THE ASAHI SHIMBUN
August 5, 2021 at 14:26 JST
Prime Minister Yoshihide Suga rebuffed criticism from all sides and stood by his government’s proposal to limit hospitalization of COVID-19 patients to only “serious” cases in areas where medical systems are strained.
After ruling coalition lawmakers on Aug. 4 called for a retraction of the measure, Suga told reporters, “I hope to gain the understanding that this measure is intended to allow those who need medical care to receive it.”
Under that policy, those requiring hospital care are defined as infected patients with serious symptoms and those at risk of falling seriously ill. COVID-19 patients with moderate or mild symptoms will be asked to recuperate at home.
To quell concerns, Suga said the measure was not for the entire nation but only the greater Tokyo metropolitan area where the spread of COVID-19 infections has been especially rapid.
He also said measures would be taken to ensure frequent contact with those recuperating at home so that they can been immediately hospitalized if their symptoms worsen.
Local governments are preparing for the shift in the hospitalization policy, but doubts are being raised that they will have enough personnel to adequately check on the conditions of the expected increasing number of patients recovering at home.
The Tokyo metropolitan government started revising its guidelines for deciding which COVID-19 patients should be hospitalized. The revision would leave out patients with mild symptoms.
Tokyo has been hit by a record-setting spread of the novel coronavirus, which has led to a sharp increase in hospitalized COVID-19 patients.
As of Aug. 4, there were 3,399 patients hospitalized with COVID-19 in the capital. The hospital bed usage ratio has exceeded the 50-percent line that defines an area as being in the most serious stage 4 in terms of the infection spread.
The metropolitan government also plans to strengthen observation of patients recuperating at home or other accommodations.
A follow-up center was established in November 2020 to monitor such patients, and additional staff will be dispatched to cover the expected increase in those recuperating outside of hospitals.
Pulse oximeters are being distributed to at-home patients to monitor their oxygen saturation levels.
But about 14,000 Tokyo residents are already recuperating at home. A surge in their numbers could create a situation in which sufficient monitoring is impossible.
“Under the current structure we have in place, there is the possibility that adequate follow-ups will not be possible if the condition of those recuperating at home should suddenly worsen,” said a high-ranking metropolitan government official in charge of medical care policy. “The risk arises of a larger number of those recuperating at home dying because they do not receive medical care.”
Past waves of the virus have shown that the conditions of patients with mild symptoms can abruptly deteriorate, leading to death.
Satoshi Kutsuna, a professor of infection disease control at Osaka University, said the more virulent Delta variant of the novel coronavirus has made matters worse.
“Even if a patient is young and has no pre-existing condition, there is the possibility of symptoms becoming serious,” Kutsuna said. “Moreover, even if oxygen saturation levels may be dropping, the patient may not feel any symptoms, such as shortness of breath, if they are resting.
“There will be a need for frequent monitoring of such patients to quickly detect when someone’s symptoms have worsened so they can be hospitalized.”
In light of the staffing shortages in Tokyo, Kutsuna suggested having doctors and nurses remotely monitor such patients through online systems or by phone.
(This article was compiled from reports by Masatoshi Toda, Momoko Ikegami, Rihito Karube and Tokiko Tsuji, a senior staff writer.)
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