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Hospitals in Japan are increasingly rejecting sick people as the country struggles with growing coronavirus infections and its emergency medical system collapses.
In a recent case, 80 hospitals rejected an ambulance carrying a man with a fever and shortness of breath and forced him to search for hours for a hospital in central Tokyo to treat him. Another feverish man finally arrived at a hospital after paramedics unsuccessfully contacted 40 clinics.
The Japanese Association for Acute Medicine and the Japanese Society for Emergency Medicine say that many hospital emergency rooms refuse to treat people, including those with strokes, heart attacks and external injuries.
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AP
In March, there were more than 931 ambulance cases rejected by more than five hospitals in Japan or driving for 20 minutes or more to reach the emergency room.
Initially, Japan seemed to have controlled the outbreak by chasing clusters of infections in specific locations, usually confined spaces such as clubs, gyms, and hangouts. But the spread of the virus outperformed this approach, and most new cases are impossible to trace.
The outbreak has highlighted underlying weaknesses in healthcare in Japan, which has been praised for its high-quality insurance system and reasonable costs. In addition to the general unwillingness to accept social distancing, experts criticize the government’s incompetence and the widespread shortage of protective equipment and gear that medical workers need to do their jobs.
Japan lacks sufficient hospital beds, medical workers, or equipment. Forcing anyone with the virus to be hospitalized, even those with mild symptoms, has left hospitals overcrowded and understaffed.
The “collapse of emergency medicine” has already happened, a precursor to the general collapse of medicine, the Japan Association for Acute Medicine and the Japanese Society for Emergency Medicine said in a joint statement. By rejecting patients, hospitals are putting an undue burden on the limited number of critical and advanced emergency centers, the groups said.
“We can no longer carry out normal emergency medicine,” said Takeshi Shimazu, an emergency doctor at the University of Osaka.
There are not enough gowns, masks and face shields, which increases the risk of infection for medical workers and makes treating Covid-19 patients increasingly difficult, said Yoshitake Yokokura, who heads the Medical Association of Japan.
In March, more than five hospitals rejected 931 ambulance cases or drove for 20 minutes or more to reach an emergency room, compared to 700 in March last year. In the first 11 days of April, that increased to 830, the Tokyo Fire Department said. Department official Hiroshi Tanoue said the number of cases increased greatly because suspected coronavirus cases require isolation until test results arrive.
Infections at various hospitals have forced medical workers to isolate themselves at home, which has worsened the staff shortages.
New Tokyo cases began to increase in late March, a day after the Tokyo Olympics were postponed for a year. They have increased at a rapid rate for a current total of 2,595. Most patients are still hospitalized, pushing treatment capacity to its limits.
With around 10,000 cases and 170 deaths, the situation in Japan is not as serious as that of New York City, which has had more than 10,000 deaths, or Italy, with more than 21,000 deaths, according to Johns Hopkins University .
NEWS FROM REN ONUMA / KYODO
Japan’s Prime Minister Shinzo Abe has called on manufacturers to step up production of masks and gowns, fans and other supplies.
But there are fears that the Japan outbreak could worsen.
Doctors say they are very thin. Since it takes time to diagnose Covid-19, patients who present in hospitals can unintentionally put those around them in danger. On Thursday, the medical workers union demanded that the government pay them high-risk allowances and provide sufficient protective equipment.
Medical workers are now reusing N95 masks and making their own face shields. The main city of Osaka has sought contributions from unused plastic raincoats to wear as clothing for hazardous materials. Abe has asked manufacturers to step up production of masks and gowns, ventilators, and other supplies.
A government virus task force warned that in the worst case scenario where no preventive measures were taken, more than 400,000 could die from a shortage of ventilators and other intensive care equipment.
Prime Minister Shinzo Abe has said that the government has secured 15,000 fans and is receiving support from Sony and Toyota Motor Corp. to produce more.
Japanese hospitals also lack an ICU, with just five per 100,000 people, compared to about 30 in Germany, 35 in the United States and 12 in Italy, said Osamu Nishida, head of the Japanese Society of Intensive Care Medicine.
Italy’s 10 percent death rate, compared to 1 percent in Germany, is due in part to a shortage of facilities in the ICU, Nishida said. “Japan, with intensive care units not even half of Italy’s, is expected to face excess mortality very quickly,” he said.
Japan has been limiting testing for the coronavirus primarily because of rules that require any patient to be hospitalized. Rising infections have prompted the Ministry of Health to loosen those rules and move patients with milder symptoms to hotels to free beds for those who require more care.
Calls for social distancing have not worked well enough in crowded cities like Tokyo, experts say, with many people still traveling to offices on crowded trains, even after the prime minister declared a state of emergency.
Authorities fear that people may travel during the upcoming “golden week” vacation in early May.
“From the medical field, we are hearing screams of despair because lives that can be saved are no longer possible,” Abe said Friday.
“I ask everyone again, please refrain from leaving.”
