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On Japan's stretched frontline, doctors and nurses face long fight against coronavirus

39 Comments
By Ju-min Park, Mari Saito and Eimi Yamamitsu

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© Thomson Reuters 2020.

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39 Comments
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So.. St. Luke's is busy, but not necessarily ALL hospitals like the headline infers. And seriously.. 8 beds in the ICU there and you're surprised it's maxed out?

-1 ( +10 / -11 )

I agree with AgentX

-2 ( +7 / -9 )

Probably time to build a hospital as the Chinese did

10 ( +15 / -5 )

Eight ITU beds! Only eight! WTF? A hospital like St Luke’s only having eight ITU beds is appalling.

Even in the time before corona, this would be scandalous - now it’’s sheer negligence.

15 ( +18 / -3 )

"(the government) it is unable to compel most hospitals to take in patients."

The British recently built the world's biggest ICU hospital in nine days. The Japanese should look to the British for inspiration as an example of a nation that can pull together in a time of crisis.

I'm tired of hearing the Japanese media, medical staff and politicians complaining that nothing can be done about this shortage, which has been going on for a while now. I'm reminded of Fukushima and the Kobe earthquake. Ugh.

17 ( +19 / -2 )

My daughter-in-law is a nurse in a private hospital near Tokyo Disneyland. She has had one 24 hour break since mid-March and is working 12 hours on - 8-10 hours off on a rotating hamster wheel shift. She’s in her mid-20’s and has aged immensely in the last month. It’s downright criminal, but she dare not complain or she will be out the door. I know nearly every nurse in Tokyo is in the same situation. This is the second pandemic. Health care workers working themselves to death.

21 ( +22 / -1 )

There was a government plan to have 9,000 beds in Tsukuba as an emergency hospital.

The government had a plan to do it, as it is close to Tokyo. Tokyo can't cope well now, and the patients must go somewhere.

If the Chinese can build hospitals in Wuhan, why can't it happen here?

3 ( +12 / -9 )

I hear Makuharri Messe is being preppped to take 1,000 people

0 ( +4 / -4 )

Every country is facing the same problem. And every country needs to learn from this and prepare.

SlaybachToday  05:43 pm JST

If the Chinese can build hospitals in Wuhan, why can't it happen here?

Because China is a one party authoritarian dictatorship and if the government chooses to do something, nothing can stop them, not individual not even human rights, Would you be happy if Japan could build a hospital very quickly like China and also be able to arrest you and make you dissappar because you voiced an opinion contrary to that of the government? Or advocated something terrible like "democracy"?

-5 ( +12 / -17 )

If the Chinese can build hospitals in Wuhan, why can't it happen here?

Sure, if you don't bother with safety, environmental, and disaster management, yeah, you can build a shitty hospital in a week. It'll collapse in the next earthquake though.

-1 ( +11 / -12 )

It seems like many nurses are kinda like soldiers being sent to war without combat gear. Unimaginable. Horrifying to think about, really.

8 ( +8 / -0 )

OssanAmerica - Every country is facing the same problem. And every country needs to learn from this and prepare.

Every country? There are more countries in the world besides Japan and the US. Many countries have beaten the virus with social distancing and closing down non-essential businesses. These countries have not run their medical staff into the ground by allowing virus cases to spiral beyond capacity of the medical facilities. Yes, countries do need to learn, but they need to learn their faults.

3 ( +12 / -9 )

SlaybachToday 05:43 pm JST

There was a government plan to have 9,000 beds in Tsukuba as an emergency hospital.

The government had a plan to do it, as it is close to Tokyo. Tokyo can't cope well now, and the patients must go somewhere.

If the Chinese can build hospitals in Wuhan, why can't it happen here?

Even the useless UK is building and opening new hospitals. A 4,000 bed coronavirus hospital in East London:

https://metro.co.uk/2020/03/25/inside-new-4000-bed-coronavirus-hospital-built-excel-centre-12455409/

And another, smaller one in Birmingham, with several more to come:

https://news.yahoo.com/prince-william-opens-uk-emergency-132116212.html

If the UK, which isn't a one-party authoritarian communist dictatorship can do it, why can't Japan? It's a good question. What could the answer possibly be?

