When her fitness worsened, she called the public health center in Hyogo Prefecture for assistance, but she said no one answered your calls.
Instead, she had to isolate herself in her tiny bedroom, while her children, aged 3 and 6, slept alone in the living room for almost two weeks. Her mother left food for the family, but she could not stay because the children had been exposed to the virus and were unable to get tested for almost a week. Su said he communicated with his children via a tablet – and used to hear them fighting.
“My young children were stuck in the little one living alone without leaving home for 10 days.” I was feeling bad, in very bad condition, but I felt more pain when leaving my children alone. “
A representative from the Hyogo Prefecture Health Center was unable to speak directly about Su’s case, but said that although they try to contact isolated patients daily, the vacation period was incredibly hectic.
But the Covid-19 pandemic has pushed the medical system to the limit, while Japan has been dealing with its worst wave since the pandemic began. Cases have more than doubled in the past two months, to more than 406,000 cases.
And while the current wave’s peak period has passed, with cases falling from more than 7,000 a day in January to less than 3,000 daily cases this month, the medical system is still under pressure.
On February 4, more than 8,700 people in 10 city halls, tested positive for Covid-19, were waiting for a hospital bed or vacancy in an isolation center. In the previous week, more than 18,000 people in 11 city halls were waiting, according to city health ministries.
Health on tap
Despite the rapid increase in the number of cases in Japan in recent months, the number of infections and deaths is still small compared to those in the United States, where daily cases on average exceed 100,000.
But experts say health expectations are different in Japan.
Since the 1960s, Japan’s universal health insurance system has provided coverage for all Japanese citizens – regardless of income or pre-existing conditions. But experts say that easy access to care has made many patients seek more care than necessary, considering the guaranteed system
“We consider (health) something like tap water, but now the tens of thousands of people with Covid-19 have had to stay at home and cannot access the health care system, cannot be hospitalized and cannot even see doctors “said Dr. Kentaro Iwata, professor and doctor at Kobe University Hospital. “This is a very harsh reality, which is very difficult for many Japanese to accept.”
It is not uncommon for patients with Covid-19 with severe symptoms in other countries to wait for a place in the hospital, said Naoiki Ikegami, professor emeritus at Keio University.
But in the early waves of the pandemic in Japan, most people who tested positive for Covid-19 were automatically hospitalized, Ikegami said.
“This is how Covid-19 was treated in the first and second phases, so there is an expectation that anyone with Covid-19 will be hospitalized, even if they have only mild symptoms,” said Ikegami.
Since then, the system has been adjusted so that not everyone is hospitalized. But hospitalization rates for Covid-19 are still higher in Japan than in other countries.
System failures
Personnel is another major problem in the Japanese medical system.
Japan has just 1,631 infectious disease specialists in 8,300 hospitals, according to the Japanese Ministry of Health, which means that most hospitals do not have an infectious disease specialist.
Unlike other nearby Asian territories such as China, Hong Kong, South Korea, Singapore and Taiwan, Japan has managed to avoid previous outbreaks of coronavirus, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
“Many infectious diseases have not arrived in Japan, so we have not prepared,” said Iwata.
“We don’t train many specialists, we don’t train the hospital wards and we don’t prepare the health system for infections and that’s the result of that,” he said.
Across Japan, hundreds of public health centers receive calls from patients and refer them to health care, monitor their health, organize examinations and contact tracking.
Dr. Hideo Maeda, head of a public health center in Kita Ward, Tokyo, said his team has quadrupled to 40 since the start of the pandemic, but it is still not enough. In his ward alone, every day, dozens of patients are waiting for a place in the hospital.
“Many employees work every day until midnight, on weekends and holidays,” said Maeda. “We are exhausted and overwhelmed – psychologically – by stress. Our team has to make difficult decisions about people’s lives in a short period of time.”
A confused answer
In January, Prime Minister Yoshihide Suga made a rare apology. “As a responsible person, I am very sorry,” he said. “We have not been able to provide the necessary care.”
His government was blamed for his slow and indecisive response to the pandemic. Suga ruled out the need for a state of emergency in late December, only to declare one for Tokyo and several other prefectures the following month. Before that, his government encouraged domestic consumption with a “Go to” campaign, which gave Japanese citizens huge discounts for traveling and eating at home. This campaign was not suspended until December.
Kenji Shibuya, director of the Population Health Institute at King’s College London, said Japan’s response has been “very slow and confusing”.
Last week, the Japanese parliament passed two bills that give authorities the power to fine offenders, including companies that refuse to cut hours and infected people who refuse to cooperate with health officials.
Under the new antivirus law, the government can also request that hospitals accept patients with Covid-19 or name them publicly if they do not respond.
The majority of Covid-19 patients in Japan are being treated in large public hospitals.
The government has yet to announce a timetable for the rest of its citizens. The vaccine will be voluntary and convincing people to get it will be a challenge in a country with a history of safety scares and concerns about side effects.
Earlier this week it was announced that Japan will have to discard one in six doses of the Covid-19 Pfizer vaccine, from which it has ordered 144 million doses, because the country’s standard syringes will only be able to extract 5 doses of the vaccine from each vial. Special syringes would be needed to collect the sixth dose.
That is if the government is able to convince people to get the vaccine.
Su has already recovered from Covid-19, witnessing firsthand the limits of the public health system during a pandemic.
She says she still has some persistent symptoms, but is grateful to be able to hold her children again.
When her isolation ended, the first thing she was told was, “Mom, please hug me.”