Nurses take care of a patient inside Seibu Hospital's ICU in Yokohama. Photo: REUTERS/Kim Kyung-Hoon/File
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Virus surge causing concern for Japan's strained medical system

60 Comments

With Japan witnessing a rapid rise in the number of new coronavirus cases in recent weeks, health care workers fear that the country's medical system may soon be strained to breaking point with hospital bed shortages becoming commonplace, especially in big cities.

Hospitals have seen bed occupancy rates rising in line with the number of severe cases, and medical workers are worried they may not have the requisite capacity to treat patients in need of emergency care if the trend continues.

Despite this, the Japanese government has decided to continue to strike a balance between protecting the economy and the populace.

It will allow social and economic activities to go on while trying to curb the spread of the COVID-19 respiratory disease even though medical experts have called on people to exercise extreme caution.

The bed occupancy situation in Tokyo is severe but the concern is not limited to the capital with some other areas also seeing rates in excess of 50 percent as the country experiences what some medical experts have described as its third wave of infections.

"We have reached a phase of rapid spread," said Norio Omagari, director of the Disease Control and Prevention Center, at a press conference with Tokyo Gov Yuriko Koike on Thursday.

The Japanese capital logged a daily record of 534 new cases on that day as the metropolitan government raised its virus alert to the highest of four levels. It reported a further 522 cases on Friday.

Among the 2,640 hospital beds designated by the metropolitan government for COVID-19 patients, 1,354 or 51 percent were occupied as of Wednesday, the figure is up 10 percentage points from the previous week.

"The strain will increase on medical facilities that have (patients hospitalized) for a long period of time. There is an urgent need to secure more beds," said Masataka Inokuchi, a vice head of the Tokyo Medical Association.

Hokkaido, a popular tourist destination known for its heavy snowfall and frigid temperatures, has seen a more urgent need with the bed occupancy rate standing at 72 percent as of Tuesday.

"We are narrowly getting by. We will not have enough workers if the number of patients increases," said a health care worker at a Sapporo hospital, which has accepted a number of patients in their 70s and 80s who require particular attention.

Asahikawa in central Hokkaido has made it a general rule to hospitalize everybody who tests positive for the virus, but that is not a prefecture-wide policy.

"We have reached a limit," said Go Asari, a senior official at Asahikawa City Hospital, which has the majority of its 35 beds occupied.

Prime Minister Yoshihide Suga said Thursday Japan is on "maximum alert" but did not put in place concrete measures against the virus except for asking people to wear face masks at restaurants as much as possible.

The government has decided against declaring a state of emergency, as it did earlier in the year, even though the number of virus cases has reached record levels this month.

The government has also decided to maintain its lifeline to the domestic tourism industry by keeping in place its Go To Travel subsidy program, despite experts saying it was partly responsible for the virus' resurgence.

A senior official in charge of the COVID-19 response at the Ministry of Health, Labor and Welfare pointed out Japan's medical system is not yet in a dire situation.

"There has not been a situation in which patients have nowhere to go and (have to) line up in the hallway," the official said.

Shinji Ogura, a professor of emergency and disaster medicine at Gifu University, however, indicated there is no room for optimism.

"Medical resources, including workers, are close to collapsing, and the level of urgency is extremely high." he said. "I want people to take thorough infection prevention measures to also protect the medical system."

© KYODO

©2020 GPlusMedia Inc.

60 Comments
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People seem to forget that hospitals are run for profit. And anyone who has been in hospital here, especially for surgery, will know that Japanese hospitals are notorious for keeping you in far longer than necessary so they can charge a princely amount to your insurance.

You stay longer, but still pay much less than the great USA. The hospitals are the victims of the system, not the patients. Here is a good read for you.

https://www.npr.org/templates/story/story.php?storyId=89626309

0 ( +1 / -1 )

Immediate shutdown. Money or save lives???.

0 ( +1 / -1 )

Before Koike's re-election she was all gun hoe about shutting down Tokyo and giving news conferences and so on....BUT NOW ...re-elected where is she?????

3 ( +3 / -0 )

I am currently in Shimane prefecture which is seeing 0 cases on a daily basis.

Why is that do you all think?

Find out the number of test performed and that will answer your question.

2 ( +2 / -0 )

The govt. should've used that time to build more temporary hospitals, supply thousands of more beds, and procured 100s of more IC respiratory machines.

I think they did prepare more beds, prep should have already included such things as respiratory machines personnel training, any other things necessary for a covid19 treatment bed/room

For mild cases, probably only hotel rooms for isolation/quarantine

Additional hospitalismight not be practicable, even during precovid times I guess it must be very difficult to acquire personnel to run them

1 ( +1 / -0 )

I've posted this elsewhere, but something is not quite adding up.

