Tokyo has not seen an increase in overall deaths during the coronavirus outbreak, boosting officials’ assertions that they have largely kept infections under control despite criticism over the limited scope of its testing.

The capital saw 33,106 deaths in the three months through March, 0.4 percent fewer than the average of the previous four years for the same period, according to data from the Tokyo Metropolitan Government. Data for April, when new daily virus cases peaked in the city, is not yet available.

The data does not provide details on the causes of death, but underlines that there hasn’t been a surge in deaths during the pandemic despite Japan having some of the earliest confirmed cases in the world outside the original epicenter in China. There were 1,200 fewer deaths in February this year than in the same month in 2019, while they rose by 428 in March.

Excess mortality has been widely proposed as a method to grasp the true scale of the fatalities from the coronavirus outbreak. The figure includes those who died without being tested for the virus as well as those who may have died of other causes but couldn’t seek treatment due to an overloaded medical system. New York City had four times the number of deaths as expected during its COVID-19 outbreak, according to one study.

Coronavirus cases in Tokyo rose significantly in April, when the capital began to see around 200 infections on many days. However, cases have dropped since the government declared a state of emergency, with fewer than 40 in the capital every day for the past week. Another 28 cases were reported in Tokyo on Tuesday, raising hopes that the state of emergency — set to be lifted in many areas as early as this week — will also be removed in the capital by the end of the month.

Japan has not adopted the mass-testing regime seen in some nations, which has led critics to contend that the scale of the outbreak is much larger than the official statistics suggest. A series of isolated cases of unusual deaths later discovered to be coronavirus victims led some credence to this theory.

As of Tuesday, there were 633 deaths in Japan attributed to the virus, far fewer than the some 80,000 in the U.S, and 32,000 in the U.K., with Japan having the fewest confirmed cases and deaths of any Group of Seven leading democracy. Japanese authorities have placed a high emphasis on identifying infection clusters and limiting their spread.

While authorities have acknowledged that, similar to other countries, the true size of the infection in Japan is unknown, they have said they’re confident in grasping the scale of the casualties. Tokyo, with an estimated population of about 14 million, has had the most confirmed cases in Japan.

“Japan conducts surveillance for pneumonia, so almost all cases of pneumonia undergo a CT scan, and most of those would do a PCR test — so I think we are picking up the right numbers of deaths,” Shigeru Omi, the deputy head of the government’s advisory panel on the virus, said at a May 4 news conference.

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