Coronavirus third wave puts many Japanese hospitals on overload

So hurry up and approve a vaccine then.

Always on the brink of collapse.

When will it collapse, if it has to?

It is more than worrying to think that a country with the worlds third biggest economy and so-called ‘better’ handling of the pandemic than most other countries is already on the brink of collapse in terms of medical facilities. Especially when you think of the size of the population and the percentage of elderly.

Back in April last year Department of Health in Australia announced this:

Australian Government partnership with private health sector secures 30,000 hospital beds and 105,000 nurses and staff, to help fight COVID-19 pandemic

Is the government in Japan too lazy to talk to the private hospitals?

After this is all over, Japan will have to socialize all its hospitals. The system is collapsing despite relatively low numbers of cases. The medical private sector has shown itself incapable of dealing with a national public health crisis.

Coronavirus third wave puts many Japanese hospitals on overload

To say precisely, designated hospitals for covid care. The large majority hospitals, mostly private and smaller sized, are not yet involved. Many beds, or about 80% of total numbers have still remained unused.

Urge those inactivated hospitals to arise cooperative with the emergency measures by taking covid patients. They may be encouraged to do so with an extra subsidy or other forms of assurance. Notice that during "peacetime" those hospitals (despite private entities) benefit a lot from state-run healthcare programs, the largest income source. They now should be more responsible for saving lives under the eminent threat.

Third wave? Any country can seemingly create waves by increasing and decreasing the number of tests as and when desired.

After this is all over, Japan will have to

revise its medical systems at all levels. But given the LDP nabobs remain in charge, expect nothing much to change.

There aren't enough doctors or nurses," said Nakagawa. "Even if hospitals are told to increase the number of beds, what can't be done, can't be done.

The government here must swallow the pride and understand that the medical system in Japan isn't reliable and can't be trusted with a task if this magnitude.

Instead it should look for help into foreign expertise treatment and streamlining self treatment options.

Access to zoom, skype for consultation , also remdesivir, avigan, oxygen bathing gear for everyone in the vulnerable group.

The financial help meant for hospitals should go to family members treating the sick.

Seriously, what’s with this “in the limit, almost collapsing” talk. Hard to believe when we’re talking about the world’s third biggest economy ( for some people still the 2nd ), a country with 130 million people.

Coronavirus third wave puts many Japanese hospitals on overload

Medical facilities across Japan are struggling to cope with the recent surge in novel coronavirus infections, leaving the medical care system in many areas on the brink of collapse.

Imagine if they had the numbers of Germany, UK, Italy, France and others, even smaller European countries.

Seriously, what’s with this “in the limit, almost collapsing” talk. Hard to believe when we’re talking about the world’s third biggest economy ( for some people still the 2nd ), a country with 130 million people.

It is terrifying to be honest.

Just today in the UK there were 4000 c19 admissions.

Is it a fear they are trying to communicate ? What is this ?

Are they looking at covid19 as a solution to the pension insurance deficit ?

Although the government is expected to provide financial support to medical facilities that secure more beds for COVID-19 patients, a shortage of doctors and nurses means it is unlikely many hospitals will answer the call.

"There aren't enough doctors or nurses," said Nakagawa. "Even if hospitals are told to increase the number of beds, what can't be done, can't be done."

For decades, hundreds of thousands of Japanese women were denied their ( potential ) future as doctors and nurses. They simply lived in a world ( Japan ) where, since a young age, they were taught that men “take care of things”, that includes being a doctor and treating others. Instead they’re now ( example ) in the kitchen waiting for their exhausted sarariman to get home.

Misleading headlines are unhelpful. The medical system here in Japan isn't overloaded or about to collapse. Hospitals not designated as a COVID facility are fine. My wife works in a large hospital that isn't designated to take COVID patients and everything is running as usual.

Meanwhile, 77 percent of the 4,000 available hospital beds for coronavirus cases in the capital had been filled as of Jan 6

That line tells you what you need to know. 4000 beds are not all of the beds in Tokyo, but the beds set aside for coronavirus patients.

