August 5, 2021

Tsuyoshi Masuda
President
Japan Federation of Democratic Medical Institutions

The government on August 2 suddenly announced a changed policy regarding hospitalization of COVID-19 patients: hospitalization will be limited to those with severe symptoms or those with high risk of developing such symptoms, and others will stay at home or, if they cannot do so, at an accommodation facility. This is in direct contradiction to the previous policy of hospitalizing a wide range of infected patients, especially those with high risk of severe symptoms, and treating asymptomatic and mildly ill patients in accommodation facilities while limiting home treatment to those who cannot stay at such facilities.

It has become clear for the last year and a half as a characteristic of this virus that its symptoms, while appearing to be mild, can get worse in a short time. If patients with pneumonia signs but mild symptoms (moderate I) are forced to stay at home, they will be at risk of rapid development of symptoms at home, which could result in many deaths. The tragedy of not a small number of deaths at home during the third and fourth waves will be repeated.

The government says that the change of policy is to prevent a shortage of hospital beds at a time when the number of new cases is surging. But it only uses the term “policy change” to refer to the “collapse of the medical care system” when patients who need to be hospitalized cannot be sent to a hospital.

This policy change was abruptly announced at a time when preparations were still insufficient at local levels to monitor health conditions of home patients and to respond to their deteriorating conditions. This is a foolish move that will plunge local medical services into confusion.

Shigeru Omi, who heads the government’s subcommittee on COVID-19 measures, stated that he had not been consulted in advance about this decision. It is absolutely unacceptable to make such a grave decision without consulting experts.

Medical facilities are receiving an increasing number of patients with fever due to the rise of heatstroke cases, and COVID-19 positivity rates among them are increasing day by day. Medical professionals continue to work hard under extreme tension. If they are further overburdened, it will increase a risk of accelerating the collapse of the medical care system.

The Japan Federation of Democratic Medical Institutions makes the following urgent requests to the government:

1. Taking the present situation seriously, the government should withdraw the new policy of limiting hospitalization and a statement regarding “treatments of patients in light of the current spread of infections (published on August 3 by the Health Ministry’s COVID-19 response headquarters)”.
2. In response to the explosive growth in infections and the crisis in the medical service system, the government should urgently take effective measures to reduce infection cases. In order to prevent deaths of patients at home, it should increase workers at public health centers and expand the PCR testing capacity as well as cooperate with local governments and medical associations to secure enough hospital beds, establish standards for treating home patients, obtain necessary medicines and allow their use.

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