Singapore and India are getting wealthier, with all the educational gains that implies. So what should Australia do?

  • Ditch the nerd-baiting: there’s something really wrong with the way the English-speaking world treats people who do nerdy things. I’m sure it’s mellowed a lot since I was a kid but it’s still there, the kind of ugly-four-eyes assumption about anyone who is interested in anything that isn’t sport or fashion. Until this weird attitude dissipates – and until the nerd world becomes more gender-balanced, to boot – it’s going to be hard to encourage the kind of cultural changes needed to make maths achievement standard across the board
  • Less intuition and initiative, more drills: I think it’s very sweet that maths teachers want to encourage their charges to think about the broader world of maths, about creative problem-solving, about applying maths to the real world, etc. But I think those are natural talents all humans possess, that cannot be unlocked without a robust background in the basic skills that make mathematics work. So leave the creativity for people who need it, and stuff kids’ heads full of “useless” rote learning of techniques and drills. It’s boring, but it’s essential to the bigger stuff. If you aren’t able to immediately see when and how to complete a square, then any problem which requires this basic technique is going to be beyond you, no matter how intuitive you are. Maths, possibly more than any other discipline, is built from the ground up, tiny block by tiny block, and all those blocks are essential. So ram them down every kid’s throat, and make every kid think that knowing the quadratic formula is not a test of some kind of obscure talent, but a basic expectation of every 12 year old
  • Force mathematics at higher school levels: When I finished school our balance of subjects had to include at least one science/technology subject, but it didn’t have to include maths. This is wrong, and part of the reason that so many students in Japan do mathematics is that you can’t get into a good university if you take this approach: every one of the better universities includes mathematics in its entrance exam. My personal belief is that completion of higher school certificates should require one foreign language, mathematics, and English. That leaves two other subjects to choose from, and guarantees that you have to do some kind of mathematics to the end of school. Not only will this very quickly lead to a society where entire generations of people are generally familiar with mathematics, it will also put a real focus on the quality of teaching at the earlier years, since any student who is doing badly in years 8 – 10 is going to fail their higher school certificate. [Probably this suggestion for a national curriculum is completely unreasonable, but at the very least students could be forced to do mathematics up until year 11, for example].
  • Make school more robust: The Japanese school system is about to shift to a “tougher” system that will include Saturday morning classes, because the previous system was considered “relaxed” compared to earlier years. This is, frankly, ridiculous, but so is the attitude towards education of most of the English-speaking world. Summer holidays are way too long and relaxed, there is a real lack of extension classes and tutoring, and expectations are altogether too low. Education isn’t valued enough, and until this changes anyone who wants their child to do better is going to be swimming against a strong current. Educational achievement is partly supported through the shared goals of a whole society, not just through the targets of individual families, and the expectations we hold for education are primarily set through the school system. So toughen it up – not in the sense of making teachers scarier or bringing back outdated “three Rs” educational styles, but by increasing the amount of time students spend at school, setting tougher standards for graduation and university entrance, making schools compete with each other (as Japanese schools partly do) and forcing parents to take greater responsibility for and involvement in their children’s education. This change isn’t specific to mathematics, but it would certainly help.

I don’t think there’s anything special about Asian students, or about Asian culture, that we can’t adopt. Asians’ mathematics achievements aren’t some kind of native or racial talent. It’s just a collection of attitudes towards education, mathematics and nerdiness that we can adopt if we want. Obviously there will be (potentially challenging) institutional changes required as well, and many people may judge it not worth the effort, but I personally think a world where everyone is good at mathematics is a better world, and we should be aiming for it. With these cultural changes maybe one day everyone will know the obvious thrill of being able to complete a challenging mathematics exam … and enjoying it!

fn1: Though obviously, the less people doing maths, the longer I will remain competitive in the marketplace …

It's all Greek to you, isn't it?

It’s all Greek to you, isn’t it?

I received a very interesting hospital dataset recently, in excel format and containing some basic variable names and values in Japanese. These included the sex of the patient, the specialty under which they were admitted to hospital, and all variable names. Initially this would be reasonably easy to convert to English in excel before import, but it would require making a pivot table and fiddling a bit (my excel-fu) is a bit rusty, but also I have address data and though at this stage it’s not important it may be in the future. So, at some point, I’m going to have to import this data in its Japanese form, so I figured I should work out how to do it.

The problem is that a straight import of the data leads to garbled characters, completely illegible, and very little information appears to be available online about how to import Japanese-labeled data into Stata. A 2010 entry on the statalist suggests it is impossible:

Unfortunately Stata does not support Unicode and does not support other multi-byte character sets, such as those necessary for Far Eastern Languages. If you are working with a data set in which all of the strings are in a language that can be represented by single byte characters (all European languages) just choose the appropriate output encoding. However, if your dataset contains strings in Far Eastern langages or multiple languages that use different character sets, you will simply not be able to properly represent all of the strings and will need to live with underscores in your data.

This is more than a little unfortunate but it’s also not entirely correct: I know that my students with Japanese operating systems can import Stata data quite easily. So I figured there must be something basic going wrong with my computer that was stopping it from doing a simple import. In the spirit of sharing solutions to problems that I find with computers and stats software, here are some solutions to the problem of importing far Eastern languages for two different operating systems (Windows and Mac OS X), with a few warnings and potential bugs or problems I haven’t yet found a solution for.

Case 1: Japanese language, Windows OS

In this case there should be no challenge importing the data. I tried it on my student’s computer: you just import the data any old how, whether it’s in .csv or excel format. Then in your preferences, set the font for the data viewer and the results window to be any of the Japanese-language OS defaults: MS Mincho or Osaka, for example.

This doesn’t work if you’re in an English language Windows, as far as I know, and it doesn’t work in Mac OS X (this I definitely know). In the latter case you are simply not able to choose the Japanese native fonts – Stata doesn’t use them. No matter what font you choose, the data will show up as gobbledigook. There is a solution for Mac OS X, however (see below).

Case 2: English language, Windows OS

This case is fiddly, but it has been solved and the solution can be found online through the helpful auspices of the igo, programming and economics blogger Shinobi. His or her solution only popped up when I did a search in Japanese, so I’m guessing that it isn’t readily available to the English language Stata community. I’m also guessing that Shinobi solved the problem on an English-language OS, since it’s not relevant on a Japanese-language OS. Shinobi’s blog post has an English translation at the bottom (very helpful) and extends the solution to Chinese characters. The details are on Shinobi’s blog but basically what you do is check your .csv file to see how it is encoded, then use a very nifty piece of software called iconv to translate the .csv file from its current encoding to one that can be read by Stata: in the example Shinobi gives (for Chinese) it is GB1030 encoding, but I think for Japanese Stata can read Shift-JIS (I found this explained somewhere online a few days ago but have lost the link).

