Lend-Lease for Ukraine

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The US has revived its historic Lend-Lease policy to help Ukraine. This was a World War II era policy in support of the enemies of Nazi Germany.

When the UK and France declared war on Nazi Germany after its invasion of Poland, the US initially remained neutral. After the fall of France, Britain remained the only major power resisting Germany. This changed only when Hitler attacked the Soviet Union in the summer of 1941. From 1939 to 1941, the Soviet Union had been an ally of Nazi Germany under the Molotov-Ribbentrop treaty and had supplied Germany with oil for its invasion of Denmark, Norway, France and Benelux.

After the fall of Dunkirk, Britain had been almost on its own (it was still supported by Australia, Canada, New Zealand and British colonies). It could buy supplies from the US but it had to pay in cash (i.e. silver) and transport the goods to Britain on its own ships. With the passage of Lend-Lease in March 1941, the US could supply arms, ammunition and other goods to Britain without requiring payment and it sent them to Britain on American ships.

After the German attack on the Soviet Union (Operation Barbarossa), the USSR was also supplied by the US with tanks, trucks, ammunition, food and many other materials for the war effort. These supplies were sent via Persia, Murmansk and the Far East. When Putins’s Russia today talks about the Soviet victory over Nazi Germany, it consistently remains silent about the US contribution to the Soviet war effort, without which the country may have collapsed.

Lend-Lease was controversial in the US. Isolationists and nazi sympathisers argued it would put the US on a slippery slope towards entering the war in Europe. However, the US still officially remained neutral and not at war with Germany and its allies. This only changed in December 1941 when Imperial Japan attacked Pearl Harbor. A few days after Pearl Harbor, Hitler declared war on the US in support of its ally in the Far East. Thus it was not Lend-Lease that got the US involved in World War II but the Japanese attack.

This holds a message for today. Countries do not automatically become parties in war if they support another country with supplies.

Wars of aggression are a violation of the UN Charter which guarantees the territorial integrity of all states and requires them to use peaceful means to settle any disputes. Every country has a right of self-defense. Under International law, countries worldwide have every right to support countries exercising their right of self-defence against aggressors and invaders. That is as true in 2022 as it was in 1939 or 1941.

Tokyo in a power crunch

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On March 22, 2022 the Tokyo Electric Power Corporation (Tepco) warned electricity consumers in east Japan about the risk of rolling blackouts from a tight supply situation. The recent M7.3 quake near Sendai had knocked several of Tepco’s thermal power plants offline, which left the company in a difficult situation when a cold spell with snow flakes hit the region of the capital. Demand at times exceeded generation capacity and only the availability of pumped hydro storage saved the day before measures to curb demand such as turning down heating and switching off lights averted an outage.

No doubt this experience will increase pressure to restart more nuclear power stations that have been shuttered since the tsunami and nuclear meltdowns in Fukushima in March 2011. Before the nuclear disaster about 30% of Japanese generating capacity were nuclear; now only about 10% comes from restarted nuclear reactors. The current high prices of natural gas will further enhance the attraction of nuclear, at least in the eyes of anyone whose financial interests are tied to the balance sheet of the utility companies, such as their individual and institutional shareholders.

However, that is not the whole story.

While eastern Japan was in a power crunch, western Japan has ample spare capacity, as did Hokkaido. Why could this power not be used in Tokyo? You would have thought Japan would have learnt its lesson from the 3/11 disaster in 2011 and addressed it in the decade since then, but you would be wrong: Japanese electricity markets are still split between a handful of regional near-monopolies with minimal interchange capacities between them. For example, the Hokkaido grid has a generating capacity of 7.5 GW but only 0.6 GW of interchange capacity with Honshu (8% of the total). Tepco supplies up to 47 GW to customers in its area but can only exchange up to 1.2 GW with major utilities in the west of Japan. This leaves little margin when earthquakes or weather events with a regional impact hit supplies.

By contrast, China has built huge high voltage direct current (HVDC) transmission lines between the industrialized coastal cities on one side and hydroelectric power stations near the Tibetan plateau and solar and wind farms in the arid north on the other. Many of these lines are longer than the distance from Tokyo to Hokkaido, let alone Tokyo to Kansai. The Chinese government understands that if it wants to wean itself from the dependence of dirty coal or imported oil and gas then it will need to vastly increase power transfer capacity from the interior of the country where renewables are available to the densely populated urban areas near the coast lines.

