Tokyo has seen a surge in the number of people infected with the new coronavirus, and its medical system is under the most pressure nationwide.
University and other major hospitals are being forced to limit surgeries and outpatient care. There may be no other option, but it is casting a shadow of anxiety on other areas of medical care.
The Tokyo metropolitan area has 15 so-called special functioning hospitals that are responsible for providing advanced medical care.
Surgery is usually one of the mainstays of care at major hospitals, but except for emergency operations, procedures have been postponed across the board.
Kyorin University Hospital decided to postpone surgeries for things such as cataracts and artificial joints. Anything that is not urgent or life-threatening is being put off.
Showa University Hospital has also postponed surgeries by its otolaryngology and other departments.
These moves have greatly reduced the number of surgeries being performed. For example, Tokyo Medical University Hospital is only performing half of the 900 to 1,000 procedures it usually carries out each month.
Tokyo Medical and Dental University Medical Hospital stopped accepting patients in its emergency medical center on April 13.
The center has reserved 30 beds for infected patients and assigned all emergency physicians to dealing with them. Patients with other urgent diseases are being turned away.
"If all hospitals are forced to accept [infected patients], regular medical care will have to be drastically reduced everywhere, which will result in total collapse. If we focus on accepting [infected patients], it will reduce the burden on other hospitals," said Prof. Yasuhiro Otomo, an emergency medicine specialist who is directing clinical operations.
The limitations on care are not only due to the resources being taken up by hospitalizing infected patients.
On Monday, the Cancer Institute Hospital announced that a nurse was infected and that surgeries would be reduced by 80 percent from normal. The hospital is not accepting infected patients.
This was probably not a hospital-acquired infection, but it is a typical example of how the discovery of an infection at a hospital leads directly to limitations on medical care. Many hospitals are also limiting care to prevent hospital-acquired infections.
People infected with the new coronavirus are contagious even when they have no symptoms. If a person who is operated on is actually infected, this could provide an opportunity for the virus to spread, which is one reason why hospitals are being cautious about regular medical care.
Some hospitals are doing their own PCR testing before surgeries or other procedures. These include Keio University Hospital and Kyoto University Hospital.
On April 16, a special warning was issued for Kyoto Prefecture on the spread of the virus.
The hospital is covering the about 20,000 yen it costs to test each person, but along with the University Hospital of the Kyoto Prefectural University of Medicine released a statement calling for PCR tests on asymptomatic patients to be covered by health insurance. The Association of Japan Medical Colleges issued a similar statement Monday.
In regional areas where medical systems are already vulnerable, hospital-acquired infections are a major threat.
Kanazawa University Hospital in Ishikawa Prefecture, which was also issued a special infection warning, is performing PCR tests before surgeries.
Since April 15 the hospital has accepted three infected patients in severe condition. Surgeries have been cut in half and outpatient care by about two-thirds.
"If a ward has to close because of a hospital-acquired infection, we can't provide outpatient care or perform surgeries. Medical care in Ishikawa Prefecture will stop functioning. The most important thing is to reduce risk," said Toshifumi Gabata, the hospital's director.
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