Encoding is one of those weird things that most people who use computers (me included!) have never had to pay attention to, but it’s important in this case. Basically there are different ways to assign underlying values to far Eastern languages (this is the encoding) and although excel and most text editors recognize many, Stata only recognizes one. So if you have a .csv file that is a basic export from, say, excel, it’s likely in an encoding that Stata doesn’t recognize on an English-language OS. So just change the encoding of the file, and then Stata should recognize it.

Working out what encoding your .csv file is currently in can be fiddly, but basically if you open it in a text editor you should be able to access the preferences of the editor and find out what the encoding is; then you can use iconv to convert to a new one (see the commands for iconv in Shinobi’s blog).

Unfortunately this doesn’t work on Mac OS X: I know this, because I tried extensively. Mac OS X has iconv built in, so you can just open a terminal and run it. BUT, no matter how you change the encoding, Stata won’t read the resulting text file. You can easily interpret Shinobi’s solution for use on Mac but it won’t work. This may be because the native encoding of .csv files on Mac is unclear to the iconv software (there is a default “Mac” encoding that is hyper dodgy). However, given the simplicity of the solution I found for Mac (below), it seems more likely that the problem is something deep inside the way Stata and the OS interact.

Case 3: English-language, Mac OS X

This is, of course, something of a false case: there is no such thing as a single-language Mac OS X. Realizing this, and seeing that the task was trivial on a Japanese-language Windows but really fiddly on an English-language windows, it occurred to me to just change the language of my OS (one of the reasons I use Apple is that I can do this). So, I used the language preferences to change the OS language to Japanese, and then imported the .csv file. Result? Stata could instantly read the Japanese. Then I just switched my OS back to English when I was done with Stata. This is a tiny bit fiddly in the sense that whenever you want to work on this file you have to switch OS languages, but doing so on Apple is really trivial – maybe 3 or 4 clicks.

When you do this though, if you aren’t actually able to read Japanese, you’ll be stuffed trying to get back. So, before you do this, make sure you change your system settings so that the language options are visible on the task bar (you will see a little flag corresponding to your default locale appear next to the date and time). Then, make sure you know the sequence of clicks to get back to the regional language settings (it’s the bottom option of the language options menu in your taskbar, then the left-most tab inside that setting). That way you can change back easily. Note also that you don’t, strictly speaking, have to change the actual characters on the screen into Japanese! This is because when you select to change your default OS language, a little window pops up saying that the change will apply to the OS next time you log in but will apply to individual programs next time you open them. So you can probably change the OS, open Stata, fiddle about, close Stata, then change the OS back to English, and so long as you don’t log out/restart, you should never see a single Japanese-language menu! Weird, and kind of trivial solution!

A final weird excel problem

Having used this trick in Mac OS X, I thought to try importing the data from its original excel format, rather than from the intermediate .csv file. To my surprise, this didn’t work! In programming terms, running insheet to import .csv files translates the Japanese perfectly, but running import to import the excel file fails to translate properly! So, either there is something inaccessible about excel’s encoding, or the import program is broken in Stata. I don’t know which, but this does mean that if you receive a Japanese-language excel file and you’re using Mac OS X, you will need to export to .csv before you import to Stata. This is no big deal: before Stata 12, there was no direct excel import method for Stata.

A few final gripes

As a final aside, I take this as a sign that Stata need to really improve their support for Asian languages, and they also need to improve the way they handle excel. Given excel’s importance in the modern workplace, I think it would be a very good idea if Microsoft did more to make it fully open to other developers. It’s the default data transfer mechanism for people who are unfamiliar with databases and statistical software and it is absolutely essential that statisticians be able to work with it, whatever their opinions of its particular foibles or of the ethics of Microsoft. It also has better advanced programming and data manipulation properties than, say, OpenOffice, and this makes it all the more important that it match closely to standards that can be used across platforms. Excel has become a ubiquitous workplace tool, the numerical equivalent of a staple, and just as any company’s staplers can work with any other company’s staples if the standards match, so excel needs to be recognized as a public good, and made more open to developers at other companies. If that were the case I don’t think Stata would be struggling with Asian-language excel files but dealing fine with Asian-language .csv files.

And finally, I think this may also mean that both Apple and Microsoft need to drop their proprietary encoding systems and use an agreed, open standard. And also that Windows need to grow up and offer support for multiple languages on all their versions of Windows, not just the most expensive one.

Lastly, I hope this post helps someone out there with a Japanese-language import (or offers a way to import any other language that has a more extensive encoding than English).


Where’s my Chai Latte!!!?

Today was moving day – up at 6am, finish packing, removalists come at 8am, cross the suburb of Kichijoji to our new river-side apartment in nearby Mure, then back to the house to clean, deliver a present to our previous landlord and done and dusted by midday. That was the plan. Things went a little wrong, though, from about 9:30, and didn’t quite right themselves until our previous landlord drove us to our new house at 2pm. Our previous landlord is a sweet 70 year old ojiisan (Grandpa) who kicked us out because his 40 year old house is crumbling down around us. To make up for kicking us out he gave us his fridge, washing machine, bedding, microwave oven, television and rice cooker. He also offered to look after our rubbish (a perennial and serious problem when moving house in Japan). In exchange we gave him a packet of tim-tams, so all is even.

In the course of moving to Mure (which, incidentally, is an archaic word for “hill”) I had the opportunity to see various examples of classic Japanese work ethic, proved that incompetence is a universal property of real estate agents not confined only to westerners, learnt the Japanese word for “nictitating membrane” (shunmaku, 瞬膜, if you’re interested), witnessed my cat get acupuncture therapy, probably experienced the curse of a suicidal alcoholic dead author, and learnt some interesting things about property ownership in Japan. Naturally, I want to share.

So, in order of appearance, here is the tale of my day.

