Before it is too late, it is important to establish a medical system to save the lives of patients in severe condition, based on the presumption of a widespread outbreak of infections with the coronavirus.
The new virus has run riot in Italy, where the medical system has plunged into a crisis and many people have died. This is because patients came flooding into hospitals, and doctors and other medical staff were also infected.
Although Japan has controlled the spread of the disease, there is concern that the number of patients will increase dramatically in large cities. With an eye on serious situations, measures must be taken to prevent the collapse of medical services.
The Health, Labor and Welfare Ministry has developed a formula to estimate the number of patients when the outbreak reaches its peak. Based on the formula, about 20,000 patients would be hospitalized a day in Tokyo at the worst, and about 700 would be seriously ill.
Based on the estimate, it is important for prefectural governments to preferentially secure beds for the treatment of patients in serious condition and to work out the roles of each medical institution.
The health ministry has notified prefectures to designate "priority medical institutions" that will be bases for dealing with infectious diseases. This is appropriate as it will be easier to secure specialists by concentrating patients at these institutions. Measures against hospital-acquired infections can be effectively implemented.
In addition to gathering medical equipment such as ventilators, it is necessary to have ordinary inpatients transfer to other hospitals. It is hoped that a concrete plan will be worked out in advance.
The ministry has also called on each prefectural government to set up a task force to coordinate the distribution of patients according to their symptoms. Coordinators familiar with intensive care will work on a round-the-clock system. It is also indispensable for multiple prefectural governments to jointly implement measures over a wide area.
If the number of patients increases rapidly, it will lead to a high demand for medical institutions in cities to provide examinations. It is essential to take measures to prevent secondary infections, such as separating ordinary patients' routes of movement from those of the infected. The health ministry should speed up preparations in cooperation with medical associations and other organizations.
It would also be necessary to review the criteria for the admission and discharge of infected patients.
Currently, those who are found to have tested positive are forced to be hospitalized in principle, under the Infectious Diseases Law.
The government is considering revising this way of handling patients in the event of a widespread outbreak and switching to home care for those who do not have symptoms or who have mild symptoms.
About 80% of the people who have been infected with the new coronavirus have had only mild symptoms. About 5% developed critical symptoms, and the elderly and people with underlying diseases are considered to be at increased risk. Given the characteristics of the virus, it is understandable that treatment of seriously ill patients is given priority.
The government should inform the public of its medical policy in emergency situations and urge them to respond in a calm fashion. Careful explanations must also be given to patients about what to keep in mind when they are at home.
-- The original Japanese article appeared in The Yomiuri Shimbun on March 29, 2020
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