My wife works in a large hospital that isn't designated to take COVID patients and everything is running as usual.

Can you please ask her how exactly this separation works ? What if you show up there with a broken arm and covid19 ?

That line tells you what you need to know. 4000 beds are not all of the beds in Tokyo, but the beds set aside for coronavirus patients.

These days same thing if you ask me.

To say precisely, designated hospitals for covid care. The large majority hospitals, mostly private and smaller sized, are not yet involved. Many beds, or about 80% of total numbers have still remained unused

Talked to a doctor yesterday that works in one of the main hospitals in Tennoji, Osaka. She said the same exact thing. Her hospital has been dead since the pandemic started as people are either told to go to the Covid hospital if showing signs or people are nervous to go to the hospital even for general check-ups.

Although the government is expected to provide financial support to medical facilities that secure more beds for COVID-19 patients, a shortage of doctors and nurses means it is unlikely many hospitals will answer the call.

"There aren't enough doctors or nurses," said Nakagawa. "Even if hospitals are told to increase the number of beds, what can't be done, can't be done."

For decades, hundreds of thousands of Japanese women were denied their ( potential ) future as doctors and nurses. They simply lived in a world ( Japan ) where, since a young age, they were taught that men “take care of things”, that includes being a doctor and treating others. Instead they’re now ( example ) in the kitchen waiting for their exhausted sarariman to get home.

cont.

Now the dinosaurs need more doctors. The system is collapsing they say.

A young boy was involved in a traffic accident and it took 40 minutes for the ambulance to find a hospital that could accept him. Because of Covid, there was a significant delay and the boy died. That is the meaning of collapse. This is what happens when you push people to travel and spread when nothing is under control. People complain and piss and moan about Covid stress; go talk to the medical workers about stress, we need to do our part out here to keep the hospitalizations down to manageable levels.

The reality is that many hospitals in Japan refuse patients with the Corona virus.

Those that do not are having a difficult time but to say that the system is collapsing is inaccurate.

Aleef’s comments are correct.

Those that do not are having a difficult time but to say that the system is collapsing is inaccurate.

It is as accurate as it gets. The SoE is the proof.

The “key word” is designated. Designated hospital beds are nearing capacity. They can always “designate” some more beds but and this is a big but..... Hospitals don’t want the designation. For each bed the hospital is allocated some funding, most hospitals regard this cash as too little especially as when the hospital becomes known as the local “covid facility” regular patients stay away in fear and revenue plummets. The mentioned Kyorin hospital being a prime example.

I think some people feel that all doctors and nurses are the same and are interchangeable. Most of the COVID-19 beds are at larger hospitals, they have the doctors, nurses and equipment for it. But they also take care of other patients. So they end up denying patients and canceling surgeries. I know a cancer patient who cannot have surgery because he lives in a rural area with only 1 major hospital nearby and they can't take him.

Because these places can't accept patients they normally would, they are then sent to other facilities. My wife who is a nurse at a mental facility get calls to take a lot of patients they have no ability to see because of COVID.

Also if outbreaks happen, which has happened, entire wards need to shutdown. Many places are a small outbreak away from leaving the public with little to no options for emergency care.

So not all parts of medical system is near collapse, but very important parts are

It sounds like there are two levels of Covid-19 beds, a small number of ICU type facilities (most of which are probably existing ICUs) and much larger number of beds, sometimes improvised, where patients are under constant observation but are not currently at immediate risk of death. Below these in the pyramid are largely asymptomatic patients staying at home or in designated hotels.

From the article and what I've seen on the news, it looks like a lot of the "collapse" is at ICU level. Even at the middle level though, the disease is placing lots of strain on hospitals with patients who need far more attention and isolation than regular patients who get left alone most of the time. This strain will only increase with the quadrupling of cases since early December.