The super-efficient removalists

The removalists started work at 8:15. There were two of them. Their task was to move about 15 boxes, 20 bags, two desks, one large cupboard, two chests of drawers, two computers, one printer, one fridge, one washing machine and sundry accumulated crap from the two floors of our house, along a narrow path and into their waiting truck. Nobody told them beforehand, but in order to get to the washing machine they had to move 20 boxes from the shed into the house (we helped with this). Oh, and they had three “hanger boxes” for our clothes, that we filled while they worked, and they then carried out. They were done by 9am, even though every time they came into the house they had to take their shoes off. They also wrapped all the furniture before they moved it, and moved everything carefully, and even managed to reseal some boxes they weren’t satisfied with.

The smaller guy couldn’t have weighed more than 60 kg, he was tiny, but he could lift the washing machine by himself. He could also carry a chest of drawers down a very narrow and windy flight of stairs. This man was so small that he wore his packing tape as a bracelet (it fitted on his wrist and came off easily). He wrapped my printer in a blanket in about 3 seconds flat, and not only did he tape it up but he put an X-mark of tape on it to indicate it was fragile. He and his mate actually ran up and down our stairs, and moved through the house at a kind of shuffling semi-run – all while carefully avoiding touching the walls or risking damaging anything. They wrapped the fridge in these kind of padded socks that stop it from damaging or being damaged by door frames, and to get these socks on was a kind of 3 second effort: one of them says “se-no!” and then they flip the whole thing over the top of the fridge like they’re putting on some kind of enormous head band. Pat Cash would be proud, if his head were the size of a fridge. These are men with a rare and refined ability to size up the dimensions and weight of an object, and be done with it in 1 second flat. And they were going to be working at this pace at houses around Tokyo until 7pm.

(If you’re moving in Tokyo, try フクフク引っ越しセンター、27000 yen for all that done professionally in 1 hour! But Japanese only, I think).

So all of this done by 9am. We were thinking that the whole day would be over by 10. Sadly, removalists’ efficiency is easily done by the universal incompetence of real estate agents …

The wrong keys, in the rain

We reached the house at 9:15, only to discover that the keys the real estate agent gave me the day before wouldn’t open the door. Luckily I had kept the real estate’s number in my bag, so I called them … they open at 10am. The removalists told me that they could wait until 10am … and then the rain started. It’s the fag end of the rainy season here so it was pretty desultory, but it wasn’t looking promising. I assumed that the removalists had another job to get to, and come 10am were going to start dumping my shit on the road. Actually I discovered later, they could wait until 10am before they started charging me a waiting fee (which was very nice of them!) But I didn’t know this, and I had visions of my stuff sitting on the mud next to my doorway, getting rained on, while I waited for the real estate agent to turn up.

Fortunately, Japanese businesses have staff in them before their appointed opening time and they answered the phone at 9:30. Our estate agent couldn’t get in touch with the landlord, however, and couldn’t understand how our key couldn’t work. It somehow took him 30 minutes to reach our house (a 20 minute walk from his office!) only to discover that the key didn’t work. Well, shock! The removalists had tried it and they couldn’t get it working – what chance did he have? As I was talking to him the electricity guy turned up to check our electricity, and I had this vision of all the utility company reps standing in a queue in the rain while the removalists dumped my shit on the pavement and I remonstrated with the real estate. No doubt, if these removalists needed to bail to their next appointment they’d have my stuff out of their truck in five minutes flat.

As an aside, when I signed the contract the real estate initially presented me with the contract for a different apartment in the same block, and a few hard words from his boss were required to get him to reprint the contract to my satisfaction. My suspicion was he’d done the same with the keys, but they didn’t work on the other empty apartment, so his mistake was way more random than that. Random incompetence is so much more frustrating than focused stupidity, don’t you think?

As another aside, when the real estate agent gave me the key the day before, he pointed out to me that it had no room number on it, but said “you can see it has the word WEST written on it, which means it’s the right one” (my apartment is on the west side of the building). Hmmm… famous last words.

So I was starting to yell at the real estate, the electricity guy was looking on in fear, the removalists were laughing, the Delightful Miss E was explaining things to the electricity guy, the rain was falling … then the removalists revealed that they wait for $35 per 30 minutes, and everything smoothed out. The real estate offered to pay while we waited for the locksmith, and then we all just waited. Fortunately he contacted the landlord (who lives nearby) just a few minutes later, and scored a key. Win!

I’m still pretty pissed off with him though. This was Sunday, so his shop was open, but if I had been moving on a Wednesday his shop would have been closed, I wouldn’t have been able to contact him, I wouldn’t have been able to get into my house, and would have had to send the removalists away (or pay them to wait a day!) So, note to self: never move on the  day that the real estate is shut. Also, maybe punching your real estate’s lights out when you meet him, just to remind him of his place in the universe, is a good idea. Just in case. Anyway, this proves that real estate agents are incompetent, without fail, the world over – I had expected better in Japan, where being thorough about details like “is this the right key?” is standard in most workplaces, but the real estate business must have not read that memo. Wankers!

The Dazai curse

So I also discovered from my landlord that my house is situated right next to the bridge where the famous Japanese author Osamu Dazai killed himself with his lover Tomie Yamazaki. He seems like a pretty dissolute and useless kind of chap – maybe his ghost is stalking the area, making real estate agents incompetent and disconnecting landlord’s phones? Actually, I think he did himself in a little further south of my house, towards Shimorenjo. Looking at the canal now, even my cat couldn’t drown in it, but apparently back in the day it was much more ferocious. Anyway, I guess if this house turns out to be cursed, it’s the fault of Japan’s version of Lord Byron. I’ll have a thing or two to say if I meet that ghost!

Cat Acupuncture

In amongst all this, it had become apparent that our cat Arashi chan was somehow sick: his nictitating membrane was showing, which is definitely not normal, and by Saturday night his eyes were half-covered. I did a brief web search and discovered it’s probably just stress, but I didn’t know a vet near my house (of course there are three, I now know) so we decided that it would be a good idea to take him to the vet we know, near our old house. So after successfully not gutting our real estate agent and feasting on his liver in the street in front of our new house, challenging though it was to show such restraint, we decided that it might be best if we went back to the old house (where, fortunately, he was still safely ensconced) and took him to his regular vet. So off to the vet, where the nurse on reception remembered Arashi chan’s name as soon as we walked in even though we hadn’t seen them since last September. He’s a lady’s man, our Arashi chan.

By now it was midday, and it took an hour to get Arashi chan into the vet after the queue of rabbits and extremely small dogs. Terazono veterinary surgery is a beacon for rabbit owners and – obviously this is pure conjecture – I suspect a lot of them are lesbians. I think there’s a secret rabbit-owning lesbian underclass (cabal?) in Tokyo, and they live in or near Kichijoji. Maybe they’re in league with Totoro, who is a damn sight shiftier than the movies give him credit for, in my opinion.

