With hay fever season ramping up and the flu still thriving, the spread of the novel coronavirus poses a challenge for medical institutions nationwide, which face the prospect of being flooded with patients who believe they have COVID-19.

Despite the government’s efforts to calm nerves, experts have raised questions about whether asking the public to observe their symptoms closely before seeking a consultation will actually prevent a rush on clinics and allow those with serious conditions to be treated in a timely manner.

On Monday, the health ministry issued guidelines for people who fear they have been infected with COVID-19, urging them to stay home if they have symptoms. If symptoms become serious, they are advised to call a special consultation center set up by the government.

As of noon Thursday, the total number of cases detected in Japan had exceeded 700, including those from a cruise ship quarantined in Yokohama port since Feb. 5.

Eiji Kusumi, director of Tokyo-based Navitas clinic, believes that such requests to the public may be not be effective in separating coronavirus patients with mild symptoms from those suffering from other conditions. Kusumi also said the move may not prevent the spread of the virus.

“It’s impossible to tell the difference between a coronavirus infection and a cold just based on symptoms,” given that complications linked to COVID-19 are identical to those found with other viral infections such as the common cold and pneumonia, Kusumi said Thursday.

In its set of guidelines, the health ministry advised that people seek a consultation if they have a fever of 37.5 degrees Celsius or above for four days or more, experience difficulty breathing or feel severe drowsiness. Medical staff at the center will then advise which hospitals a caller should visit for treatment.

In confirmed COVID-19 cases, some patients only have mild symptoms, while others develop serious conditions such as pneumonia, which can lead to death.

“The virus may further spread within clinics if people infected … share waiting rooms with those who come to the clinic with common cold symptoms,” Kusumi said.

“There’s no way to separate patients with suspected coronavirus infections within clinics,” he said, also stressing that those who take public transportation to visit hospitals may expose others to the virus. He added, however, that the virus is more likely to spread from people with more severe complications.

The government guidelines have come amid concerns among medical workers that an influx of patients with cold-like symptoms would put a strain on resources. | BLOOMBERG
The government guidelines have come amid concerns among medical workers that an influx of patients with cold-like symptoms would put a strain on resources. | BLOOMBERG

Hitoshi Oshitani, a professor at the Department of Virology at Tohoku University’s Graduate School of Medicine and a former adviser to the World Health Organization’s Western Pacific office, said the speed and characteristics of COVID-19 may result in many cases going unnoticed.

The government guidelines came amid concerns among medical workers that an influx of patients with cold-like symptoms would put a strain on resources.

At a news conference in Tokyo on Tuesday, Oshitani warned that hospitals treating a growing number of patients with pneumonia and other severe symptoms may not be able to handle a large number of coronavirus patients.

“Hospitals should concentrate on treating people with severe (complications),” he said, warning that if priority is not given to those with serious conditions, severe cases could be overlooked.

Kusumi believes the health care system, with its widely available hospitals and clinics nationwide, serves as an incentive for patients to quickly seek medical attention.

“Many people tend to seek help as soon as they develop symptoms. … Many people with suspected coronavirus infections will likely seek medical attention within the first two days after they start feeling unwell,” he said.

But Kusumi urged calm, saying that while the elderly and people with underlying health conditions should be more vigilant, as they are more vulnerable to the virus, mild cold-like symptoms should clear up within a few days even if caused by the coronavirus.

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