Nov. 13th, I took a 15 minute walk to a fairly large public hospital here in Kanagawa-ken (Noborito), for my 'kenshin' — an explanation and advice regarding results of the yearly health check. Living in Japan for 37 years now, I speak Japanese, and am on friendly chatting and joking terms with at least a dozen nurses, doctors, and staff ... but noticed there are no signs or paperwork in any other language other than Japanese. Although the hospital seemed to be running smoothly, business as usual and under no stress, as I was handing out some post-halloween / pre-Christmas chocolate, I offered my services as a communication volunteer for foreign patients. I had done the same back in the U.S. over 40 years ago as an undergrad biology major.

The head nurse thought it was a splendid idea, and immediately called her supervisor, who in turn ordered her to relay a message to me, 'Thanks, but no thanks, Not necessary.' — in Japanese. Even with our masks on, it was easy enough to see the nurse and I shared a sheepish smile at the irony of the message.

The next day, Nov. 14, NHK's 7:00 pm news aired an announcement by the governor of Kanagawa prefecture ... officially declaring the prefecture as now in a public health crisis.

Contrary to my doctor's advice, I just popped the tab of another can of SuperDry, and switched to a movie channel. At least the fiction is more entertaining.

-5 ( +1 / -6 )

May be if the government "urged" the virus to go away things would get better, ( sarcasm )

2 ( +2 / -0 )

I am currently in Shimane prefecture which is seeing 0 cases on a daily basis.

Why is that do you all think?

-2 ( +0 / -2 )

Had a relatively low number of cases for about four months. The govt. should've used that time to build more temporary hospitals, supply thousands of more beds, and procured 100s of more IC respiratory machines.

2 ( +2 / -0 )

When this all over and dusted, the bureaucrats, experts and mainstream media should be investigated.

2 ( +2 / -0 )

Just watched a live cam of the Shibuya crossing. Tens of thousands of people like there was no covid-19.

-1 ( +1 / -2 )

excited for my kyoto trip next week.....

-3 ( +0 / -3 )

Osaka, 90%

Tokyo 61%

Is that Tokyo 23-wards to Tokyo prefecture? If the latter, than likely Tokyo 23-ward level is closer to Osaka's level.

The problem with that high level is that it becomes harder and harder to find the few available hospitals that can still take patients (i.e. busing patients around). Assuming that certain areas within the city have more cases than others, which seems like a reasonable assumption.

2 ( +2 / -0 )

I would prefer an answer about bed occupancy rather than just a down vote.

2 ( +3 / -1 )

I think there are many hospitals that do not cater to covid19 patients that is why we hear of so many that do not accept incoming covid19 suspected patients

1 ( +1 / -0 )

Should be for covid-19 only as the name of the website implies

https://www.stopcovid19.jp/

2 ( +2 / -0 )

AgentX

@Zichi - was that the surplus, or total costs? And sorry, but, I'm not sure the US healthcare system is a good one to compare to for obvious reasons...

Ok. ¥25,000 for biopsy and ¥145,000 for the cancer op is what I paid.

My situation is different because I'm retired. In our city I pay a maximum per month of ¥12,000 for hospital visits. I pay ¥35,000 per month for in treatments and hospital stays. That covers everything except charge for private room and food I think.

I spent one night in HCU (not ICU) which is normal for all patients coming out of an op.

Difficult to estimate but I think the full cost of my cancer op would be about ¥800,000. Considering the cost of the robot and the skill levels needed that would be reasonable.

The robot op is still limited and not available all all major hospitals. I travelled to Kobe for mine.

The traditional cut surgery would have had me in hospital for a longer period and longer for recovery.

From the time of discovery June 2019 until op Feb 2020 all the doctors and staff at three hospital discussed all the details with me and all the options. My private doctor advised the op so I went for that.

4 ( +4 / -0 )

Bed occupancy rates. Does that mean all the hospital beds or the ones set aside for covid-19?

4 ( +4 / -0 )

Bed occupancy rates for covid-19 patients: https://www.stopcovid19.jp/

Osaka, 90%

Hokkaido 63,8%

Tokyo 61%

Aichi 61% also

3 ( +3 / -0 )

Same as @zichi

I had an op lasting about hour, and I was not even proposed to stay overnight. I would have believe that normal in my country.

I can't remember the price but I had full personal insurance, and so they did not profit from the fact I was fully covered whatever the cost.

