The Japanese government is considering lowering the classification of the novel coronavirus, COVID-19, to "Class V" under the Infectious Disease Control Law. That would put it in the same category as seasonal influenza. Prime Minister Fumio Kishida and relevant ministers will discuss the proposal.
The five-tier classification system ranks infectious diseases according to severity. COVID-19 currently is de facto treated as belonging to "Class II," which includes high-risk diseases like tuberculosis and SARS (severe acute respiratory syndrome). Recently the rates of severe illness and fatalities have decreased, and coping strategies have been put in place. Under the circumstances, review of the classification appears appropriate.
Avoiding COVID-19 China Crisis
However, we must by all means avoid a repetition of what has occurred after China's lockdowns. There, relaxation of COVID restrictions in one fell swoop has resulted in an explosion of infections.
There are many aspects of Japan’s COVID countermeasures that need to be taken into account.
During the eighth wave with its high number of infections, the number of deaths exceeded 10,000 in a little over a month. We also have to be concerned about XBB-1.5 (Kraken), a recombinant variant of two highly infectious Omicron subvariants.
Is there a risk of increased infections and deaths due to a change of classification? The government should indicate the prospects for that happening and clarify how it would respond to such a situation.
What Changes with Reclassification
If COVID-19 is reclassified as Category V, the ability to isolate patients changes. There will be no basis for prefectures to recommend that patients be hospitalized. Similarly, prefectures cannot request that patients not leave home.
It is also expected that responsibility for payments for COVID-19 treatment will shift from the current public funding to patient copayments under the health insurance scheme. Such a change must be made in stages to avoid chaos.
Some of the medical care that the seriously ill receive is quite expensive. The government will need to continue to pay for such costly treatments and drugs. These should be handled separately from drugs prescribed for the mildly ill, such as medicines to relieve fever and pain or cough medicines.
The role of health centers remains important in coordinating hospital admissions and discharges when there is a shortage of beds. Everything possible needs to be done to ensure that those who require hospitalization are properly admitted.
Access to COVID-19 Treatment
Some observers contend that the number of medical facilities prepared to treat COVID patients will not suddenly increase, even if the disease is designated as Class V. That would be unacceptable. The government must show leadership in significantly expanding the number of medical institutions accepting these patients.
Drugs have been also approved for the treatment of less severe cases. We need to strongly encourage medical institutions to do their part in the fight against COVID.
It's unrealistic to expect vaccinations to be paid for completely out-of-pocket.
Although shots for Omicron are being given free of charge, not enough people have taken advantage of them. For the time being, we would like to see the arrangement under which vaccinations can be given for free continue as is.
Changing Risks of Exposure to COVID-19
Apparently, health officials are considering eliminating as unnecessary the general rule that when indoors people should wear masks. Nonetheless, that should not be construed to mean that people can take off their masks anywhere at any time.
Above all, the dissemination of health information should be conducted with accuracy and care.
Changing the status of COVID-19 under the Infectious Diseases Control Act will not eliminate the virus. Border control measures should always be applied expeditiously and rigorously.
- Masking Down? Think Again!
- Welcome to Japan: Individual Travelers, Visa Waivers Return for the First Time Since COVID-19
- EDITORIAL | China Can No Longer Cover Up Rising COVID-19 Cases
(Read the editorial in Japanese.)
Author: Editorial Board, The Sankei Shimbun