To dispel anxiety in a society reeling from the scourge of the coronavirus, it is essential to establish stable medical systems within local communities, as well as stabilize the business environment for the small and midsize companies that support employment.
Using lessons learned from the first outbreak, workers on the medical front are doing their best through trial and error, aiming to build a society that is resistant to infectious diseases.
In Toyama city, nearly 200 people were reported to have been infected with the coronavirus over a one-month span from the end of March. A cluster of infections broke out starting on April 9 at Toyama City Hospital, one of the medical institution designated to handle infectious diseases, and 17 people -- including doctors and nurses -- were found to be infected over five days.
"The number of the infected persons shot up, and I was prepared to face a wide spread of the virus in the hospital," recalled Dr. Yoichi Ishida, 65, general manager of the hospital.
There was an overwhelming shortage of personnel to deal with the crisis at the time. Despite being a designated medical institution, the hospital does not have a specialist in infectious diseases on staff. Concerns of being infected themselves spread among the staff as they worked in close quarters with the virus. At the request of the hospital, a medical specialist from the University of Toyama was quickly dispatched to the hospital to provide medical support.
At the time, just three out of the eight designated medical institutions in Toyama Prefecture -- including Toyama City Hospital -- had a medical specialist, and only one each.
On the scene, the specialists had to handle a variety of tasks. First, they had to determine the severity of patients who were being transferred to another hospital.
They had to determine the extent to which there was a possibility of people being infected, then "zoning" areas as dangerous or safe in an effort of prevent the spread of the virus.
At a nursing home for the elderly in the city, a cluster of infections occurred shortly after the outbreak in the hospital. For that, too, medical specialists with abundant experience in crisis management took the lead. While Toyama City Hospital ceased to function, Dr. Kenichi Ogura, 51, an official at the prefecture's health and welfare department, decided on a strategy of holing up all but the most serious patients in the hospital.
The prefectural government sent letters to medical institutions in the prefecture asking for staff to join a medical support team. However, no place had any to spare, and only one nurse responded to the call. Ogura had no choice but to use his connections as an emergency room physician to call on his acquaintances and veteran doctors, throwing his line in the waters one by one.
University of Toyama Prof. Seiji Yamashiro, who is a general practitioner, was one who responded. "I prepared myself for the risk of being infected," he said.
Yamashiro, 64, learned from the specialists the finer points on how to safely put on and take off protective gear. "I was able to focus on my work of facing residents [of the nursing home] and their families with ease of mind," he said. "The impact of the specialists was huge."
In late May, the prefectural government added the University of Toyama, which has specialists on staff, to its list of designated medical institutions.
In 2010, the Japanese Association for Infectious Diseases set a target of having 3,000 medical specialists nationwide, but the current number is still just over half at 1,560.
"To prepare for emergencies, it is advisable for the government to establish a department specializing in infectious diseases at the designated medical institutions and dispatch specialists," said Toho University Prof. Kazuhiro Tateda, the association's chairman. "It is essential to train personnel who can provide advice for any department, even in ordinary times."
Cash flow problems
The 46-year-old president of a concrete formwork firm in Tokyo has been facing difficulties due to the spread of the coronavirus.
"Cash flow became so tight that the possibility of going bankrupt in June crossed my mind," he said.
The company works as a subcontractor for major general contractors, but one work request after another has been suspended since around March, when the infections began spreading more in the nation. Sales in May were half that of last year. The company had borrowed hundreds of millions of yen in anticipation of demand for the Tokyo Olympics and Paralympics but repayment of the loan has stalled.
The company has managed to hold on and keep its employees by using the so-called "special rescheduling system" in which repayment of the debt is postponed for one year with the support of the government. However, at the same time, the cost of preventing heatstroke and infection among workers at the construction sites has gone up.
"Our current cash flow plan does not anticipate a second wave," the president said. "If that happens, we'll have to start over."
The rescheduling system is designed to allow small- and medium-sized enterprises with cash flow problems to postpone repayment of debts with financial institutions through the mediation of public council to support the revitalization of those companies. Consultations under the system averaged around 200 until March, but it has doubled since April, indicating a sharp rise in the number of companies at risk. As this is only a temporary postponement, if a second wave of infections occurs and the impact is prolonged, firms with limited financial strength could face a dire situation.
An automotive parts manufacturer in Hamamatsu has seen its May sales drop by 70% from a year earlier due to the impact of production adjustments at its main customers. It posted a loss of 20 million yen.
"Even if the infection is contained, consumer confidence will not recover, meaning our difficult situation is likely to continue," the president of the company said.
As a precaution against a downturn in cash flow, the company had received by May an emergency loan of more than 200 million yen, effectively interest-free. However, the deficit made it impossible to repay the loan. "We have no choice but to ask for an extension of the interest-free period," the president said.
Another crisis looms undetected for companies.
A group of Liberal Democratic Party lawmakers met to discuss economic security strategies on June 9.
"In China, some people are urging, 'Take this opportunity to take control of key companies [in Japan] that are facing difficulty,'" said the head of the group, Akira Amari, chair of the LDP Research Commission on Tax System, at the outset of the meeting.
There is a risk that small and medium-sized enterprises and start-up companies with technology and research and development capabilities will struggle with their cash flow and end up being forced to rely on Chinese and other capital. This concern is widespread among politicians and the government's economic agencies.
Read more from The Japan News at https://japannews.yomiuri.co.jp/
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