Why SOE... well simple put medical stuff for covid-19 patients are limited, you can add more beds and more ventilators but that doesn't help if you don't have the medical staff available to deal with the number of patients. Hospital workers for positive Covid-19 patients can not treat non covid-19 patients so hospitals are under strain 77% beds full mean staff are stretched extremely thin. Adding more patients to the hospital just applies more pressure on staff.

"The medical care system is already in a state of collapse," he said.

Still no serious measures to curb infections, only “requests”.

I wonder where this will take Japan.

The general public is just not aware of the real dimension problem as max testing in Tokyo was so far 15,000 in one day.

If testing was allowed for everyone, numbers will be shocking and people would finally start behaving and taking this seriously.

All the efforts we are trying may be in vain. The nature is trying to reduce the population of human beings which increased too much.

Hospitals overloaded, yet nothing practical and useful is being done to alleviate the problem. Cancel events and ban large gatherings for a start. Expect a spike in the Hanshin area in a couple of weeks, judging by the number of people crushed together at our local shrine festival. Cut the red tape, start testing the vaccines NOW and you can be vaccinating in a couple of weeks.

For each bed the hospital is allocated some funding, most hospitals regard this cash as too little especially as when the hospital becomes known as the local “covid facility” regular patients stay away in fear and revenue plummets. 

In the latest plan, the government will offer hospitals the financial aid of max. 19.5 million yen (up from the previous 15 million) per bed for covid treatment in Tokyo and the neighboring three prefectures under SOE.

1床あたり最大1950万円補助、緊急事態宣言の1都3県

https://www.nikkei.com/article/DGXZQODF0847H0Y1A100C2000000

Though not sure if the amount is now sufficient, I only stress that burdens should be shared among all community members under crisis, and hospitals are not exception.

This is why the government’s foot dragging on doing anything to prevent the surge is such a disaster. It takes years to train doctors and nurses, so they can’t just dump a bunch of cash on hospitals and expect them to be able to significantly increase their care capacity in an emergency. The only effective way to protect the system was to suppress the pandemic.

Now they’ve botched that and it seems to be spreading out of control, and the medical system will not be able to keep pace. Plus they haven’t shown any urgency in getting a vaccine approved, let alone distributed.

I fear that the luck those of us in Japan have had so far has now run out and we’ll be seeing what it has been like for people in the US and Europe going through this very shortly.

Oh, and because I think it deserves repeating in this context, f*** the Olympics.

They’ve had more than enough time to act on this, but have preferred the “wait and pray” method.

All the doctors and nurses I have spoken to over the past few months have said that their hospitals are quiet. Other than the few of them that have specialist Covid wards, and even there it's only the Covid wards that are busy. Lots of regular patients are staying away.

There is something inherently broken in how the Japanese medical system works, if they are needing to cancel operations when hospitals are quiet, if they can't get enough staff or beds to deal with the relatively low number of cases so far.

Every hospital and clinic I have visited in Japan has had a massive number of nursing staff. As such, I can't believe there is an actual shortage of nurses. The little local clinic near me has one old guy doctor, with an apparent harem of 6-8 nurses. There's usually 2-3 patients when I visit, so there is usually the doctor giving the consultation, 2-3 nurses assisting, and another 2 or so nurses hanging around.

It's rather disturbing that most hospitals in Japan seem unwilling to accept Covid patients, and that the government seems to have very limited ability to require them to do so.

It is also rather sad that it seems the main response of many medical professionals in Japan has been to quit rather than risk treating Covid patients. Other countries have had people volunteering by the thousands. Ex doctors and ex nurses have been signing up to help. Celebrities and politicians who have medical training have been putting aside their careers to go back and help out at hospitals.

But in Japan if a hospital agrees to accept Covid patients half the medical staff quits. ????

I said this before back in May but Japan needs to build a large, public super-hospital on the old Tsukiji Fish Market site and make the emergency room accessible by water to water taxis and water ambulances. To help pay for this hospital, they can build a large flat roof and turn it into a drone airport and distribution hub and lease it to the private sector. A part of the roof can also be used for flying cars/helicopters landing and taking off. Also make it a "smart" hospital with the latest information technologies like sensors and 3D printing and artificial intelligence to help alleviate staff shortages.

