When her condition worsened, she called the Hyogo Prefectural Public Health Center for assistance, but she said no one answered his calls.
Instead, she had to isolate herself in her small bedroom, while her children, ages 3 and 6, slept alone in the living room for almost two weeks. Her mother would leave the family food, but she could not stay because the children were exposed to the virus and could not be tested for almost a week. Su said she communicated with her children through a tablet – and often heard them fighting.
“My young children were trapped alone in the small living room, without going out at all for 10 days.” I was feeling sick, in a terrible condition, but I felt more pain leaving my children alone.
A representative from the Hyogo Prefectural Health Center could not speak directly about Su’s case, but said that while trying to contact isolated patients on a daily basis, the holiday period was incredibly busy.
But the Covid-19 pandemic has pushed the medical system to the brink as Japan faces the worst wave since the pandemic began. Cases have doubled in the last two months, reaching over 406,000 cases.
And while the peak of the current wave has passed, with cases dropping from more than 7,000 a day in January to less than 3,000 cases a day this month, the medical system is still tense.
As of February 4, more than 8,700 people from 10 prefectures, who tested positive for Covid-19, were waiting for a hospital bed or space at an isolation center. One week earlier, more than 18,000 people from 11 prefectures were waiting, according to the prefectures’ health ministries.
Faucet medical care
Despite the rapid growth of cases in Japan in recent months, the number of infections and deaths is still pale compared to those in the US, where daily cases exceed an average of 100,000.
But experts say expectations for healthcare are different in Japan.
Since the 1960s, the universal Japanese health insurance system has provided coverage to all Japanese citizens – regardless of income or pre-existing conditions. But experts say easy access to care has led to many patients seeking more care than necessary, taking the system for granted.
“We consider (healthcare) to be like tap water, but now tens of thousands of people with Covid-19 have had to stay home and can’t access the health care system, can’t be hospitalized and can’t even see doctors, “said Dr. Kentaro Iwata, a professor and doctor at Kobe University Hospital.” This is a very harsh reality, which is very difficult for many Japanese to accept. “
It is not uncommon for patients with severe symptoms of Covid-19 in other countries to wait in the hospital, said Naoiki Ikegami, a professor emeritus at Keio University.
But in previous waves of the pandemic in Japan, most people who tested positive for Covid-19 were automatically hospitalized, Ikegami said.
“This is how Covid-19 was treated in the first and second phases, so anyone with Covid-19 is expected to be hospitalized, even if they have only mild symptoms,” Ikegami said.
Since then, the system has been adjusted so that not everyone is hospitalized. But hospitalization rates for Covid-19 are even higher in Japan than in other countries.
System failures
Staffing is another key issue in the Japanese medical system.
Japan has only 1,631 infectious disease specialists in 8,300 hospitals, according to the Japanese Ministry of Health, which means that most hospitals do not have an infectious disease specialist.
Unlike other nearby Asian territories, such as China, Hong Kong, South Korea, Singapore and Taiwan, Japan has managed to avoid previous foci of coronavirus, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
“Many infectious diseases did not come to Japan, so we were not prepared,” Iwata said.
“We didn’t train a lot of specialists, we didn’t train the wards and we didn’t prepare the health system for infections, and that’s the result,” he said.
Across Japan, hundreds of public health care centers receive calls from patients and direct them to health care, monitor their health, organize testing, and track contact.
Dr. Hideo Maeda, head of a public health center in Tokyo’s Kita Ward, said his staff had quadrupled in 40 since the pandemic began, but it’s still not enough. In his department alone, every day, dozens of patients are waiting for the hospital space.
“Many employees work every day until midnight, on weekends and holidays,” Maeda said. “We are exhausted and overwhelmed – psychologically – by stress. Our staff have to make difficult decisions about people’s lives in a short period of time.”
A confusing answer
In January, Prime Minister Yoshihide Suga apologized rarely. “As a manager, I am very sorry,” he said. “We have not been able to provide the necessary care.”
His government has been blamed for its slow and undecided response to the pandemic. Suga rejected the need for an emergency at the end of December, only to declare one for Tokyo and a few other prefectures next month. Prior to that, his administration encouraged domestic consumption with a “Go To” campaign, which offered Japanese citizens big discounts on traveling and eating at home. That campaign was not suspended until December.
Kenji Shibuya, director of the Institute for Population Health at King’s College London, said Japan’s response was “too slow and confusing”.
Last week, the Japanese parliament passed two bills that give authorities the power to fine-tune violations, including businesses that refuse to cut hours and infected people that refuse to cooperate with health officials.
Under the new antivirus law, the government may also require hospitals to accept patients with Covid-19 or to appoint them publicly if they do not respond.
Most Covid-19 patients in Japan are treated by large public hospitals.
The government has not yet announced a timeline for the rest of its citizens. The vaccine will be voluntary and convincing people to receive it will be a challenge in a country with a history of safety scares and concerns about side effects.
Earlier this week, it was announced that Japan would have to drop a dose of six of the Cfid-19 Pfizer vaccine, of which it ordered 144 million doses, because the country’s standard syringes will only be able to extract 5 doses of the vaccine. each ampoule. Special syringes would be needed to collect the sixth dose.
That’s if the government can persuade people to get the vaccine.
Su has now recovered from Covid-19, directly witnessing the limitations of the public health system during a pandemic.
She says she still has some persistent symptoms, but is very happy that she can keep her children again.
When her isolation ended, the first thing they told her was, “Ma, please hug me.”