Japan is actually in a similar situation. The elephant in the room that nobody wants to talk about is offshore wind. While European countries and the US are building up tens of Gigawatts of offshore wind power capacity, Japan has very little installed capacity, particularly offshore. The entire conversations seems to be about nuclear vs. solar vs. gas vs. coal, leaving out one of the most promising renewable energy sources available to Japan. So far the regulatory hurdles for erecting and connecting wind turbines in Japan have been high and that has left wind as an also ran compared to much more widely deployed solar. However, solar does not provide power at all hours. Wind would complement it.

Much of the European wind power capacity is installed offshore where wind speeds tend to be high and more consistent than onshore. This is where the largest and most economical turbine models tend to be used. By contrast, almost 99% of Japan’s wind power capacity is still onshore. A cumulative total of only 51.6 MW of offshore wind capacity was installed at the end of 2021 while total installed wind power capacity was 4.6 GW. Meanwhile the UK had 24.7 GW of wind power capacity, Spain 27.1 GW and Germany 62.2 GW. China is in a league of its own with 282 GW, more than all of Europe combined. Japan’s installed wind power base is less than that of small European countries such as Belgium (4.7 GW) that have relatively short coast lines and tiny EEZs: Japan’s EEZ of 4,479,388 km2 is over 1000 times larger than Belgium’s at 3,447 km2!

Japan is really only starting to build up offshore wind capacity, with projects off the coasts of Akita, Chiba and Nagasaki getting under way in the last two years. By 2030 its goal is for 10 GW of offshore capacity either installed or under construction which is still tiny compared to the already installed base of Germany, Spain or the UK.

Unlike fossil fuel or nuclear power stations, wind turbines are not location independent. They will be installed where wind conditions are favourable, where the sea is not too deep and connections to the coastal grid are cost-effective. To make the most of the wind conditions, the grid will need to be greatly expanded to allow large amounts of power to be transferred from regions with plenty of wind to regions with many consumers. This will be quite different from the current model where utility companies try to generate all the power they need within their own region, which is why there is only limited interchange capacity to help out if one company loses a large part of its generating capacity as happened in the recent quake or after 3/11.

Japan needs to start building high capacity long distance HVDC power lines like China has in order to enable a transition to zero carbon electricity. The fragmented power markets dominated by local utility companies are an obstacle to this transition as the interests of the regional companies seeking profits from existing investments in their area are not aligned with the interests of the consumers who want reliable green energy regardless of where it comes from.

Japan quickly needs to remove regulatory obstacles to expanding wind power and then invest to build a HVDC backbone to connect renewable power generation with consumers.

Reiwa Shinsengumi and Putin

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On February 28, 2022 the Japanese left-wing populist opposition party Reiwa Shinsengumi led by actor turned politician Yamamoto Taro refused to support a resolution by the Japanese Diet to condemn the Russian war of aggression against Ukraine.

LDP politician Kono Taro wrote on twitter the next day:

Parliamentary Resolution to denounce the invasion of Ukraine by Russia was passed in the House of Representatives. Surprisingly, the three Reiwa Shinsengumi members voted against the Resolution.

I was curious why they would refuse to join an anti-war resolution and checked their party website.

What I found there was a statement that repeated a Putin talking point, blaming the war on NATO expansion into eastern Europe that supposedly violated a promise made to the Soviet Union not to admit now members from the former Soviet bloc:

今回の惨事を生み出したのはロシアの暴走、という一点張りではなく、
米欧主要国がソ連邦崩壊時の約束であるNATO東方拡大せず、を反故にしてきたことなどに目を向け、この戦争を終わらせるための真摯な外交的努力を行う
(“We don’t want to make the blanket statement that it was Russia’s outburst that created the current catastrophe.
Make a sincere diplomatic effort to end this war, focusing on the fact that the U.S. and major European countries have reneged on their promises made at the time of the collapse of the Soviet Union not to expand NATO eastward.”)
(【声明】ロシアによるウクライナ侵略を非難する決議について（れいわ新選組 2022年2月28日）, 2022-02-18)

This Putin talking point that has been repeated by Russian propagandists over and over seeks to repaint the violent assault on a neighbour country as an act of self-defense. It is revisionist history and has been widely discredited as a myth. No such promise was ever made and Russia has not provided any evidence for its claim.

