New wave of infections threatens to collapse Japan hospitals

TOKYO (AP) — Hospitals in Japan are increasingly turning away sick people as the country struggles with surging COVID-19 infections and its emergency medical system collapses.

In one recent case, an ambulance carrying a man with a fever and difficulty breathing was rejected by 80 hospitals and forced to search for hours for a hospital in downtown Tokyo that would treat him. Another feverish man finally reached a hospital after paramedics unsuccessfully contacted 40 clinics.

The Japanese Association for Acute Medicine and the Japanese Society for Emergency Medicine said many hospital emergency rooms are refusing to treat people including those suffering strokes, heart attacks and external injuries.

Japan initially seemed to have controlled the outbreak by going after clusters of infections in specific places, usually enclosed spaces such as clubs, gyms and meeting venues. But the spread of virus outpaced this approach and most new cases are untraceable.

The outbreak has highlighted underlying weaknesses in medical care in Japan, which has long been praised for its high quality insurance system and reasonable costs. Apart from a general unwillingness to embrace social distancing, experts fault government incompetence and a widespread shortage of the protective gear and equipment medical workers need to do their jobs.

A man rides a bike at the Harajuku area of Tokyo. PHOTO: AFP

Japan lacks hospital beds, medical workers or equipment. Forcing hospitalisation of anyone with the virus, even those with mild symptoms, has left hospitals overcrowded and understaffed.

The “collapse of emergency medicine” has already happened, a precursor to the overall collapse of medicine, the Japanese Association for Acute Medicine and the Japanese Society for Emergency Medicine said in a joint statement. By turning away patients, hospitals are putting an excessive burden on the limited number of advanced and critical emergency centres, the groups said.

“We can no longer carry out normal emergency medicine,” said Osaka University emergency doctor Takeshi Shimazu.

There are not enough protective gowns, masks and face shields, raising risks of infection for medical workers and making treatment of COVID-19 patients increasingly difficult, said Yoshitake Yokokura, who heads the Japan Medical Association.

In March, there were 931 cases of ambulances getting rejected by more than five hospitals or driving around for 20 minutes or longer to reach an emergency room, up from 700 in March last year. In the first 11 days of April, that rose to 830, the Tokyo Fire Department said. Department official Hiroshi Tanoue said the number of cases surged largely because suspected COVID-19 cases require isolation until test results arrive.

Infections in a number of hospitals have forced medical workers to self-isolate at home, worsening staff shortages.

Tokyo’s new cases started to spike in late March, the day after the Tokyo Olympics was postponed for a year. They’ve been rising at an accelerating pace for a current total of 2,595. Most patients are still hospitalised, pushing treatment capacity to its limits.

With about 10,000 cases and 170 deaths, Japan’s situation is not as dire as New York City’s which has had more than 10,000 deaths, or Italy’s, with over 21,000 fatalities, according to Johns Hopkins University.

But there are fears Japan’s outbreak could become much worse.

Doctors said they are stretched thin. Since it takes time for COVID-19 to be diagnosed, patients who show up at hospitals can unintentionally endanger those around them. On Thursday, the medical workers’ union demanded the government pay them high-risk allowances and provide sufficient protective gear.

Medical workers are now reusing N95 masks and making their own face shields. The major city of Osaka has sought contributions of unused plastic raincoats for use as hazmat gowns. Abe has appealed to manufacturers to step up production of masks and gowns, ventilators and other supplies.

A government virus task force has warned that, in a worst-case scenario where no preventive measures were taken, over 400,000 could die due to shortages of ventilators and other intensive care equipment.