Covid-19 testing at Fujimino Emergency Hospital in Saitama Prefecture, on December 9, 2020.
Photographer: Noriko Hayashi / Bloomberg
Photographer: Noriko Hayashi / Bloomberg
Coronavirus infections in Japan are a fraction of the western countries, but the island nation is increasingly indicating that the highly regarded medical system is facing.
Although it is the citizens of the world who have the longest and have an abundance of hospital beds and medical equipment, the reports of overwhelming hospitals and deaths due to mild infections have expressed quarantine concern. Last week, the government extended a state of emergency over Tokyo and other regions, in part due to the insecurity of the health system.
The breach is a challenge to Japan’s reputation as a rich medical resource, and it’s another source of frustration for citizens who are already dissatisfied with the country’s management of the pandemic, which is seen as reactive and contradictory.
Given Japan’s relatively small amount of about 400,000 infections, questions are being asked about why the government says the medical system is under stress, a description that evokes scenes of overwhelming hospitals, such as in countries hit hard. Meanwhile, neighbors such as South Korea and China have adequately handled their recent waves of Covid-19.
Initially, most expected Japan’s health infrastructure to present the challenge. The health system is in the highest decile among 204 places investigated by SU Universal Health Coverage index, a measure that measures the effectiveness of 23 different aspects of a health care system.
As the pandemic progressed, the strengths of the system worked against it, showing how a predominance of private hospitals was established. in the direction of general and preventative care do not have the flexibility to respond quickly. Important weaknesses, such as a lack of doctors compared to the number of hospital beds, were also highlighted.
“To let the medical system break down like this, we really did not expect it, and we need to think about it,” Health Minister Norihisa Tamura said in an interview with Bloomberg on January 15. In the future, community medical care programs in Japan will need to have a strategy for pandemic response, he said.
Japan currently has about 33,000 patients in need of hospital treatment and has suffered about 6,000 Covid deaths, a relatively low number compared to other countries.
Love Docs
Japan is the best in hospital bed numbers, but its doctor numbers are low
Source: OECD
Japan’s medical system is dominated by private hospitals, which make up 70% of the 8,300 institutions nationwide, which include specialized facilities such as psychiatric and long-term care. During normal times, their competition for business increases the level of service for patients. But in an emergency for public health, it has led to a lack of coordination: medical systems in some towns or prefectures have empty beds that Covid patients can take, while others are overwhelmed.
Unlike in the US and the European Union, there was no central coordinating effort to transfer patients or medical staff from strained hospitals to those with free capacity. In December, the medical systems of Osaka and Hokkaido were under pressure from a surge in Covid-19 patients, and the country had to send medical personnel from the self-defense force to help. Meanwhile, there were plenty of unused resources in other prefectures.
Kagoshima in southern Japan had only two seriously ill Covid-19 patients and the intensive care unit was almost empty in early February, said Hiroyuki Morita, a medical journalist who is also a doctor at a nearby clinic. , said.
‘The Japanese health care system does not have the flexibility to respond quickly to situations, ”he said. “Things like relocating patients or staffing – you can do that in Europe, but not in Japan.”
Covid Hospitale
Most of the private hospitals in Japan cannot accommodate Covid-19 patients
Source: Japanese Ministry of Health
Another problem is that Covid-19 has been given a government designation that requires all positive patients to be admitted to hospital, even if they are not very ill. The rule has been relaxed to allow asymptomatic and mild cases to be quarantined in hotels or at home.
Yet Morita says that about 30% of those who tested positive are hospitalized in Japan, compared to the US, where the corresponding number is only about 2%.
Most private hospitals are small and have no specialized staff trained for infectious diseases. Only a third of private hospitals have the necessary requirements to take coronavirus patients, compared to about three-quarters of public hospitals, according to the Japanese Ministry of Health. Some private hospitals were also unwilling to embark on the Covid-19 effort for fear of becoming a place of outbreak or of avoiding paid patients.
Modular units at the Nippon Foundation’s treatment facility for Covid-19 patients in the Odaiba area of Tokyo, August 2020.
Photographer: Toru Hanai / Bloomberg
The government now subsidizes some hospitals to 19.5 million yen ($ 185,000) per bed for severe cases, and converted some publicly owned hospitals into Covid treatment centers. A recently revised law would allow governments to name and shame hospitals that do not admit patients, but by practicing physicians it is criticized as misunderstanding the limitations that hospitals face.
The country’s medical system needs to be better utilized, said Takao Aizawa, president of the Japan Hospital Association.
“There is a mechanism to protect the community through hospital-to-hospital collaboration,” said Aizawa, who also heads a private hospital in Nagano Prefecture. “If this system worked, we would not be in trouble.”
– Assisted by Emi Nobuhiro