According to Soviet leader Mikhail Gorbachev, there was no such agreement. What did happen was that during the negotiations leading up to the reunification of Germany western powers agreed not to deploy NATO troops other than troops from Germany itself into parts of the former GDR (East Germany) once Germany was unified. NATO countries have kept this promise to this present day.

Admission of new NATO members was a subject not even talked about back in 1990. As sovereign nations, it is the right of former Warsaw pact states to apply for NATO membership just as it is the right of NATO members to accept or reject their applications to this mutual defense treaty. After the annexation of Crimea and support for a separatist war in eastern Ukraine by Russia it is now quite clear why eastern European countries have been seeking safety in numbers by wanting to join NATO.

Putin justifying his invasion of Ukraine by its desire to join NATO to keep him off is like a guy justifying the rape of a woman by her calling the police last time he beat her.

Frankly, I don’t expect anything better of Vladimir Putin who is more akin to a mobster than to a regular politician but I am disappointed by Reiwa Shinsengumi whom somehow I had expected to be on the side of democracy and human rights and not of a right-wing dictator.

Is Omicron milder than Delta?

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Early in the Omicron wave in South Africa some local doctors were commenting that they were seeing many “mild” cases of Omicron, quite different from what they had seen with Delta in the previous wave in the country.

Soon there were two competing takes on Omicron in the public discourse, one that concludes that Omicron is more like a bad cold and another that the true virulence of Omicron, even if it was somewhat lower, would matter less than the larger number of cases from its rapid spread. “A small percentage of a very large number can also be a large number,” is how many of the experts cautioned us.

The picture was further clouded by the fact that Omicron was spreading in parallel with Delta: Many of the countries that were seeing Omicron waves were already in the midst of a Delta wave connected to the onset of winter in the northern hemisphere. For example, Japan had cases growing about 20 percent week on week for several weeks before it saw significant numbers of confirmed Omicron cases. Many of the deaths seen while Omicron cases were already growing rapidly were still Delta cases.

Death numbers always lag a few weeks behind case numbers. For example, in Tokyo the average gap between Covid diagnosis and death is about 15 days. Then it takes another 16 days on average for the death to be reported in the evening news. This means, the death count reported in the media was from people who on average died 16 days ago after having a positive PCR test 31 days ago. The positive result of the PCR test would have been included in the daily count on average about 2-3 days after the test was taken.

There is some evidence that Omicron is less virulent than Delta. A study on hamsters showed that the variant seems less capable of infecting lung cells and seems to be more focussed on the nose, throat and windpipe, which may also contribute to its easier spread. It’s not clear how these animal study results translate to humans. In December, different numbers were reported for how much less virulent Omicron was overall or specifically for unvaccinated people, with risk reductions mentioned anywhere from 15 to 70 percent.

In any case, milder than Delta does not mean mild: Delta was worse than Alpha which was worse than the D614G strain that devastated Italy and New York city in March 2020, which was worse than the original Wuhan strain. Omicron may still be as bad as one of its pre-Delta ancestors, which were deadly enough.

Finally, we have some numbers coming in.

During the Delta wave the UK 7-day trailing count of deaths had reached a peak of around 1,200 in early November 2021, when almost 100% of cases were still Delta. On January 14, 2022, when most UK cases were Omicron, this had increased to about 1,800 deaths in the last 7 days, about 50 percent more deaths per week than at the peak of Delta.

The picture is similar in Canada, where 7-day deaths peaked at 344 in October with Delta. On January 15, 2022 the same metric reached 606, almost twice as deadly, with Omicron.

While the Case Fatality Rate (CFR), which is defined as the number of deaths divided by confirmed cases, has declined with Omicron relative to Delta, this is primarily because of the extraordinarily rapid growth of cases, which grew faster than deaths climbed. The CFR went down even as deaths increase. Thus Omicron can appear to be milder and not so mild after all, as it ends up killing more people per week than Delta did. If cases go up 5-fold but deaths “only” double, the CFR will fall by 60 percent.

The only saving grace may be that Omicron will most likely burn through the infectable population more quickly than Delta ever did. Cases have peaked in South Africa, the UK and most of the US. By February they will probably also peak in Japan (before I and most others can get a booster here).

Wear a good mask, if you meet people do it outdoors, ventilate, get vaccinated and get a booster if you can.

