It was found on April 5 that 9 prefectures including Miyagi, Tochigi, Kanagawa, Osaka, and Fukuoka may face a shortage of ventilators needed to treat patients in serious condition at the peak of the new coronavirus outbreak, according to a Kyodo News analysis. There is concern over the possibility of an overwhelmed medical system where some patients in serious condition cannot be treated. Experts point out that only a limited number of personnel can use such equipment and that specific measures to prevent overwhelming the medical system should be considered.

The Japanese Society of Respiratory Care Medicine conducted a survey of ventilators and ECMO (extracorporeal membrane oxygenation) devices in each prefecture from Feb. 12 to 20. The survey was conducted through prefectural associations for clinical engineers, collecting data from 1,558 facilities. There were 22,254 ventilators in Japan overall. Of that number, 13,437 were available for treating new coronavirus patients, excluding those used to treat other patients.

The survey also calculated the number of serious patients at the peak of the outbreak based on the estimation formula released by the Ministry of Health, Labour and Welfare (MHLW). Assuming one patient will infect two other people, the maximum number of patients in serious condition was calculated to be 903, 431, and 388 in Tokyo, Hyogo prefecture, and Fukuoka prefecture, respectively. Comparing the calculated patient numbers to the number of ventilators, it was found that 9 prefectures will face a ventilator shortage.

There were 8 prefectures where patients in serious condition are expected to use over 80% of the ventilators and strain the medical system. Among them were Hokkaido, Ibaraki, Shizuoka, and Ehime.

The Japanese government plans to increase production of ventilators and ECMO devices to prepare for the further spread of infection. An MHLW official says that [medical systems of] some prefectures may be strained, and that there is a need [for prefectures] spanning a wide area to lend each other equipment.

Nationwide, there are about 1,400 ECMO devices, which are essential for treating patients in very serious condition. Because ECMO devices can only be used by physicians and nurses with a high level of skill and experience, the number of ECMO machines available for new coronavirus patients with respiratory failure will only be about 300.

Osamu Nishida, president of the Japanese Society of Intensive Care Medicine, notes that there will be a lack of ICUs (Intensive Care Units) and medical personnel who can use ventilators relative to the number of patients with severe pneumonia. “There is a need to discuss how to allocate or concentrate personnel,” says Nishida.