Medical staff say virus stigma driving Tokyo hospitals to edge of collapse

https://www.japantimes.co.jp/news/2020/04/24/national/tokyo-front-line-hospital/

167 108 6 years ago

japantimes.co.jp

samizdis• 6 years ago

This is the first time that I've read about health/care workers being shunned and stigmatised, but I can see how it can happen. I can't imagine that this is a purely Japanese phenomenon, though. Anyone from anywhere outside of Japan able to point to similar media reports?

Edited to add: thanks for the posters below who pointed me at relevant articles concerning workers similarly stigmatised elsewhere. Shameful and depressing are words that spring easily to mind :-(

HarryHirsch3• 6 years ago

There are enough reports from the US about physicians and nurses getting evicted because tenants are getting concerned about coronavirus spreading in the building.

Daily Beast isn't a real newspaper of record, but I've seen similar articles in reputable papers: https://www.thedailybeast.com/coronavirus-nurses-face-evicti...

exhilaration• 6 years ago

The New York Times had a similar story: https://www.nytimes.com/2020/04/03/nyregion/co-op-board-coro...

The Doctor Came to Save Lives. The Co-op Board Told Him to Get Lost.

masklinn4• 6 years ago

There are enough reports from the US about physicians and nurses getting evicted because tenants are getting concerned about coronavirus spreading in the building.

To be fair this is not specific to the US e.g. in france at least one nurse was harassed into leaving (heating and hot water shut off) by their landlords, in belgium one was expelled by their co-tenants, in germany one got thrown out of a supermarket, in australia a doctor got evicted, healthcare workers got assaulted in india, …

BurningFrog2• 6 years ago

That does seem like a valid concern.

Not sure what a solution might be.

egyptiann• 6 years ago

In Egypt [0] villagers blocked the burial of a doctor who died of coronavirus. [0]: https://www.bbc.co.uk/news/world-middle-east-52272762

khuey• 6 years ago

https://www.thedailybeast.com/coronavirus-nurses-face-evicti...

eden_hazard• 6 years ago

My gf in Colombia said that healthcare workers are being told by certain groups not to go to the hospital or they will be killed. They are writing that stuff outside their doors and buildings.

HarryHirsch3• 6 years ago

What do these "groups" hope to achieve by crippling the healthcare system? Do they want to keep Coronavirus off their turf by driving healthcare workers of their turf or something else? These people are normally rational. Some piece of context is missing.

maximente• 6 years ago

that's intense.

here in medellin there are several tenants in our building (estrato 4, so not uber wealthy) begging the health care workers that do live here to temporarily live elsewhere or stop working, mostly bc there are a lot of elderly people that live here and a single unavoidable set of stairs that everyone has to use.

dpeck• 6 years ago

reports of some health care workers being attacked with bleach in Mexico, https://www.bloomberg.com/news/articles/2020-04-23/hold-the-...

hutzlibu2• 6 years ago

So people risk their lives for others ... and not get credit, but stigmatised? Glorious.

Here in germany I have not seen it, or heard of it and rather support, but my neighbours for example would be the type, to do this as well. Fear brings out ugly sides in humans.

MrGilbert• 6 years ago

Well, take it with a grain of salt, but there has been at least one article about a nurse in a german village, which got thrown out of a supermarket after an acquaintance told 'em that this person works in a hospital where italian COVID-19-patients are treated:

https://www.merkur.de/leben/karriere/angst-coronavirus-krank...

rjvs• 6 years ago

There is one case in Australia that is similar, although also more personal https://www.abc.net.au/news/2020-04-22/coronavirus-fears-doc...

skybrian• 6 years ago

Here is an article about stuff like that in India: https://www.bloomberg.com/news/articles/2020-04-13/doctors-c...

enitihas• 6 years ago

India was very quick in passing an ordinance imposing harsh penalties on attacking healthcare workers though.

gvjddbnvdrbv• 6 years ago

Someone attempted to evict a paramedic in the UK.

biofox• 6 years ago

Not just attempted. The poor guy was evicted:

https://www.theguardian.com/world/2020/mar/22/nhs-paramedic-...