Links:

Waiting for third doses in Japan

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In December, 470,000 medical workers, 280,000 seniors (65 and above) and 90,000 others in Tokyo were qualified to receive the 3rd dose because of the time interval since their second dose and their status. Only 63,292 (7.6%) of them actually received their dose. 1,829,880 booster doses were supplied by the central government. As for January, out of 620,000 qualified individuals, 29,645 (4.8%) have received their dose so far. The scheduled supply for this month is a further 1,702,800 doses for Tokyo, for an accumulated total of 3,532,680. The number of people eligible for boosters in Tokyo by the end of February is only 2,100,000.

Also, according to the Cabinet Office (kenbetsu-vaccination_data2.xlsx file), Tokyo had received 16,586,310 million doses of Pfizer for 1st/2nd shots in 2021, of which they have used 15,358,949 doses (92.60%). Therefore, about 1,227,361 Pfizer doses should still be have been available before any of the above mentioned supplies were delivered.

Nationwide, about 10 million doses of Pfizer have been supplied but not used (165,148,620 vs. 155,989,956). Of the 50,000,000 doses of Moderna that the central government had contracted for, 34,251,400 had been distributed and 31,938,353 actually used. That leaves about 18 million doses unused, which translates to 36 million booster shots, if you add 18 million sets of syringes (Moderna boosters are half doses of regular 1st/2nd doses).

It’s not a supply problem. Based on these numbers, it’s going to be something like a mere 120,000 people with a booster in Tokyo by the beginning of February, when literally millions could have received them. Meanwhile, new cases numbers (most of them Omicron) have been increasing 4 to 5-fold week on week. We will soon hit unprecedented numbers of cases.

Without a 3rd dose, two doses of Pfizer received 5 months ago offer little protection against symptomatic infection with Omicron, though they still reduce the risk of hospitalizations and other severe outcomes. This is because of the immunity escape from Omicron. Even two weeks after the second shot, efficacy is only a little over 60% with Omicron, significantly lower than with Delta. A third shot boosts efficacy to a slightly higher level than after the 2nd shot, winding the clock back by 6 months or more. Accelerating the booster campaign by using left-over vaccine doses as soon as possible should be a high priority.

Another important point is to improve the messaging on masks: Many people are still using simple masks that cover the face but do not fit particularly well. Mask policy in Japan is still not based on the recognition that Covid-19 is airborne disease that spreads via aerosols. One person can infect another without them being in the room at the same time. High grade masks like N95, KN95, KF94, FFP2 offer much better filtration because they reduce the unfiltered side stream. They offer the best first line of defense against the explosive spread of Omicron. A rapid roll-out of boosters should be the second line.

Numbers listed for all 47 prefectures in this MHLW document:
追加接種対象者数、接種回数及びワクチンの供給量 (“Number of subjects to be additionally vaccinated, number of times vaccinated, and quantity of vaccine supplied”, mhlw.go.jp)

Vaccination data by prefecture from Cabinet Office:
kenbetsu-vaccination_data2.xlsx (kantei.go.jp)

Upgrading to the Pixel 6 Pro

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After several Nexus phones, a Pixel 3 and a Pixel 3a, the new Google Pixel 6 was an easy upgrade choice. I’ve been very happy with both the Pixel 3 and Pixel 3a, especially the image quality, so much so that I virtually stopped using my cameras. Just about the only thing the DSLR still did better was the optical zoom. The new Pixel 6 Pro has one dedicated telephoto lens that should help narrow the gap. I ordered it in December and it arrived in the new year.

I chose to migrate the contents of my Pixel 3 to the Pixel 6 Pro, since that was my main camera phone before. The new phone has 512 GB of flash memory vs. 256 GB in the old one so there are no storage issues. Copying files across using the upgrade tool and a USB-C cable was relatively straightforward. I wish the migration did not default to Japanese (my old phone was set to English), but that was no major obstacle and I could change the language afterwards.

Moving Line and WhatsApp chats across via a Google account was not difficult either, I just had to do some searches to get the backup and restore steps right. I moved the data-only SIM card from the old phone to the new one before I started. With the data-only SIM card I use a Google Voice account for SMS-verification but I will soon swap the SIM card for a voice-enabled SIM that directly handles SMS with a new phone number.

On my Pixel 3a I am using Pasmo/Suica for contactless payments and train fares since it has the Mobile FeliCa chip needed for “osaifu ketai” (wallet mobile phones). My US sourced Pixel 3 does not have this functionality. I wasn’t sure if the Pixel 6 purchased from the Japanese Google online shop would have the chip or not, since I could not find any explicit reference to it. However, it seems to work.

