Nepalibabu comments

Posted in: Japan reports record high 255,534 coronavirus cases; 27,453 in Tokyo See in context

I agree with the other posters here critical of the J-gov's expectation that self-restraint is enough to 'live with covid'.

There are over 4000 deaths in the last 30 days, easily beating the previous wave -- that's abject policy failure.

I hope that when they 'analyze' the result of their guidance U-turn (read: zero intervention) they don't call this a 'success'. . . unless 'success' is drawing attention away from the LDP's Moonie mess, in which case they may have something going. . .

4 ( +10 / -6 )

Posted in: Japan reports 231,499 coronavirus cases; 29,416 in Tokyo See in context

I agree that medical infrastructure should be increased in Japan, but the issue is also the medical staff, which is in shortage -- I wonder why they haven't brought in the military doctors and nurses this time? Bad optics? I suppose it would underscore how this policy U-turn has yielded the greatest number of infections and deaths to-date. . .

As for touting vitamins and off-label pharmaceuticals: if those did indeed work, wouldn't the WHO be giving that guidance, especially to poor countries? The poorer the country, the more pragmatic they are in workarounds, and yet, universally they are clamoring for vaccines, antivirals and antibody treatments, just like the rich countries. For me, that says a lot.

As for the aged seeking medical treatment when they develop a sustained fever: they are the most vulnerable, so the government wants to make sure that they are monitored, if possible -- that is sound medical practice.

-1 ( +4 / -5 )

Posted in: Japan reports 231,499 coronavirus cases; 29,416 in Tokyo See in context

For the anti-crowd, let me ask you: what is your public health guidance?

Should we just stop caring no matter how many people are getting infected and dying?

Or does it not matter because those most impacted are pre-Internet literate, so they can't mount an online response to the wanton insensitivity?

5 ( +10 / -5 )

Posted in: Record high number of ambulances struggling to find hospitals in Japan See in context

1500+ dead in a week from covid.

No flu does that.

Medical systems heavily impacted; this article shows the effect on ER.

This is a policy failure, IMO. The J-gov experimented with a 'hands-off' approach: these are the consequences.

@Makoto Shimizu: thank-you for your feedback -- I agree about the need to emphasize personal responsibility in mitigating risk. As for extra medical facilities (and as @Brian William Meissner also mentioned), the issue is the required staffing, not just the extra beds. Again, Mr. Shimizu, I agree that the dropping of restrictions has led to this.

Those most impacted by CV are the most aged in this society, who are also the least represented on online forums like this; how do we address their very real concerns that each wave is bringing higher amounts of hospitalization and death and not the reverse -- isn't this an indictment of current J-gov policy? What mitigation measures can relieve the infirm/aged concerns?

@Alex: thank-you. I agree with you, for the most part. When I needed extensive consultation with a doctor, I benefitted from having a primary care physician who would see me by appointment (or now, with LINE doctor which is a wonderful covid-era telemedicine response). I have had a very few bad experiences with consultations, but, by-and-large, my family has received attentive, intelligent and correct diagnosis and treatment.

@Antiquesaving: I didn't presume the West is America, even though I am an expat American, but it is important for a significant number of the U.S. posters here to understand the difference, because there is an expected amount of ignorance as to what those differences are. Thank you for your comment.

Everyone: for the benefit of practical discussion, at what point do you think the J-gov should do more to mitigate the effects of this pandemic, in light of the breakdown of the healthcare services and with the largest numbers of infections and deaths to date? Should there be any directive to reduce movement, or guidance to businesses to change hours of operation that depends on infection/mortality? Any other policy recommendations?

1 ( +6 / -5 )

Posted in: Record high number of ambulances struggling to find hospitals in Japan See in context

Granted, there are no perfect medical systems.

Ambulances are free here in Japan -- I never wince thinking of picking up the phone to have one pick up someone in our family. True, they also serve as dispatch and call around -- that should change, even though it hasn't negatively impacted our usage of their services thus far.

