<![CDATA[In Japan, a foreigner's coronavirus ordeal sheds light on country's troubled pandemic response]>

A foreigner's account of being turned away by at least 15 hospitals in Japan while battling symptoms of a suspected coronavirus infection has been making waves on social media, attracting comments from others who have had similar experiences.

The woman, who did not want to be named, was finally able to get treatment with the help of her American friend Jordain Haley, who said the ordeal of securing a diagnosis in the country was not "unique to foreigners".

Her experience also offers a first-hand look at how Japan, with more than 13,000 confirmed cases and 370 deaths so far, is struggling to treat coronavirus patients. Authorities are not legally empowered to enforce strict lockdowns like in other countries, nor penalise businesses or individuals for not following isolation guidelines, and although the government declared a nationwide state of emergency this month, it is unable to compel most hospitals to take in patients.

There have been reports of coronavirus patients being turned away because hospitals are not properly equipped to deal with the contagion, or cannot afford to shut down the routine surgeries and short hospital stays that provide their main sources of revenue.

There have been reports of hospitals in Japan turning away coronavirus patients. Photo: Kyodo

In an almost 3,000-word post recounting her friend's story in the Covid-19 Japan Discussion Group on Facebook, Haley relayed the numerous difficulties that the two had even trying to secure a coronavirus test in Tokyo " despite her friend's symptoms worsening over the course of three days to the point where she could "barely say a full sentence without launching into a minute long coughing fit".

On the fourth day, after having already had two chest X-rays and a late-night ride in an ambulance in which "the paramedics called over 15 different hospitals to ask for permission to bring in a Covid patient", Haley's friend " who is described as having only "conversational level" Japanese " was finally able to get a referral to a testing centre.

"As I expected, the staff were incredibly resistant to offer a test," said Haley, who made the call on her friend's behalf. "They spent a very long time asking me 100 questions about her symptoms, what treatment she had received so far, what hospital she went to the night before and the name of the doctor who recommended her a test."

Haley said it took almost three hours to make the appointment, after which it materialised the test would be done at "a medical facility that's currently closed, but is being used as a corona testing site on the down low".

An extract from Jordain Haley's Facebook post detailing her friend's ordeal trying to secure a Covid-19 test in Tokyo. Photo: Facebook

"The woman on the phone made me promise not to tell anyone other than my friend the name of the place where she was being tested, because if people knew they were doing testing there it would 'cause a commotion'," Haley said.

Even after being tested, however, the ordeal was not over " Haley's friend was not immediately hospitalised, despite her worsening symptoms, and the pair spent much of the weekend of April 18-19 struggling to get more information, advice and access to treatment.

Then, on Monday, the test results came back. Haley's friend had tested negative for Covid-19. In her post, Haley expressed some suspicion at this result, citing the "false negatives [that] occur about 15-30 per cent of the time", but acknowledged "it is entirely possible that she had a very severe bout of viral bronchitis". The friend has since recovered.

Medical workers treat a Covid-19 patient at a hospital in Kawasaki, Japan, on Thursday. Photo: Kyodo via Reuters

"I think being a foreigner makes it much harder to get tested [for Covid-19 in Japan], especially if you can't self advocate or don't have an interpreter," Haley said.

"I was lucky to be able to get through to the public health centre hotline ... I had to be more aggressive on the phone than I've ever been before."

According to the Ministry of Health, Labour and Welfare, as of Monday Japan had carried out 124,456 tests in a population of 126.5 million. South Korea, by comparison, has tested nearly 600,000 people and has a population less than half the size.

On Tuesday, Japan Medical Association President Yoshitake Yokokura told a media briefing that the level of testing in the country was still not sufficient to prove that the contagion was under control, adding that he did not believe it will be possible "at this stage" to lift the state of emergency that was declared earlier this month.

In the meantime, hospitals are turning away patients because they fear the virus spreading within their facilities, said Yoko Tsukamoto, a professor of infection control in a nursing environment at the Health Sciences University of Hokkaido.

She said they also cannot afford to lose more trained medical staff " nearly 1,500 patients and medical professionals are thought to have either contracted Covid-19 inside Japan's health care facilities or tested positive while working or staying at such institutions, according to a Reuters analysis.

"We are seeing a shortage of hospital staff and personal protective equipment, while hospitals are also worried about seeing their names reported in the media whenever a cluster occurs," Tsukamoto said.

Ideally, she said, regional health authorities would have designated a medical facility in each of Japan's cities to receive suspected coronavirus cases, but this did not happen earlier and now it is too late.

"Unfortunately, more people are going to be turned away from hospitals, and that is far from ideal because they are then going home and potentially spreading the virus with family members or they may even die alone," Tsukamoto said.

"Right now, health workers across the country are just doing the best they can in these very difficult conditions."

Additional reporting by Reuters

This article originally appeared on the South China Morning Post (SCMP).

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