First I tried to directly charge the phone with cash at a machine at train station but the phone wasn’t recognized when I placed it into the charging cradle.

Then I tried to install and setup the Mobile Suica app, a truly horrible piece of software that must have roots in the pre-smartphone era. No joy! It turns out there is also a Pasmo app in the Google Play store. Uusally I treat Pasmo and Suica as synonymous since they’re different brand names for the same technology but in this case they’re not the same thing. The Pasmo app was really easy to install and set up. I selected the configuration without personal details (i.e. not linked to a bank account or credit card) and everything went smoothly. Charging it at the train station worked and so did a payment at a convenience store.

So how about the camera, the main reason I bought the phone? I tested it on Monday, which was a public holiday (Coming of Age Day), on a 162 km bicycle ride in west Izu. The weather was perfect for the numerous Mt Fuji views. I took shots from morning to after sunset, many of them telephoto shots zooming into Mt Fuji (see image above and below).

I will be able to make good use of this on my bike rides.

Hokkaido wind power for Japanese energy

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Nikkei reports (“Japan pushes for undersea cables to solve wind power puzzle”, 2022-01-02) that the government is allocating 5 billion yen (about US$43 million) in its supplementary budged for a feasibility study for a 4 GW high voltage direct current (HVDC) link between the power grids of the northern island of Hokkaido and the main island of Honshu, where most of Japan’s population lives. This would be by far the biggest HVDC link ever built in Japan. The Japanese government wants to generate 45 GW of power from offshore wind in 2040, up to about a third of which (14.65 GW) is to be produced in Hokkaido. The development plan lists several promising offshore areas along the southwest coast of Hokkaido.

For this power to be available to consumers outside the northern prefecture, it would need to be exported via a HVDC link. This is the preferred technology for shifting large amounts of power over long distances, especially between AC grids not synchronized with each others or operating on different frequencies. Since 2019 there have been two 300 MW HVDC links between the two islands. Their combined capacity is to be doubled to 1.2 GW by 2028.

Japan has relatively little capacity for transferring power between its regional grids. This is because its grids used to be operated by regional monopolies that had little incentive to ever import or export power. This lack of interconnect capacity became a major problem following the power shortage after the 2011 Tohoku earthquake and tsunami when less affected areas could not help out the most affected region. There is a conflict of interest between the local utility companies and the country as a whole. Tepco owns a lot of nuclear power stations, expensive infrastructure with huge sunk costs. It would rather generate power from these plants than pay another supplier from outside its area for renewable energy. However, many of these power stations have yet to be restarted since their shutdown following the Fukushima meltdowns. By restricting how much power can be imported from other grids, Tepco can put pressure on regulators to allow it to restart more reactors to ensure a stable supply of power. On the other hand, expanding interconnect capacity would ease the pressure. Which side will the Japanese government take?

A related issue is the variable output of renewable power sources. Long distance transmission will make it easier to compensate for local weather patterns by shifting power between different regions, which allows a larger share of renewable energy to become part of the mix without having to resort to either energy storage or peaker plants (e.g. gas turbines to cover peak loads). That again means Tepco loses leverage to maintain coal and other fossil fuel powered generating capacity as insurance against shortfalls of renewable energy.

China, one of Japan’s main economic rivals in the world, has pursued a completely different course. Over the past decade it has aggressively expanded long distance HVDC links to stabilize its grid. Japan operates a single HVDC link of at least 1 GW, a 1.4 GW link between Honshu and Shikoku that started operating in 2000. All other links are only in the several 100 MW range and most of those are not long distance lines but back-to-back local interconnects, for example between the 50 Hz grid of eastern Japan and the 60 Hz grid of western Japan near Nagoya. By contrast, China has built over 20 HVDC links over 1 GW, mostly with a capacity of 3 GW or more. Many of the biggest projects cover distances of 1,000 to 2,000 km. This allows China to supply it coastal megacities with hydroelectric power from its southeastern mountains or from other power sources from its arid central parts. China is the world leader in wind power. Its windiest parts are along its border to Mongolia and on the Tibetan plateau. Large scale HVDC is key to China’s energy policy for the 21st century.

