Eight months pregnant, Yumi called the emergency room in Kashiwa, Chiba Prefecture (40 km from Tokyo) after bling on the 17th. An ambulance answered the call but could not find a hospital in time. She was forced to give birth at home, but the premature baby could not resist.
In her thirties and diagnosed with Covid-19, Yumi was not treated in a hospital because not all medical facilities in the region are allowed to admit pregnant women with this disease or to perform Caesarean sections and isolate new ones. born linked to cases of the new coronavirus.
His case is one of more than 45,000 Japanese people with Covid who have been ordered to undergo treatment at home. After the Tokyo Olympics, which ended on August 8, Japan is experiencing a spike in infections driven by the delta variant, with severe cases on the rise and the medical system overloaded. This month, Prime Minister Yoshihide Suga ordered hospitals to admit only patients with very serious illnesses, who need intensive care and the use of life support.
“They say it is a treatment at home, but it is in fact an abandonment at home”, criticized the parliamentarian Yukio Edano, leader of the opposition, after the government formalized the directive.
Like Yumi, Yukie, in her forties, was unable to seek treatment in time in the capital. Diabetic and showing symptoms such as fever and cough, she was diagnosed on the 10th and ordered to be treated at home, along with her husband and son, who were also infected. Two days later, her condition worsened and she died.
Kenji, in his 50s, had to knock on the doors of more than 100 medical facilities in Tokyo to get a bed. He was recovering from Covid-19 at home, but had to be admitted because he couldn’t breathe – it took more than 5 hours for the ambulance to find a hospital capable of admitting him.
Yumi, Yukie and Kenji are fictitious names: the identity of the three has not been disclosed by authorities – NHK, a Japanese state-owned media company, has reported all three cases.
“The wings intended for the Covid-19 are almost entirely occupied [80%], mainly in the Tokyo metropolitan area, ”said Folha Haruka Sakamoto, researcher in the Department of Global Health Policy at the University of Tokyo.
There, about 60% of those who called the emergency room for help because of worsening symptoms during home treatment did not have access to hospitals. “It’s a serious situation.”
The Fire and Disaster Management Agency has started counting suspected Covid-19 cases picked up by ambulances and refused by at least four hospitals. In the last week of July, they were 991; in the first week of August, 1,387; in the following, 1679.
“The Olympics are over, so no one has to pretend all is well anymore,” Italian producer Cesare Polenghi, from an agency that promotes football in Asia, said on a Facebook discussion forum on the pandemic in Japan.
This week, however, marks the start of the Paralympic Games, the opening of which is scheduled for Tuesday (24). In the capital, the situation was qualified as a calamity by the expert panel of the local Ministry of Health. On the 18th, 27 of Japan’s 47 provinces recorded record cases; 13 of them are in a state of emergency until September 12.
Since the start of the pandemic, Japan has recorded 1.3 million cases and 15,500 deaths. Vaccination is progressing (as of August 19, 40% of the Japanese population was fully immune), but not enough to stem the current tide. Of the 238,000 active cases in the archipelago, more than 7,000 are considered critical.
Japan has 12.98 beds per 1,000 people, the highest per capita average among developed countries, according to data from the OECD (Organization for Economic Co-operation and Development), but most relate to mild illnesses – it there are only 5 intensive care beds per 100,000 inhabitants.
“It’s an image that may surprise Brazilians, who often imagine Japan as a country of the first world, where everyone has guaranteed access to healthcare. In fact, there is no SUS-type system, and Japanese private hospitals can refuse patients, ”explains São Paulo psychoanalyst Carine Sayuri Goto, based in Higashine (Yamagata province).
In Japan, all residents must register and contribute through taxes to a public insurance, such as Kokumin kenko hoken (health insurance) or Shakai hoken (social insurance), which covers 70% of medical expenses and hospitable. The remaining 30% is paid by the patient directly to medical institutions. In other words, the model is public, but not completely free like the SUS in Brazil, since most institutions are private (70%).
Out of 3,008 active private hospitals, only around 30% manage to treat patients with Covid-19. This means that a hospital can refuse admissions if there is no room in the disease department – even if there are beds available in others.
In recent days, at least nine provinces have decided to set up “oxygen stations,” makeshift facilities in places like hotels and gyms to help those who cannot find beds in hospitals.
There are also reports of doctors who have decided to bring oxygen from clinics to the homes of patients with a fever of 40 ° C and an oxygenation level of 89% (considered severe) on their own. According to Goto, the possibility of being refused by hospitals worsens the feeling of insecurity in the face of the pandemic, especially for immigrants.
“Imagine that you have a fever and you feel short of breath, but live with the doubt that you will not be able to be accepted by a clinic on time? Apart from the language barrier, for those who do not speak Japanese and need translators to share their feelings with the doctor. This intensifies the feeling of helplessness, ”underlines the psychologist from the Amae institute, which takes care of Brazilians in Japan.
“Everyone’s on edge,” says Virginia Yumi Oshima, a 50-year-old translator from Paraná, who lives in Komaki, Aichi Prefecture.
Author of “Multilingual Medical Conversation”, a multilingual glossary of medical subjects, she is part of a cooperative of interpreters and translators opened to serve immigrants in 2016.
Since the start of the pandemic, they have been sought after by Brazilians seeking help in applying for government financial aid and translated information on the epidemic situation.
“I’ve written more ‘condolences’ than ‘happy birthday’ messages this year.”
In cities where there are many immigrants, official bodies often publish important information translated into languages such as English, Filipino and Portuguese.
Toyohashi in Aichi Prefecture is one of them. “The highly contagious delta variant is spreading in Japanese territory,” Mayor Asai Yoshitaka published in an urgent letter to the city on the 17th. “And I have a strong sense of danger.”