Learn from History of Pandemic to Avoid Future Hospital Bed Shortages

Editorial

16:18 JST, May 15, 2023

A shortage of hospital beds became a serious problem during the COVID-19 pandemic, which continued for more than three years. Learning from this, efforts must be made to establish a system in which patients can be hospitalized quickly and surely, in preparation for the next pandemic.

Japan’s number of hospital beds per capita is among the highest in the world. Despite this, securing beds for COVID-19 patients became a challenge, with the medical system strained in each wave of coronavirus infections.

For hospitals, accepting patients with infectious diseases is burdensome due to the manpower that is required and the protective measures that must be taken. Japan has many privately run hospitals, so the central and local governments cannot increase the number of beds for COVID-19 patients as they wish simply by issuing requests.

Efforts were also made to turn existing hospitals into facilities just for COVID-19 patients. However, at some hospitals in Tokyo that suspended general medical care services and concentrated on treatment for COVID-19 patients, doctors and nurses left in droves, complaining that they could not gain experience in surgery and other procedures there.

Even though effective measures to deal with such problems have not been found, COVID-19 has been reclassified to the same risk level as seasonal influenza under the Infectious Diseases Law, and the nation’s medical system has returned to a usual state.

However, it is unknown when the next pandemic will occur. The problems that emerged from the COVID-19 pandemic should be examined and the vulnerabilities of the medical system should be rectified.

Under the revised Infectious Diseases Law, which will take effect in April next year, prefectural governments and hospitals will be required to conclude agreements to determine in advance which hospitals will reserve how many beds for infected patients in preparation for an outbreak of a new infectious disease.

The central government aims to first secure a total of 19,000 beds at 500 hospitals nationwide in the early stages of an epidemic, and then increase the number to 50,000 or more.

How to make this agreement workable is extremely important.

The nation must not repeat the situation that was seen during the COVID-19 pandemic, in which hospital beds were secured but patients could not be admitted due to a lack of hospital manpower. In addition to reserving hospital beds, it is also necessary to consider measures to secure medical personnel.

It is hoped that hospitals that have difficulty admitting infected patients will make plans to dispatch their doctors and nurses to other medical institutions. Based on such plans, the central and prefectural governments should establish a mechanism for wide-area dispatch of medical personnel.

It is desirable to take advantage of Disaster Medical Assistance Teams (DMATs), which are dispatched in times of disaster, in a flexible manner to respond to infectious diseases as well.

Response to a pandemic in its early stages is particularly important. If there are missteps in such stages, confusion will grow when infection spreads. It is crucial to promote a division of roles according to the size of medical institutions and the symptoms of patients, such as by having more general practitioners handle fever outpatient care.

In Japan, there are many small and midsize hospitals where it is difficult to admit patients with infectious diseases, as treating such conditions requires more personnel. It is also necessary to devise ways to increase hospital beds in each region through consolidation of and collaboration among hospitals.

(From The Yomiuri Shimbun, May 14, 2023)