An alternative to shifting power long distance is to use it to locally generate hydrogen from water (“green hydrogen”) and feed it into pipelines or use it to make ammonia. This makes some sense for applications that already use hydrogen, such as the fertilizer industry or for carbon free alternatives to existing technology, such as direct reduction of iron ore for steel making without using coking coal. However, it makes little sense to use green hydrogen for power generation: if you convert electricity to hydrogen which you then use to generate electricity, more than 70 percent of energy is lost in the process while less than 30 percent remains. By contrast, batteries are 90 percent efficient. Therefore, if excess wind or solar power is used to produce hydrogen, that resource should best be used by industries that directly consume hydrogen, until all fossil fuel currently used for such purposes has been replaced.

If Hokkaido had a surplus of hydrogen from wind power, it would make more sense to have it consumed by steel works and fertilizer plants built in the prefecture rather than sending it through a pipeline to Honshu.

Although green hydrogen or ammonia can be used as fuel in thermal power plants in place of coal or LNG, it would be a terribly wasteful use. Because of the huge conversion losses, we would need three times more wind or solar power to end up with the same amount of usable electricity than if we used grid-scale battery storage to absorb any surplus and make it available when needed. This advantage makes grid-scale battery storage a strategic technology.

Most existing Li-ion batteries depend on relatively scarce resources such as cobalt, nickel and lithium. Lithium-iron-phosphate (LFP) batteries only require lithium and widely available materials, while sodium ion batteries use only readily available raw materials. Japan will need to invest in high capacity long distance HVDC links as well as in battery storage to speed up its transition to a carbon neutral economy.

Japan’s sixth COVID-19 wave and third doses

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Compared to over 100,000 new cases a day in countries like the UK and France (each with roughly half the population of Japan), 500+ Covid cases in Japan may seem almost trivial. Japan has recently experienced something of a post-5th wave honeymoon after months of falling cases, but that is set to end very soon.

As of today (December 31), the weekly average of new cases in Tokyo has been higher than the weekly average one week earlier for 23 consecutive days. In the entire month of December the 7-day average only decreased week on week on 4 days, all of them towards the beginning of the month.

What’s more, the rate of increase is going up. Before Dec 19, the highest week on week increase was 1.26. Since then it has been 1.40 or higher. Today’s weekly comparison reached 1.68, the highest since August 4. Only six days in the 5th wave had a higher weekly increase, all between July 30 and August 4, when Delta cases outgrew Alpha cases.

Is this because the more infectious Omicron strain is outgrowing Delta now? Most likely not yet! The number of confirmed Omicron cases from community spread is still small compared to Delta. That means the cause is likely to be social: People are feeling relatively safe because of the much lower case count compared to last December’s 3rd wave and also they want to do things that they will most likely not be able to do in a couple of weeks, once Omicron takes over. Sadly, that’s exactly how Omicron will take over. We’ve entered super-exponential growth, even if it’s from a low basis.

What’s the Japanese response to this? So far, no new restrictions have been imposed yet. Opportunities for free testing, regardless of symptoms, have been expanded. However, the plan for 3rd vaccine doses has been left virtually unchanged. The booster program was originally created when it was found that immunity to Delta dropped after a number of months. Japan then decided on an 8 month interval between 2nd and 3rd doses. However, it takes a much higher level of antibodies to neutralize the heavily mutated Omicron strain, even if you’re still far from 8 months. A third shot of Pfizer/BioNTech will raise vaccine efficiency against symptomatic infection from under 30 percent to over 70 percent, close to what it was for Delta with two doses. Japan has not responded to this new reality yet. The official policy on the Cabinet Office website still states that 3rd doses are due “in principle” after 8 months. That means, people who were vaccinated in August and September are not due for booster shots until April or May. There is no question that Omicron will blow up into big number in January and February already.

It may be some comfort that the number of cases in Tokyo on New Year’s Eve 2021 was only 6 percent of the cases of a year before. On the other hand, it took South Africa only 14 days to go from a weekly count of ~2,000 cases to ~33,000 cases when Omicron arrived. Do the math!

From December 2 (the first day of the booster campaign) to December 28, the latest date for which data is available, Japan has deployed 531,296 third shots to healthcare workers. That’s just 11% of the healthcare workers who received 2 doses and about 0.4% of the entire population. That means before the New Year starts, 8 out of 9 healthcare workers who will soon have to be dealing with an onslaught of Omicron cases have not yet had their immunity level doubled.

