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Editorial: Osaka Pref.'s medical system is collapsing, and we need to know why

The surge in COVID-19 cases in Osaka Prefecture is threatening to break the local health care system, and the prefecture has decided to formally request that the Japanese government further extend the coronavirus state of emergency for the area.

    Total deaths from COVID-19 in Osaka are approaching 2,200, with more than 1,000 of those lives claimed by Japan's fourth infection wave since March 1. The prefecture is in the grip of extraordinary circumstances.

    One major factor in Osaka's coronavirus crisis is that it was there that virus variants thought to be both more infectious and more likely to cause serious symptoms spread first in Japan.

    Meanwhile, Osaka Prefecture had the previous coronavirus state of emergency lifted there early, on March 1. It also reduced the beds reserved for severe COVID-19 cases from 215 to 150.

    However, serious case numbers have now exceeded the beds available for them, and some patients have been shunted to beds intended for mild to moderate cases. Like falling dominoes, this has made it hard for people with lighter symptoms of the disease to get treatment. Some patients recovering at home or in designated accommodations have even died after their conditions worsened suddenly and they were unable to find a place in a hospital for treatment.

    Thus far, 19 people in Osaka have died while recuperating at home or designated hotels. The figure was just one between October 2020 and February this year, during the third infection wave.

    From the start of the fourth wave, information that the virus variants were highly infectious was already circulating in Japan and abroad. It is possible that more people were lost to the virus because government officials were too slow to respond. It is certainly conceivable that another, even more infectious variant could appear, triggering yet another wave. Authorities must assume this risk exists, and take measures to get out in front of it. It is very important to have a sense of crisis.

    To prevent people from dying of COVID-19 at home, measures are needed immediately to allow accurate checks on the condition of at-home patients, and get them treatment when needed.

    For times of emergency threatening human lives, we need to build a system tying local public health centers and private medical practitioners together, and one that can respond to health needs quickly.

    There is only so much a local government can do on its own if the health system comes under severe strain. The national government should provide direction, and consider creating rules for accepting patients that exceed the prefectural framework.

    The government must examine why and how Osaka Prefecture's medical system broke down under the COVID-19 surge, and share the lessons learned with all local governments across Japan.

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