OSAKA -- Many hospitals that are treating COVID-19 patients are left with unwashed sheets piling up because contractors refuse to collect them and clean the facilities out of fear of becoming infected as a result of the coronavirus epidemic, the Yomiuri Shimbun has learned.
In the past three months since March, these types of cases have become increasingly prominent. If contractors continue to refuse to do their work, it could lead to a heavy burden on frontline medical institutions. An expert stresses the need to come up with measures to solve the situation to prepare for a second and third wave of infections.
Bags containing sheets, pillowcases and the like used in the past three months were seen piled up in a room at Toyonaka Municipal Hospital in Toyonaka, Osaka Prefecture, in late May.
The hospital began accepting COVID-19 patients in late February because of its designation as a medical institution to treat patients with infectious diseases. On average, patients will stay in the hospital for two to three weeks and their sheets need to be changed about once a week.
Linens used by patients with infectious diseases should be disinfected with hot water at 80 C or higher before being handed over to contracted cleaners, according to a 1993 notice issued by the then Health and Welfare Ministry, the present Health, Labour and Welfare Ministry.
However, the hospital, which initially had only about 15 beds for patients with infectious diseases, had to allocate nearly three times as many beds to accommodate COVID-19 patients, making it extremely difficult to disinfect the sheets in a timely manner.
The ministry allows hospitals to outsource the washing of sheets and other linens without disinfecting them as "unavoidable circumstances." Based on this, the Toyonaka hospital negotiated with the contractor, but failed to reach an agreement with the contractor saying, "With the coronavirus being an unknown virus, there is a risk of the infection [spreading]."
Cases such as this are believed to have occurred nationwide. Nippon Byoin Shingu Kyokai, a Tokyo-based association that has about 140 hospital bedding leasing companies nationwide as members, began receiving inquiries from medical institutions around March that said their contractors refused to collect the linens that had not been disinfected.
The ministry decided to allow hospitals to entrust contractors to wash linens that have not been disinfected on April 24, however, it must be sealed in a container that clearly states "not disinfected." The ministry notified local governments of the new procedure.
However, in some cases, these efforts have not led to any changes. Japanese Red Cross Kyoto Daini Hospital in Kyoto had to dispose of used sheets as medical waste, which can be costly. According to a medical institution in Osaka Prefecture that also had to dispose of its linens, said it costs 70 yen to have a set of sheets and a pillowcase washed by a contractor while disposing of it as medical waste and purchasing another set costs 40 times that amount.
"If hospitals continue to accept infected patients for a longer period, their business will be put under so much pressure," said a medical institution official.
A similar problem has also occurred in trying to disinfect hospitals.
Nurses at a hospital in Osaka Prefecture that set up a specialized ward for COVID-19 patients, have had to disinfect and clean the facility since March when a cleaning company refused to clean the hospital, citing "the risk that employees may become infected with the virus."
In eastern Japan, a hotel, which began accepting people with mild symptoms in late April, lost its contract with a cleaning company after the company requested it to be terminated.
There are also circumstances on the part of contractors.
Sanei Kijun Shingu, a company in Habikino, Osaka Prefecture, that leases and washes bedding for more than 400 medical institutions among other facilities, has agreed to accept linens that have not been disinfected, but its employees must wear goggles, masks and gloves during the disinfection process to be extra careful with their work.
"There is always a risk of infection among our employees," said Takeshi Yoshikawa, 75, president of the company.
A Tokyo-based cleaning company was approached by a number of medical institutions in April, apparently, after their contracted cleaners refused to clean their facilities. The company was asked to clean the COVID-19 wards of the medical institutions but the company turned them down.
The company already purchased face guards and protective gear, but the president remained cautious and said, "If we receive another similar request, we'll make a decision after discussing infection protocols with the hospital."
"To create an environment where medical workers can concentrate on treatment, it is essential to have cooperation from companies outside of hospitals," said Akira Babazono, a professor in medical management at Kyushu University. "The central and local governments, in cooperation with outsourced companies, should consider how they can support measures to prevent infections, also in terms of cost, to maintain the medical care system when the nation faces a second and third wave of infections," he added.
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