In many countries in Europe, between 20 and 50% of the adults with 2 doses have received their third dose already and yet they are experiencing tens of thousands of cases. For example, Portugal, which has only 70% of the population of Tokyo but a higher rate of two vaccine doses in its population and where a quarter of the population have had 3rd shots, counted over 17,000 new cases on December 29. Tokyo counted a mere 76 cases.

While two doses will still offer good protection from hospitalization and death, they will not prevent a rapid increase in cases. On present plans, the third shots will come too late for many healthcare workers and senior citizens.

The other lines of defense should be masks and ventilation. Most people in Japan do not yet use high grade masks such as N95/KN95/FFP2/KF94/JN95 and I am seeing little effort to promote their use over regular surgical or other masks. Likewise, there is little emphasis on preventing airborne spreading, such as installing HEPA filters, upgraded ventilation, etc.

Omicron and Japan’s sixth COVID-19 wave

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Three members of a family hospitalized with Covid-19 symptoms in Osaka have tested positive for the Omicron variant. They are the first cases reported in Japan without a travel history or linked to someone with travel history. All other cases were either detected at immigration inspections or in quarantine or linked to someone who had recently arrived from abroad.

It must be assumed however that there are many other cases that remained undetected and spreading under the radar screen. As the Washington Post reported on December 15, the Philippines had quarantined a man on December 1 who had tested positive on arrival from Japan and who was later confirmed to have been infected with Omicron. It therefore sounds likely that there was already some community spreading in Japan three weeks ago, soon after the variant was isolated by scientists in South Africa.

During the Delta-driven fifth wave in July/August, the 7-day average of cases peaked on August 24, with the health care system in crisis. At that point the reproduction rate fell below 1. For several weeks the fall was so steep, cases almost halved every week. The most likely explanation for that was increasing immunity in the population from a successful vaccination campaign in combination with continued wearing of masks and reduced mobility (e.g. working from home, less eating out in restaurants). After two months the reproduction rate slowly increased again but as long as it stayed below 1, it still resulted in a further reduction of cases. Weekly cases reached a temporary minimum on November 9. For about a week, cases slightly increased before sliding again at a somewhat slower rate than before. Since then the reproduction rate has been gradually drifting up. Since the minimum in late November/early, December Tokyo cases have been rising from a very small basis of about 100 cases per 7 days, 99.7 percent below the 33,000+ cases per 7 days in late August. They are now around 200 cases per 7 days, a doubling in three weeks.

For the last 4 days the 7-day average increase from a week earlier has been over 40 percent, which is equivalent to a doubling every two weeks. This is not really surprising. Once cases had dropped to less than one percent of the peak, people felt safe to resume activities that they had not been able to do for a very long time, such as enjoying year end parties or having wedding receptions with guests. They felt the risk was low enough.

However, Delta has not gone away. It is still around and as people’s level of antibodies from vaccines gradually wanes, they become more susceptible to infection again, even if they remain largely protected against hospitalization or death. This is compounded by greater risk-taking when cases are perceived to be “rare enough.”

We knew that Omicron would eventually spread in the community. When it does, it will not immediately replace Delta. For a while, both will be increasing but at different rates. A level of immunity and non-medical interventions (such as mask-wearing) that is only just about adequate to control Delta will be unable to halt the spread of much more infectious Omicron. Under the current conditions where even Delta cases are increasing, we would continue seeing Delta grow relatively slowly while Omicron cases would explode. Eventually, especially as hospitals start to fill, people will modify their behaviour to reduce exposure, for example by avoiding restaurants or by using KN95/KF94 masks instead of surgical masks or cloth masks. This would then push the reproduction rate of less infectious Delta below 1 and its cases would fall while cases of more infectious Omicron would still increase but at a slightly reduced rate. That is the point from which Omicron will start to replace Delta rather than spread in addition to it.

Third doses can reduce the exposure to Omicron, especially for the older generations who were first to get vaccinated this spring and summer but Japan has not taken any measures yet to speed up the additional shots. From the beginning of December to December 21, third shots averaged a mere 10,000 per day which is less than one percent of the rate achieved and maintained for several months in the Summer.

Japan is still running its booster campaign as if its only purpose was to prevent a resurgence of Delta (like in Israel last summer) rather than to protect the population as well as possible against the immunity escape that comes with the new Omicron variant. This has to change.