The same also happened to a doctor in the UK:

https://news.sky.com/story/coronavirus-nhs-doctor-evicted-fr...

vkou2• 6 years ago

If the world were just, the landlady should lose the property she evicted him from. This should assuage the her fears about her tenant spreading COVID.

tilolebo2• 6 years ago

There are similar stories in France, but it's mostly hearsay.

And with some "journalists" relying on twitter to write their articles, it gets harder to distinct hearsay from real news.

jakub_g• 6 years ago

There was a report in France 2 and some pictures of papers the "friendly neighbors" put on nurses' appartment doors asking them to move out.

tantalor• 6 years ago

An emergency room doctor in Miami has temporarily lost custody of her 4-year-old daughter while she treats patients during the coronavirus pandemic.

https://www.cnn.com/2020/04/13/us/custody-coronavirus-er-doc...

kyawzazaw• 6 years ago

in Myanmar, there have been reports where landlords evict the medical workers(doctors/nurses) because they fear the virus.

chadlavi• 6 years ago

I saw a CNN story about medical professionals in Mexico being physically attacked: https://www.cnn.com/2020/04/23/world/mexico-coronavirus-atta...

clairity2• 6 years ago

it's evidence that over-hyping the pandemic and stoking fears have real negative consequences. every single day there are literally thouasands of stories about how terrible and terrifying this disease is without any attempt at grounding these stories in an appropriate context (like how bad it is compared to the flu, while ignoring/defying the political connotations therein).

this isn't meant to be anti-media by any measure; but we need to hold media accountable so that it can modulate future coverage appropriately.

crooked-v• 6 years ago

like how bad it is compared to the flu, while ignoring/defying the political connotations therein

What political connotations?

sebwi2• 6 years ago

Unfortunately, I do not have an English source but a nurse was thrown out of a supermarket in Germany as well [1].

[1] https://www.zeit.de/arbeit/2020-04/intensivpflege-coronaviru...

nabla9• 6 years ago

Same stigmatization happened for people from Fukushima. People were treated like pariah even when radiation is not infectious.

robk• 6 years ago

A doctor friend in the UK had her flatmates ask her to move out because of the risk she brought to the house. It was devastating to her.

arkitaip• 6 years ago

This isn't really surprising in a country where saving face, social standing and collectivism is everything. Other horrible consequences of these deeply embedded social systems are "evaporated people" [0][1] and the terrible treatment of single parents [2][3].

[0] https://www.pri.org/stories/2017-04-25/japans-evaporated-peo...

[1] https://www.businessinsider.com/evaporated-people-disappeari...

[2] https://www.theatlantic.com/business/archive/2017/09/japan-i...

[3] https://www.youtube.com/watch?v=PYmivmkZvIg

sebwi2• 6 years ago

Do you have any insight on what differentiates Japan from other Asian countries like South Korea? Collectivism is not a unique characteristic to Japan and South Korea has arguably done a good job.

ericmcer• 6 years ago

In the USA most doctors doing residency would get an immediate pay bump if they went on unemployment.

throwaway5752• 6 years ago

That's not a fair point. People here talk about guilds and apprenticeships occasionally and that's what residencies are. You have a high, secure lifetime salary afterwards. It's a hard job, but it's just a career stage in an otherwise lucrative (although sometimes a difficult, stressful, and dangerous) career path.

seattle_spring• 6 years ago

Can you provide evidence to your claim? Not to mention that even if it were true, it would prevent or delay them from making $200k to $1m / year after residency. Hardly seems like a worthwhile trade-off.

kingkawn• 6 years ago

A quick search says the average us residency salary is $61,200 as of 2019, which is above the unemployment maximum even taking into account the additional $600 a week in pandemic funding.

skellera• 6 years ago

I think they’re going off a per hour basis. If a resident is working an 80 hour week, they aren’t getting paid much per hour.

yardie• 6 years ago

The pay for residents isn't bad compared to the rest of the country. But they do work crazy hours. $/hr they are making like $18/hour x 18 hours/day x 10 day rotation.

