One year since the Noto Peninsula Earthquake, over 270 people have died from disaster-related secondary causes. Poor conditions at emergency shelters and lack of healthcare are among the contributing factors. Experts say these reasons are the same ones that led to death in past disasters, and the country's failure to identify systemic issues means they will be repeated again in the future. We search for ways to improve Japan's natural disaster response system and look at how a lack of clear communication between the national and municipal governments is leading to problems.