My suspicions about this vet were confirmed when, having told me that Arashi chan was suffering from stress, he offered to administer a soothing session of acupuncture! Cat acupuncture! The great thing about conducting these kinds of negotiations in Japanese is that I don’t understand half of it, and my natural response is to trust my interlocutor and say “yes” while I catch up with what’s going on. So by the time the needle was in Arashi chan’s shoulder blades I was just catching up with the details. OH! Acupuncture! Like Black Adder in the German prison – “ooohhh! It’s a scythe!” He also got a needle in his inside thigh, just near his bum. It did seem to calm him down, and he certainly didn’t notice it. How strange! The vet told me that that cat acupuncturists are very rare, though he has heard it’s all the rage with horses in Australia[1], which had me imagining rapiers, or a vet turning up to the farm with a nail gun “for therapeutic use only.” How do you administer acupuncture to something as large and as thoroughly, irreconcilably evil as a horse? It’s like massaging a satanic whale.

So, Arashi chan calmed down (apparently – it’s hard to tell with an animal that spends 23 hours a day sleeping and one hour a day being profoundly stupid), and after a brief clean of our old house we went to hand in the keys to our previous landlord. After delivering the tim-tams, though, we discovered that all the taxis in Kichijoji were full or booked or dead, and we couldn’t get a taxi.

It’s as if just for this one day of the year, the 1st July 2012, Tokyo had decided to do a bad service exchange agreement with Sydney. No taxis? That never happens! Bad real estate agents? Sydney! Note to self: don’t move house on a day when the entire city of Tokyo has decided to do an exchange of bad vibes with Sydney.

So, our landlord offered to drive us to the new house, and during the drive we found out why he was unconcerned that we only did a perfunctory clean of his granny flat … and strange indeed it is …

Buying a house on someone else’s land

Our landlord is moving in August. Apparently his son is rich, and has bought the whole family a nice place in nearby Mitakadai[2]. I asked “what will you do with the old house?” His reply: “knock it down.” (actually, he said “destroy it,” but whatever). After establishing that knocking the house down will cost him money, I naturally asked, “will you just sell the land?” and he replied “oh no, we don’t own the land!”

WTF? You bought a house on land you don’t own? In Tokyo? Isn’t that a little risky? Is that even possible in Australia[3]?

Apparently it’s not risky, because they’ve lived there for years and it was their decision to quit, not the owner’s. They’ve been asking him to sell the land for years but he keeps saying no. Why, they don’t know – he lives in Shikoku, and doesn’t care one whit about Tokyo. But he won’t sell so they finally gave up and decided to move. I guess that this means their house is really just a very elaborate version of a mobile home, that you buy and stick on someone else’s land and then move away with, only in this instance “move away” means “take off and nuke the entire site from orbit.” Maybe this is why a retired typesetter can afford a massive two-storey home with Granny flat in one of Tokyo’s most sought-after locations – because he only bought the house, and is renting the land at some dodgy dirt-cheap pre-bubble rate.

Is that even possible in Australia? And would you do it?

I wonder if a lot of the houses I see going for sale cheap in Kichijoji are operating like this – you’re actually buying a home that, if you can’t sell it on when you try to move, you have to destroy. That is so radically different from western concepts of property ownership. And probably something to look out for if you’re planning on buying a house here…

So that was my day. My feet hurt, my cat is composed entirely of nervous energy and nictitating membranes, my real estate couldn’t organize a root in a brothel, and my house may be cursed by the ghost of a dissolute alcoholic cheating bully who wrote overwrought prose about self-destructive idiots, a kind of wartime-era Sid Vicious of letters. Have I made the right decision moving to Mure? Perhaps I should have bought a house on someone else’s land in Chiba? Ah, the complexities of finding a home in Japan …

fn1: I guess these vets don’t call themselves “the horse poker” for obvious reasons.

fn2: Mitaka means “three hawks.” My house is also in Mitaka and, rather shockingly, around the corner from my house is a “hawk cafe” where you can have coffee in a building that contains owls and hawks. You can get your photo taken with them. Today I discovered that birds can consciously control their nictitating membranes. That’s right, that blink they do is them sneering at you.

fn3: Well obviously, everyone’s doing it, in essence, since no one ever bought the country from its original inhabitants, but I think property law somehow managed to … cough … find a way to overlook that.

On Sunday I signed a contract to rent a new apartment, which I will move into next weekend. Currently I’m living in a kind of Granny flat (called an ohanare) behind the home of my landlord, in South Kichijoji near the famous Inokashira park. I like Kichijoji a lot, so our new apartment will be in nearby Mure, about 5 minutes’ walk from Inokashira Park, and 1 minute’s walk from the sports fields and other recreational parts of the same park. It’s probably 10 minutes’ walk from the Studio Ghibli Museum, so my cat can hunt Kodama. It’s a ground floor apartment, what in Japan is called a 2DK and would in Australia be called a 1 bedroom apartment with study.

Finding an apartment in Tokyo is so much easier than anything like it in Australia. Every year at least the Sydney Morning Herald produces a report like this that tells you what you need to do to find a rental apartment in Sydney: prepare a CV (including one for your dog!), dress nicely, form a personal relationship with a real estate agent, and offer more than the advertised rent. My experience of house-hunting in Sydney was terrible: queues of people turning up to look at one apartment, only to have the agent be late or not turn up; looking at apartments while people still lived in them (and being interrupted by unannounced inspections when I lived in an apartment!), and routinely being lied to about the place: turning up to a “3 bedroom” house to discover it was actually 2 bedrooms and a living room, for example.  Also, rents are shocking: the most recent census tells me that median weekly rent in Australia is $285, and my last two apartments were considerably more. Six years ago in Sydney I paid $360 a week for a 1 bedroom + study apartment in Stanmore, about 45 minutes by public transport from the city centre. Before I left Sydney I paid $190 a week for a 1 room apartment in Redfern – Sydney’s most dangerous suburb – on a street with signs warning against car-jackers. It had a shared laundry that occasionally would be smeared with vomit. Before I left London I was paying about 60,000 yen a month (about $150 a week) for a single room barely larger than a walk-in closet, in a share house with three other people and no real living room.

