Abstract
Despite substantial inflow of infected cases at the early stage of the pandemic, as of the end of April, Japan manages the outbreak of COVID-19 without systematic breakdown of health care. This Japanese paradox - limited fatality despite loose restriction - may have multiple contributing factors, including general hygiene practice of the population, customs such as not shaking hands or hugging, lower prevalence of obesity and other risk factors. Along with these societal and epidemiological conditions, health policy options, which are characteristic to Japan, would be considered as one of the contribution factors. Some health policy factors relatively unique to Japan are described in this article.