Strengthen Medical System to Prepare for Effects of Downgrading Disease

The classification of COVID-19 under the Infectious Diseases Law is set to be revised. This will mark a major shift in the nation’s response to the pandemic, which has continued for three years. Prior to the status revision, there are many issues to be tackled, such as the buildup and improvement of the medical system.

The government has announced that the legal status of COVID-19 will be downgraded from the current “equivalent to Category II” to Category V, the same level as seasonal influenza. The change will take effect on May 8. Once COVID-19 is reclassified, people infected with the novel coronavirus will no longer be subject to recommendations to be hospitalized or stay home, among other restrictions.

After the status change, the government said it also will no longer make a blanket request that people wear masks, leaving the matter up to the individual’s judgment. Ahead of the reclassification, the government on Jan. 27 scrapped the capacity limits for professional sports and large-scale events.

Since the omicron variant of the novel coronavirus became dominant, the rate of severe illness among COVID-19 patients has decreased, with the fatality rate also becoming comparable to that of influenza. This situation may have led the government to decide to steer toward the normalization of social and economic activities.

Uncertainty remains, however. During this winter’s eighth wave of infections, the daily number of deaths related to COVID-19 hit a record high exceeding 500, with many victims being elderly. This is believed to be due to an explosive increase in infection numbers.

Unlike influenza, COVID-19 outbreaks recur regardless of the season. If the government makes moves without sufficient preparations on the premise that COVID-19’s status will be shifted to Category V, confusion in society might once again ensue.

What is important is medical preparedness. Under the law, if COVID-19 is classified the same as influenza, patients can be treated at any medical institution.

This would mean that medical institutions that have not treated COVID-19 patients would have to accept them along with patients suffering other diseases. Is that a feasible reality?

The central and local governments as well as medical associations should work together to develop a system to accept COVID-19 patients smoothly, such as by taking steps to give these institutions guidance on necessary infection control measures.

Once the status is revised to Category V, there will no longer be a system for coordinating hospitalization by public health centers and other entities. Who will coordinate the admission of COVID-19 patients in case hospitals of preference are being strained? The hope is for the consideration of specific measures to prevent confusion in case a medical institution accepting COVID-19 patients cannot be found.

The category revision will have a major impact on medical expenses. Currently, COVID-19 is fully covered by public funds, but this will gradually be reviewed, with patients expected to shoulder some of the costs. Under such circumstances, more people could refrain from receiving medical services and vaccinations.

Isn’t it important for the central government to respond flexibly by, for example, continuing to use public funds to cover COVID-19 medical costs for the elderly and those who are at high risk of developing serious illness?

What schedule should be set for preparations in order to ensure a smooth and reasonable transition? It is desirable to take such steps as drawing up a timetable for the category revision so the central government can present specific plans to the public.

(From The Yomiuri Shimbun, Jan. 28, 2023)