2 ( +2 / -0 )

health system = health insurance system
-2 ( +1 / -3 )

Bed occupancy rates for covid-19 patients: https://www.stopcovid19.jp/

Osaka, 90%

Hokkaido 63,8%

Tokyo 61%

"Medical resources, including workers, are close to collapsing, and the level of urgency is extremely high. I want people to take thorough infection prevention measures to also protect the medical system."

Shinji Ogura, professor of emergency and disaster medicine, Gifu University
5 ( +5 / -0 )

@Zichi - was that the surplus, or total costs? And sorry, but, I'm not sure the US healthcare system is a good one to compare to for obvious reasons...

In my experience, the same op I had in my native (western) country was outpatient/day surgery. Here (Japan), they wanted me to stay for 6 weeks, and even put me in their ICU for a night once I woke from anaesthesia. No joke. I was completely flabbergasted as not only should those beds be kept available for patients in need of them, but it also made zero sense as I was perfectly fine to be left to rest (at home would have been better). The ICU was very quiet btw - far from running at capacity...

I guess mileage will vary. But there are plenty of anecdotal stories of Japanese hospitals keeping patients in for longer than necessary. Coddling their patients as they add charges to the bill. As I say, they are a business, and the health system can hardly question them about their charges. It's a well-established economy at the top of the pyramid.

3 ( +3 / -0 )

kohakuebisu

I've had a brain MRI in Japan at a time when I didn't have insurance and was charged 42,000 yen. If that is the same total used when someone has insurance, it is not profiteering.

you paid 100%. Most people would pay 30%. For a single MRI session I pay less than ¥5,000.

3 ( +4 / -1 )

People seem to forget that hospitals are run for profit. 

Your point being?

1 ( +1 / -0 )

I've had a brain MRI in Japan at a time when I didn't have insurance and was charged 42,000 yen. If that is the same total used when someone has insurance, it is not profiteering.

6 ( +6 / -0 )

AgentX

will know that Japanese hospitals are notorious for keeping you in far longer than necessary so they can charge a princely amount to your insurance.

Not true from my experience. Two hospitals stays. One for a biopsy. The other for a prostate op. Both stays in good private rooms. Biopsy just overnight. Charge ¥25,000. The op was a 7 day stay and the total charge was ¥150,000. My NY bros was shocked at those low prices which would have been many thousands of dollars.

7 ( +7 / -0 )

People seem to forget that hospitals are run for profit. And anyone who has been in hospital here, especially for surgery, will know that Japanese hospitals are notorious for keeping you in far longer than necessary so they can charge a princely amount to your insurance.

-7 ( +1 / -8 )

A senior official in charge of the COVID-19 response at the Ministry of Health, Labor and Welfare pointed out Japan's medical system is not yet in a dire situation.

"There has not been a situation in which patients have nowhere to go and (have to) line up in the hallway," the official said.

Well that's certainly cheery information. Numbers increase, it is a holiday weekend. The government encourages and subsidizes travel and tourism. The connection while mildly acknowledged is ignored.

Atop the current malaise and intent to push forward with The Games, as if the current situation is not a warning.

7 ( +7 / -0 )

Further to my previous point, don’t forget we’ve been here before.

remember back at the start of the second wave so called reputable mainstream news outlets like AP and CNN were making all sorts of dire predictions that Japan’s health care system was on the brink of collapse and there would be 400,000 cases a day or some such nonsense. CNN even flew in Will Ripley and some other hack to ring the alarm bells of imminent disaster, and what happened? It didn’t occur and they moved on to some other ‘trouble spot’ looking for some story to scare the bejesus out of their viewers

im not denying there is cause for sensible caution just don’t let the media get in your head too much

-10 ( +2 / -12 )

How is it possible that they are now worried as hospitals are filling up because of a virus that they have barely tested for by first world standards?

Testing like in USA and Europe? Great job it is doing them...

-4 ( +3 / -7 )

I am confident the government ... will respect their opinion.

Seriously? What on Earth would give you this confidence? Can you cite even one example when the government listened to anybody without being forced?

10 ( +10 / -0 )

Virus surge causing concern for Japan's strained medical system

...

health care workers fear that the country's medical system may soon be strained to breaking point with hospital bed shortages becoming commonplace

...

medical workers are worried they may not have the requisite capacity to treat patients in need of emergency care

...

"We are narrowly getting by. We will not have enough workers if the number of patients increases,"

...

"We have reached a limit,"

...

"Medical resources, including workers, are close to collapsing..."

One can almost think we’re talking about a 4th world country or something. ...smh...

12 ( +12 / -0 )

Not too hard given it was already under strain before the virus. Remember those ambulance stories?

