Before the Games were pushed back, Japan appeared to have its outbreak largely under control. Despite the global pandemic, organizers maintained they were forging ahead with preparations for the 2020 Summer Olympics to kick off in Tokyo on July 24, and they encouraged athletes to do the same.
On that day, Japan had reported just 1,140 diagnosed cases of COVID-19, the disease caused by the new respiratory virus, according to data compiled at the time by Johns Hopkins University. As of Thursday night, that tally was up to around 5,500, not including the 712 cases linked to the Diamond Princess cruise ship that docked in Tokyo earlier this year, according to figures published by Japan's national broadcaster NHK. By prefecture, Tokyo tops the list of infections with over 1,500.
Over 100 people in Japan have died from the disease so far, including 11 from the cruise ship, according to NHK. There has been a threefold increase in deaths since the Tokyo Games were postponed.
The sharp rise in cases and deaths has prompted speculations that Japan had previously understated the scope of its outbreak. Several Japanese citizens, whom ABC News spoke to on the streets of Tokyo, said they believe the government was trying to keep the numbers low so that the Olympics would take place as scheduled.
However, a doctor in Tokyo who talked to ABC News on condition of anonymity said he didn't believe there to be a cover-up but rather that red tape has kept testing to a minimum to prevent hospitals from overcrowding.
ABC News has reached out for comment from the Japanese government.
The Japanese government has maintained publicly that their strategy all along has been to target clusters of cases rather than conduct mass testing, which officials say has kept Japan from the brink so far. Officials link the recent increase in infections to people coming into the country from abroad. The Japanese government has also admitted that infection routes cannot be traced in a rising number of cases. The prime minister, however, has pledged to ramp up testing.
Japan's National Institute of Infectious Diseases declined ABC News' request for access to videotape its laboratory activities and COVID-19 testing, citing security concerns and biohazard risks.
An administrator at the public health center for Tokyo's Shinjuku ward who only gave his name as Aria told ABC News they're getting calls from a rising number of residents who want to be tested for COVID-19.
"We’re receiving over 200 [calls] per day," Aria said. "Concern among the people is on the rise. Our people answering phones can’t get a break."
Abe on Tuesday declared a monthlong state of emergency -- but not a lockdown -- for Tokyo and six other prefectures to stem the spread of the deadly virus in the world's third-largest economy. The Japanese government does not have the legal authority to enforce the kinds of lockdowns seen across Europe, where fines and other penalties have been imposed. So instead, officials have asked the public to practice "jishuku" or self-restraint by voluntarily heeding their calls to stay home and close businesses.
"What this means is that the Japanese people are required to voluntarily follow the government, without the latter providing incentives or compensations in return to the people and, importantly, without taking responsibility for what is in real terms government orders," Koichi Nakano, a political science professor at Sophia University in Tokyo, told ABC News. "So the containment policies are made by the government, but their costs are borne by the people who 'voluntarily' restrain themselves."
Nakano said Japan's unique approach to combatting the virus is a disjointed combination of two things: the absence of political interest and leadership on the one hand, and the bureaucratic denial and risky experiment on the other.
"The Japanese ruling elite form a class of their own, out of touch with the reality of the daily life and concern of the people. They are preoccupied with the Olympics and have prioritized the resume of what remains of Abenomics over serious countermeasures against the spread of the virus," Nakano told ABC News, referring to the economic policies enacted by Abe at the outset of his second term. "In the absence of clear and firm political leadership, the bureaucrats and public health experts who are left to devise the government policies continue to refuse to face up to the magnitude of the outbreak and have also committed Japan to a 'unique' and highly-risky approach that is based on a certain 'cluster infection' theory."
Nakano said the hypothesis was that the virus outbreak could be combatted through a narrow focus on clusters of infection, while ignoring the infections that do not result in clusters.
"If the theory worked and if people voluntarily bore the cost of social distancing," he noted, "then the state would have enough medical resources to treat the severely ill patients, according to this approach."
The problem unfolding now is that the theory failed and the Japanese government did nothing to enhance state capacity to cope with an eventual explosion in the number of severely ill patients, according to Nakano.
"[The government] has consistently, grossly under-tested," he said. "And as a result, to date, there is no data to base judgment on the scope and speed of the infection."
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Reporting by Anthony Trotter in Tokyo, Japan. Writing and additional reporting by Morgan Winsor in London, United Kingdom.