With a steady worsening of hospital bed shortages, the nation's healthcare system is in dire need of a support structure that supersedes prefectural jurisdictions. 

Also requiring urgency is the implementation of sound countermeasures against further surges of COVID-19 cases.

Osaka Prefecture on April 20 formalized a request for the central government to issue a state of emergency for the prefecture under special laws concerning the novel coronavirus.

It is now inevitable that the prefecture will come under a state of emergency for a third time, following the last one that began in January and ended in February.

Governor Hirofumi Yoshimura is considering calling for a suspension of operations at not only eating and drinking establishments, but also department stores, shopping centers, theme parks and other facilities that draw large crowds.

Although Yoshimura is not seeking to close all schools across the board, Osaka Mayor Ichiro Matsui has asked elementary and junior high schools to consider setting up classes online.

During the last state of emergency, Osaka decided its priority was to prevent COVID-19 transmission through respiratory droplets, and focused its attention on eating and drinking establishments.

But this time, its primary aim is to restrict the movement of people and minimize physical person-to-person contacts, which was more or less what the prefecture did during the first state of emergency.

Osaka will not decide on its specific plan of action before talking it over with the central government, but we do hope experts will be brought in to help expedite the decision-making.

The prefecture will also need to devise an adequate economic support policy for the businesses and facilities concerned. 

Prefecture-wide, there are scores of COVID-19 patients in serious condition who, for a lack of available beds at better-equipped facilities, are stuck in hospitals meant only for those with milder symptoms.

Because these seriously ill patients require extra care, doctors and nurses have less time to tend to those with milder symptoms and other health issues. With no prospects of improvement in the situation, frontline health care personnel are under tremendous strain.

In terms of the degree of urgency, some experts rate the situation as at "disaster level," a category applied to the immediate aftermath of a major earthquake or natural disaster.

There is no choice but to weather through this health crisis with an extensive support system.

As at the time of the last state of emergency was issued, a program is in place to dispatch nurses and other health care workers through a coordinated network comprising the central government and local administrative bodies.

In this regard, transferring patients in a serious condition to out-of-prefecture hospitals is currently being considered. Shiga Prefecture, which has more vacant hospital beds than other prefecture in the Kinki region, pledged its commitment to this program.

Every local government must be struggling on a daily basis to deal with infections within its jurisdiction, and we pray that every effort will be made to save as many lives as possible.  

Hospital bed shortages factored in past infection spikes. But what lessons have been gleaned from those experiences?

Yoshimura cannot escape responsibility for inviting another health care crisis again. The threat of COVID-19 variants has been known since late last year. He must not expect to get away with the excuse that their virulence was beyond anything that anyone could anticipate.

Hyogo Prefecture's hospital bed shortage is just as dire as Osaka's, and new infections are surging beyond control in Tokyo. Both prefectures are now weighing whether to ask the central government to issue states of emergency.

Under revised laws concerning the novel coronavirus, prefectural governors are empowered to call the shots on hospitalization procedures. We hope they will exercise their authority in consultation with frontline health care experts to protect the lives of their residents.

The government, like every prefectural governor, is being tested on its commitment and ability to fight the pandemic.

--The Asahi Shimbun, April 21