My rent in my new apartment is about $1200 a month – about $300 a week – for a house with 2 air-conditioning units, 15 minutes walk from Kichijoji station, in the area that is voted number one place to live in Tokyo every year. It’s trivial to find a one room apartment in the heart of Kichijoji for $190 a week, and there’s zero risk of car-jacking. I also didn’t have to fuss around with open inspections, offering higher rent, or special CVs. I just visited a few real estate agents, told them what I was looking for, and they drove me to a variety of apartments around Kichijoji.

In essence, it’s easier and cheaper to rent an apartment in Tokyo than it is in Sydney. Finding an apartment is a very smooth process, and if you don’t have a pet there’s a huge range. Going even a small amount above what I am paying gets you a very large and comfortable place. If you want to live in Shibuya I think it’s a very different story, but then, on on the flipside, Chiba is even cheaper. The big down side to renting in Tokyo is the upfront money – it’s not 100% of apartments, but for the majority of places you’ll have to put down 3 months’ rent upfront, of which you will only get back 1. If you have a cat, it’s 4 months rent upfront. It is possible to find places that don’t make this demand, but they’re often older or not so common. Still, the average real estate will have 2 or 3 such places, and there is a huge number and range of housing stock.

I’m not sure why this difference exists, but it’s one of the key reasons I think the cost of living in Japan is low. Share housing is not very common even in Tokyo, because it’s quite easy to live alone in the suburb of your choice for between $500 and $800 a month – even students can live alone. I think it’s a mixture of things, but I wonder how much of it is a legacy of the 1980s housing boom, how much of it is ageing population, and how much of it is weak property rights. I suspect a lot of it has to do with the latter, which makes it easy to throw up new buildings higgledy-piggledy even in expensive suburbs. Also there seems to be a lot more corporate investment in housing – why, I don’t know. Tax arrangements here seem to be less favorable to family homes, though I don’t know the details. But renting is cheap and easy, and real estate agents – precisely contrary to their behavior in the west – are polite, honest, and very helpful. It’s as if renting were a respectable lifestyle decision, and a viable way to live. Have you ever heard of such a notion?

Is it Gypsies and Lace?

About a week or two ago I went to another goth-lolita night courtesy of a la Mode Tokyo. Three of the bands were the same as the last time I went, and the night seemed to be running on something of a steampunk theme. One of the bands, Strange Artifact, even claims to play “Steampunk Music,” and have been invited to the steampunk worlds fair (in Washington, I think) this year. Which got me thinking, what actually is “steampunk rock”? The picture above shows the singer from Strange Artifact – she is wearing a kind of gypsy/lace/punky outfit. The picture below is her bassist, who was wearing a gasmask last time but this time just looks like a standard leather-and-spandex rocker.

Parlour music, Ikebukuro style...

So I’m not sure what makes them steampunk. The other band that seems to have a bit of a steampunk styling is Black Dead Butterflies, pictured below in their pirate capes. These guys are calling themselves a Gothic Unit and styling themselves as lovers (I don’t know if they are). Surely pirate lesbians have a steampunk element?

Lesbian pirates are steampunk ... right?

So what is steampunk rock? As a genre steampunk literature seems to be marked out by a few simple properties:

  • Victoriana and the general industrial/technological trappings of the steam age
  • A fascination with Europe and European history
  • Girls in lead roles

The last part might not seem obvious but it seems to me that there is always a lead female character in a steampunk story, at least all the ones I’ve read. Philip Pullman, Stephen Hunt, Scott Westerfield, Steven Harper, are examples that spring to mind. Obviously steampunk as a literary genre is also not so perfectly defined, but it seems to have this as a strong element. And the goth-lolita scene is really noticeable for the prominence of women as organizers, performers and traders within the scene. So they at least have this in common with steampunk. But shouldn’t music genres be at least partly defined in terms of their musical style? What makes steampunk rock steampunk rather than just rock? Or is it just gothic rock wearing a bit more brass and lace, with the odd lesbian pirate thrown in?

A cold planet ... a Zombie planet!

Ikaho is a hot spring resort in the mountains Northwest of Tokyo, about an hour and a half from Tokyo by bullet train and local train and bus. It is famous for being the historical summer home of emperor’s, and also for having a huge flight of stone stairs that runs from the bottom of town to the top. This flight of stairs is lined with shops, and at the top is the source of the town’s hot spring water. I’ve been told that even today, hot spring water is allocated from this source in strict accordance with the degree of nobility of the recipient’s heritage, though I don’t know whether that’s true or not. The town is essentially a resort town, with no other business to be found except tourism. It’s also slowly crumbling, as are many rural towns in Japan, as the population ages and the young people leave for the cities. A good proportion of the buildings in this town, that used to hold thriving businesses, are now derelict. In fact, you can’t see it from the second rate photo I took from my second-rate hotel room, but in front of my ageing hotel there was a wide patch of scrub grass on a slope, essentially untended and growing very tall, in amongst which a few crumbling sheds were being slowly reclaimed by nature. A room with a view indeed … However, Ikaho’s fading charms aside, it does make quite an excellent mountain fastness from which to weather the zombiepocalypse.


Defensibility: Although Ikaho is accessible from several locations, much of the town consists of multi-storey buildings on slopes accessible only through a single road or steps. In some cases (such as my hotel) the area in front of the buildings is open space, and some of these buildings may have an exit to the hillside that is above the entrance (e.g., my hotel had an emergency exit on a higher level than the main entrance, and the exit emerged from the opposite side of the hotel). In other cases, buildings may be quite isolated from the rest of the town and surrounded by quite thick forest. This makes them potentially quite defensible (Japanese forest at its thickest is impenetrable for people). At the top of the town is a long flight of steps, perhaps 200 m long, lined with small souvenir shops and restaurants. These steps are joined at regular intervals by narrow side streets, but these side streets would be easy to block. At the top of the steps is a kind of hotel or administrative building, surrounded by walls and a gate, and near that is the source of the hot spring water. By blocking the streets and closing off the buildings one can establish a quite defensible redoubt – live at the base of the steps and, if a zombie horde encroaches, flee up the steps, drawing them into the natural death trap formed by the souvenir shops – then roll rocks down on them, or close off a single barrier and use stakes and spears to destroy them. In this sense the town is defensible in quite a low-tech way.

