Long-term Hospitalization of COVID-19 Patients Fills ICU Beds in Japan

Courtesy of Showa University Hospital
Physicians and nurses care for a critically ill COVID-19 patient.

A state of emergency is expected to be declared in Tokyo and its neighboring prefectures of Saitama, Chiba and Kanagawa, where novel coronavirus infections are spreading. The number of people infected with the virus has not decreased, even during the year-end and New Year holidays. With beds filled to capacity in hospitals, medical workers strongly desire that infections be curbed as soon as possible.

“We have been forced to stop accepting emergency patients for heart attacks and strokes since Jan. 2,” said Hironori Sagara, director at Showa University Hospital in Shinagawa Ward, Tokyo. Sagara specializes in respiratory medicine.

As of Tuesday, the hospital had 11 seriously ill patients infected with the virus in its ICU. Also hospitalized were 31 patients with moderate or less severe COVID-19 disease. The number of patients at the hospital has increased rapidly in the past two weeks, far exceeding the number that the Tokyo metropolitan government had requested it to handle — six seriously ill plus 25 moderately ill or less severe patients.

The hospital has decided to postpone some surgeries for diseases other than COVID-19 scheduled for next week or later, as its ICU is almost full. “Our staff will not be able to cope with the situation if it does not change,” Sagara said.

Regarding the expected declaration of a state of emergency, Sagara said, “It should be effective in reducing the number of infections.”

On Tuesday, the number of newly confirmed coronavirus infections nationwide reached a one-day record high of 4,915, including 771 patients who were seriously ill. This was also the highest number for a single day.

The infections in Tokyo, Saitama, Chiba and Kanagawa account for about half of the nation’s total. In Tokyo, occupancy rate for hospital beds secured by the metropolitan government for COVID-19 patients reached 86%.

The death rate has been declining, partly because measures such as the use of steroids have been taken to prevent the disease from getting worse. There are more treatment options now than in the spring of last year, when the first wave of infections occurred.

However, the number of elderly patients has been increasing in the current third wave. Elderly patients tend to be hospitalized for a long time, making it difficult for hospitals to keep beds available.

Tokyo Hikifune Hospital in Sumida Ward, Tokyo, which accepts patients with mild symptoms, is struggling to find a new hospital for its patients whose symptoms have grown severe.

“Recently, there are fewer beds available in university hospitals and other medical institutions that can deal with the serious illness. In some cases, we had difficulty finding hospitals to accept our patients and had them transferred to hospitals quite far from here,” said Kunihisa Miura, the hospital’s deputy director.

At present, the concentration of COVID-19 patients in some specific hospitals is one factor in the shortage of hospital beds. “It will be important to control the spread of infections [during the state of emergency], but at the same time, we need to reorganize the system so that many hospitals can cooperate and work together to take care of COVID-19 patients,” said Yujiro Tanaka, president of Tokyo Medical and Dental University.