February 8, 2023
Tsuyoshi Masuda
President
Japan Federation of Democratic Medical Institutions

The government’s task force on countermeasures against Covid-19, based on a meeting of the infectious disease subcommittee of the Health Ministry’s Health Sciences Council on January 27, announced on the same day that since May 8, Covid-19 is no longer classified as an infectious disease under the Infectious Diseases Control Law and is reclassified as a Category 5 infectious disease.

With the explosive growth in the number of infected cases since the seventh wave of the outbreak, the emergency care system became dysfunctional, and the death toll reached its highest level. Clusters occurred in many medical facilities and elderly care facilities, and many of their employees were infected or had close contact with coronavirus patients, which had a significant impact on their daily operations. Many elderly care facilities had to give up on continuing operations due to the unprecedentedly high cost of utilities in addition to a significant drop in revenue due to the shutdown of operations without proper compensation.

The Omicron variant is highly transmissible, and even though it is less pathogenic, it still poses a risk of serious illnesses for the elderly and those with pre-existing conditions. Medical and elderly care facilities need to continuously take the same measures to prevent serious illnesses and death of patients and users (sufficient support system, spaces for zoning and isolation, medical supplies, infection protection equipment, etc.). If government subsidies are reduced in line with the reclassification, many medical and nursing care facilities will certainly face financial difficulties. Continued financial support is thus essential.

The government’s latest policy shows no determination to prevent another crisis in medical and long-term care fields and is significantly detached from the feelings of medical and nursing care workers. The policy makes it difficult for such facilities to continue infection control measures. It could destroy the environment in which everyone can safely access medical and nursing care.

Standing on the principles of the Constitution and calling for the protection of human rights, the Japan Federation of Democratic Medical Institutions demands that the government withdraw the latest decision and establish new measures to protect the lives of the people.

(1) Medical care delivery system
The government calls for a medical care delivery system necessary to ensure that Covid-19 patients can be seen at a wide range of medical facilities. However, many medical facilities that had difficulties responding to the pandemic failed to separate potentially-infected patients from other patients or separate time and space due to the structure of their buildings. Therefore, they cannot protect the elderly and patients with pre-existing conditions from the risk of infection. As for inpatients, such facilities have no ward structure that allows for effective ventilation or zoning and difficulties with staffing. The government should suggest how to solve these specific problems.

(2) Medical costs for patients
The suggested reduction of publicly-funded medical care could restrain patients from seeing doctors. It is clear that requiring Covid-19 patients to pay part of their medical bills will deprive them of access to medical care and interrupt their treatment. The government states that it will be implemented in stages, but the people’s economic situation is serious. It is estimated that a single visit to a hospital with a prescription for medicine will cost tens of thousands of yen, greatly infringing on the people’s right to receive medical care. The current public funding should be continued.

(3) Coordination of hospital admission
The government says, “Coordination of hospital admission will be gradually shifted from administrative involvement to individual medical institutions.” The fact that patients in need of treatment could not be properly hospitalized and had to stay at home or in elderly care facilities was one of the causes of the largest number of deaths. The administrative involvement should not be halted, and the current coordination system be maintained.

(4) Support to medical and nursing care facilities
In order to continue safe infectious disease treatment, it is essential for medical facilities to conduct adequate testing, stockpile PPE and other infection-protection equipment and prepare isolated spaces for infected patients. The resulting decrease in patients and revenues is inevitable. The present support program should be maintained as its termination may force medical facilities to discontinue their Covid-19 treatment. We also demand that financial assistance to nursing care facilities be implemented immediately as the largest number of such facilities have gone bankrupt.

(5) Drastic improvement of government’s risk communication
The government said, “Assuming that the infection might spread again in the future, necessary infection control measures should be taken to protect those with a high risk of serious illness, such as the elderly and patients with pre-existing conditions. Careful risk communication should be conducted in order to avoid public division and such misunderstanding that infection control measures are no longer necessary.” In the seventh and eighth waves, statements by the prime minister and other cabinet members were so inappropriate that they could be criticized as misleading the public. Their failure to communicate risks of the infectious disease and the realities of medical and nursing care facilities was one of the factors that led to the increase in the infected cases. Without scientifically and honestly explaining the health risks associated with the reclassification, it is impossible to gain public understanding. We demand that the government change its past response and establish a political stance that sincerely addresses the public.