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To prepare for the spread of infections with variants of the novel coronavirus, the number of hospital beds for COVID-19 patients must be increased as soon as possible. Prefectural governors should take the initiative in strongly urging medical institutions to do so.
The hospital bed occupancy rates for COVID-19 patients are rising in prefectures such as Osaka and Hyogo, where the pre-emergency priority measures to prevent the spread of infections have been applied.
April 7 marked one year since the first state of emergency was declared, but the vulnerabilities in the medical system to deal with the infectious disease have not been reduced at all.
The number of infected people will increase at a faster pace than in the past if the variants, which are believed to be highly contagious, spread, thus leading to a situation in which there will inevitably be a further shortage of hospital beds. It is essential for the central and local governments to share a sense of crisis and increase the number of hospital beds.
The Health, Labor and Welfare Ministry has revised its guidelines stating that patients infected with variants should be hospitalized in principle, allowing patients with mild symptoms to stay at hotels and other facilities to receive medical treatment.
The ministry apparently intends to be flexible in dealing with people infected with variants to avoid further straining the hospital bed situation, but the impression of an ad hoc measure cannot be dispelled. The central and prefectural governments need to expand health care facilities, including building new temporary medical wards. It is hoped that the current situation in which testing for variants has not caught up with the increasing number of patients is improved.
The Medical Care Law stipulates that prefectural governments formulate medical care plans. It is the responsibility of prefectural governors to secure the necessary hospital beds in keeping with the circumstances of each area.
The ministry requested prefectural governments in late March to review their plans to secure hospital beds. Assuming that the number of infected people per day will increase to about double the peak of the third wave of infections, the ministry is looking for them to put together emergency plans by the end of April.
It is urgent to thoroughly divide the roles of medical institutions so that core hospitals can concentrate on treating patients with serious symptoms. It is vital to increase the number of logistical support hospitals in charge of rehabilitation and medical care for people who have recovered from the infectious disease and encourage the smooth transfer of patients to other hospitals.
Prefectural governments need to actively expedite coordination among hospitals to eliminate the bottleneck of people admitted to and discharged from hospitals.
In order to secure sufficient hospital beds, the central government has established a system to provide medical institutions with a subsidy of up to ¥19.5 million per bed. Under the revised special measures law on coronavirus countermeasures, it also created a system to allow the health minister and governors to issue recommendations to medical institutions that they treat COVID-19 patients.
It is important to take advantage of such measures and seek cooperation from many hospitals and medical associations to steadily prepare the medical system to deal with such patients.
Prefectural governments nationwide have secured about 30,000 hospital beds for COVID-19 patients, still only about 3% of existing beds. Structural problems seem to be behind this, such as the large number of private hospitals and the uneven distribution of medical professionals.
With infectious disease responses remaining insufficient, safe and reliable medical care is far off. The central government cannot postpone facing these challenges, but must launch full-scale reforms.
— The original Japanese article appeared in The Yomiuri Shimbun on April 7, 2021.
