Japan hospitals slammed after underestimating third COVID wave

Nikkei -- Jan 06

Hospitals in areas of Japan hit hard by a resurgent coronavirus outbreak are struggling to accommodate patients, despite far lower case numbers and more beds than in Europe or the U.S. A failure to adjust excessively rosy assumptions as facts on the ground changed is partly responsible for the situation.

Many experts had warned of the possibility of a winter surge for months. Yet the number of beds set aside for coronavirus cases has actually declined since the first wave last spring.

There is no shortage of overall capacity. Japan has a total of around 900,000 hospital beds for regular patients and infectious disease cases, of which only 3% or so have been allotted to the COVID-19 response.

In mid-May, when about 3,400 COVID-19 patients were hospitalized, more than 30,000 beds were expected to be available across the country. This fell to around 27,000 in mid-August, during the second wave. Because this surge largely affected younger people and brought relatively few serious cases, local authorities may have grown complacent about securing more capacity.

As a result, the number of beds available had barely budged in late December, during the current third wave, compared with more than four months earlier.

This stands in contrast to hospitals in other nations that have adapted more flexibly to surges in coronavirus patients.

In the U.S., where state health authorities hold significant power, New York has directed all hospitals across the state to add 25% more beds and asked retired doctors and nurses to return to work. The U.K.'s National Health Service, which is directly overseen by the health ministry, told hospitals in December to free up all possible beds for coronavirus patients.

The current bed numbers for Japan are derived from scenarios provided by experts based on the first wave and have not changed much since then even as the actual situation has worsened. Tokyo, for example, had been projected to see a peak of 477 new cases per day, yet it reported 1,337 on Dec. 31.

"Even when a bed opens up, it's filled right away by a new patient," said an employee at a university hospital in Tokyo that has brought in six COVID-19 patients, twice as many as it originally set aside capacity for. At the Tokyo Medical and Dental University hospital, the eight beds for severe coronavirus cases are almost always occupied, and the 25 beds for moderate cases remain about 60% to 70% full.

Nationwide, about 40% of the beds that municipalities expect to be able to provide for coronavirus cases were occupied as of late December, according to the health ministry. But more than 50% of beds are full in Tokyo and other hard-hit areas, and many individual facilities are at their limit.