There is one difference in Japan to Italy that might explain the lower infection rates: it's socially accepted to wear face masks (not only since covid but since the 90ies actually!)
Making mask wearing more acceptable might be a cultural adjustment humanity has to make as we become more urbanized and globalized if it'll help reduce the severity of disease transmission. Looks like Japan's stumbled onto a very useful societal adaptation.
[1] [2]
Germany 3.7 24.6
France 3.3 9.3
England 2.7 3.3
USA 2.4 20
Canada 2.4 13.5
Japan 2.2 4 to 5
2. Number of ICU beds (per 100,000 population)
Edit: Never mind, that was total number of hospital beds. The number of ICU units is really small.
https://link.springer.com/article/10.1007%2Fs00134-015-4165-...
Edit: nevermind, I misunderstood the definition of "Curative care (acute care) beds in hospitals".
https://www.nytimes.com/2017/11/30/world/asia/japan-lonely-d...
A lot of people seem to think that Japan must somehow have a higher infection rate but I haven't seen any evidence that this is true.
For all the docileness of the mainstream media and the lame-duck politics it is a free and democratic society. The government couldn't hide a mass outbreak of corona virus anymore than it has been able to hide any other scandal. In fact almost certainly less given the levels of public interest.
The Ministry of Health and Welfare publishes updated statistics daily (https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000164708_... -- in Japanese). looking at the current stats published there's not really any obvious problems. They're seeing about an 8% positive rate on corona virus tests and 1.8% of those with confirmed infections have died. This is well below the rates seen in Iran, Italy, America and China suggesting they've been relatively thorough in catching infections, although less so than South Korea.
In truth the Japanese healthcare system is probably the best in the world at providing population level care. Since long before Corona virus standards of hygiene have been very high. Masks and hand sanitizer bottles have been a common site for a long time, hand washing and gargling is heavily encouraged, and direct contact (hand shakes, hugs, back pats .etc.) is very restrained.
Whats more for all the criticism it copped the Japanese government has been pretty decisive in responding to corona virus. It's shut down schools. It's shut down public spaces (museums, libraries .etc.). It's discouraged crowds. It's encourage working from home. It's restricted travel from hot spots. It's isolated those with infections. Also most age homes seem to have gone into lock down weeks ago.