Will policy to limit hospitalizations help save coronavirus patients’ lives?

The Yomiuri Shimbun

11:51 JST, August 4, 2021

There has been an explosive spread of novel coronavirus infections. To overcome the crisis, effective measures must be devised in response to changes in the infection situation.

The government has announced that it will review its medical treatment policy for people infected with the coronavirus. Hospitalization will be limited to those with severe symptoms or those at a high risk of developing such symptoms. Patients with moderate or mild symptoms, who have conventionally been hospitalized or treated in hotels or other overnight medical care facilities, will in principle be required to recuperate at home.

The government said that it will distribute pulse oximeters, which measure oxygen levels in the blood, to patients who are recuperating at home, and public health centers, and doctors and other medical professionals in local communities will check whether their symptoms are getting worse.

This is a major shift in the medical care system. Coronavirus control measures were supposed to be based on quarantining infected patients to prevent the virus from spreading. It is difficult to recuperate in a small home without infecting other family members.

It will be hard for coronavirus patients who live alone to even contact a public health center or other medical institution if their condition suddenly deteriorates. The government said that if patients recuperating at home become seriously ill, they will be hospitalized. However, it will be difficult to determine whether their condition is serious enough to need hospitalization, and there are also concerns that treatment could arrive too late if their symptoms become extremely severe.

It is questionable whether it is really possible to protect the lives of patients through a mechanical selection method which dictates that those with mild symptoms recuperate at home, and only those with severe symptoms are allowed to be hospitalized. While vaccinations for the elderly have been progressing, the spread of the highly contagious delta coronavirus variant has led to a rapid increase in the number of new coronavirus cases. The reality seems to be that there are few measures left to take against the pandemic.

The importance of securing hospital beds for coronavirus patients has long been pointed out. It is obvious that the efforts of the central and local governments to date have been insufficient.

Efforts should be made from now on to strengthen measures, such as increasing the number of medical institutions that accept coronavirus patients and establishing temporary facilities where patients can recuperate or be provided with medical care.

An intravenous antibody cocktail therapy is expected to prevent symptoms from becoming serious. It is necessary to swiftly consider administering the drug not only to inpatients but also to outpatients.

Vaccinations, which are key to fighting the pandemic, have not caught up with the spread of the virus, partly due to a shortage of supplies to local governments. In particular, many people in the working generation, who are considered to be a low priority in the vaccination campaign, are unable to get vaccinated even if they wish to do so.

The central government has so far distributed vaccines throughout the country on equal terms across-the-board based on the ratio of population. As large cities are currently the centers of infection, it may be necessary to allocate vaccines intensively to higher priority areas.

In areas subject to the latest state of emergency, it is worth considering prioritizing vaccinations for younger generations, who are more active.

States of emergency have become ineffective due to repeated declarations. It is impossible to foresee a path to containing the pandemic by simply repeating stopgap measures and aimlessly watching the situation unfold.

— The original Japanese article appeared in The Yomiuri Shimbun on Aug. 4, 2021.