A total of 9,793 people infected with coronavirus were recuperating at home in Tokyo on Friday, a record high amid a nationwide surge in infections.
Although the vaccination of elderly residents has progressed, the uptake has been slow among younger generations, who, if infected, are less likely to become seriously ill and more likely to recuperate at home.
In Sumida Ward, Tokyo, 179 people were recuperating at home as of Wednesday, about 16 times more than last month.
"If the virus continues to spread at this pace, we won't be able to cope," said Itaru Nishizuka, head of the ward's public health center.
The majority of those infected in the ward are in their 50s or younger. There have been fewer cases of serious illness among such patients, and many have opted to recuperate at home.
However, as there is a risk of a sudden change in the condition of people recuperating at home, the public health center regularly checks on each patient by phone.
From July, the ward has doubled the number of staff handling such checkups to 100.
There have been cases when the condition of a patient recuperating at home suddenly deteriorated and oxygen treatment was required.
To respond swiftly to such situations, the ward has acquired oxygen concentrators for doctors from the ward medical association to use during house calls.
Also, medical facilities in the ward have started using a new drug to treat hospitalized patients who are at risk of becoming seriously ill, such as those with preexisting conditions.
"Even though our resources are limited, we have no choice but to take every conceivable measure to save lives and mitigate the spread of infection," Nishizuka said.
In Tokyo, the number of people recuperating at home has soared in a short period. On Friday, the number had reached 9,793, more than 10 times that of a month earlier, and surpassing the previous high of 9,442, logged on Jan. 18 during the third wave of the pandemic.
The metropolitan government set up a "follow-up center" in November to reduce the burden on public health centers, with 80 staff members checking the condition of people recuperating at home.
However, the center has been unable to keep up with the latest surge in cases. Since Wednesday, the target has been narrowed down from people under 65 to people under 30 with public health centers left to pick up the slack.
Tokyo Medical and Dental University Medical Hospital in Bunkyo Ward, Tokyo, which accepts patients with moderate or serious symptoms of COVID-19, has treated six patients whose condition suddenly changed while they were recuperating at home or in hotels since July 16.
One of the patients had severe breathing difficulties and was treated with extracorporeal membrane oxygenation (ECMO).
The hospital was treating five patients with severe symptoms and 16 patients with moderate symptoms as of Friday. Fifteen patients were under 60 years old, with the majority in their 40s and 50s.
"Even if symptoms are mild at first, the condition of some patients who recuperate at home will deteriorate, including people in their 20s and 30s," said a doctor at the hospital. "If the number of cases increases, it will lead to bed shortages."
To contain the pandemic, there is an urgent need to push ahead with the vaccination rollout, but the vaccine supply is still not stable.
Shinjuku Ward in Tokyo has prioritized vaccinations for people in their 20s and 30s but since the start of this month, the supply of vaccines has dropped sharply.
Only 2.4% of people in their 20s and 30s have been fully vaccinated in the ward.
"We're in a situation where we want to target young people, but we can't," said ward official Hironori Kusuhara. " I would like vaccines to be distributed on a priority basis, taking into account the situation in urban areas where people move around more."
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