Escape routes: In addition to the obvious ways in and out of the town, at the very top of the steps after a short run one can reach a river in a kind of canyon, that is crossed by two small bridges. If one were to park a car on these bridges they would become essentially uncrossable, but there is a road on the far side that – I guess – leads out of town through a little-used route. This gives a good escape route from the town, assuming a zombie horde came from the lower reaches (i.e. closer to the nearest towns) and not from the mountains. By establishing a small car pool on the far side of this bridge and preparing mobile barriers for the bridge itself (or, better still, a means of knocking the bridges down) one would have a fairly reliable escape option. As far as I can tell the only other way across this canyon is through the riverbed, but like most rivers in Japan it is concrete-lined and hard to scale. Ikaho also features a rope way leading up to a mountain top, so another option could be to establish a flying fox mechanism from their back into town – then, lead the zombies up the mountainside, and when you get to the top use the flying fox to rapidly get back down the hillside, leaving them lost and confused on the mountainside.

Location: Ikaho is located far from Tokyo, but it is not in as secluded a location as Hakone. It is a short bus ride from the town of Shibukawa, a typical sprawling (by Japanese standards) rural supply town. The most likely approach will be through Shibukawa, with a stop to get urgent supplies; this would be dangerous. There are bypasses which take the intrepid survivor group through smaller country towns, and this is the best bet if one wants to guarantee rapid and safe access to Ikaho. Ikaho’s slight remove from Shibukawa is useful though, because it gives survivors the option of raiding Shibukawa’s shopping centres (“doing a run” as they say in The Walking Dead) for essentials. Looking at the map of the area, I notice that there are quite a few golf courses nearby, which at least provide a wide range of clubbing weapons and possibly a clubhouse to raid for supplies. However, the nearness to Shibukawa and the main roads running north from Tokyo means that Ikaho may be a target for random zombie encounters and/or hordes. Remoteness is a useful property in a survival location.

Concealment: Like Hakone, Ikaho is largely invisible from the larger towns, so zombies won’t congregate on its distant lights or the sounds of habitation here – it will only draw zombies who are already just wandering through the mountains aimlessly. Assuming zombies radiate outward from Shibukawa randomly once they’ve eaten all its residents, it is likely that they will mostly miss Ikaho and wander into the wilderness. Establishing a solid barrier at a suitable juncture – such as in front of the visitor’s centre at the edge of town – might cause them to turn down a different road leading away from the area long before they receive any indication that there are humans in the town. Thus even small hordes would be less likely to approach the town, and defending it would likely consist of keeping an eye out for occasional lone wandering zombies. Unfortunately, these zombies will still have many places to hide and cause trouble – the crumbling buildings and scrubland make it easy for a zombie to be missed even from the best vantage points in town, so patrols might be necessary in order to ensure the town’s safety.

Sustainability: As a remote tourist town, Ikaho boasts a lot of restaurants and a small resident population. It’s likely that in the short term there would be a large stock of fresh and preserved foods to consume while preparing defenses. It’s worth noting here that tourist towns in Japan contain a lot of souvenir shops selling food, and much of this food is preserved food – dried and pickled fish are very popular souvenirs, as are low-sugar sweets (dumplings and cakes) that are designed to last for up to a month after purchase. So upon arrival, the group could establish a simple consumption order: first the fresh food that can spoil, while the fridges are still running; then the frozen goods once the electricity dies; then move onto the preserved foods. Potentially in a place like Ikaho one would have as long as a month to establish a mechanism for sustainable food supplies, and maybe even longer. There would likely be huge stocks of rice on hand, and these would be easy to cook – one can establish a steaming mechanism using the onsen (hot spring) water from the top of the hill, and in fact there is a little restaurant at the top of the town which serves eggs boiled in onsen water, so the mechanism has already been established.

Most importantly though, Ikaho comes with a supply of fresh meat and a potential farming area pre-prepared. Near the bottom of the town is a tourist ranch, holding cows and sheep and goats, that will likely still be functioning if the survivors arrive fast enough. In addition to holding the animals, the ranch is intended as an educational enterprise so likely contains basic information on how to milk and herd them. If the ranch staff are still there they could even be convinced to participate in establishing the long-term survival of the community. The nearby golf-courses can be converted into rice paddies, as probably could the stepped slopes of the town itself, and there is ample scrubland for planting potatoes and vegetables. Just a short drive away from the town is Haruna lake, which in addition to a source of fresh water for the town (through the aforementioned stream) also probably contains fish. Haruna lake is unlikely to be thronged with zombies, being even more remote than Ikaho, so a pair of people visiting the lake could fish for the group with relative impunity.

Ikaho’s main sustainability problem is its lack of fuel and distance to the local town, but this could be easily solved by bringing a large number of bicycles, and using them to move to and from Haruna lake. Then fuel can be conserved for visits to the town of Shibukawa – and that fuel need only be used for the drive back, since cars could coast to the town. With such mechanisms in place it is likely that Ikaho could provide a good long-term survival spot from which to weather a few seasons of the zombiepocalypse.

Natural hazards: The main risks to life in Ikaho are the possibility of collapsing buildings, forest fires and of course the ever-present risk of rock falls and landslides. Ikaho is far removed from the centre of Japan’s typhoon zone and unlikely to flood, but one problem it does have is winter. Being north of Tokyo and in the mountains, it will have a long, harsh winter. Even in early April when I visited there was no sign of a single new leaf on even one tree – it was barren as far as the eye could see. With potentially 6 months where nothing grows, winters will be harsh if one does not arrive with a very large stock of rice and tinned goods. The local stocks of rice – particularly in the hotels – would likely last a whole season, but the work in the next summer to secure sufficient rice and potatoes for a second winter could be hard. Staying warm in winter would not necessarily be a challenge – in addition to the ample local wood supplies, the onsen water could be used to warm houses, or one could just sit out the winters in an onsen. Winters of this severity also offer the opportunity for a respite from zombie incursion, as zombies will likely freeze, and this gives the residents potentially a three month period in which to work freely on establishing defenses, preparing the ranch, and so on. Winters after the first could be lean times, but provided some farms could be established in the first year, they will be survivable.


In fleeing to the countryside one should remember that Japanese rural towns all have many automatic rice-dispensing facilities, which can carry hundreds of kgs of rice. Before the electricity runs out these will be easy to use – take a large supply of money and sacks, and just feed the money in! One great thing about vending machines is that they can’t profiteer, so while the rice sellers in town will soon be hiking up their prices, unless the companies are very organized and somehow immune to the general societal collapse, these rice hoppers will continue to sell rice at peacetime prices. Money isn’t going to be relevant, but a good supply of rice is going to be priceless. If one wants to survive long-term in Japan after the zombiepocalypse, the first thing one should grab is a very very large stash of sacks. Every hopper you come to, loot for everything its got. Then you have both a barter good for dealing with people you meet, and a source of long-term survival that, if treated carefully, may last more than a year.