7 ( +7 / -0 )

they say the hospital situation is “severe” but then say occupancy of beds designated for Covid is at 50 percent.

That is not strange, the number of cases have just began increasing importantly, but already 50% of the space has been used, if this was already the peak it would not be bad at all, but being only the beginning of the increase it means the capacity will be reached soon, and after that big consequences for anybody that will need to be hospitalized, for COVID-19 or any other thing.

Anyone living in Japan knows well that the hospitals are not experiencing any problems connected with the virus...

As long as the number of cases begin decreasing? sure. It is not the same to see the gas gauge closing to the empty mark if you are just a short trip from the gas station than while you are in the middle of a desert. In both cases the car will keep moving without problem, but what you expect will happen is completely different.

I am surprised that nobody here finds it odd that a country as big as Japan can handle so few cases in hospitals

Different countries have very different priorities on health services, in some is a business with huge margins to keeping a lot of capacity in reserve is not really a sacrifice, in others its a business based on volume so tending an extra million people is just a matter of increasing the services a 10-20%. Japan is not one of these countries, here the system work on a precarious balance forced by many factors, from the huge costs needed to become a doctor to the culture of the minimum acceptable care that hospitals must offer for your insurance.

Hospitals share a lot of the responsibility of failing to prepare for the expected increase in patients, but it is not so easy as just putting out some extra beds and hire from a pool of doctors and nurses that are without jobs.

9 ( +13 / -4 )

I've been waiting for this kind of announcement since the daily numbers totals reported by the media do not tell the story. This is the main issue, the strain on the health care. If the numbers rise the system may not be able to take care of you. This is why we need to be vigilant to stay away from events that allow too much contact with others.

7 ( +9 / -2 )

I am surprised that nobody here finds it odd that a country as big as Japan can handle so few cases in hospitals. In most countries they have 10 times the capacity and they are much smaller countries. But of course there doctors don’t just become a doctor because daddy is a doctor and they don’t run when an infectious patient arrives.

14 ( +17 / -3 )

Oops ! If this interpretation of the hospitals situation is indeed representing reality and the concern is real it might mean we are looking at another very risky SOE ( god forbid) .

The hospitals around Japan should make the call. I am confident the government and people will respect their opinion.

Quite honestly I am not convinced Japan needs nor can afford another SOE . This time around I think people will feel it.

-8 ( +3 / -11 )

After 10 months hiding the obvious through ridiculous low testing, promoting traveling, allowing outside business travellers to arrive with no PCR test being done... the most densely populated metropolis in the world, prone to huge natural disasters is already feeling the pressure of the virus?

This is something extremely concerning, and shows how things are SO slow to adapt here in Japan. “Taking action” is not a thing, and the result are the crowds that are right now packing restaurants and all kinds of places around the city, when we are in the peak of the number of cases!

Based on what’s happening the only possible result is an even more significant increase in the number of cases, and if these decrease, it must be a lie. Just look by yourselves when you are in the city, no need to believe my words.

Lastly, let’s hope there is no serious Earthquake anytime soon, the infrastructure is simply not ready to cope!

9 ( +11 / -2 )

strike a balance between protecting the economy and the populace.

I don't think that any balance was made or tried. They simple chose the economy. While I love the discounts of the "go to eat" and "go to travel" campaigns, I do think they were counter productive to protecting people during the pandemic.

4 ( +6 / -2 )

Anyone living in Japan knows well that the hospitals are not experiencing any problems connected with the virus...

-16 ( +3 / -19 )

@ KnowBette r- Today  07:06 am JST

They refused to test more.....They avoided at all costs testing...They made it near impossible to get tested....They made it nearly the whole year in denial ...

Indeed the best post I have read about this subject on this pages for a while. Not much more to add. Except that when once this very common trajectory here has started, there's little hope for changes of course. But instead, digging in deeper, deny even more vehemently and rigorously follow the dotted line.

5 ( +8 / -3 )

If Japan was doing the opposite of what is doing now, you would be complaining

I don't think anybody is suggesting the opposite. Nice try at an argument, though.

7 ( +13 / -6 )

It is important to find a balance between economy and health.

In my country the opposite is happening: people are complaining because basically the government has implemented a lot of restrictions. Hundreds of little businesses bankrupt, many kids and university students no longer getting education, and some people literally starving.

This is not what you want either. Some people will have to die (specially those in risk) in order for the economy to keep going steadily, but people die everyday right?

If Japan was doing the opposite of what is doing now, you would be complaining, just like in my country, because people need to eat too.

