As It Happens·Q&A

Why are COVID cases spiking in the U.K., but dwindling in Japan?

André Picard, a health columnist at the Globe and Mail, has been covering COVID-19 since it first emerged, and says each government's success or failure comes down to how quickly they're willing to act, and whether the people are willing to listen. 

Globe and Mail health columnist Andre Picard says it comes down to policy and culture 

People wearing protective masks make their way at a shopping district in Tokyo, Japan, on Sept. 9. (Kim Kyung-Hoon/Reuters)

Story Transcript

A year-and-a-half into the global pandemic, COVID-19 trends remain difficult to predict. 

The United Kingdom showed early success with its vaccination efforts, only to see cases shoot up again. Japan, which saw hospitals overwhelmed by COVID in the summer, has since seen cases plummet to an 11-month low.

In Canada, where the pandemic response has been largely the responsibility of provinces and territories, there's a similarly uneven patchwork of cases. Saskatchewan and Alberta are currently facing a crisis unlike any of the other provinces, with soaring cases and jam-packed intensive care units.  

They are rivalled only by the Northwest Territories, which as of Tuesday, had the highest rate of active COVID-19 cases in the country — more than double the rate of Saskatchewan, which has the second highest.

The Globe and Mail's health columnist André Picard has been covering COVID-19 since it first emerged, and says each government's success or failure comes down to how quickly they're willing to act, and whether the people are willing to listen. 

Here is part of his conversation with As It Happens host Carol Off. 

Let's look at Japan first. Because we were looking at a huge spike in cases not very long ago in August. And now it's like business as usual. What happened there?

They've gone from about 6,000 cases a day to 100, so quite dramatically. 

Japan was very late to vaccinate. They were very slow to start. But when they did it, they did it very quickly and very intensely, and they vaccinated a lot of people. They've caught up with most of the world in a very short period, and had an immediate impact.

What about mask wearing?

I think that's a big part of it. It's more traditional. It happens all the time during a flu season, during the fall, etc., on public transit.

I think there's also this notion that culture really matters. The civic duty, you know. When you're told to get vaccinated, you get vaccinated. [When] you're told to wear a mask, you do it. So it's really a country of rule followers, and we see in countries where they follow the rules, things go better much more quickly.

André Picard is a health columnist for the Globe and Mail. (

I remember not so long ago how envious we were of the U.K. and its success in its vaccination rollout. We were all thinking, oh my gosh, if only that could happen here. And now, look, they're having these massive numbers. So what happened in the U.K.?

They did have a great rollout at the beginning. They were a leader on vaccination. 

But then they lifted all their restrictions right at the end of the summer, and we've seen cases explode.

I think some of it is because they were the first to vaccinate, they're seeing some waning immunity, so that's not helping. But they're also just behaving as if there's no pandemic anymore. So there really are no rules, and it makes it really easy for the virus to spread.

U.K. COVID-19 cases surge, hospitals strained

1 month ago
The U.K. reported more than 49,000 new cases of the coronavirus Monday, raising fears of a difficult autumn and winter for health services. (Henry Nicholls/Reuters) 3:45

Let's compare this to Canada. And it's difficult because every province ran its own program, some of them very much like what you're describing in the U.K., where in Alberta there was a decision that was: "Everything is business as usual, let's have a great summer." And we know what's happening there. But [it's] even worse in [some of] the territories. So what lessons has Canada learned well, and which ones has it not?

The lesson we've learned is that, you know, if you take your foot off the pedal a little too soon, you pay the price. I think Alberta acted a little too rashly to get rid of the restrictions, and then it saw this soaring number of cases, which it's still paying for in hospitalizations, etc. Same in Saskatchewan.

So I think the lesson here is, you know, vaccination is important, but it doesn't mean we stop doing everything else. You can't have just one tool in your toolkit; you have to use them all. 

And I think a lesson we've learned from Day 1 in the pandemic is you always have to shut down quickly when things are going badly, and you have to reopen slowly. And, again, we haven't always followed that rule in Canada.

Since the beginning of the pandemic, you have been writing about the difficulty of trying to find that balance.... People need to be able to live. They need to get out and do things. At the same time, they need to protect public health. So has Canada always found that balance?

Unfortunately, we haven't found that balance.

We're very slow to act in Canada. You know, we're very small-c conservative. We're very cautious. And that serves us well most of the time. But it hasn't served us well in the pandemic, because we just don't bring in rules quickly. We don't do things 100 per cent. We do them kind of 85 per cent.

They've been doing things pretty close to 100 per cent in many of the Atlantic Canada provinces. And so, do you think they have found a balance?

The Atlantic provinces had the advantage of they've done this since Day 1. So it's really, really difficult now to impose harsh rules in jurisdictions where you haven't. So they were smart and then they did it from the beginning, and they stuck to it, and they've benefited greatly. Life is almost normal in the Atlantic provinces. And when things do go south, when they start seeing cases, they really clamp down quickly.

Had Ontario, Quebec [and] Alberta done that, they would be in a similar situation. But they've always been slow and they've allowed the virus to get a foothold for now four separate waves, and we'll probably be seeing a fifth wave.

[Premier] Jason Kenney in Alberta said that he had to let people out. He couldn't control them. He didn't have that capacity, didn't have the strength politically to restrict people the way that the Atlantic provinces' premiers have been able to. Are they just different national characters involved here?

I think we've underestimated all along through the pandemic the importance of that political culture.

We see it in countries where people are rule followers, where they believe in the collectivity. All those countries have done much better because there haven't been these fights about who gets vaccinated, etc. People just do it, and they do it for the greater good. 

As opposed to, say, the U.S., where there's much more individualism. We see that character much more in Alberta than, say, Nova Scotia. So yeah, that culture really, really matters.

We're about to face the next big test in this country, which is the rollout of vaccines for children, for kids between five and 11 years of age. And already we're seeing polls where even people who support vaccines for themselves are hesitant, reluctant, worried, concerned about getting their children vaccinated. So how can Canada move ahead with that very, very difficult hurdle?

It's about sending the message [that] if we want this to end, we have to have widespread vaccination. We can't exclude children. It's good news that they don't get as sick, but they can get very sick. Children can die. But more importantly, they spread it to other people. So the pandemic will never end unless we manage to vaccinate a large number of children as well.

Written by Sheena Goodyear. Interview produced by Kate Swoger. Q&A has been edited for length and clarity. 

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