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Japan has the most beds per capita in the developed world. So why is its health system crashing?

The single mother-of-two had a persistent fever and trouble breathing. She knew that her asthma and chronic bronchitis had left her vulnerable to the worst effects of the illness

“I wondered if I would wake up tomorrow,” said the 32-year-old, who asked not to be identified because of the stigma Covid-19 carries in Japan.

When her condition worsened, she called the public health center in Hyogo Prefecture for assistance but she said no one answered her calls.

Instead, she had to isolate in her tiny bedroom, while her children, age 3 and 6, slept alone in the living room for nearly two weeks. Her mother would drop off food for the family, but could not stay because the children had been exposed to the virus, and they couldn’t get tested for nearly a week. Su said she communicated with her children via a tablet — and could often hear them fighting.

“My small children were trapped in the small living room alone without going outside at all for 10 days. “I was feeling sick, in terrible condition, but I felt more pain leaving my children alone.”

A representative at the Hyogo Prefecture Health Center could not speak directly to Su’s case, but said that while they try to contact isolating patients daily, the holiday period was incredibly busy.

But the Covid-19 pandemic has stretched the medical system to the brink, as Japan deals 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 peak period of the current wave has passed, with cases falling from more than 7,000 a day in January to fewer than 3,000 daily cases this month, the medical system is still under strain.

As of February 4, more than 8,700 people across 10 prefectures, who tested positive for Covid-19, were waiting for a hospital bed or space at an isolation center. The week before, more than 18,000 people across 11 prefectures were waiting, according to the prefectures’ health ministries.

Despite Japan’s rapid rise in cases in recent months, its infection numbers and deaths still pale in comparison to those in the US, where daily cases on average exceed 100,000.

But experts say the expectations towards healthcare are different in Japan.

Since the 1960s, Japan’s universal health insurance system has given coverage to all Japanese citizens — regardless of income or pre-existing conditions. But experts say easy access to care has led to many patients seeking more care than necessary, taking the system for granted

“We regard (healthcare) as something like tap water, but now the tens of thousands of people with Covid-19 had to stay home and they cannot have access to the health care system, they can’t be hospitalized and they can’t even see doctors,” said Dr. Kentaro Iwata, professor and doctor at the Kobe University Hospital. “That’s a very harsh reality, which is very difficult to accept for many Japanese.”

It is not unusual for Covid-19 patients with severe symptoms in other countries to wait for hospital space, said Naoiki Ikegami, professor emeritus at Keio University.

But in earlier waves of the pandemic in Japan, most people who tested positive for Covid-19 were automatically hospitalized, said Ikegami.

“That was how Covid-19 was dealt with in the first and second phases, so there’s an expectation that anyone with Covid-19 is going to be hospitalized, even if they had only mild symptoms,” Ikegami said.

The system has since been adjusted so that not everyone is hospitalized. But the rates of hospitalization for Covid-19 are still higher in Japan than in other countries. Read from source….