So many other parts of the Japanese medical system work beautifully, however: it provides very good care to the masses in a socialized manner. If you don't have money, you're still taken care of. That makes it the envy of so many countries in this world, IMO.

This article is underscoring how the current covid policy 'experiment' (zero restrictions on movement, other than 'guidance' to elderly/infirm to be 'vigilant') is leading to the record high infections and hospitalizations, which in turn is dramatically affecting ER services in much of Japan.

A more interesting discussion would be: at what point (infections/death) should the J-gov change tack and incrementally increase interventions to push the curve down to lower infections and deaths? Can they employ more preventive policy in the future to avoid what is happening now?

This month of August is the reporting the highest levels of infections and deaths of this pandemic so far: how does this reflect on the J-gov's hand-off approach?

Some posters say that downgrading this to flu-like designation is the answer, but that will not change the transmissibility of this variant (which spreads faster than the measles). We know how this virus hits centers with vulnerable populations, like nursing care facilities and hospitals: how are the aged and infirm going to benefit from magically deciding this virus is no worse than the flu? We know it is far more dangerous than the flu for vulnerable people.

What are your thoughts about J-gov policy now, and what metrics should decide public health policy intervention?

3 ( +7 / -4 )

Posted in: Japan reports 166,205 coronavirus cases; 23,511 in Tokyo See in context

Policy discussion:

The J-gov said that no restriction on movement was necessary, and yet, here we are with the highest rate of infection and death this month of August.

Those dying are even more in the higher age brackets, passing away from secondary effects of covid, rather than pneumonia, strokes, etc.,, like in Delta, and earlier waves.

I, for one, and being medically vulnerable, didn't want to see the introduction of SOE or limitations on business, understanding the economic and psychological impacts on society -- to be honest, I wanted to be able to go to prefectures far away without stigma. I understood and supported this 'experiment' with the policy shift of the J-gov.

However, now I wonder this: at what point (infections/deaths) should the government intervene, in the way of guidance on movements and restrictions on business? Should there be none at all, no matter how many deaths and hospitalizations?

Keep in mind: this is impacting the aged the most, and of course, the infirm as well.

Personally, my baseline has always been about the state of the healthcare system: if they become less efficient (or inoperable), then that is when I have advocated for government intervention in the way of guidelines and 'soft' intervention (like early closing of businesses, weekend suspension of large scale retail facilities, etc.).

How about you all?

2 ( +7 / -5 )

Posted in: Japan reports 166,205 coronavirus cases; 23,511 in Tokyo See in context

For more information on the effect of vaccination status vis-a-vis infection and death rates, see here: https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-status

1 ( +8 / -7 )

Posted in: Japan reports 166,205 coronavirus cases; 23,511 in Tokyo See in context

The largest segment of the population that are double-vaccinated are also the oldest, who in turn are the most vulnerable, who in turn are the most likely to be hospitalized and who are in turn are the most likely to die, simply because they are the largest population of the most vaccinated people.

One cannot 'analyze' efficacy of the vaccination by 'looking' at the numbers in this way: otherwise false conclusions will be drawn. . .

5 ( +14 / -9 )

Posted in: Injured motorcyclist returned to accident scene after hospital refuses to take him due to positive COVID test See in context

Medical services are faltering under the increased numbers of infections, despite bureaucratic changes in preparation for this wave.

Downgrading this virus' severity to influenza will not change the transmissibility of this virus, which is greater than the measles -- what used to be the most contagious of airborne pathogens.

If medical staff are infected, they are a risk to the vulnerable patients they care for: this is why there are strict rules on which establishment can take a CV+ patient and/or ER patient.

I think we can imagine how doctors, nurses and health officials feel about the 1300+ people who died during the last 7 days in Japan, and the tens-of-thousands who are hospitalized in moderate-to-severe condition.

And then the covid-fatigue of the general public, wishing for a magical ending to this all.

Between the hammer and anvil is what they're feeling.

1 ( +3 / -2 )

Posted in: Japan reports 138,613 coronavirus cases; 23,135 in Tokyo See in context

Certainly the families and friends of the 1300+ dead this past week are very sad, FF Steve.

