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The health ministry has asked the nation's prefectures to beef up their health care systems and create a more resilient means of dealing with a projected sixth wave of COVID-19 infections this winter.

Japan is known for having the world’s highest number of hospital beds per capita, but that has not spared the country's medical system from nearing collapse in major metropolitan areas. The spread of the highly infectious delta variant had led to daily nationwide caseloads of nearly 26,000, including more than 5,700 in Tokyo alone, in August.

The government is hoping the country's gradually rising rate of fully vaccinated people — which vaccine rollout minister Taro Kono said Friday could reach around 80%, up from the current 60% — could help reduce the number of daily infections, serious cases and deaths.

Still, health minister Norihisa Tamura has called for expanding the number of available beds across the country on the assumption that the next wave of the virus could be at least as bad as this summer's fifth wave.

The requests come as the lessons learned from the ongoing battle with the delta variant weigh heavily on the minds of those leading the government's coronavirus response.

The deadly virus had pushed the number of people self-isolating at home to a record of over 130,000 at one point. This included patients with breathing difficulties and others at high risk of becoming seriously ill who were unable to be admitted to hospitals and saw their conditions deteriorate in a matter of hours unbeknownst to health officials.

“It's true that we fell short in adequately streamlining the medical care provision system,” Tamura told a news conference Friday. “I offer my condolences and apologies for those who lost their lives.”

Medical workers at Osaka Medical and Pharmaceutical University Hospital work in the operation wing of the hospital in Takatsuki, Osaka Prefecture, on May 17. | REUTERS
Medical workers at Osaka Medical and Pharmaceutical University Hospital work in the operation wing of the hospital in Takatsuki, Osaka Prefecture, on May 17. | REUTERS

The health ministry the same day urged all of the nation's 47 prefectures to put in place by November a comprehensive medical care system that puts local residents at ease by dedicating resources not only to managing the coronavirus, but general medical cases, as well.

The health ministry said it is aiming to minimize the number of serious cases and deaths by taking advantage of a range of new treatments for COVID-19 patients in early stages of exhibiting symptoms. This includes the use of a monoclonal antibody treatment that has begun to be administered in some cities to high-risk individuals who are recuperating at home.

Government officials are also pushing to realize a system under which all patients are in constant contact with health centers or medical facilities and receive the necessary treatment or are hospitalized promptly when needed.

The move comes as experts, including Masahiro Kami, executive director of the Tokyo-based nongovernmental Medical Governance Research Institute, have called on the government and municipalities to work together to increase the number of hospital beds for COVID-19 patients. Based on the previous year’s pattern, they believe the next wave of infections could emerge later this month and peak in early January.

The height of the pandemic in the summer has laid bare a number of systemic problems, including some hospitals' inability to procure promised beds for COVID-19 patients due to a lack of skilled physicians and insufficient preparations. If it was found that these hospitals did not admit COVID-19 patients without valid reasons, the ministry will ask them to return subsidies paid out for securing the beds.

A medical worker at Osaka Medical and Pharmaceutical University Hospital enters the intensive care unit of the hospital in Takatsuki, Osaka Prefecture, on May 17. | REUTERS
A medical worker at Osaka Medical and Pharmaceutical University Hospital enters the intensive care unit of the hospital in Takatsuki, Osaka Prefecture, on May 17. | REUTERS

The public health centers have also been overwhelmed, with staff arranging the hospitalization of high-risk patients and checking up on others. Many employees remain exhausted from chronic overwork. To avoid a recurrence of this situation, the ministry has called for beefing up staffing numbers, including mobilizing local government employees.

By allowing doctors to check up on self-isolating individuals in addition to health centers, the ministry is also aiming to ensure that all patients are contacted by health centers or doctors within one day of their positive test at the latest.

The ministry cited as an example the city of Kyoto, which has set the number of additional personnel needed at health centers based on the number of positive cases relative to its population.

To deal with a resurgence in the number of patients with acute COVID-19 symptoms who cannot be hospitalized due to bed shortages, the ministry has also asked prefectures to streamline temporary medical facilities and have hospitals temporarily dispatch health care workers to the facilities on a rotational basis.

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