I can only hope that the first official case of community transmission of Omicron will galvanize the government into action for dramatically speeding up the distribution of third shots, especially to senior citizens and people with medical conditions that make them more vulnerable.

Waiting for Vaccine Boosters in Japan

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In the spring of 2021 Japan was running about 4 months behind the US and much of Europe vaccinating its population against Covid-19. Vaccinations for senior citizens did not start ramping up significantly until May when other countries had started in December 2020 or January 2021.

After Israel and then the US decided to go for 3rd shots to boost immunity after antibody levels dropped months after 2nd shots of Pfizer and Moderna, Japan also negotiated for booster shots from Pfizer and Moderna. The government went for an 8-month interval and planned for 3rd shots for healthcare workers from December 2021 and the general population from January 2022, with eligibility starting 8 months after the second shot.

Then came Omicron which significantly escapes immune system responses from antibodies. Without boosters protection against symptomatic infection drops significantly with this new variant, as it takes a much higher concentration of antibodies in the blood serum to achieve sterilizing immunity. Long term T-cell immunity, which still protects against hospitalization and death, is much less affected.

In the city of Setagaya, Tokyo where I live, those who have received their second dose at the end of June will receive tickets by the end of January that will allow them to make vaccination appointments some time in February. So far no date has been announced for the group I’m in but having received my shots in July, I probably won’t be getting those tickets before late February and no booster appointment before March. It’s going to be a very long three months when some European countries are expecting to be Omicron-dominated by Christmas, within 4 weeks of the WHO having awarded B.1.1.529 its new name!

Japan is talking to Pfizer about moving part of the 78 million booster doses due for delivery in Q1 2022 forwarded so they can be dispenses sooner. However, former vaccine czar Kono Taro recently pointed out on his personal blog that Japan has enough leftover vaccines still in stock to give 56 million booster shots without waiting for any supplies from Pfizer or Moderna.

In order to protect the public from the new coronavirus, efficiency and speed are more important than equality and fairness.

Some people say that if the vaccine is brought forward, the supply of the vaccine will not be sufficient in time.

At present, Pfizer and Moderna have about 10 million doses of vaccine in stock in the market.

There may be a few doses that have been discarded, but there is no way that 1 million doses were discarded.

In addition, 4 million doses of Pfizer have already been distributed to local governments.

Another 12 million doses of Pfizer will be distributed next week and the week after.

In addition, we have 15 million doses of Moderna in stock for this year, and since the third dose of Moderna is only half the amount of the first and second doses, we will need 30 million doses for the third dose. This will be 30 million doses.

This means that 56 million doses of vaccine could be distributed by the end of the year.

In the first quarter of next year, Pfizer will distribute 30 million doses and Moderna will distribute 24 million doses. In the first quarter of next year, Pfizer will receive 30 million doses, Moderna will receive 24 million doses, and the third dose will be 48 million doses, for a total of 7.8 million doses. In the first quarter of next year, Pfizer will receive 30 million doses, Moderna 24 million doses, and 48 million doses for the third dose, for a total of 78 million doses.
(３回目のワクチン接種, 2021-12-09 [translation by DeepL])

The Japanese government can not blame a slow booster vaccination campaign on a lack of supplies. It needs to act as quickly as possible. The day before yesterday, Germany gave about 1.3 million booster shots in one day.

While officially no community spread of Omicron has been detected in Japan yet, that may simply being because they are not looking for it hard enough.

On Wednesday, 2021-12-15 the Philippine government reported its first Omicron case, a Philippine resident of Japan who had arrived from there on December 1 and tested positive. He had symptoms of a cold at the time. After the positive test the sample was sequenced and determined to be Omicron. This suggests that most likely Omicron was already circulating within Japan two weeks ago. Regardless, it will officially be here very soon.

Once it hits the hospitals, many nurses and doctors are likely to get infected and may have to quarantine. As of today, only about 149,884 of about 5 million healthcare workers (about 3 percent) who had been fully vaccinated have received a third shot. That’s after two weeks of booster campaign. 97 percent are yet to receive their booster. Only 0.11 percent of the Japanese population have received a 3rd shot. In many European countries it’s 20 percent and more.

The vaccination of the elderly is not even due to start until another two weeks from now. There are 52 million people in Japan who have received two doses and are age 50 or above. We should use the doses that we have now as soon as we can.

We really have no time to lose.