【Aging, safety net and fiscal crisis in Japan】No.329:MHLW refutes claims of an ICU bed shortage for COVID-19 patients

According to a report released by the OECD in April 2020 [Beyond Containment: Health systems’ responses to COVID-19 in the OECD], the number of acute care hospital beds per 1,000 people in Japan is 7.8 (Figure 1). As such, it ranks first among OECD countries and is well above the OECD average of 3.7. However, the number of intensive care (ICU) beds per 100,000 people in Japan is 5.2, which is less than half the OECD average of 12.0 (Figure 2). This suggests that Japan lags behind other countries when it comes to securing ICU beds to save the lives of patients that are critically ill with COVID-19.

The Ministry of Health, Labour and Welfare (MHLW) responded to this criticism by releasing more statistics in April 1, 2021 (Table 1). The Ministry explained that intensive care beds for patients that are critically ill with COVID-19 include life-saving beds and high-care beds, which provide ICU-equivalent care in addition to the standard ICU beds. When this is taken into account, the total number of intensive care beds per 100,000 people in Japan is 15.9, which is higher than the OECD average of 12.0. However, the Ministry has not been able to explain the chaos surrounding the lack of beds for critically ill patients at the peak of the COVID-19 pandemic, although this had already occurred numerous times in the past.

On September 13, 2021, the Japanese Society of Intensive Care Medicine (JSICM) announced a proposal to strengthen the intensive medical care provision system during the COVID-19 pandemic. The JSICM estimates that the number of ICU beds that are necessary in normal times is approximately 9,000, which is 2,000 more than the 7,015 beds that were available as of April 1, 2021. 7,200 ICU specialists are needed to maintain these 9,000 beds, although there were only 2,127 specialists as of April 1, 2021. Additionally, there were 23,000 nurses engaged in intensive care in 2020, of which only 1,536 were certified by the Japanese Nursing Association as having intensive care expertise. There is also a shortage of clinical engineers, who manage the medical devices used in intensive care.

Figure 1: The number of acute care hospital beds per 1,000 people (2017 or nearest year)

Source: OECD, Beyond Containment: Health systems responses to COVID-19 in the OECD

Figure 2: The number of ICU beds per 100,000 people (2020 or nearest year)

Source: OECD, Beyond Containment: Health systems responses to COVID-19 in the OECD

Table 1: The number of ICU beds and ICU-equivalent beds in Japan (As of April 1, 2021)

Source: The Ministry of Health, Labour and Welfare