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Health care workforce under strain in Japan amid surge of viral infections among kids

Clinic Bambini Director Akifumi Tokita, left, is seen examining a child at an outpatient ward in Tokyo's Minato Ward on July 22, 2022. (Mainichi/Rikka Teramachi)

TOKYO -- As Japan has entered into the seventh wave of coronavirus infections, health care services for children have been under overwhelming pressure, as ambulance crews struggle to find hospitals to accept emergency pediatric patients.

    While the country's daily COVID-19 cases have been marking record highs consecutively, infections with viruses other than the COVID-19 virus are also gradually spreading. From the front lines, there have been cries that workers are having the toughest time now since the coronavirus outbreak in spring 2020.

    On July 22, at Clinic Bambini in Tokyo's Minato Ward, Director Akifumi Tokita, who was dressed in blue protective gear, put a cotton swab inside a child's nose for a COVID-19 test, as a nurse told the child "good job." Children with fevers and their parents went inside the examination room one after the other.

    Over the past few days, many patients with fevers have been visiting the clinic, and the number of outpatients is double its usual total. Tokita has limited the number of appointments by new patients, saying, "We can barely examine our regular patients and families."

    While 20% to 30% of patients with fevers are COVID-19 patients, around 20% of them have been infected with the respiratory syncytial virus (RSV), which causes symptoms including difficulty in breathing. Amid a shortage of testing kits, as the desired amount has not been delivered to the clinic since a week ago, staff have been examining patients with no fever, while refraining from testing them.

    The institution has also received phone calls at night from parents of children who were infected with RSV and complained of suffocation. Though it advised them to call an ambulance, there have been cases where rescue workers would not accept them. Tokita said, "Even for children who are infected with the coronavirus, symptoms are lighter if they are vaccinated. As for the long-term physical effects of the vaccine, their safety is theoretically guaranteed. I'd like people to actively consider having their children receive the vaccine."

    The Tokyo Metropolitan Children's Medical Center in the city of Fuchu has also received about triple its usual number of emergency outpatients, following the spread of the coronavirus and RSV. In some cases, the hospital had to have patients wait for a few hours inside an ambulance as there were no available examination rooms for COVID-19 patients. Hiroshi Hataya, head of the general medical practice department, said, "If infections spread further, it is possible that we will postpone hospitalization for surgeries and tests scheduled for summer break."

    The number of new nationwide COVID-19 cases marked a record high of over 200,000 on July 23. About 30% of patients were aged below 20, and pediatric patients continue to be on the rise. According to the National Institute of Infectious Diseases, the number of patients with hand, foot and mouth disease, a viral infection common in young children, per medical institution between July 4 and 10 was 5.25 in Niigata Prefecture and 5.06 in Chiba Prefecture, both exceeding the alert level of 5 people. Infections besides COVID-19 have begun to spread again following a lull since 2020.

    Hiroyuki Moriuchi, president of the Japanese Society for Pediatric Infectious Diseases and professor at Nagasaki University's graduate school, commented, "For children, infections with the omicron subvariant are less likely to lead to serious cases compared to influenza and RSV. Only symptomatic treatment is available even if they develop a fever, so they have a better chance of recovering if they sleep well and take water and meals at home, rather than wait many hours at a crowded medical institution." However, he warned, "In cases where symptoms differ from those of regular colds, such as a pale face and being in a stupor, please contact a medical institution immediately."

    (Japanese original by Rikka Teramachi and Hiroyuki Harada, Lifestyle and Medical News Department)

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