Far more mildly ill or asymptomatic COVID-19 patients in Japan are opting to self-isolate at home than hole up in hotels, leaving accommodations catering to them with abysmal occupancy rates, recent figures show.

Health ministry statistics as of April 28 showed that of the 8,711 official COVID-19 patients nationwide, only 862 were recovering at hotels catering to the mildly ill.

A separate survey released by the ministry around the same time, meanwhile, found that 12,090 hotel rooms were available for patients nationwide, indicating a measly occupancy rate of 7 percent. The number of patients at hotels, in fact, pales in comparison to the number recovering at home, who totaled 1,984, the figures showed.

Tokyo, for example, has more patients at home, 635, than any other prefecture, versus just 198 staying in hotels.

Both the ministry and the Tokyo Metropolitan Government stand by the position that mildly ill patients be sent to hotels rather than recover at home in order to avoid spreading the disease to family members. Staffed by doctors and nurses who provide daily checkups, the hotels are deemed instrumental in preventing those who live alone from going unnoticed if they become critically ill.

The central government’s original policy was to hospitalize all COVID-19 patients, but as it became clear the nation’s medical system was being overwhelmed, it changed tack to steer the mild patients toward hotels and homes. But as reports emerged of patients either infecting family members or seeing their health deteriorate, the ministry adjusted its policy further to prioritize hotel stays.

Officials attribute patients’ choice of homes over hotels to factors including the need to look after ailing parents, children and pets. Since patients aren’t responsible for the costs of hotel stays, money is not likely an issue, they say.

In Tokyo, public health centers have been instructed to persuade those with mild symptoms to opt for hotels, “but since their recommendation is not legally binding, there is nothing they can do when the patients refuse to comply,” a metropolitan official said.

“That’s certainly a dilemma for them.”

Partly with the goal of remedying this situation, the health ministry issued a notice to all prefectures Wednesday to the effect that they are now empowered to designate hotels as “makeshift medical institutions” per the revised emergency legislation.

Such a designation would effectively give prefectures the power to order that patients be “hospitalized” at hotels, although refusals will still not come with any penalties. The move, however, is at least expected to give more weight to the words of public health centers by legally endorsing their recommendations, and hopefully go a long way toward more prevalent use of public accommodations, a health ministry official said.

“I don’t think the notice will solve the problem immediately, but it will at least give public health centers the option to claim that patients are now legally obliged to stay at hotels,” the official said.

Tokyo Gov. Yuriko Koike is aware of the issue, too, enumerating a list of measures the metropolitan government is taking to facilitate the use of hotels, at a news conference earlier this month.

To allay concerns over the prospect of leaving pets unattended, Koike said the city has launched a hotline for pet owners and is seeking cooperation from the Tokyo Veterinary Medical Association.

Public health centers are also collaborating with child welfare centers to arrange accommodations for children at medical institutions and other facilities while their parents are gone.

Since those cooped up in hotels are susceptible to becoming stressed, the Tokyo Medical Association is offering consultations over the phone with psychiatrists, Koike added. Some hotels are even deploying robots to serve as receptionists to welcome patients and clean their rooms, she added.

“We want to keep their stay at hotels as stress-free as possible,” Koike said.

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