COVID-19 Impact on the Japanese Healthcare System and Comparison of its Countermeasures With South Korea and Taiwan

Since the coronavirus disease 2019 (COVID-19) pandemic has begun, Asian countries/regions, such as Japan, South Korea, and Taiwan, had generally controlled the pandemic better than other countries. In this article, we showed the big impact of the pandemic on acute care hospitals in Japan, where the number of COVID-19 patients has been smaller than in other countries. We also compared the mitigation measures against the COVID-19 pandemic among Japan, South Korea, and Taiwan to study the factors affecting the differences among these relatively well-controlled countries/regions. We analyzed Diagnosis Procedure Combination data from the Quality Indicator/Improvement Project database, in which Japanese hospitals participated voluntarily. During the first declaration of emergency, which was from April 4 to May 25, the numbers of inpatients decreased roughly 20% for adults and 40% for those aged under 18 years compared to those of the same period in the previous year. In the analyses by disease, hospitalizations with acute coronary syndrome, ischemic stroke, cancer, childhood non-COVID-19 acute infections, infant and pediatric asthma decreased in number, whereas those with alcohol-related liver diseases and pancreatitis increased. Comparing selected mitigation measures against COVID-19, such as border control, enforced measures, information governance, and contact tracing, among Japan, South Korea, and Taiwan, the implementation and dissemination of measures were less strict, slower, and less comprehensive in Japan. This might explain why Japan has experienced a comparatively high incidence of COVID-19 and indicate a substantial risk of infection explosion. A change in behavioral compliance could trigger an infection explosion under poor performance in the response set. Further monitoring is warranted to promote the evolution of effective sets of countermeasures to overcome the pandemic