October 19, 2022
Tsuyoshi Masuda
President
Japan Federation of Democratic Medical Institutions

We call for thorough discussion of bill to revise Infectious Diseases Control Law and establishment of medical and nursing care systems capable of guaranteeing people’s safety

For the last two and a half years, more than 2.178 million people have been infected to the covid-19, resulting in 45,890 deaths (as of October 17, 2022). From the fifth to the seventh waves of the spread of the infection, infected people were kept at home or nursing facilities where clusters occurred and died without medical treatment.

In order to prevent such situations from happening again, what the overwhelming majority of the public wants is the establishment of medical and nursing care systems capable of protecting people’s lives and health in preparation for a possible pandemic of other infectious diseases in the future. To this end, it is essential for the government to provide adequate financial support to medical institutions, nursing facilities, and other healthcare establishments.

A bill to revise the Infectious Diseases Control Law, which is scheduled to be submitted to the 210th extraordinary Diet session, fails to take into account lessons from experiences with the covid-19 infections over the last two and a half years.

The central pillar of the bill’s crisis management response is to place a responsibility to secure beds for infectious disease patients on prefectural governments and to strengthen control over medical institutions by law. Specifically, medical facilities are required to conclude “agreements” with prefectures regarding the securing of beds and opening of fever outpatient clinics. Public hospitals, hospitals with specific functions, and regional medical support hospitals are required to provide infectious disease care and are subject to penalties, such as revocation of designation, if they do not follow recommendations and orders. Private medical institutions must discuss with prefectural governments to conclude an “agreement, and the status of implementation of the agreement will be made public. If hospitals fail to follow the agreement, they will be instructed to do so and their name will be publicly released.

No fundamental solution is presented for rebuilding the public health system and functions of public health centers that collapsed during the fifth through seventh waves. The bill has no mention of increasing the number of public health centers or their staff.

Public hospitals, hospitals with specific functions, and regional medical support hospitals provide cancer treatment, advanced medical care, and difficult surgeries in their communities. Restrictions on and postponement of such medical services must be avoided as much as possible even in the event of a pandemic.

In areas without a sufficient number of acute care beds, securing beds for infectious diseases may not be possible. General medical institutions, which had been struggling to manage their operations, have played roles of supporting local medical care during the covid pandemic amid inadequate financial support. As the bill does not include measures to maintain such general and logistical medical providers, local medical care services could collapse.

The bill also lacks viewpoints on providing integrated services from medical care to nursing care in local areas. It divides medical facilities responding to infectious diseases from those supporting the elderly, dementia patients, and nursing home residents as well as keeps infected patients in nursing facilities that suffer scarce medical resources. Its failure to strengthen medical support for nursing homes could lead to maintaining responses deviating from the basics of infection control.

What needs to be done now is to thoroughly review measures taken against the covid-19 infection based on opinions of experts and to build medical and nursing care systems with sufficient capacity. The Japan Federation of Democratic Medical Institutions demands that the bill to revise the Infectious Diseases Control Law be thoroughly discussed and that the law not be hastily revised.