-7 ( +8 / -15 )

This is typical Kyodo reporting.

they say the hospital situation is “severe” but then say occupancy of beds designated for Covid is at 50 percent.

also no mention of all the hotels that have been set up to accommodate patients with less severe cases.

this is just alarmist reporting and sadly many JT readers just buy into it.

and to be fair it’s not just Kyodo. Most media outlets these days ring the alarm bells to boost sagging sales figures.

8 ( +14 / -6 )

"Medical resources, including workers, are close to collapsing, and the level of urgency is extremely high." he said. "I want people to take thorough infection prevention measures to also protect the medical system."

The truth is that hospitals all over Japan are full of the elderly.Patients in their eighties and nineties are operated on to provide income for hospitals. Hospitals need income to pay staff but the Japanese population is so healthy that the elderly are the main source of income.

Where the infection is spread in hospitals and a cluster occurs then operations cease for several weeks and the adverse publicity causes a drop in visitors.

The resultant income drop is what causes this ‘concern’

Also, many hospitals are being asked by their wards and prefectures to make space for possible corona virus infected patients.

Due to the low number of these patients there is an added shortfall as space cannot be utilised effectively.

-7 ( +6 / -13 )

@ zoroto

Ever heard of Google?

-18 ( +3 / -21 )

The Japanese people had better brace themselves for the stiff bill they will have to pay for the ignorance and incompetence of the ruling elite who once again have refused to accept reality and out of pride and fear prioritized money over lives. Now in the coming weeks we can forget this year's bonenkai and expect burials instead.

9 ( +15 / -6 )

Go To was always going to result in go the the hospital. One of the primary mandates of controlling a highly infectious disease is to control its spread, LDP are doing the exact opposite with their ludicrous campaigns. Once again, the chickens have come home to roost. 'Rona - 3, LDP - O.

7 ( +11 / -4 )

But what about those face-to-face classes at the university level that MEXT wanted? Gone? Seriously, these Japanese politicians are THIS stupid to not FORESEE that winter season brings on more flu cases. Why do these fool always REACT instead of preventing problems?

1 ( +7 / -6 )

In the winter hospital occupancy is generally around 90%

Citation needed.

Many hospitals can not make a profit under 70%.

Citation needed.

9 ( +17 / -8 )

"Despite this, the Japanese government has decided to continue to PRIORITIZE protecting the economy over the populace."

Fixed it for you. I wonder why no news organization can state an indisputable fact.

14 ( +20 / -6 )

Is that because they haven't had nine months to think about this situation and prepare for it?

13 ( +15 / -2 )

With Japan witnessing a rapid rise in the number of new coronavirus cases in recent weeks, health care workers fear that the country's medical system may soon be strained to breaking point with hospital bed shortages becoming commonplace, especially in big cities.

my advice is don’t fear. It might not happen. There’s too much fear and projection around this thing.

-7 ( +10 / -17 )

There were similar tales of doom and gloom in April. Which turned out to be untrue.

Hokkaido, a popular tourist destination known for its heavy snowfall and frigid temperatures, has seen a more urgent need with the bed occupancy rate standing at 72 percent as of Tuesday.

In the winter hospital occupancy is generally around 90%

Many hospitals can not make a profit under 70%.

-8 ( +13 / -21 )

It’s as if they didn’t have 8 months to prepare.

22 ( +29 / -7 )

It's times like this that the true character of people and institutions shine through. This is what you get with the LDP.

17 ( +22 / -5 )

Where are the posters who keep insisting there is nothing about which to worry because the CFR is low? Tell us again that we don’t need to worry about hospital capacity.

14 ( +23 / -9 )

Wait, what?!? They refused to test more as they promised back during the summer. They tested fewer when the numbers of infected were rising. They avoided at all costs testing those that died suspected of having the virus. They made it near impossible to get tested in the first place due to all the requirements and costs. How is it possible that they are now worried as hospitals are filling up because of a virus that they have barely tested for by first world standards? Can they not just deny that the hospitals are filling up with virus cases and keep going with the charade? They made it nearly the whole year in denial while the rest of the world is dealing with it, some (Taiwan) MUCH BETTER than others. Of course they will blame the colder weather for this and not their 'head in the sand' lunacy and goal to hold the Olympics at any cost.

26 ( +30 / -4 )

Causing concern? The government does not want to cause panic, but when it uses "soft" language like this, it makes me think that things are at least 10 times worse than what is being reported.

Better that people use common sense and stay the hell home! It's criminal, in my opinion, to promote travel, and going out to eat, when the country is facing a worse situation than when the pandemic first hit the scene.

Stay safe people!

21 ( +29 / -8 )

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