11 ( +16 / -5 )

The UK Nightingale hospitals were built in unused large conference centres, using exhibition divider panels (Octanorm) for patient spaces, set up power, vacuum and oxygen lines, then beds and treatment equipment. 5 built so far, 2 more to go, with capacities from 300 - 1,000 (ultimately 5,000) patients. Most of these buildings were provided free of charge, though some owners had to be shamed into that. Sadly, they are hardly used, due to policy and staff shortages, even though they have non-working airline staff and other volunteers in there as care support workers.

There are enough large conference centres in Japan to do the same, as well as exhibition builders who could easily construct it, and power it.

12 ( +12 / -0 )

There is shortly to be a minutes silence in the U.K. to remember the essential workers who have died of the virus. At least 140 healthcare workers and carers have died, as well as transport workers. The government do not have enough PPE and don’t care - they just lied about the amount of equipment available eg counting single gloves as one item. Essential workers are just canon fodder.

6 ( +7 / -1 )

MAY GOD save all the good people.

0 ( +2 / -2 )

Paraphrasing the old PBS "Frontline" open

In the world there is a line where the men and women dedicated to medicine work, the frontline. Their dedication is heroic and uplifting. Now, their story.

3 ( +3 / -0 )

J-govt had a good 2 months window to prepare seeing what was happening overseas...in their typical style they did sh..t all to get ready , no proactive approach whatsoever , just reacting to everything after the fact and very poorly at that....ya know, sh... is hitting the fan just about now, lets set up a panel to meet, study, mull over what we could possibly recommend and urge everyone to do. Medical equipment shortage? Only after hospitals started running out of gear has Jgovt asked J-Inc to co-operate in producing whats needed , with the exception of Sharp that started their mask production reasonably quickly ( thanks to Taiwanese mgmt no doubt ) we perennially hear Suga announce such and such manufacturer agreed to co operate and will get rolling by ' next month ' or so. Smaller family run businesses have been much quicker to step up and credit to them for that. Abe & LDP Inc ? Hopeless.

7 ( +10 / -3 )

The UK Nightingale Hospital is just a government PR job and a waste of money and resources. 2,000 beds with another 4,000 but since it opened less than 50 patients. Shortage of nurses. Army now removing some of the equipment.

750,000 British people volunteered to help out but very few actually used.

UK Government said 100,000 per day tests by end of April. We are at the end of April and less than 40,000.

British medical staff without enough PPE's promised by the government.

8 ( +10 / -2 )

This article is trying to sex up the situation in Tokyo like it's the U.S. or in parts of Europe.I don't read about the 500,1000 or 2,000 dying per day here like elsewhere was going through.Behave!

-5 ( +6 / -11 )

For heavens sake, it doesn't have to be a long fight! It's not an insurmountable problem. Other countries can deal with it. Why can't Japan?

AND AGAIN, INVALID CSRF!

2 ( +6 / -4 )

Tokyo is the epidemic center of Japan-if only Tokyo residents could stay at home....

7 ( +8 / -1 )

The UK Nightingale hospitals... Sadly, they are hardly used, due to policy and staff shortages, even though they have non-working airline staff and other volunteers in there as care support workers.

They were hardly used because due to early lockdown UK hospitals never reached capacity (except for one hospital in NW London) and ICU bed capacity is now over 50%. There was never an issue with staffing.

It is true that like everywhere else, UK hositals came close to running out of PPE, but never did and were alwayys able to meet WHO guidelines for hosital staff at all times. Its a very different case in private nurseing homes which have had to buy their own equipment due to shortages. There is evidenc eof some hospitals contributing to shortages by hording equipment and the NHS Logistics Management has been critizised by the Army. No one in the UK, including opposition parties, Unions and Healthcare workers have claimed the Government doesn't care - just that it has been too slow.

Japan is different - many small proviate hositals that are not greated up for pandemic type situations, few ICU beds and quite basic facilities in some. But the level of infection and number of deaths remains very low comared to other developed countries.

3 ( +7 / -4 )

AgentXToday 04:37 pm JST

So.. St. Luke's is busy, but not necessarily ALL hospitals like the headline infers. And seriously.. 8 beds in the ICU there and you're surprised it's maxed out?

