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Japan's medical system strained as coronavirus patients fill up available beds

In this Jan. 28, 2020 file photo, the head of the Infections Disease Center of Rinku General Medical Center in Izumisano, Osaka Prefecture, explains an advanced type of hospital bed. (Mainichi/Kenji Konoha)

TOKYO -- Several local governments in Japan have expressed a sense of crisis over the strain the novel coronavirus pandemic has placed on medical institutions, as securing enough beds for patients is the key to preventing a collapse of the medical system.

"We still can't say there are enough hospital beds," an official of the Ishikawa Prefectural Government in central Japan said with a sense of panic. The Mainichi Shimbun conducted an interview with major local governments on April 28, and found that 132 of the 170 available beds in Ishikawa Prefecture were already filled with inpatients -- nearly 80% of the total.

Shortages of hospital beds are also a concern in other areas. The southwestern Japan prefecture of Fukuoka, one of the first seven prefectures to be subject to a state of emergency over the coronavirus, secured 300 beds for patients, but 215 patients have already been hospitalized. With over 70% of the beds filled, the governor has asked large-scale hospitals to start accepting coronavirus patients who are moderately ill.

In Saitama Prefecture, north of Tokyo, inpatients fill 277 of 457 available beds, or about 60% of the total. Medical institutions designated to handle infectious diseases initially had beds for 75 inpatients, but at least 100 people are hospitalized now. A prefectural official said, "We need to secure more hospital beds on the assumption that there will be a steep rise in coronavirus patients after the long Golden Week holiday period ends."

In the western Japan prefecture of Hyogo, inpatients have filled up 258 of 454 hospital beds. Though only 57% of the beds are used by COVID-19 patients, the prefectural government says, "Letting down our guard may lead to an increase in infections."

A government expert panel analyzed on May 1 that the medical systems in "special alert prefectures" remain under pressure. Though new infections are decreasing, patients are hospitalized for two to three weeks on average. Meanwhile, since late March when coronavirus cases began to surge, the number of people with severe symptoms including those who need to use ventilators has risen sharply.

According to ECMOnet, a group comprising the Japanese Society of Intensive Care Medicine and other bodies, only 59 patients had been using ventilators as of March 20, but the number increased to 315 -- more than five times the original figure -- as of April 27. Doctor Akifumi Imamura of the Tokyo-based Komagome Hospital, explained, "It will take a while for the burden on the medical system to ease off."

Tomotoshi Iseki, professor of community medicine at Josai University, said, "There are many patients with mild or moderate symptoms, but the number of medical institutions that accept them varies from region to region, and there tend to be few available. Prefectures need to work together, and the central government needs to implement fiscal measures covering medical institutions and facilities that can accommodate patients to promote their acceptance."

There are many cases in which medical institutions decline to accept potentially infected emergency patients over the fear of in-hospital infections. Iseki says it is important to prevent the spread of infections by extending the state of emergency.

The government expert panel also says that in order to ease strict regulations, such as refraining from going out, it is essential to establish a health care system where patients can be accepted to different hospitals depending on the severity of their symptoms, and where it is possible to get a swift grasp of hospital bed availability and share the information.

(Japanese original by Takashi Kokaji, Regional News Department, and Eri Misono and Yuki Ogawa, Lifestyle and Medical News Department)

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