With s drastic increase of new COVID-19 cases, the healthcare crisis is getting worse. Inpatient bed occupancy rate exceeded the "Stage 4” level in 33 prefectures. It is the worst score of the health alert levels set by the government, indicating "explosive outbreaks." The number of patients recuperating at home or "patients inaccessible to medical care” topped 25,000 in Tokyo, the area with the largest number of COVID-19 patients, and also the number of "semi-inaccessible patients" who are waiting to be admitted to hospital exceeded 10,000.

On August 2, the government changed the hospitalization policy. Before the policy change, asymptomatic patients and those with mild symptoms were sent to hotels for recuperation and patients with moderate or severe symptoms were admitted to hospital in principle. By way of the cabinet decision, the new policy indicates that "severely ill patients and those who are at high risk of becoming severely ill” are exclusively admitted to hospital, leaving others to recuperate at home in principle. As the change is almost like withdrawal of the previous policies, it should be criticized as a reluctant recognition of the delayed measures to prevent the spread of coronavirus variants which were alertly predicted. After all, the policy change without establishing any follow-up system to observe patients’ medical conditions has caused social confusion and misfortune exactly as we feared for such outcome.

In response to the severe situation, the Ministry of Health, Labor and Welfare and the Tokyo Metropolitan Government requested all medical institutions in Tokyo to secure hospital beds and accept COVID-19 infected patients according to the revised Infectious Diseases Control Law. Medical institutions that do not comply with the government’s requests without giving proper justification will “receive a warning” to follow them. If they continue to disobey the requests, their names will be publicly disclosed. In short, it means “Institutions that are not cooperative in providing more available beds are attached a stigma of dishonesty." But at the same time, it is noteworthy that the "Community Healthcare Vision" that started in 2014 is still in effect. The new vision is intended to promote the reorganization and integration of medical institutions to align with the expected number of necessary beds according to the anticipated functions in 2025, and besides, subsidies are provided when hospital beds are reduced as expected. In other words, it is a “trimming/thinning” method taken in the medical field, and notably the budgets for subsidies were allocated last year and this year as well.

This past summer, Yano Research Institute also witnessed a reality of the COVID-19 when our young employee who got infected was forced to recuperate at home. I once received an e-mail from the employee, saying, "I felt the shadow of death" for the fear of sudden changes of the disease symptoms.

Experts point out that the status of the fifth wave brought by the highly contagious variant is "as serious as a disaster we have never experienced." If that is correct, an appropriate system to correspond to the state of emergency is essentially required. Only the stopgap measures are nothing but drawing back from a fight against the pandemic. If it is the national mission to protect the lives of the people, securing hospital beds should be placed as a top priority. The effective conversion in the use of the Olympic Athletes Village, the largest possible accommodation for hospital beds in Tokyo, has not been achieved so far. However, it would be one of the options for the facility after mid-September. Can we think of alternative facilities to be used for patient care? To say the least, long-term strategies that are effective in normal times should be suspended for a while and the entire budget for medical restructuring should be delivered to prepare additional beds. That will surely be the authentic message to medical institutions and to the people in the long run.

This Week’s Focus, August 26

Takashi Mizukoshi, the President