The infirm and aged are horrified by this wave -- it is the worst yet.

No glossing over their misery. . .

2 ( +9 / -7 )

Posted in: Japan reports 168,826 coronavirus cases; 20,401 in Tokyo See in context

If people are sick enough to need hospitalization, then they are -- if there is capacity.

Whatever the J-gov decides to do in terms of reclassification of CV, it will not change the virus' dynamic towards a population: it will still sicken people, regardless of how we regard it -- even if it is a hinderance to our everyday enjoyment, and we punish it by putting it into the 'influenza corner'.

Cost of care being shouldered by the J-gov (and incidentally that means we-the-taxpayers foot the bill) leads to the question of both the burden of cost for the minority who get very sick, and the associated cost that we have to fork out in social insurance premiums, when financing the medical budget.

It's a delicate dance: liberalizing restrictions and not overloading the whirring gears of medicine.

Yet, that is the experiment we're all witnessing now, and one that is absolutely necessary to do. Yes, that's right: we need to know how far we can open things up and reduce restrictions to find that balance between caution and freedom.

Even if we manage to get through this seventh wave without enormous loss of life (which remains to be seen) and without undermining ER and other medical services, my concern is for the possible emergence of a deadlier variant (i.e., more transmissible and/or more pathogenic).

Coupled with 'rona-fatigue and magical thinking, that scenario would be less pretty than this one right now.

Have fun, act responsibly, and remember to see both the tree-for-the-forest, and the forest-for-the-tree.

3 ( +7 / -4 )

Posted in: Japan's summer holidays in full swing with lack of COVID restrictions See in context

Hopefully the results of the one-way border crossing experiment will lead to the J-gov dropping entry restrictions ASAP. I agree with the main thrust of the posts here: reciprocity of free movement should be a sign of international respect for each country to another.

I state that as a vulnerable person who is taking every precaution that I can for myself and my family: we need to test the limits of the healthcare system's capacity to absorb infections/hospitalizations in a sincere attempt for attaining a 'new normality'.

Personally, I won't engage in many of the activities that others may: but that is my choice borne out of medical necessity.

I respect that people, especially the young, are entitled to pursue their happiness, and for the governments of the world (please listen, Japan!) to do everything to accommodate that.

If the healthcare system falls down, then that will force the benchmark to be tightened to safeguard this critical infrastructure (because it serves all age groups): but we will only know whether that will happen by testing the expansion of freedoms, not the reverse.

Fingers crossed!

Enjoy you summer breaks and holidays and stay safe.

0 ( +4 / -4 )

Posted in: Japan reports record high 250,403 coronavirus cases; 34,243 in Tokyo See in context

@mountaingrill: thank you for those firsthand details; it helps for those outside of Japan to understand the incredible job, under duress, that the medical system and government are attempting to do.

FYI, being in a high-risk group, I don't pay for the test at all.

Every day I thank my HR, my municipal health authorities and my doctors for the shielding they are providing me and my family.

I hope your bout was short-lived and inconsequential to your longterm health. :-)

3 ( +7 / -4 )

Posted in: Japan reports record high 250,403 coronavirus cases; 34,243 in Tokyo See in context

@Nosui,

Once the disease, the long-covid phenomena and infection patterns are better understood, then I think it will be given the 'flu' status, IMO.

As for vulnerable populations; many are middle-age and working, so to give them additional financial burden is to be avoided. So, when the gov't is picking up the tab, they look for ways to reduce infection, and by keeping this in the top-tier, they can give mitigation guidance to companies and public institutions to reduce infections and serious disease -- which helps the bottom-line.

Less infection, less hospitalization means less expense for all tax payers.

2 ( +9 / -7 )

Posted in: Japan reports record high 250,403 coronavirus cases; 34,243 in Tokyo See in context

Medical services are 'critical infrastructure'; if they begin creaking, a government that shoulders the lion's share of care makes decisions based on public utility and financing.

Again, this is no flu -- just because it would be expedient to arbitrarily decide it is, does not magically change what this virus is doing to the population-as-a-whole.

