May 11, 2021 at 13:15 JST
Deadly new coronavirus clusters that recently killed nearly 40 residents at two senior homes in the western Kansai region have underscored afresh the acute shortages of hospital beds for COVID-19 patients.
These shortages are forcing hospitals to restrict whom they admit and leading more Japanese to die needlessly.
Tackling this dire situation effectively requires closely coordinated efforts by medical institutions, including local clinics, and local and central governments. They must work together to enhance the nation’s capabilities of testing people for the virus and increasing the number of beds for caring for COVID-19 patients.
COVID-19 clusters found at nursing homes in Kobe, Hyogo Prefecture, and Kadoma, Osaka Prefecture, in April killed a total of 38 residents.
At a geriatric health service facility in Kobe, 25, or nearly 20 percent of its residents at the time, died, 23 of whom were trying to recover at the facility.
Most of them were not admitted to hospitals despite their serious conditions, according to a senior municipal government official. At a nursing home in Kadoma, 13, or nearly 30 percent of the maximum number of residents, died, eight of whom were waiting to be hospitalized.
Nursing care facilities for elderly people are vulnerable to outbreaks of infectious diseases. In a COVID-19 cluster last year, 17 people died at a nursing home in Sapporo.
Older people tend to develop serious conditions when they catch the virus. Enforcing strict measures for infection prevention and control, including mandatory mask wearing, at such facilities can be a tough challenge because some of the residents are likely to have cognitive problems such as dementia.
Diagnosing infected residents as soon as possible and ensuring that they receive proper hospital care and are admitted to hospitals if necessary are critical for preventing cluster outbreaks at such facilities.
But the nation has yet to have sufficient capabilities to implement this strategy.
It will be some time before most residents and staff members at these facilities are fully vaccinated in the ongoing immunization campaign.
While nurses are being dispatched to Osaka and Hyogo prefectures, which are facing a serious shortage of beds for COVID-19 patients, from other parts of the nation, it is unlikely that the situations in these areas will improve quickly.
In Osaka Prefecture, where most of the hospital beds reserved for patients with relatively mild conditions are being used for seriously ill patients, the number of patients being forced to recover at home surged more than fivefold to over 13,000 in four weeks through early May.
In addition to enhancing testing and health care capabilities at nursing homes, it is urgent to provide better care for people who are not admitted to hospitals, including those seeking to recover at designated hotels or their own homes.
Smaller clinics that support local health care need to play greater roles in tackling the challenge.
There are many things they can do, including treating more COVID-19 patients, making house calls and supporting facilities struggling with health care needs of residents.
In some areas where many patients are waiting to be admitted to hospitals, local governments have introduced systems to ask doctors at clinics to provide telemedicine services and visit homes of patients.
Local medical associations and administrations should work together to expand such cooperative efforts to deal with the crisis.
Meanwhile, it is mainly the responsibility of major hospitals to increase the number of beds for COVID-19 patients. Besides remodeling their facilities to accept more COVID-19 patients, they can also help by offering beds for patients who have recovered to an extent that they no longer pose infection risks for others.
The national and local governments should do their part by providing financial support for such efforts.
In Osaka, a senior prefectural government official in charge of allocating hospital beds for COVID-19 patients sent an email to local public health centers saying it was necessary to give a lower priority to the elderly for hospitalizations. The official was forced to retract the message after being criticized.
Every possible effort must be made to save as many lives as possible.
--The Asahi Shimbun, May 11
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