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The government is reviewing how it implements the infectious disease law in order to reduce the burden of measures against the coronavirus on medical professionals.

The government hopes to promote the treatment of people at hotels and other accommodation facilities for some patients instead of hospitalizing them.

COVID-19 is currently considered equivalent to or worse than a Category I Infectious Disease, the most dangerous category in the five-step scale under the infectious disease law. The top category also includes Ebola.

The disease was initially not classified on the five-tier scale as details of the viral disease were unknown at the time of the first domestic infection in January. It was classified only as a “designated infectious disease.”

It was then categorized to be on par with Category II diseases, including tuberculosis, making it possible for public authorities to advise that patients be hospitalized and to limit their work.

Revisions of ordinances related to the epidemic since then have effectively pushed up the government’s categorization of COVID-19 to Category I, making it possible to advise hospitalization for asymptomatic patients. The government then made it possible to request that people stay home, which is a stricter measure than allowed for the top category.

As a result, the governors of the 47 prefectures now have the authority to advise hospitalization. In April, however, the health ministry called for asymptomatic people to be treated at accommodation facilities in principle, to avoid a shortage of available hospital beds.

But some municipalities continue to abide by the ordinances and hospitalize such people, instead of following the exception urged by the ministry. This has led to heavier burdens on medical resources and staff.

A training session for using extracorporeal membrane oxygenation, or ECMO, to treat seriously ill COVID-19 patients is conducted at Jichi Medical University Saitama Medical Center in Saitama on Aug. 30. | KYODO
A training session for using extracorporeal membrane oxygenation, or ECMO, to treat seriously ill COVID-19 patients is conducted at Jichi Medical University Saitama Medical Center in Saitama on Aug. 30. | KYODO

Some have called for lowering the classification for COVID-19, but placing it in Category V, alongside seasonal flu, would make it so authorities are unable to advise hospitalizations for infected people.

“We can urge people to be treated in accommodation facilities because we can advise hospitalization if they refuse,” in line with the current classification, a senior ministry official said.

Placing COVID-19 in Category V would also extend the period within which doctors must report infection confirmations to seven days, making it difficult to track the up-to-date spread of the virus.

As a result, the ministry is now planning to maintain COVID-19’s categorization and to push for the treatment of asymptomatic people at accommodation facilities mainly through revisions of related ordinances instead. It will set up a task force of expert advisers to hammer out the details.

“The situation regarding the epidemic, and the knowledge we have, are different from when it was designated in February,” an expert planning to join the advisory panel said regarding COVID-19. “Instead of simply continuing with what we implemented then, we must discuss the positive and negative aspects (of the decision).”

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