Tokyo’s up-until-dawn nightlife scene is posing one of the biggest obstacles to reining in coronavirus cases, even as its famed “hostess clubs” are scheduled to fully re-open this week.

Nearly half of the 95 confirmed coronavirus cases found in the metropolitan area over the previous two days have been young men in their 20s and 30s that work at nightclubs in Tokyo’s Shinjuku district, according to domestic media reports. The Japanese capital is seeing infections spike after coming out of a state of emergency last month that helped bring daily cases to single digits.

Shinjuku is home to the Kabukicho red light neighborhood, known for bars where patrons pay to spend time socializing with male or female escorts who are called “hosts” or “hostesses.” Some of the close contact — including sharing drinks or singing together — could make infections spread more easily, experts said. The establishments are also typically in windowless spaces that are not well ventilated.

Key Risk

Nightlife establishments present a key risk for officials around the world trying to allow normal life and activity to resume in cities whose economies have been devastated by the pandemic. In Tokyo, the traffic drawn by bars and clubs support an ecosystem of small businesses like eateries and convenience stores.

“To find a balance between the economics and infection control is nearly impossible,” said Tetsu Okumura, an infectious disease doctor who oversaw a set of virus control guidelines for an industry association representing hosts and hostesses. “There’s an economic limit to how much business owners can afford to stay closed.”

Although Tokyo encouraged businesses like host clubs to stay closed until the last phase of re-opening set to start this Friday, following the guidance was voluntarily. Many reopened earlier, after the nationwide state of emergency was lifted in late May, or never closed at all.

“There are huge discrepancies in which clubs follow the rules and which don’t,” said Kaori Kohga, the head of the industry association representing hostesses and clubs.

By Friday, Tokyo will lift all restrictions on businesses, though individual companies may continue to implement their own guidelines. National restrictions on travel between prefectures will also be relaxed, though international borders will remain shut.

Japan has about 17,500 confirmed coronavirus cases as of Monday, while deaths have remained below 1,000, the lowest number among Group of Seven nations. On Tuesday, Tokyo found 27 additional cases, according to TBS.

More Testing

The rise in infections this week comes as more club and bar workers are being tested after initial clusters were found among them in the first week of June.

Nightlife has posed a particular problem across nations trying to curb the virus’s spread, given the close contact among bar and club-goers and the prospect of alcohol-fueled reckless behavior. Hong Kong and South Korea have both wrestled with outbreaks tied to clubs, and the latter especially faced a challenge in getting patrons of gay clubs to come forward for testing due to the country’s lingering homophobia. Health officials were able to bring the virus under control by setting up free, anonymous testing centers.

Anonymity is also an issue with Japan’s host and hostess bars. Many customers are reluctant to admit they patronize such clubs, making contact tracing more difficult if an infection is found. Over the weekend, officials put forth more non-binding guidelines for clubs and bars, including taking down customers’ contact information and maintaining space between guests. It’s uncertain how many will follow such guidelines.

Vulnerable Industry

Despite the risks, Japan plans to stick to its schedule for re-opening. Officials will continue to monitor the situation carefully and consult with the panel of experts advising the coronavirus response, economic revitalization minister Yasutoshi Nishimura said Monday.

Still, as the testing continues among Tokyo’s host clubs, more infections are likely to come to light, a fact that may invite discrimination and be harmful for club operators, Kohga said.

Such businesses are particularly vulnerable to a stricter shutdown. Some weren’t able to claim small business subsidies offered by the government during the state of emergency, as aid was limited to establishments that mainly serve food. Also, many of the hosts and hostesses that work at the clubs are living paycheck to paycheck.

“There’s many hosts that are barely getting by with one meal a day,” Kohga said.

The dilemma on reopening Tokyo goes beyond the nightclub scene, said Yoko Tsukamoto, a professor of infection control at the Health Sciences University of Hokkaido. “They’re probably struggling with this, but it’s not just host clubs. Wherever you go, if you share things to eat and drink, it’s a risky behavior.”