TOKYO (AP) – Yoshihiko Takeuchi, who ran a small restaurant on the island of Okinawa, only told a few friends that he had coronavirus. When he went three days without answering calls from public health workers, the police went to his house and found him dead in his bed.
He was one of hundreds of those who died while complying with Japanese policy of sending some COVID-19 patients home to recover there.
In many countries, infected people stay home to isolate and recover, but critical voices point out that in Japan, one of the countries with the most accessible and affordable healthcare system in the world, people have been denied hospital care and Rather, the strategy has led to the abandonment of the sick at home.
Takeuchi’s sister and the daughter of another man who died at home from COVID-19 have formed an online support group for the families of these victims.
The number of infections in Japan has fallen dramatically in the last two months, and the government has outlined a plan to improve its response to the pandemic. The protocol approved on November 12 aims to have beds for up to 37,000 patients across the country by the end of the month, compared to 28,000 previously.
By comparison, more than 231,000 coronavirus patients required hospitalization at the end of August, according to government data. Many had to recover at home.
Prime Minister Fumio Kishida also promised that medical staff would routinely visit COVID-19 patients with mild symptoms at home.
Public discontent over inadequate treatment with the country in the world with the most beds per person is just one factor in these changes. Kishida’s predecessor, Yoshihide Suga, resigned after just one year in office, mainly due to the widespread unpopularity of the government’s handling of the pandemic.
Protesting takes courage in a conformist society like Japan’s, and class action lawsuits are rare. But Takeuchi’s sister, Kaori Takada, and other members of the group believe their relatives were denied the medical care they deserved.
“I had to raise my voice,” he said.
She is not sure what to do. Thousands of people follow the group’s Twitter account and others have shared equally painful stories.
Takada, who lives in Osaka and runs a small nursery at her home, was Takeuchi’s only living relative. They spoke on the phone just before he was diagnosed, but his brother did not tell him that he was sick and alone at home. Given the widespread apprehension in Japan of COVID-19, he didn’t want the word to get out.
Takada said that he was a kind and well loved man.
“We got together, we tried to recover, to share how people were treated so cruelly and maybe we helped each other take that first step forward,” he said in a telephone interview.
Local public health offices, responsible for organizing care for COVID-19 patients, were having trouble finding hospitals that would accept them. In some cases, ambulances were turned away from hospital after hospital.
A few makeshift centers offered oxygen supplementation and treatment, but calls for large field hospitals were ignored.
In New York, for example, hospitals quickly adapted to add thousands of additional beds and Intensive Care Units for virus patients. A Navy medical ship and other facilities were turned into makeshift hospitals. At the peak of the outbreak, in April 2020, there were more than 1,600 new hospitalizations a day in the city.
In August this year, when infections in Japan spiked driven by the delta variant, Japanese hospitals were quickly declared overshot even though there were far fewer cases than in the United States, Europe and other countries in Asia and South America. At the beginning of September there were more than 134,000 patients with the virus in their homes, according to records from the Ministry of Health.
Some 18,000 Japanese have died of COVID-19-related causes in a population of 126 million people. No one knows exactly how many people died at home, although the National Police Agency, which monitors the deaths, said 951 people had died in their homes since March 2020, 250 of them in August 2021.
Shigeru Omi, a senior government adviser and head of the Japan Community Health Organization, or JCHO, has urged the government to build emergency field hospitals, specifically to prevent deaths of people sent home.
The Japanese health system is dominated by small private hospitals and clinics, and few inpatient centers are equipped to handle infectious diseases. Many beds are occupied by psychiatric patients, the chronically ill and the elderly, and there are relatively few doctors, intensive care specialists, and nurses.
In some places, local authorities determined that these centers would accept patients who were no longer contagious and were recovering from a serious illness after they were cared for in larger hospitals. But overall, the number of cases was much higher than the beds available for critical care.
The JCHO manages 57 of the largest hospitals in the country. They all get big grants of taxpayer money. The Health Ministry said it provided up to 100,000 yen ($ 900) per bed for COVID-19 patients.
In October, the JCHO said it had prepared 972 beds for virus patients nationwide, or less than 7% of its 14,000 total beds, although in August it temporarily made room for about 1,800 patients.
JCHO declined to comment on Kishida’s request for thousands more beds.
Dr Takanori Yamamoto, a critical care physician at Nagoya University, believes that hospital care should be restructured to serve critically ill patients in designated centers, rather than spread out across small hospitals that have only a handful of ICU beds.
Resources were mismanaged, he noted, including hospitalizing people who did not need it. Public health offices are designed for medical research and are ill-equipped to filter COVID-19 care, he added.
Problems are deeply ingrained in a system designed decades ago, and Yamamoto feared that even if Japan manages to weather this pandemic, it is poorly prepared for the next.
“No other country turned patients away like this, not even countries that had many more cases. The idea of doctors not seeing patients should be out of the question. If you are a doctor, you have to take care of the sick, ”Yamamoto said.
“Japan has done nothing. There has been no leadership ”, I affirm.
Now is the time to act, before another outbreak of contagion hits, said Dr. Kenji Shibuya, director of research at the independent think tank Tokyo Foundation for Policy Research.
“They didn’t act before, even though they knew it was coming,” said Shibuya, who has work experience in Britain. “It’s a lack of commitment, a lack of will, a lack of passion to make a difference in a time of crisis,” he said.
In August, Yuko Nishizato, a co-founder of Takada’s group, implored hospitals to admit her 73-year-old father. But he died after testing positive for COVID-19, without even receiving treatment other than fever medication.
Telephone records show that he called the local public health center several times until he died. It breaks her daughter’s heart to know that she only managed to listen to recorded messages.
“I wanted him to live to see his grandchildren. I wanted him to see an older version of me, ”Nishizato said. “There are so many who have suffered in the same way, and I don’t understand why.”
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