As medical bureaucratic structures are changed, increasing medical service availability and as more advanced medical technology is developed and deployed, that hopefully will change the equation.

7 ( +15 / -8 )

Posted in: Japan reports record high 250,403 coronavirus cases; 34,243 in Tokyo See in context

@Nosui

Because this is categorized at the most dangerous level of airborne contagion, people don't pay for treatment.

Normally, we pay 30% of the cost of any treatment, including hospitalization, up to a monthly cap.

Since moderately-severely ill covid patients can be hospitalized for weeks or months (especially those on ECMOS life-support), this can be very costly.

Also, consider that it is the infirm and elderly who are most impacted, and many of those in that demographic have limited means of income.

The J-gov is carefully considering that point; discussion is now centered on allowing for exceptions in how the costs are carried if they downgrade CV to flu-like status.

However, as this surge is showing, hospitalizations are very high, and deaths are almost certainly going to be larger than the last surge, which dwarfed the previous surge (Delta).

7 ( +13 / -6 )

Posted in: Japan reports record high 250,403 coronavirus cases; 34,243 in Tokyo See in context

The difficulty in downgrading this to a flu is for those who develop severe symptoms and need hospitalization: they will have to pay out-of-pocket, unlike they do currently with the most severe categorization of the disease. In this sense, the situation is very different from Thailand (I know, since I lived in Thailand before). In Thailand, you have to sort out your private medical insurance, otherwise public medicine standards are substandard.

3 ( +12 / -9 )

Posted in: Japan reports record high 250,403 coronavirus cases; 34,243 in Tokyo See in context

The numbers are cresting, as a national average, but the slope going down might be long indeed, given the Obon movement of the population.

I hope that the wider availability of antivirals and the ongoing 2nd booster rollout will help those most in need of protection.

-2 ( +9 / -11 )

Posted in: Japan reports 212,552 coronavirus cases; 29,115 in Tokyo See in context

Alright, let's frame it differently: how about a poll?

How many daily deaths from CV are acceptable enough before the naysayers here think that masking up, following the 3C's and actively mitigating risk are required?

500 a day?

1000 a day?

1500 a day?

If you were public health advisors, at what point would you tell the public it's high time to keep those masks snuggly fit?

When would you start recommending the vaccines to the vulnerable?

I know what the experts say, but I'm curious what you'd tell an aged/infirm person right now who is afraid their sniffles might be their doom.

Incidentally, how many lives does the influenza take, at most on a single day? I don't think it is 278. . .

4 ( +12 / -8 )

Posted in: Japan reports 212,552 coronavirus cases; 29,115 in Tokyo See in context

278 souls RIP

That's a daily record, no?

So much for this being just some 'sniffles'.

0 ( +15 / -15 )

Posted in: Japan reports 212,552 coronavirus cases; 29,115 in Tokyo See in context

Spanish and Italians have very high life expectancies.

The Mediterranean Diet is highly regarded.

And yet, the pandemic nailed them.

Any culture that already valued mask-wearing to slow airborne pathogens had, and still has, an edge in reducing risk.

But again, why take it from me?: the science and medical consensus is clear on this point.

0 ( +16 / -16 )

Posted in: Japan reports 212,552 coronavirus cases; 29,115 in Tokyo See in context

For a country with 125 million people, of which 28% are 65+ years old (36M), yeah, the masks and vaccinations are doing a great job compared to other countries with large, elderly populations.

Groupthink has its advantages, at times: personally, it's reassuring to see an ocean of masks during a surge like this.

I know the aged, the infirm and the parents agree with me, by-and-by.

Keep yourself safe -- and keep other safe by doing it.

-9 ( +13 / -22 )

Posted in: Japan to offer Omicron COVID shot to at least twice-vaccinated people See in context

@virusrex

Thank you for being a standard bearer for truth-as-scientific-method.

Keep your fingers flying and your eyes squinted.

-1 ( +5 / -6 )

Posted in: Japan to offer Omicron COVID shot to at least twice-vaccinated people See in context

Being a medically vulnerable person with children who share these vulnerabilities, I welcome any and all medical innovations to reduce risk.

