Elderly COVID-19 cases pile pressure on hospitals in Japan

By: 3 years ago

A nurse feeds a patient in a COVID-19 ward at IUHW Narita Hospital in Chiba Prefecture on Tuesday. The Yomiuri Shimbun

TOKYO — Pressure on medical institutions is mounting amid a surge in the number of elderly COVID-19 patients being hospitalized and delays in the transfer of recuperating patients to backup facilities.

A nurse in protective gear was feeding a patient in his 70s on Tuesday evening in a COVID-19 ward at the International University of Health and Welfare (IUHW) Narita Hospital in Narita, Chiba Prefecture.

The patient, a resident of an elderly care facility, was admitted to the hospital on Feb. 8 with pneumonia. It took about 30 seconds for the man to swallow a spoonful of rice porridge. According to the hospital, it can take as long as one hour for a nurse to feed patients in a fully-occupied 4-person room.

As of Tuesday, 28 COVID-19 patients were being treated at the hospital, which has 71 beds earmarked for such patients. Among the patients, 25 had moderate symptoms and 3 were mild cases. Twenty-four out of the 28, or 85% of them, were in their 70s or older, and 18 required nursing care.

Although the bed occupancy rate was 40%, extra staff were required to provide nursing care. “Even if some beds are unoccupied, it is difficult to admit more patients,” said Kenji Tsushima, the assistant director of the hospital.

Elderly patients tend to require hospitalization for longer periods, partly because of the risk of preexisting health problems worsening, or the need for IV treatment.

To free up beds for serious COVID-19 cases, the hospital has been trying to transfer patients whose conditions have improved to backup facilities, but it said the facilities frequently reject its requests.

The number of omicron patients who have required ventilators in the sixth wave of the pandemic is said to be lower than the number of people who needed such treatment during the fifth wave last summer when the delta variant was dominant.

However, there have still been shortages of beds for non-severe COVID-19 patients, because of the surge in the number of elderly patients with underlying health issues that worsened as a result of the disease.

The central government has asked Tokyo and other prefectural governments to secure so-called backup hospitals that can admit patients whose treatment for COVID-19 has ended but who cannot be discharged for reasons such as weakened physical health

However, the transfer process has been inefficient.

The biggest factor is the increase in the number of elderly patients being hospitalized. People aged 60 or older accounted for 29% of hospitalized COVID-19 patients in Tokyo on Sept. 1, at the peak of the 5th wave.

On Feb. 16, the same demographic accounted for nearly 70% of hospitalized COVID-19 patients in Tokyo.

In many cases, elderly patients need specialist medical and nursing care, such as dialysis treatment, anticancer drugs, and dementia support, but only a limited number of backup hospitals can meet such medical needs.

“Our beds are already almost fully occupied with general emergency patients. We have no capacity to spare,” said Yutaka Koyama, director of Tokyo Kamata Hospital in Ota Ward, Tokyo, a designated backup facility.

Infection clusters at backup hospitals are another factor hampering the transfer of mild COVID-19 cases.

Local governments and medical facilities have also faced problems coordinating transfers.

The Health, Labor and Welfare Ministry in October asked Tokyo and other prefectural governments to compile lists of backup hospitals and share them with facilities handling severe COVID-19 cases.

The Tokyo metropolitan government posts a list of backup hospitals online, and negotiations can be made directly between the medical facilities. The metropolitan government has also been helping to coordinate transfers since December, but it has only completed 34 since January.

As there is no information on bed vacancies at backup hospitals on its website, “officials make phone call after phone call to check the status of beds,” an employee of a Tokyo hospital said.