Hospital beds occupied by 'hidden serious' COVID-19 patients in west Japan

HIMEJI, Hyogo -- Local medical institutions in Japan are on edge amid the new coronavirus pandemic. At the National Hospital Organization Himeji Medical Center, a hospital in this western Japan city that accepts COVID-19 patients with mild to moderate symptoms, beds designated for such patients have been continually occupied since December 2020.

One reason for this is that even patients with serious symptoms cannot be transferred to another hospital designated for patients like them if they do not consent to receiving certain treatments including using an artificial respirator.

The Mainichi Shimbun interviewed the hospital's assistant director, Tetsuji Kawamura, 59, who said, "I would like to share the sense of crisis we have with people."

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At Himeji Medical Center, one ward with 12 beds is currently designated for COVID-19 patients. The municipal government is planning to add 20 more beds citywide, with each hospital that accepts coronavirus patients adding a few more beds. Hospitals receive support from the government, including subsidies, but there are issues over how they will secure medical staff including nurses.

The majority of those hospitalized at our facility are elderly, among whom are some with dementia and some with disabilities. Unlike when treating patients with other diseases, health care staff need to change their medical gowns and be disinfected after each time they give medical assistance to these patients -- thereby putting more of a burden on our employees and leading us to require greater numbers of them.

In addition, some elderly patients won't agree to medical treatment, such as using an artificial respirator, even if they have serious symptoms, such as severe pneumonia. In principle, patients with serious symptoms are supposed to be transferred to other major hospitals designated by the prefectural government, such as Hyogo Prefectural Kakogawa Medical Center.

However, patients who won't receive treatment with an artificial respirator or in an intensive care unit are classified as having moderate symptoms, which they can't be transferred for. There are quite a few "hidden serious cases," which are not included in the prefectural government's tally of serious cases. Also, even if patients with serious symptoms were transferred to other hospitals, there are cases of them being returned to our hospital after their symptoms improve.

Our beds continue to be fully occupied for these reasons. As new patients can't be hospitalized as necessary, the occupancy rate should effectively be considered 100%.

When transferring a patient to another hospital, a doctor accompanies the patient in a car. There have been cases where doctors took a leave of absence after becoming ill because of these daily duties. Though taking paid leave is a mandatory work practice in these situations due to workstyle reforms that have been implemented, the doctors can barely take the minimum allotted days off, and no one took a long break over the New Year holiday period.

Meanwhile, medical examinations of patients with other diseases have been affected. Many patients diagnosed with lung cancer or other diseases during checkups usually come to our hospital, but I feel that the number of such patients has decreased by several dozen percent. I suspect that the number of those undergoing checkups is decreasing because people, out of a wish to avoid infection, are reluctant to visit medical institutions. When a patient being treated for lung cancer gets a fever, they must be quarantined and receive a polymerase chain reaction test to check whether they are infected with the coronavirus, placing a greater burden on medical workers.

Though the government's response in securing hospital beds is seen as problematic, the most important thing is to prevent more people from getting infected. It's the same idea as when people try to save energy while power generation is being boosted due to a short supply of electricity. Each person must take infection prevention measures.

I don't think it's problematic to dine at restaurants, but when dining with other people, young people in particular tend to speak louder when drunk. It's important to remember, "If I get infected, that means I'll threaten the lives of my grandparents." As there have been cases of infections spread at karaoke venues, older people should also take good care of themselves.

I think that sharing a sense of crisis with many people leads to protecting frontline medical care.

(Interview by Norihito Hanamure, City News Department)