Ikaho’s defenses are not so intuitive as in Takao, so to prepare a proper defense of the town – with its winding streets and multiple possibly inter-connected crumbling buildings – would require poring over a map, establishing choke points and defensive layers, and preparing fall back positions. It’s probably also not such a good place for a very small group of survivors – I would guess that with less than 20 people in your group you won’t be able to set up the required defensive positions quickly. Upon arrival the best idea is probably to establish a redoubt at the top of the stairs, and to fan out from there securing the rest of the town once the group has its first base intact. Because it’s a tourist town, it’s easy to pick up maps and guides when one arrives, and the town is self-contained and small enough for new arrivals to quickly get a sense of all its ways and byways. Starting from a small base, one could slowly secure the town and establish defensive rings and tactics.


Ikaho is not as defensible as Takao but offers better long-term sustainability options, and is further removed from the hordes of Tokyo. With its local ranch and nearby golf courses, as well as a nearby fishing lake, it offers both short term and long term food supplies, and the presence of a strong and reliable local onsen source reduces the need for electric power for cooking and heating. Provided that some degree of farming can be established within a year and mechanisms put in place for weathering the worst of winter, it may be an ideal spot to weather the initial storm of the zombiepocalypse, and a good base from which to reclaim at least a small part of the world for human habitation.

Battleship Island

Battleship Island is an abandoned island in Nagasaki, that for some years was the most densely populated island on Earth. It was abandoned over a 3 month period in the 1970s, so most of the buildings were left intact, with even some possessions still inside. The island built up over 200 years for the sole purpose of undersea coal-mining: it hosts two mineshafts that go about a kilometre underground and branch out in a network under the sea. Because the island is too far from the mainland for commuting, a community built up around the mines. At its peak this community included schools at all grades, a cinema, pharmacy, clinic and city hall. The island is only about 500m long and 150m wide, so the community was densely packed, and by the 40s the island was so heavily built up that it resembled a battleship – hence the name, gunkanshima (軍艦島), although the island’s official name is Hashima (端島).

While I was in Nagasaki presenting my HIV model, I took a trip to gunkanshima. It’s a fascinating place in its own right and, I think, for people interested in role-playing settings, could make an excellent adventure setting. Some kind of Meiji-era Outland-style detective story springs to mind, or a Cthulhu-in-the-mineshafts post-WW2 horror story. So here are some pictures and background to give a feel for the place, as both a fine example of modern industrial archaeology and a potential adventure setting – and an excellent zombie survival spot. Also, if you’re in Nagasaki this is an excellent afternoon trip, so I’ll give a few pointers on how to get there at the end.

The Island from the tennis-court end

It takes about an hour to get to the island from Nagasaki harbour, with a brief stop at Takashima to look at a diorama of Battleship Island and visit a museum of coal-mining in the area. This is interesting for its depiction of coal mining through the ages, and its excellent three dimensional cut-away models of the mineshafts under the islands. Here you can get a sense of what a claustrophobic and grim world coal-mining was during the era of the island’s existence, and why the setting is ripe for cthulhoid fantasies. The guide will also give you an explanation of what it was like to live on the island (he grew up there) and set a kind of stern tone of things-that-are-gone that I think is quite helpful for appreciating the decay on the island itself.

The view from the coal-loading side

The boat approaches the island from the coal-mining side, so you see the flat (Eastern?) side of the island with the apartments and schools of the tennis court end on your right, and the shrine just visible at the top of the island. The parts most visible from this approach are the most intact; once you land you can see a lot more rubble.

Coal-processor remnants

From the pier it is possible to see the stilts that used to hold the coal conveyor belt, and which once ran through piles of coal. The buildings in the distance are the old schools: elementary school at the bottom and high school further up, with the top floors devoted to a gym of some kind. From this the proximity of the residents to their only source of employment – and the reason for the island’s whole existence – is pretty clear. As someone who lived in the shadows (literally) of a lead smelter in a one-industry town, I can imagine the importance this industrial infrastructure had on the island – everyone who lived here was either directly working in the mines, or there purely to provide services to those who were. It’s a town that must have closed down as soon as coal mining stopped, and the Japanese economy shifted rapidly away from coal in the 1960s and 1970s, so it was inevitable. In fact the whole island was owned by Mitsubishi – so when they closed it no one had a choice, and everyone had to move out in a very short time. There are apparently still apartments with their televisions left behind, and other markers of residential habitation still stuck on walls or doors.

Coal miners' baths (left) and pit head (far right)

Further to the south are the pit head and coal mining facilities. The miners bathed in heated sea water, and for much of the history of the island everyone experienced strict water rationing – no fresh water could be used for anything except drinking and food preparation until a pipe was laid from the mainland in the 50s. There were also no private bathing facilities – the apartments were linked to public baths that everyone shared (a very common Japanese practice even now in towns like Beppu, where for example there is a guesthouse for foreigners that doesn’t have its own bathrooms but expects guests to use the local public bathhouse). The building at the top of the above picture held a rainwater trap, I think, and a pipe leads down the hill to the apartments. The lighthouse was added after the island was abandoned, since before then it gave enough light from human habitation not to need its own lighthouse.

The view from the swimming pool

On the western side of the island from these facilities are more apartments, pictured here with a building whose purpose I don’t know (left, foreground). This picture was taken from near the swimming pool, which was a salt water pool filled directly from the sea. The whole island is surrounded by sea walls to protect it from storms but during typhoons these walls are insufficient – on the tour you will be shown photos of waves crashing over the building in the foreground, and residents of the apartment blocks looking down on the storm from the roofs of their homes. All of the apartments in Battleship Island had gardens on their rooftops, because although greenery is visible in these pictures there was none when the island was in use – the green you see here is a recent, natural addition. For the residents the only chance to appreciate elements other than stone and water was the time in the rooftop gardens.

Battleship Island's eastern side

This photo, taken on the return to the ship, shows the island in more perspective. The block in the middle is the second pit head; the building on the hillside is another apartment, possibly containing the city office. The vista stretching away from the foreground is of the coal processing facilities with the school in the background. What you see here is the work of 40 years of typhoons and storms and salt water. Most of this area was reclaimed from the sea in the first half of the 20th century; I guess by the last half of this century it will be reclaimed by the sea, unless someone decides to preserve the island in perfect form. As it is the whole place is a dangerous place, an we all had to stay very carefully inside the fenced off areas, and once the sea has had another 40 years to work its destructive way through the reclaimed areas I guess the island will become unvisitable.

