The Kishida government has compiled a comprehensive policy to cope with a sixth round of corona virus infections. Last summer the country experienced the fifth wave, at the peak time of which the medical care system was overwhelmed by the patients. The new policy, learning from the lessons, will manage well a coming strike of the disease. Its effectiveness will be challenged.
EFFECTIVE IMPLEMENTATION IS NECESSARY
The government told it had successfully secured 37 thousand of hospital beds for COVID-19 patients; the figure means an increase by 30% of the number of patients at the peak time and these beds will be ready by the end of this month. An oral drug to treat patients with mild symptoms will be obtained in a volume of 1.6 million doses. The medicine will be commercialized by the year-end.
A new-born baby died
At the peak time of the fifth wave last summer in total 26.7 thousand people were hospitalized maximumly nationwide, but one-thousand and a hundred people could not be admitted, left behind at their homes (Ministry of Health, Labor and Welfare). In Chiba prefecture an infected pregnant woman could not be admitted and she gave a birth at home. The baby died.
The government, learning from the experiences, has increased the number of hospital beds by 30%, which counts 10 thousand, to respond to a sixth wave to come. Last summer the occupancy rate of hospital beds was 68% across the country and the government is to surge it up to 82%.
Temporary accommodation facilities will be ready other than hospitals, which will accept 3,400 people for medical treatment or waiting for it, which is four times larger than the number of people of the highest last summer.
The government proposes to conclude an agreement between the prefectural authority and a medical institution so that hospital beds can be used effectively; to agree on a necessary period of time when beds are ready. It also requests the parties to present reasons in a written form when a medical institution cannot accept patients.
In addition, IT will be utilized so that medical care facilities and local governments can share information in common on accessibility to and occupancy of beds. The national government will publicize every month after December about the number of beds available and occupancy rates for each of medical institutions.
Verify and monitor progresses
Recently it was disclosed that some beds were left unused at the peak time though they were certified for COVID-19 patients - in other words there were ‘ghost’ beds. Information was not managed rightly and precisely. The Ministry of Health did not receive essential data.
A problem lies in operations of the policy scheme; how the state’s government, prefectures, doctors’ associations and hospitals could cooperate in practice, sharing recognition mutually.
The government says the state’s authority could handle human resources beyond the prefectural boundary at a critical moment, but the existing medical policy is firmly maintained at the municipal level nationwide to reduce hospital beds.
Tests are necessary to detect infections and variants of the virus, but the new policy indicates a decline in a remuneration of medical consultations that may lead to reducing quantity of tests. A verification system is needed to survey and monitor progresses.
病床３・７万確保の政府対策の全体像は、感染者数がピークだった今夏に比べて３割多い患者が入院できる体制を今月中に構築し、軽症者向けの飲み薬を１６０万回分確保し、年内の実用化を目指すことなどが柱となっている。
新生児が亡くなる
具体的には、今夏の第五波のピーク時には全国で合わせて最大で２万６７００人が入院したが、およそ１１００人が入院できなかった(厚労省)。千葉県では感染した妊婦の入院先が決まらず、自宅で出産し新生児が亡くなっている。
このため政府は第六波に備え、入院可能な病床を夏の時点から３割に当たる１万床増やし、およそ３万７０００人が入院できる体制を整え、その上で今夏全国で68％だった病床の使用率を82％に引き上げることを見込んでいる。
また、病院以外の臨時の医療施設や入院待機施設についても４倍に当たる３４００人を受け入れるとしている。
その対策として病床を確実に稼働できるよう都道府県と医療機関の間で、病床が対応可能となるまでの期間や、患者を受け入れることができない場合の理由などを明確化した書面を締結することも示された。
さらにＩＴを活用し、医療機関や自治体などとの間で病床の確保や使用状況を共有できる体制を構築するとともに国が医療機関ごとに病床の確保状況や使用率を12月以降、毎月公表するとしている。
対策の進捗管理を
第五波時、コロナ病床と申告されていながら、実際には使用されなかったいわゆる「幽霊病床」があったことが最近判明した。対策施策が進行管理されず厚労省に上がっていなかったのだ。
問題は、絵図面ができても実際それを実行する政府・都道府県・医師会・医療機関との認識の共有・連携が担保されなければならないことは自明だ。
ひっ迫時に国の権限で都道府県を超え医療人材を融通するというが、今後病床削減を進める地域医療構想は堅持されている。感染拡大・ウイルス変異を捕捉するためにはＰＣＲ等の検査は必要条件だが、検査体制の縮小につながりかねない診療報酬の引き下げを示唆している。確実な実行監視がこれまで以上に必要だ。
英訳版↓
No. 1237 A Possible Sixth Wave of the Pandemic
The Kishida government has compiled a comprehensive policy to cope with a sixth round of corona virus infections. Last summer the country experienced the fifth wave, at the peak time of which the medical care system was overwhelmed by the patients. The new policy, learning from the lessons, will manage well a coming strike of the disease. Its effectiveness will be challenged.
EFFECTIVE IMPLEMENTATION IS NECESSARY
The government told it had successfully secured 37 thousand of hospital beds for COVID-19 patients; the figure means an increase by 30% of the number of patients at the peak time and these beds will be ready by the end of this month. An oral drug to treat patients with mild symptoms will be obtained in a volume of 1.6 million doses. The medicine will be commercialized by the year-end.
A new-born baby died
At the peak time of the fifth wave last summer in total 26.7 thousand people were hospitalized maximumly nationwide, but one-thousand and a hundred people could not be admitted, left behind at their homes (Ministry of Health, Labor and Welfare). In Chiba prefecture an infected pregnant woman could not be admitted and she gave a birth at home. The baby died.
The government, learning from the experiences, has increased the number of hospital beds by 30%, which counts 10 thousand, to respond to a sixth wave to come. Last summer the occupancy rate of hospital beds was 68% across the country and the government is to surge it up to 82%.
Temporary accommodation facilities will be ready other than hospitals, which will accept 3,400 people for medical treatment or waiting for it, which is four times larger than the number of people of the highest last summer.
The government proposes to conclude an agreement between the prefectural authority and a medical institution so that hospital beds can be used effectively; to agree on a necessary period of time when beds are ready. It also requests the parties to present reasons in a written form when a medical institution cannot accept patients.
In addition, IT will be utilized so that medical care facilities and local governments can share information in common on accessibility to and occupancy of beds. The national government will publicize every month after December about the number of beds available and occupancy rates for each of medical institutions.
Verify and monitor progresses
Recently it was disclosed that some beds were left unused at the peak time though they were certified for COVID-19 patients - in other words there were ‘ghost’ beds. Information was not managed rightly and precisely. The Ministry of Health did not receive essential data.
A problem lies in operations of the policy scheme; how the state’s government, prefectures, doctors’ associations and hospitals could cooperate in practice, sharing recognition mutually.
The government says the state’s authority could handle human resources beyond the prefectural boundary at a critical moment, but the existing medical policy is firmly maintained at the municipal level nationwide to reduce hospital beds.
Tests are necessary to detect infections and variants of the virus, but the new policy indicates a decline in a remuneration of medical consultations that may lead to reducing quantity of tests. A verification system is needed to survey and monitor progresses.
December 8, 2021