TomToday 04:39 pm JST

I agree with AgentX

LudditeToday 05:06 pm JST

Eight ITU beds! Only eight! WTF? A hospital like St Luke’s only having eight ITU beds is appalling.

Even in the time before corona, this would be scandalous - now it’’s sheer negligence.

St Likes has Several Critical Care Sections in the hospital the Cardio Care Unit has around 50 beds which were almost full pre COVID19.

As the quality of service is so high and reliable compared to other hospitals very reliable and modern compared to other hospitals in town like Hiroo, which I would I not recommend their ICU at all. I was lucky to get a room in St Lukes ICU as the demand is so high to get in. All ICU rooms are private and most staff speak english. They have more the 8 ICU beds (and applies to most hospitals in Japan), but they cant kick out current ICU patients who need care. And most of the floor I was on, most of the patients on my floor really looked frail and needed Critical Care.

They have a dedicated Infectious disease center who are very thorough, sometimes over thorough when they check your case. And Dr Sakamoto is very level headed and down to earth person in handing things when I met her. Far better than 2 other hospitals I was at last year before St Lukes.

AgentXToday/TomToday/LudditeToday assumptions arent facts.

1 ( +3 / -2 )

Another lazy piece of journalism. They (seemingly) talk to ONE hospital and then write a sensational article about how Japan's healthcare system is collapsing - instead of actually researching the nationwide situation. So far, Japan is dealing with this pandemic very well. The system is (as expected in a global pandemic) under pressure, but it's still coping. We have less than 400 total deaths nationwide in a country of over 126 million people. You can argue about testing this and that, ICU beds here and there and so on, but the only real measure that matters is the number of deaths. Hopefully Japan will continue to cope with this in a calm and appropriate manner. There are so many people, not least foreigners living in Japan, complaining about how poorly Japan is handling this crisis. These people don't seem to look at the facts but rather get carried away with emotional outbursts based on nothing but their own biased opinions. It is also rather telling when one looks at how the home countries of these complainers are dealing with this situation compared to how Japan is doing.

-3 ( +5 / -8 )

Would you be happy if Japan could build a hospital very quickly like China and also be able to arrest you and make you dissappar because you voiced an opinion contrary to that of the government?

Yes, and then no. Are you implying that to be able to build an emergency hospital quickly you also have to arrest or disappear people? Is it not possible to do a good thing without having to do a bad one too? Please talk us through your logic.

6 ( +7 / -1 )

Sorry zichi but your info is wrong, despite various shortcomings the reason so few of the Nightingale beds have been used has nothing to do with staffing but because the social distancing measures taken by the vast majority of people have done what they were meant to do; the curve has been flattened enough that the NHS has coped. The equipment is being redeployed rather than sit there unused. Believe me I will be happy if all the emergency hospitals prove to be a waste of money!

Democracies can react as fast and more efficiently than one party states once you give people the freedom and responsibility to act. Dictatorships are dependant on top down direction which is always inefficient and often miss directed. Whether Japan can emulate what has been done elsewhere will be determined by their culture and societal infrastructure. Democracies are not all the same.

-3 ( +0 / -3 )

englisc aspyrgend

Sorry zichi but your info is wrong, despite various shortcomings the reason so few of the Nightingale beds have been used has nothing to do with staffing

Not what I read in the British media. There is a shortage of ICU nurses.

https://www.theguardian.com/world/2020/apr/21/nurse-shortage-causes-nightingale-hospital-to-turn-away-patients

5 ( +5 / -0 )

I really wouldn’t trust the Guardian.

-5 ( +0 / -5 )

englisc aspyrgend

I really wouldn’t trust the Guardian!

I do and read it everyday (Guardian). The post isn't a Guardian exclusive.

How about the East Devon Watch?

https://eastdevonwatch.org/2020/04/22/nurse-shortage-causes-nightingale-hospital-to-turn-away-patients/

The are many media outlets with the same post.

5 ( +5 / -0 )

There is a shortage of ITU nurses in the UK. That’s why the Nightingale turned away patients. The NHS had 43,000 nursing vacancies before coronavirus, there is a chronic shortage of nurses of all specialisms.