They wouldn't get a pay bump by going on UI. They would get more sleep.

btilly2• 6 years ago

In the discussion in https://news.ycombinator.com/item?id=22934704 patio11 was pilloried for claiming that, We project a true count of over 500,000 infections, including more than 5,000 severe cases, and a breakdown in provision of care (“overshoot”) in Nagoya, Osaka, and Tokyo, before the end of April.

And yet, according to medical staff, Tokyo is close to a collapse of the medical system. https://www.worldometers.info/coronavirus/country/japan/ says that there are currently over 12,000 reported cases in Japan and this doubled in the last 10 days. So it is likely to be in the 20-25k range by the end of the month. https://www.nbcnewyork.com/news/local/new-york-virus-deaths-... says that New York reported COVID-19 seems likely to underreport actual cases by a factor of 10. Which puts Japan at the 200,000-250,000. But as widespread reports say, Japan's testing has been extremely anemic. That can easily put us back in the ballpark discussed.

You know, that projection is looking reasonably close for having been made over a month ago.

aikinai• 6 years ago

The article isn’t talking about the volume of patients but the stigma on medical professionals. “Collapse” was probably a poor word choice since these days that almost exclusively means going over capacity due to a surge in Covid-19 patients.

jiofih• 6 years ago

They warned that a “collapse of the medical care system” come happen soon if the situation continues.

It is about the stigma causing the medical professionals to quit, which will lead to lower, and hence exceeded, capacity. It helps when you read it.

danielharan• 6 years ago

The NY study is preliminary, not peer reviewed. The sampling strategy used over-represents people going out, and we have no information on which test was used or its accuracy.

Given antibody testing done in places like Vô, the NY results seem a bit of a stretch.

Hopefully Japan gets it together and starts testing properly, though.

rbritton2• 6 years ago

The NY study does align fairly well with similar studies done in Santa Clara County and Los Angeles County in California, though. All three indicate a significantly lower IFR than previously expected.

davidw• 6 years ago

Vô

Nitpick: it's Vò https://it.wikipedia.org/wiki/Vo%27

I used to ride my bike through there on many a Sunday when I lived in Padova.

throwawayiionqz• 6 years ago

There are two NYC studies with likely over-sampling phenomena:

- the NYC antibody study one you mention, done at shopping centers, indeed likely over-represents people going out. 20%-21% of that population has antibodies.

- the SARS-CoV-2 testing study with pregnant women [1], tested just before delivery. Among those, 13% tested positive. It is reasonable to expect that this study over-represents subjects that barely go out: pregnant women to go out as little as possible to protect themselves and their future baby.

Because the sampling over-representation is opposite in the two studies, the truth is likely in between. in terms of antibodies, it is likely that the pregnant women that tested positive weeks ago have now developed antibodies or will do so in the next 1-2 weeks. Among pregnant women, the 13% also ignores women that had already developed antibodies before delivery; another phenomenon that may push the truth above 13%.

[1] https://www.nejm.org/doi/full/10.1056/NEJMc2009316

adventured• 6 years ago

Japan's testing has been extremely anemic

Anemic is definitely a nice way to put it.

Japan is testing at a per capita rate below that of Iraq, Ukraine, Vietnam, Mongolia, Moldova and South Africa.

Their testing rate is so extraordinarily low, the US is testing more people per day than Japan has tested in total across the past four months.

blago• 6 years ago

I'm not sure how Vietnam ended up on your list but I'm pretty sure they have been testing pretty extensively, and more importantly, much earlier than most other countries.

ipsum23• 6 years ago

TeMPOraL4• 6 years ago

Have you read that blog post? He published a hash as a point of reference (which is a great thing in itself, because "nobody could see it coming" bullshit comments are plenty), but on top of that, he started and led a working group and spoke out behind the scenes to relevant parties, in order to save lives.

You'd have him die on his sword and achieve nothing just for the sake of appearances.

hbosch• 6 years ago

Exactly what kind of clout do you think he has? What kind of audience? He's a local celeb here on HN, and more broadly a somewhat prominent figure in tech circles, but he's not Bill Gates. Certainly he isn't the kind of guy to get a slot on CNN and further, if he did, he wouldn't be taken seriously.