Global medical consensus supports vaccines, antivirals, antibody treatments and the like.

I feel fortunate to be in a country that can afford state-of-the art medicines and that has fully socialized healthcare.

I know that the vast majority of the elderly, infirm and disabled (whose voices don't make it to online platforms like this) would also share their gratitude for those invested in saving our lives every day -- particularly the hundreds of years of vaccinology which has saved hundreds of millions, if not billions of lives thus far.

To the naysayers, I say that your lack of trust is shameful and undermines public health measures intended to save your lives: if not now, then when you, too, are old and infirm.

Please downvote this: I'll take it as a source of pride.

1 ( +4 / -3 )

Posted in: Japan reports 227,559 coronavirus cases; 30,970 in Tokyo See in context

We're in a medical state-of-emergency in Osaka officially, thus the directive from the governor that the elderly and medically vulnerable are advised to reduce their mobility and risky activities.

When the medical system is coming off the rails (as it is here and in quite a few other prefectures) is when the government steps up its guidance and intervention.

Clearly the J-gov is experimenting with this wave: seeing how little they can intervene without seeing the medical system collapse -- and also the reason for giving more localized power to prefectural governors to make necessary public health policy decisions.

We know that industry is pressuring the government to limit interventions, and here we are.

Now, the real question is how much serious illness and death will the public accept in exchange for this hands-off approach? My guess is that as long as it primarily hits those with the least political clout (the aged, the disabled and the infirm), then people, by-and-large, will become desensitized to the numbers. But when medical systems falter, then then criticism is brought to bear on the government for not doing enough.

Let's also remember what we're seeing with this wave: the medical system is throwing all available tools at this surge: anti-virals, increased beds and medical staff, and the ongoing rollout of the 4th shot (2nd booster). If this what 'living with covid' means, then endemicity means a greater amount of risk is now part of life -- some will accept this and others will live more cautiously out of necessity.

The coming weeks will show the real mortality rates of this surge -- and whether the public will stomach it or not remains to be seen.

For the vulnerable, those who've keenly watched both the government and public reaction, there is a feeling of wariness: which priority will win out? Frustrated desire for a return to 'normalcy' or a demand that medical systems are not run ragged?

$$¥¥ vs. souls

2 ( +7 / -5 )

Posted in: Role in Japanese war machine made Hiroshima, Nagasaki A-bomb targets See in context

My grandmother was part of the Manhattan Project, as a young (and exceedingly rare female) physicist.

Her involvement was the source of much family controversy, leading to my uncles and aunts becoming avowed anti-war, anti-nuke activists during the late '60's, '70's and '80's.

She had no remorse for her role, saying that wartime circumstances required it. She was proud of her work.

She would later visit China as a tourist, shortly after Nixon met Mao, but skipped Japan. I always wondered about her reasons for avoiding Japan. Guilt? Anger?

My father worked in U.S. intelligence (USIA) in the '60's. He explained to me that the dropping the A-bombs on civilian populations in Japan was pressing the point to the Russians about what they could expect should their post-WWII ambitions go too far: the dawn of The Cold War.

He went on to teach me that, if the Americans just wished to demonstrate the repeatability of the technology and force the Japanese to surrender, they could have detonated The Bomb off the coast of Tokyo, consecutively, over a period of a few days, rather than annihilate countless humans in urban settings.

Sadly, such a model of intimidation would drive so many nations to seek these weapons of mass destruction and lead to our precarious situation that we find the world in now.

4 ( +9 / -5 )

Posted in: Japan reports 249,830 coronavirus cases; 38,940 in Tokyo See in context

@Yubaru

Those numbers are extremely alarming.

I hope that the proposed new guidance coming from Tokyo, that prefectural/municipal leadership can have greater power in making policy intervention to save lives will be adopted, and that Governor Denny puts the public welfare front-and-center.

I deeply empathize with you and the people of Okinawa; we're in a rough patch, too, in Osaka, but with medical services here that are so numerous compared to that gem of an island you are on.

