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COVID-19 death rate among Hokkaido dialysis patients higher than Japan average

The office of the Hokkaido kidney disease patient liaison council is seen in Sapporo's Kita Ward on June 20, 2021. (Mainichi/Yui Takahashi)

SAPPORO -- The COVID-19 death rate among artificial dialysis patients in Hokkaido was as much as 2.7 times higher than the national average.

    During May and June, when the "fourth wave" of infections hit Hokkaido, nearly half of the more than 100 kidney disease patients receiving dialysis who were infected with the coronavirus at hospitals and other places died. Many dialysis patients have not been vaccinated, and they fear daily for their lives.

    Tomoyuki Suzuki, the 70-year-old secretary-general of the Hokkaido kidney disease patient liaison council, received a phone call in late April from a fellow patient in her 60s, who was crying and saying, "Everyone's infected." Apparently, there was a coronavirus cluster among dialysis patients at a medical institution in Sapporo's Minami Ward, where an acquaintance made regular visits. Forty-five infections had been confirmed at the clinic by the end of June. Suzuki said, "I was shocked as it was the first time I'd heard about a cluster hitting dialysis patients."

    Since then, the liaison council's office has received reports from across Hokkaido about infections and deaths among dialysis patients. However, the reports did not cover all cases. Suzuki said that to confirm deaths they "have to check newspaper obituaries." He added that he still cannot contact one acquaintance in his 70s.

    Patients generally visit medical facilities about three times a week for dialysis. Typically, they are in an outpatient room with many beds occupied by fellow patients, spending four to five hours hooked up to a dialysis machine, which removes waste from the blood. That the patients gather in a closed space for treatment raises their infection risk, and many are elderly and therefore more vulnerable to developing severe COVID-19. A lot of them also have other preexisting conditions such as diabetes.

    According to the joint committee against the coronavirus, which consists of three related groups -- the Japanese Association of Dialysis Physicians, the Japanese Society for Dialysis Therapy and the Japanese Society of Nephrology -- that collect dialysis patient information, a total of 1,987 patients had been infected with the coronavirus across the country by July 1, of which 332 died. In Hokkaido, where there are some 16,000 patients, 158 have been infected, more than 100 of them in May and June. With 72 deaths, the mortality rate in Hokkaido stood at 46% -- about 2.7 times higher than the national average of 17%.

    Joint committee head Kan Kikuchi, who manages a medical corporation in Tokyo, thinks that the main reason for the high mortality rate in Hokkaido is the cluster infection, saying, "The cluster of 40 to 50 dialysis patients was one of the largest in the country, and large enough that other hospitals could not take them. Apparently, most of them died without receiving necessary treatment."

    Kikuchi added, "There are a limited number of inpatient hospital beds with the facilities to give coronavirus patients dialysis treatments. And when a cluster happens in a wide place like Hokkaido, accommodating patients is difficult."

    While vaccination is the best response, it has been delayed in Hokkaido. According to a tally by the Japanese government's National Strategy office of Information and Communication Technology, the proportion of people aged 65 and over in Hokkaido who have received their first shots stood at 51.08% as of July 5, the lowest among all Japan's 47 prefectures.

    "Dialysis patients are innately vulnerable to infectious diseases," Kikuchi pointed out. "To raise the survival rate, they should be given high vaccination priority."

    (Japanese original by Yui Takahashi, Hokkaido News Department)

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