Tokyo needs to be better prepared not just for pandemics but also for the next great Kanto earthquake when the narrow streets will be inaccessible to ambulances and patients will have to be transported by air and water.

The "nurses" at your local clinic and ICU nurses are completely different and in no way comparable.

If it's an emergency situation then you make do.

I assume they have some form of medical training. At the very least that kind of nurse could support the more minor cases in the hospital, freeing up resources for the more senior nurses to devote to more serious cases such as Covid.

If some hospitals and clinics are quiet, those staff could be lent to the hospitals that are overloaded.

But I was just using them as an example, every clinic or hospital I have visited in Tokyo has had far more nursing staff than I've seen in similar hospitals or clinics in the UK.

In my local area, at least, there are also just a lot more clinics than you'd find in a similar area in the UK.

Speaking of the UK, huge numbers of Dental Nurses have been working in hospitals battling Covid for the past year. I imagine there's a big difference between a Dental Nurse and an ICU Nurse too, but that doesn't seem to have stopped them.

So there are definitely resources available, it just takes some creative solutions to use them. Or some actual central government control, of which there seems to be none.

I assume the SDF has a fair number of doctors and nurses as well, who could be deployed if needed.

Zoroto

They already have a facility built and ready to use: the Olympic Village.

But as it's been mentioned many times, beds are easy, it's the people running them which are in short supply.

Except the village is not completely ready and operating yet, and definitely not at a level necessary to accommodate any kind of patients. I know, because I know people who are working there.

The doctors and nurses should only do their main work, everything else can be done by amateurs or other external staff being taught in a 3-week-intensive course. They certainly shouldn’t manage or monitor those ICU and ECMO machines, but they can for sure refill disinfectants, move the beds around, clean the floors or bathrooms and all the like. And all the rest should consider to stop bullying or stigmatization of all people who work there, because you may be the next who needs help and available staff at your last bed in the last weeks before dying.

Speaking of the UK, huge numbers of Dental Nurses have been working in hospitals battling Covid for the past year. I imagine there's a big difference between a Dental Nurse and an ICU Nurse too, but that doesn't seem to have stopped them.

Dental nurses, dentists and vets have been working in U.K. hospitals, firefighters have been driving ambulances, senior doctors from various specialities have been working nursing shifts. None of them, however, have been doing the work of ICU nurses or are providing specialist care, or working as a registered nurse would do because they can’t. They have been working as health care assistants/nursing assistants, under the supervision of registered nurses or working on proning teams. They are not and cannot do the job of nurses, especially ICU nurse.

The doctors and nurses should only do their main work, everything else can be done by amateurs or other external staff being taught in a 3-week-intensive course. 

Somethings can, but certainly not “everything else” and not taught in three weeks.

"Meanwhile, 77 percent of the 4,000 available hospital beds for coronavirus cases in the capital had been filled as of Jan 6"

....which does not match the screaming headline about doom and gloom. If more people need to be hospitalized, how about add some more isolation wards? 4000 in a metropolis of 20 million is hardly something drastic.

Fwiw, our neighbour is a medical doctor, running his own small clinic and also visiting hospitals, and he can not confirm the media reports AT ALL. His experience is that everything runs normally.

None of them, however, have been doing the work of ICU nurses or are providing specialist care, or working as a registered nurse would do because they can’t.

No one said they were working as ICU nurses. They are working on wards and doing a lot of the work that regular nurses would be doing though.

eg: https://www.dental-nursing.co.uk/news/think-carefully-before-you-say-no-frontline-dental-nurse-urges-colleagues-to-have-coronavirus-vaccine-1

No one said they were working as ICU nurses. They are working on wards and doing a lot of the work that regular nurses would be doing though.

You did, and they are not doing the work of registered nurses.