Hospital capacity is being tested in the nation’s hardest-hit areas by a third wave of COVID-19 as a growing number of severely ill patients occupy a dwindling number of available beds.

The number of patients severely ill with the disease in Japan reached 280 on Thursday — the highest since August — in a concerning trend that could overwhelm hospitals, health care facilities and intensive care units, delaying treatment for patients in critical condition.

More than 50% of hospital beds for COVID-19 patients are occupied in Tokyo, Kanagawa, Osaka and Hokkaido prefectures following an abrupt surge in new cases that began last week. Experts are concerned about the prolonged pressure this will put on front-line workers.

“Prolonged hospitalization is becoming a bigger burden for health care facilities,” said Masataka Inokuchi, vice president of the Tokyo Medical Association, during a meeting Thursday at the Tokyo Metropolitan Government. “Securing more hospital beds is an urgent necessity.”

As of Wednesday, 1,354 of 2,640 — or about 51% — of hospital beds for COVID-19 patients in Tokyo were occupied, a 10 percentage point increase from the week prior.

The Tokyo Metropolitan Government recorded 522 cases on Friday, following a record-breaking 534 cases on Thursday and 493 on Wednesday, bringing the capital’s total past 36,700 infections and 476 deaths. Nationwide, 2,429 cases were confirmed, marking a record daily high for the third straight day.

On Thursday, Tokyo Gov. Yuriko Koike raised the city’s virus alert status to its fourth and highest level, indicating that “infections are spreading.” The previous level, which was the second highest, had indicated that “infections appear to be spreading.”

“The number of elderly people infected as well as asymptomatic and untraceable cases are rapidly increasing,” Koike said during a news conference Friday.

Koike added that, while new cases were emerging at an unprecedented rate, “severe cases are not increasing as abruptly and, in that regard, the situation is still within control.”

As of Friday afternoon, the capital had reported 37 active cases in which COVID-19 patients were severely ill.

Tracing routes of infection is becoming increasingly difficult since the circumstances in which clusters of cases have emerged are more diverse in comparison to previous waves, experts said during a meeting Thursday at the Tokyo Metropolitan Government.

Norio Ohmagari, director of the Disease Control and Prevention Center and an adviser to the metropolitan government, predicted that the capital could start to record more than 1,000 cases a day four weeks from now if current trends continue.

Hospital bed availability in areas hard-hit by a surge of COVID-19 cases
Hospital bed availability in areas hard-hit by a surge of COVID-19 cases

Elderly patients accounted for most infections during the first wave, while it was clusters traced back to young people infected at hostess clubs and bars that nearly incapacitated hospitals during the second wave.

More recently, clusters in workplaces, public facilities and households have continued to emerge in Tokyo, Hokkaido, Kanagawa, Aichi, Osaka and Ibaraki prefectures, among others.

Hokkaido was the first prefecture to see an uptick in new cases last month. Officials are concerned that more clusters of infections will arise as winter approaches, and people are forced indoors into enclosed spaces with poor ventilation where the virus is thought to spread more easily.

Despite the unprecedented nationwide increase in new cases, the central government says no municipality has asked to be removed from the Go To Travel campaign, a government-subsidized domestic travel program that experts and health care workers say is exacerbating the ongoing spread of the virus.

An expert panel on the pandemic advised the government on Friday to immediately review the Go To campaigns in regions where infections are spiraling, including possibly excluding some areas from the initiatives.

“We sincerely ask the government to make a bold decision,” it said. The government has voiced its intention to maintain the tourism promotion campaign, which was kicked off in late July.

At Friday’s meeting of the panel led by Shigeru Omi, head of the Japan Community Health Care Organization, it also called on local authorities to request restaurants and other establishments to shorten operating hours and ask residents to refrain from going out at night.

Regarding the Go To campaigns — which also subsidize dining out and attendance at public events — Prime Minister Yoshihide Suga said earlier Friday that no alterations will be made at this time.

“We’ve adapted our policies in consultation with the opinions of experts and front-line workers, and intend to continue moving forward in the same spirit,” Suga said.

According to Suga, of the 40 million people who have traveled using discounts from the Go To Travel campaign, 176 have tested positive for COVID-19.

Japan Medical Association President Toshio Nakagawa said during a news conference Wednesday that, though it was unclear whether the travel campaign was responsible for the surge in new cases, it “surely acted as a catalyst.”

“I urge people not to underestimate the virus, or to grow complacent,” Nakagawa said.

Heading into the three-day weekend, health minister Norihisa Tamura urged residents to wear a mask and take precautionary measures when leaving the house.

“If the virus spreads any further, we will have no choice but to ask residents to curb their behavior. We need to prevent that from happening,” Tamura said during a news conference on Friday.

“There’s a limit to the support that can be provided to secure more hospital beds,” he went on. “What’s important is how we avoid spreading the virus over the weekend.”

Information from Jiji added

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