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Looming coronavirus bed shortages prompt Japan local govt's to secure more hospitals

The athletes' village for the Tokyo Olympic and Paralympic Games is seen in the capital's Chuo Ward on March 24, 2020. (Mainichi/Kaho Kitayama)

As the number of novel coronavirus infections keeps increasing in Japan, there are growing concerns over a possible shortage of beds for people who have tested positive for the virus as they are subject to hospitalization even with mild or no symptoms.

The sense of alarm is especially high among urban areas for a possible explosive increase in coronavirus cases, a phenomenon called "overshooting," and the prefectural governments of Tokyo and Osaka are scrambling to build up a medical system to secure enough hospital beds to prioritize treatment of those with severe symptoms. These two prefectures are home to the highest and second highest numbers of coronavirus cases in the country.

In Tokyo, 394 people had been hospitalized due to the new coronavirus as of March 30, amid the spike of patient numbers in the capital. The figure is already well over the 140 slots that the capital's 12 medical institutions designated to treat infectious diseases can accommodate. Authorities are barely managing the situation even with the cooperation of private hospitals.

On March 25, 41 new cases of the novel coronavirus were confirmed in Tokyo, and the corresponding figure spiked to a daily high of 78 on March 31. While patients with mild or no symptoms account for about 80% of the cases, all those who have tested positive for the virus are hospitalized based on the infectious diseases control law. As a result, more and more hospital beds are being occupied.

Following the precedent of responses to the 2009 outbreak of a new type of influenza, the Tokyo Metropolitan Government has secured additional medical institutions to accept patients that are beyond the capacity of designated hospitals, and has subsidized them for the cost of installing virus leak prevention and other equipment. Furthermore, the metro government has sought cooperation from other ordinary medical institutions, managing to secure a total of 500 hospital beds thus far.

However, as medical facilities in the capital have already accommodated patients from the coronavirus-hit Diamond Princess cruise ship and people who tested positive during quarantine at Haneda Airport, they do not have enough space to accept more patients.

According to the metropolitan government, some medical institutions with enough equipment to accept coronavirus patients are reluctant to do so out of fear of possible harmful rumors and transmissions to medical staff, amid the lack of any curative drugs or vaccinations like those for influenza.

"The situation is becoming increasingly difficult," said a metropolitan government official responding to coronavirus issues.

Under a policy compiled on March 23, the metro government aims to secure up to 700 hospital beds to accept severe patients and another 3,300 beds to treat moderate cases. These targets were set based on potential inpatient figures estimated by the central government, which comes to 20,500 a day in Tokyo at peak times.

"It's not easy to increase the number of beds to those levels," the same official lamented.

In Osaka Prefecture, whose 200-plus coronavirus cases are the second largest after Tokyo, the prefectural government is rushing to secure 600 hospital beds including those at private medical institutions, and ultimately aims to secure 1,000 beds in total. In order to prevent a breakdown of medical systems due to an overwhelming number of coronavirus cases, the Osaka government launched what it calls a "hospitalization follow-up center" in March in a bid to adjust patient distributions to hospitals depending on their conditions.

"The medical system won't be able to survive if specialized hospitals accept those with mild or no symptoms. The measure is intended to protect severe and high-risk patients," said Osaka Gov. Hirofumi Yoshimura.

The Tokyo government also prefers to have mild patients recuperate at home in order to avoid a situation where medical institutions become too preoccupied to cope with severe patients.

Tokyo Gov. Yuriko Koike met with Prime Minister Shinzo Abe on March 26 and requested that the national government review the operation of the infectious diseases control law to allow coronavirus patients with mild or no symptoms to recover at home or accommodation facilities.

At a regular press conference the next day, Koike referred to the possibility of using the athletes' village for the Tokyo Olympic and Paralympic Games in Chuo Ward to temporarily accommodate mild cases. The facilities are set to be turned into condominiums after the Tokyo Games.

(Japanese original by Koichi Uchida, Tokyo City News Department, and Toru Tsukui, Osaka City News Department)

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