2 ( +2 / -0 )

@Zichi The Guardian is a notorious left wing source of headline grabbing disinformation. This is the NHS response as reported in the Nursing Times, which I hope you would agree is a more reliable source.

https://www.nursingtimes.net/news/coronavirus/nhs-refutes-claims-nurse-shortages-behind-nightingale-hospital-underuse-22-04-2020/

To put Japan's experience in context with W Europe. Belgium 622 deaths per 1m pop, Spain 503, Italy 446, France 350, UK 311, Japan 3. Even allowing for significant differences in recording morbidity, image the pressure Japan's hospitals would be under if the country were anywhere near these numbers

-7 ( +0 / -7 )

I work in a hospital that serves population of 200 000 people in small European country. Our relatively small hospital had 10 ICU beds and in a short time that was doubled and if necessary we can create more beds to operation rooms. We have public healthcare and our hospital can never refuse to take any patient. It is ridiculous that hospitals in Japan can refuse to take in patients in critical condition.

4 ( +5 / -1 )

so when you have this type of administration , this is what happens in pandemic

first deny that they have a problem,

second, they have everything under control

third, they are doing everything possible, shortage of medical masks, medical equipment for hospital staff, equipment for ICU, testing kits, and 1000s more.

fourth, they are doing things special for their people ( free masks)

fifth, they are asking people to sacrifice for good of the country , stay home

finally, if you are sick, best of luck to you. hope you can find a hospital,

2 ( +2 / -0 )

And they’re talking about possibly re-opening some schools after May 8th, that just wouldn’t be the smartest thing to do without a plan whatsoever.

0 ( +1 / -1 )

God help us if a chemical or biological attack ever happened in Japanese soil. I hope after this has cleared that local governments will come up with a plan to turn a gymnasium or concert facility into a mass causality center for respiratory type illnesses. Oxygen tents, breathing apparatuses etc. with proper planning, this can be accomplished. Just like the military stockpiling weapons, governments can plan for this also.

1 ( +1 / -0 )

I have an idea. Shut down prefecture borders for the next week. Close the Shinkansen and other major train lines. Close highways and domestic flights.

Stay at home as much as you possibly came. This will all take pressure off doctors and nurses and other support workers. Over 100 National Health Service workers have died in Britain already. Is not fair on these people.

0 ( +1 / -1 )

The BBC made a video report about a "makeshift" Covid-19 centre, created recently in Japan:

"Until recently, Japan had been one of the success stories in controlling the spread of Covid-19. In February and March, Japan succeeded in suppressing early cluster outbreaks, and in keeping total infections in the hundreds. But now the capital Tokyo appears to have a developing epidemic with more than 3,500 cases confirmed. Countrywide there are now more than 12,000 cases.

> Doctors in Tokyo say a state of emergency, declared two weeks ago, is not slowing the spread of the virus enough to stop new cases overwhelming the hospital system.

Rupert Wingfield-Hayes and the BBC's Tokyo team have been inside...[St Marianna Hospital, Kawasaki]...south of the capital, which has built a makeshift Covid-19 unit in just 10 days, to try to deal with the overflow."

https://m.youtube.com/watch?feature=youtu.be&v=R8GMs6N3vN4
0 ( +0 / -0 )

I have an idea. Shut down prefecture borders for the next week. Close the Shinkansen and other major train lines. Close highways and domestic flights. 

Now you’re talking about incapacitating the country and that’s something the leaders in Japan won’t do, makes sense to me, but you have to remember that Japan leaders don’t want to bear the full responsibility of a complete meltdown and millions of complaints and lawsuits, not to mention the suicide rate that they have to be financially and politically responsible for.

Stay at home as much as you possibly came. This will all take pressure off doctors and nurses and other support workers. Over 100 National Health Service workers have died in Britain already. Is not fair on these people.

They can’t even force the Pachinko parlors to close, how will they tell people to remain indoors? Look, you’re making absolute rational and logical sense, but these leaders STILL focus and talk about the Olympics during this pandemic, I personally don’t know a single person that’s thinking about the games now. But yeah, rest assured Tokyo will make sure we all pay for this, so tax hikes will be coming down the road.

0 ( +1 / -1 )

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