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On Japan's stretched frontline, doctors and nurses face long fight against coronavirus

Apr 29, 2020 (Japan Today) - At any given time, seven out of eight beds in the intensive care unit of St Luke's International Hospital in Tokyo are taken up by critically ill coronavirus patients.

"If we max out eight beds we can't place patients who suddenly take a turn for the worse, so we always keep one bed open," said Fumie Sakamoto, who manages the 500-room hospital's infection control division.

The extra ICU bed also needs to stay open for any coronavirus patients who could arrive at any hour of the day in an ambulance, Sakamoto said.

"Our ICU is now really only for COVID patients," she said.

As the number of confirmed coronavirus cases in Japan tops 12,000, hospitals like St Luke's are saving their limited ICU capacity for an increasing number of critically ill patients and improvising makeshift gear to protect frontline medical staff.

With some hospitals reluctant to take in COVID-19 patients, the most critical cases are transferred to willing hospitals like St Luke's, which are already inundated.

St Luke's has a special designation as a facility for infectious diseases and so receives government subsidies to take in infectious cases.

The pandemic has posed particular challenges in Japan where authorities are not legally empowered to enforce strict lockdowns like in other countries nor penalize businesses or individuals for not following isolation guidelines.

Although the government declared a nationwide state of emergency this month, it is unable to compel most hospitals to take in patients.

Japan is also in the same scramble for protective gear and medical equipment seen in many countries around the world.

Some doctors and other experts say there has been a failure by the central and some local governments to provide adequate financial assistance and protective gear to hospitals and medical staff.

"We do not have a legal tool to force (hospitals to take patients), but even if we did, I don't think we should make such a request to hospitals that are not prepared for infectious diseases," said Yoshiyuki Sugishita, a senior official handling the coronavirus response at the Tokyo metropolitan government.

He said Tokyo had set up an online database this month where hospitals and public health centers can update the number of coronavirus cases they have admitted on a voluntary basis.

More than 370 people have died of COVID-19 so far in Japan, with 100 of them in Tokyo.

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