While I get your point (why hide a prediction that could have saved lives?), I think you're overly idealistic about what impact this same prediction would have had if released publicly at the time.

tvanantwerp• 6 years ago

As someone who works in policy, his response was about as good as I could hope for from someone not involved in policy normally. Talking privately to credible people, working with experts, and getting the message to media channels, are all what you're supposed to do. Him shouting on Twitter wouldn't have accomplished anything.

(I'm still a bit mystified by the purpose of the whole hash dropping thing. I don't really know what it achieves, aside from the potential to say "I knew it!" at some point in the future.)

pcurve• 6 years ago

considering how late they're to the game, how massive and dense Tokyo metro is, even 200,000 looks like charitable estimate to me. Tokyo metro has 38 million people.

Jeema101• 6 years ago

"At the hospital, about 10 nurses and other staffers have left since the first COVID-19 case was found on the medical staff. The list included clerical workers."

I fear this is going to be an increasing problem if we continue to rely on the belief that medical personnel can be abused indefinitely.

TeMPOraL4• 6 years ago

That's actually the nicer side of the problem. Given current conditions pretty much everywhere, doctors and nurses that don't run away end up overworked to the point of exhaustion. Some of them die, rest are left with PTSD. Healthcare systems worldwide are bleeding medical staff, and unfortunately, training a new medical professional takes many years (more than a decade if you want them to be any good).

ISL2• 6 years ago

If we're hemorrhaging healthcare workers, it is because we're not giving them enough support.

We're spending $2+T on keeping everyone afloat in the US. We can spend a lot of that money encouraging everyone to pitch in to fight Covid.

We need ~hundreds of thousands of contact-tracers. If that were our only need, we could offer $1,000,000 to everyone who works as a contact tracer and have money left over.

I'm already volunteering ~70% of my time on FindTheMasks.com. I can only imagine how much more work could be done if unemployed people were given the opportunity to work on fixing the root cause of unemployment!

nwatson• 6 years ago

Japan already has formal stigmatizing of groups: https://en.wikipedia.org/wiki/Burakumin ... this is how caste systems develop.

Burakumin: "They were originally members of outcast communities in the Japanese feudal era, composed of those with occupations considered impure or tainted by death (such as executioners, undertakers, workers in slaughterhouses, butchers, or tanners), which have severe social stigmas of kegare (穢れ or "defilement") attached to them."

Add to this now "medical professionals".

the_af• 6 years ago

This phenomenon is sadly not exclusive to Japan.

In Argentina nurses and health care personnel have been abused by their neighbors. In one case, a nurse was harassed and threatened until she was forced to leave the apartment she was renting (yes, she filed a complaint with the law).

Unfortunately fear drives some people to get very nasty, even against people who could save them. Or maybe they always were nasty.

masklinn4• 6 years ago

This specific issue is hardly limited to japan. You can sadly find this sort of cases in the US, in India, in Germany, in France, in Belgium, Australia, …

From cars getting degraded to harassment to eviction to assault and battery.

viklove2• 6 years ago

I don't think the US has a history of confining them to villages though...

jefftk• 6 years ago

This is described as "stigma", but it looks like people making reasonable decisions trying to avoid getting sick. The child of someone who works in a hospital really does bring higher than normal risk to their daycare.

People with medical jobs not being able to get childcare is a serious problem, but we need dedicated separate childcare if we're going to keep the spread down.

akiselev• 6 years ago

For a disease as transmissible as Ebola or the flu that might be true, but for a brand new highly transmissible disease like COVID-19 with limited testing supply, it might be safer to live near someone who might actually have access to regular testing. Do the people stigmatizing healthcare workers have the data to back up your theory?

Trying to explain away prejudice with science requires actual science.

mensetmanusman2• 6 years ago

Humans are irrational fear driven creations.

Only institutions (involving decision making by multiple humans) can help in these circumstances, because we need each other.

InfiniteRand• 6 years ago

I know in some places the hospital workers are given decent hotel accommodations, that seems to be a pretty reasonable compromise for medical workers in dense living situations, in some places that would require building some additional places or taking possession of some, but given the amount of slack resources right now that also seems reasonable

Medical staff say virus stigma driving Tokyo hospitals to edge of collapse

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