Photo/Illutration A COVID-19 patient with moderate symptoms uses an oxygen inhalation device. (Asahi Shimbun file photo)

The Tokyo metropolitan government is preparing for a restrictive policy on hospital treatment for COVID-19 patients but wants medical professionals, not simple guidelines, dictate who gets hospital beds.

The record-setting pace of the latest surge in novel coronavirus infections has put the capital in the most serious stage 4 level in terms of hospital bed usage.

To prevent a medical care collapse, the central government wants hospitals to only treat COVID-19 patients who are in serious condition or at risk of developing severe symptoms.

The metropolitan government decided on Aug. 5 to clearly define the roles of the 170 or so hospitals in the capital treating COVID-19 patients.

Although the Suga administration’s new policy is to have COVID-19 patients with less severe symptoms recuperate at home, some hospitals in Tokyo will still be designated for treating patients with mild to moderate symptoms but deemed difficult for recuperating at home.

The other medical facilities will handle individuals with serious to moderate symptoms.

Until now, staff at local public health offices decided on which hospitals the COVID-19 patient should enter.

But from now, such decisions will be based on the opinions of doctors, not broad guidelines.

“Decisions about hospitalization will be made after health care professionals examine the overall health of the patient,” said Masataka Inokuchi, vice chair of the Tokyo Medical Association who belongs to the metropolitan government panel of experts dealing with the pandemic.

To help free up hospital beds, the Tokyo metropolitan government will also move away from the central government’s guideline concerning when COVID-19 patients can be discharged from hospitals.

The standard is to allow patients to leave if 10 days have passed since they developed COVID-19 and three days since their symptoms improved.

But under the changes, doctors can decide to let patients recuperate at home, even if those time standards are not met.

In addition, those waiting at home for an available hospital bed will be given pulse oximeters to monitor oxygen saturation levels in their blood, as well smartphone apps to help monitor daily changes in their condition.

More than 50 percent of hospital beds set aside for COVID-19 patients in Tokyo are already occupied. But officials said the situation could be much more dire.

One metropolitan government official said although 6,406 hospital beds have been secured for COVID-19 patients, “some hospitals are not capable of using all the beds they have reported” to the metropolitan government.

The official said that means there is no longer enough leeway to hospitalize all patients with moderate symptoms.

Another metropolitan government official noted that a rising number of patients are recovering at home or other accommodations even though their oxygen saturation levels are below the 96 percent cutoff line that would normally require immediate hospitalization.

Another troubling trend is the sharp increase in COVID-19 patients with serious symptoms.

Until mid-July, Tokyo had fewer than 60 COVID-19 patients with serious symptoms. But the figure reached 135 on Aug. 5, approaching the record high of 160 set on Jan. 20.

At the Aug. 5 meeting of the panel of experts, Inokuchi warned that a sudden increase in patients with serious symptoms would throw Tokyo’s medical care structure into crisis.

He also pointed out that the trend of younger patients developing serious symptoms was heightening the burden on hospital staff.

Younger patients often have shorter hospital stays, so the turnover in patients with serious symptoms is now greater.

New patients must be equipped with breathing and other equipment, a time-consuming and nerve-wracking process for hospital staff.