Stay safe.

2 ( +5 / -3 )

Posted in: Japan reports 249,830 coronavirus cases; 38,940 in Tokyo See in context

When the medical system begins buckling, especially in countries with socialized healthcare, governments begin to ramp-up their public health directives.

If they can get more hospitals to receive moderate-severe CV patients, while not reducing quality of care for other kinds of patients, then that's great, and the mainstay of society and commerce can continue more-or-less normally.

We're summiting the peak now or soon -- it will be a rough ride down, with the lagging infections of a vulnerable minority swelling in number, as is the case with these surge curves.

For those who can (and for those who must), life moves on. For those like me, middle-aged and vulnerable, a father to vulnerable kids, we try to mitigate and reduce risk, but there are no guarantees -- but life is full of such choices.

We feel we're in a much better place now that we've accessed vaccines (twice boosted), with antivirals, antibody treatments and clinical practice based on 2.5 years of 'trench warfare' on standby for eventual infection.

Personally, in my opinion, the 'nocovid' approach will not work: this is now a part of our biological environment like colds and flus (but MUCH more pathogenic) are, so we evolve to live with the new danger: think of how we've adapted to other health threats in our day-to-day lives: we'll get through this, while sheltering the most vulnerable around us.

Take care, stay safe, and carry on.

8 ( +15 / -7 )

Posted in: Japan reports 139,687 coronavirus cases; 21,958 in Tokyo See in context

@master

They are unmasked and smiling when eating. They are unmasked for sport. They are unmasked going to and coming from school. I spend time with them daily; they are not as mentally impacted as you think. Again, consider their history of mask usage and the ability of other body language we use to convey meaning: those cues are even more dynamic now, absent an inflected mouth expression.

1 ( +4 / -3 )

Posted in: Japan reports 139,687 coronavirus cases; 21,958 in Tokyo See in context

There is no simple solution: as one ages, risks go up. If one has comorbidities, the risks go up as well. My doctor sends me a text when his clinic is picking up high positivity rates with their own PCR machines -- tells me its time for switching from a 3-layer 'quilter's cotton' fabric mask to an N-95 one.

At the same time, our kids' schools are notified by the board of education to increase vigilance for vulnerable students; those students are put near to windows and doors; the whole class' attention is brought to bear on prevention strategies. Of course, nothing is iron-clad, but it helps, and that is the important part: everyone understands that, in a county of multi-generation households, the aged family who provide daycare for the youngest are the most at-risk.

Japan has done phenomenally well, for a country its size and with voluntary compliance to government guidelines. Chalk it up to easy access to medicine, a culture that already used masks for slowing down the spread of colds/flus and a place renowned for hygiene: these all factored into slower spread.

Numbers are highest now: most transmissible variant to-date, palpable heatstroke concerns removing masks from faces (especially for children who are receiving explicit gov't instructions to not succumb to the heat) and vastly more available testing - both at-home and expanded institutional access. This is not surprising, but certainly no case for abandoning mitigation efforts: to the contrary, it supports their continuation, as best as can be done, given heat stroke concerns, which impacts the youngest and oldest the most.

Here in Osaka, asking the aged to reduce their movement is very wise: they have the most at risk, they are the largest demographic, they are the ones that fill the hospital beds first. That's shielding advice in its best application.

As for the not-so-aged (ahem), but medically vulnerable (ahem), it's a matter of personal risk assessment and life adjustments. Human Resources is very clear at this point about accommodating my needs: for a mid- to large scale employer, they have a legal obligation to reduce workplace danger: so remote work (teaching in my case) is always made available, and will continue to be the case for at least another six months: this will give the government time to gauge the medical system's capacity for high-volume infections across the age strata. I foresee a time when all my lesson prep will be pre-recorded so students can see my unmasked face, but with me masked in a classroom helping and assessing them.

I am waiting for next-generation vaccines, antivirals, antibody treatments: technology is moving a tremendous speed, and I have so much gratitude for those who are saving our lives now and engineering our future safety and care.

1 ( +4 / -3 )

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