“I am determined to have all eligible senior citizens vaccinated for COVID-19 by the end of July.”

　　　　　On the heels of this pledge by Prime Minister Yoshihide Suga on May 11, a vaccination program for senior citizens over 65 years old has started across the nation. On May 22, I got my first shot at a nearby community center in Minato Ward in central Tokyo. The ward’s inoculation program started five days before, on May 17. Frankly, there was plenty of room for improvement here and there in the program, as ward authorities obviously were new to this undertaking.

　　　　　Arriving at the center a half hour before my 12:30 p.m. appointment, I was led by an attendant to a waiting room on the fourth floor, where I saw around 20 people waiting with the required documents: an inoculation ticket, a medical questionnaire, and a form of identity.

　　　　　Appointments are every 15 minutes. With those with noon appointments apparently having already been ushered into the inoculation booths, the waiting room was rather quiet. I looked around to find staff in matching T-shirts, about the same number as those of us waiting, going about their business.

　　　　　Some ten minutes later, an attendant announced: “Those of you with a 12:15 appointment, please step up.” Several people rose from their chairs simultaneously to head for the registration desk but were quickly reminded that “only two” could submit their documents at a time. So all but two had to take the trouble of walking back and sitting on their chairs again. I thought all they should have done was stand in line by keeping a decent social distance from each other, instead of taking their seats again.

　　　　　When the next duo walked up to the desk, one man was found to have made the mistake of coming for his shot one day too early.

　　　　　“I’m very sorry but could you come back again tomorrow?” said one of the attendants.

　　　　　She was polite but the man looked sad as he left. I truly felt sorry for him. After all, he had come all the way for his shot. “Why can’t they make an exception for him and give him a shot today?” I wondered.

　　　　　There is no question we Japanese are in the midst of a national crisis. Desperate to have as many Japanese inoculated as soon as possible—a day or even an hour sooner—the Japanese government is doing everything in its power to implement a nationwide vaccination drive. All expenses are being covered, including of course the estimated 344 million doses that have been secured so far, enough to cover the entire Japanese population. This also includes remuneration for doctors and nurses and other support staff as well as the cost of courtesy buses transporting citizens to and back from vaccination centers. Other costs, such as partitions, chairs, and desks required to set up inoculation centers are also covered. These are the expenses the government sees as mandatory in order to stem the pandemic as soon as possible so the nation will be able to go back to a normal life again. The government is spending our tax moneys, so there is every reason each local government must perform its task with maximum efficiency.

　　　　　I sat waiting for my turn, wondering “why this inefficiency despite the good intentions on the part of the government,” when I heard an attendant call: “Those of you with 12:30 appointments please proceed.” Like the people who were in the earlier group, I took out my documents and was led into another room. There I found to my surprise another group of men wearing matching T-shirts, their number larger than those in the group I saw earlier. I want to emphasize that all these men were extremely gentle and kind, warning me for instance, to “please watch your step.” Their demeanor was much appreciated, but what was just as important to me at the time was for the inoculation to be given speedily.

Bound by Rules

　　　　　In this new room, I was asked to show my documents again. They verified my identity against an appointment sheet and my name was crossed out with a yellow marker. I was then once again instructed to wait, sitting on one of the chairs that were spaced apart. Altogether there were perhaps a little more than a dozen persons in the room. I wondered if that included everyone who had a 12:30 appointment.

　　　　　There were three desks in the back of the room, each occupied by two persons wearing white gowns—a doctor and a nurse. I expected to quickly be given my shot, but nothing happened. We senior citizens were sitting about six feet from the three doctor-nurse teams. The two groups silently looked back and forth at each other. The vaccines were undoubtedly ready, and so were the doctors and nurses. But nothing was happening. What is the use of acquiring these doctors and nurses if these hard-to-get human resources cannot be utilized fully and effectively?

　　　　　Time hung heavy on my hands. Five minutes passed and then another minute, but nobody moved. The clock on the wall said 10 minutes to 12:30 p.m. Only then did I come to understand the situation. Vaccines cannot be administered before the time of the appointment comes—regardless of how long the citizens have been waiting or whether the doctors and nurses are ready.

　　　　　In a location controlled by the ward, things progressed as programed under predetermined rules and regulations. A little before 12:30 p.m., a male attendant peeked into the three inoculation booths one after another, whispering: “Please start again.” But I heard the whisper loud and clear. Finally it was my turn to get the shot.

　　　　　Why does this operation have to be this inefficient, I kept wondering. As a nurse was giving me the jab, I felt a little anger rising in my heart. Actually, the female doctor and the nurse were very pleasant and the nurse did a good job jabbing the needle into my arm. I felt absolutely no pain. I was next led to the last room, where I was to rest for 15 minutes before going home.

　　　　　I then saw another nurse walking busily about, asking those of us in the room if everything was alright. I struck up a conversation with her and learned that most of the attendants I saw at the center were contract workers, that she herself was a contracted nurse, and that the center was staffed by only a small number of employees of the ward, if any.

Slow and Inefficient Operation

　　　　　I finally realized what the problem was with the center as I figured out why the woman at the first reception desk told the old man to come back for his shot the next day, instead of deciding to give him the shot on the spot. She simply had no choice but to say so. Ordinarily, I would have expected a response like: “You’ve come all the way for the shot, so wouldn’t you like to get the shot today although you mistook the date and came one day too soon?” As a contract worker, however, she obviously had not been authorized to say so.

　　　　　The absence of ward employees at the vaccination site leads one to suspect that the ward is turning too heavily to outsourced workers for some important aspects of its vaccination scheme. I assume the ward authorities are making their best efforts to carry out the program successfully, but their approach definitely is not working smoothly. It is not enough to say the national government is footing the entire cost and leave it at that. The actual execution of the program needs to be overhauled and made much more efficient.

　　　　　But then what I experienced that day was limited to Minato Ward, where I am registered as a resident. Of course my one-time experience at the ward community center doesn’t represent what is taking place in vaccination sites across the nation. I know of some local governments that are carrying out vaccinations efficiently. And I certainly hope things will have been significantly improved with experience by the time I show up again for my second shot in three weeks. And yet I still wonder what explains the slow operation that troubled me on May 17.

　　　　　On May 24 the government opened two large vaccination sites in Tokyo and Osaka, manned by medical officers and nurses from the Japan Self-Defense Forces (JSDF). I suspect that the government, alarmed by the lack of full backing from the Japan Medical Association and the sluggish vaccination efforts on the part of local municipalities amid the critical shortage of medical workers, eventually decided to turn to the JSDF as the last resort. Now that the government will cover all costs as mentioned earlier, I earnestly hope that local municipalities will forge ahead with their respective inoculation programs with full effort. Our leaders obviously are hopeful that our national crisis resulting from the Wuhan Virus will be overcome when the central government, local municipalities, and the people join hands firmly together.

　　　　　In Taiwan, where coronavirus infections have suddenly increased in recent weeks, President Tsai Ing-wei had her IT minister Audrey Tang successfully complete a system in just three days that enables the government to keep track of the activities and whereabouts of practically all Taiwanese. The government will hold personal information in order to prevent epidemics, and nobody will object. We Japanese must learn from the sense of crisis with which the people of Taiwan are earnestly fighting against the coronavirus.

(Translated from “Renaissance Japan” column no. 952 in the June 3, 2021 issue of The Weekly Shincho)