Industry abandoned: the remains of the coal loading dock

The island is in many respects a kind of microcosm of Japan’s industrial history – it grew as Japan’s economy grew, and its economic and physical fate were determined by the powerful economic forces shaping Japanese society; as a result its demographic development mimicked that of Japan as a whole. Our guide showed us a magazine article from the 1960s, when Battleship Island was the most heavily populated place on earth, asking “Is this the future of Japan?” Now it is deserted and crumbling, a fate that will undoubtedly come to many other Japanese towns of similar size. As a model of the way industrial societies grow and decline this island is a powerful example, and an extreme example as well of the way that access to resources shapes the physical and cultural landscape. This isn’t the only such example in Japan – Shimane’s Iwami Ginzan is an abandoned silver mine in a slowly fading rural area that harkens back to the time when Japan was the richest country in the world because of its silver resources. They are long gone, and Shimane is now famous for its religious heritage and its crumbling seaside towns, and not much else.

If you visit Nagasaki I strongly recommend a visit to the island. You will also get a nice overview of Nagasaki’s working harbour, and see some of the scenery in the peninsula, during your trip. I booked my trip with Takashima Kaijo, which at time of writing does 9am and 14:00pm departures for 3 hour round trips, and employs a guide who used to live on the Island. It’s all in Japanese, but they have an English pamphlet that gives you the crucial information you need and some nice pictures. The staff speak enough English to get you on the ship – you need to sign a disclaimer and pay 4300 yen (about $43) for the trip (not refundable if the weather is too harsh to get onto the island). The conditions are described on their website in English, too.  Their office is a little distance from the main harbour terminal, but their website has a map and you can find other cruise companies in the terminal if you don’t want to take the risk. They can take up to 210 people, so if you go during a busy time it will be a bit crowded; you probably need to be prepared for a fairly regimented style of tourism but it’s not too cloying (but don’t take photos while the guide is talking – he’ll get angry). You get about 15 minutes to take photos and wander around and since you can’t leave the confines of the viewing area this is more than enough. The staff are very sweet and accommodating, overall. The ship also stops at Yojima, which apparently has an onsen (hot spring) and hotels, so if you wanted you could make a nice couple of days by booking into an onsen hotel in Yojima and making the trip to Gunkanjima a side trip (about an hour shorter from Yojima).

Finally, it should be recognized that Gunkanjima is a heritage site and as such a little respect should be shown: as the guide says, to us it’s a pile of rubble but to him it’s his hometown (実家). So don’t go breaking their rules because you think they’re silly, or get worked up because they wouldn’t land on the island and you lost 4000 yen. Also, if you are planning to go to Nagasaki I think this week – the 24th – 30th – is probably best because it coincides with the tall ship festival, which is quite a nice harbourside event. This season the weather is a little unpredictable, but I think it’s clearing up for the end of spring, so if you are in Japan in late April Nagasaki could be worth the effort. And if you’re in Nagasaki at any time, Battleship Island is a great afternoon trip, well worth the money and of interest to anyone who is interested in history or a little urban exploring.

I’m in Nagasaki this week to attend the 86th Annual Meeting of the Japanese Society for Infectious Diseases, where I have presented the results of my work building a mathematical model of the HIV Epidemic in Japan. The model is currently submitted to a journal so I can’t give any detail about it here, but I can present a chart I used in the conference presentation, that is based on publicly available data from the Ministry of Health, Labour and Welfare. This chart shows the number of new cases of HIV/AIDS notified to the government annually, divided into three main transmission modes (Figure 1).

Figure 1: Annual new cases of HIV/AIDS in Japan by transmission category, 1985-2010

In this Figure, “same sex contact” means “homosexual contact,” since there’s no such thing as a case of HIV transmitted by same sex contact between women. From Figure 1 it should be pretty clear that while the epidemic appears to have peaked and even beginning to decline in the heterosexual population, amongst men who have sex with men (MSM) it is growing rapidly. Now, there are some caveats on such a conclusion in Japan: testing rates are quite low so it could be that these “new” cases are actually old cases that have only just been identified, for example, but it would be a strange world indeed if the entire slope of that line were due to remnant cases finally coming to light. So, it’s reasonable to conclude with some confidence that the HIV epidemic is growing rapidly amongst MSM in Japan. Currently prevalence is probably low, but that was the case in Australia back in 1985, and prevalence amongst MSM in Australia now is probably above 5%.

This comparison is noteworthy because Figure 1 makes it look like Japan’s experience of HIV is Australia’s 20 years ago, and if the epidemic continues to follow Australia’s trend, HIV will spread rapidly through Japan’s gay community. Of course there are big differences in HIV treatment and prevention now compared to 20 years ago, and very few people die of AIDS in Japan because of the combination of low prevalence and good treatment. But the rapid increase amongst MSM shown in Figure 1 suggests that prevention efforts to date haven’t been working, and it would be best if something could be done to prevent the further spread of the disease.

Another minor concern (raised in my presentation, actually) is that MSM in Japan tend to be less open than in the rest of the developed world, making them even harder to study but also raising the possibility that they marry and have at least some sexual contact with women. Sexuality in Asia is, in general, more fluid than in the West and less constrained by categories and boundaries, so the idea seems superficially plausible. If this is true though, it means that there is a small risk that the epidemic won’t be contained within the gay community forever. Unfortunately, no one knows the extent of this overlap in Japan, and no one knows how much injecting drug use is happening here, so it’s hard to make judgments about how such behavior might affect the future of the epidemic. This is what my mathematical modeling is (partially) aiming to do, and although I won’t reveal the results here the future is not pretty for MSM if the epidemic is allowed to continue. Even without the benefit of a mathematical model, it’s pretty easy to see from Figure 1 that Japan needs to improve interventions amongst MSM, primarily by increasing rates of voluntary testing and targeting a test-and-treat prevention strategy at this community. Given the current low prevalence of HIV, even a relatively unsuccessful test-and-treat program will probably be sufficient to contain the epidemic (though the international evidence suggests that it takes a very rigorous and probably unrealistically well implemented program to eliminate the disease). It remains to be seen whether such a targeted approach will be tried here, but hopefully my work will be one tiny step towards encouraging such a change.