Doctors in Japan have warned that the country's medical system could collapse amid a wave of new coronavirus cases.

Emergency rooms have been unable to treat some patients with serious health conditions due to the extra burden caused by the virus, officials say.

One ambulance carrying a patient with coronavirus symptoms was turned away by 80 hospitals before he could be seen.

Japan, which initially appeared to have the virus under control, passed 10,000 confirmed cases on Saturday.

More than 200 people have now died with Covid-19 and the capital Tokyo remains the worst-affected area.

Groups of doctors at GP surgeries in the city are assisting hospitals with the testing of potential coronavirus patients in order to ease some of the pressure on the health system, officials say.

"This is to prevent the medical system from crumbling," Konoshin Tamura, the deputy head of an association of GPs, told Reuters news agency.

"Everyone needs to extend a helping hand. Otherwise, hospitals would break down," he added.

Japan's virus response criticised

Analysis by Michael Bristow, BBC World Service Asia editor

Testing is also governed by local health centres, not on the national government level - and some of these local centres are not equipped to carry out testing on a major scale.

But, on Friday, Prime Minister Shinzo Abe indicated that the government was shifting its policy on testing and rolling it out more widely.

"With help from regional medical associations, we will set up testing centres," he told a news conference.

"If home doctors have decided testing is necessary, test samples are taken at these centres and sent to private inspection firms" he said. "Thus, the burden on public health centres will be lessened."

His comments came shortly after he announced a nationwide state of emergency due to the worsening outbreak.

The move allowed regional governments to urge people to stay inside, but without punitive measures or legal force. It will remain in force until 6 May.

After the initial state of emergency came into force on 8 April, a number of other regional governors called for the measures to be extended to their areas, saying that cases were growing and their medical facilities were overwhelmed.

Japan's two emergency medical associations also issued a joint statement warning that they were "already sensing the collapse of the emergency medical system".

And the mayor of Osaka appealed for people to donate their raincoats, so they could be used as personal protective equipment (PPE) for health workers whom he said were being forced to fashion PPE out of rubbish bags.

This is a stark warning.

Two medical associations said the coronavirus outbreak was reducing the ability of Japan's hospitals to treat other, serious, medical emergencies.

Hospitals are already turning away patients, and all this while the number of confirmed cases of Covid-19 remains relatively low compared with other countries.

Doctors have complained of a lack of protective equipment, which suggests Japan has not prepared well for the virus. This is despite the fact it was the second country outside China to record an infection, way back in January.

Meanwhile, Prime Minister Shinzo Abe has been criticised for not introducing restrictions to deal with the outbreak sooner for fear they could harm the economy.

His government has argued with the governor of Tokyo, who wanted tougher measures introduced more quickly.

Only on Thursday did Mr Abe extend a state of emergency to the whole country.

The government is also working to increase the rate of testing by introducing drive-through facilities. In recent weeks, Japan has conducted far fewer tests than in other countries and experts say this has made it more difficult to track the spread of the disease.

Last month it conducted just 16% of the number of PCR (polymerase chain reaction) tests that South Korea did, according to data from Oxford University.

And unlike South Korea - which has brought its outbreak largely under control through a programme of large-scale testing - the Japanese government said that carrying out widespread testing was a "waste of resources".

https://www.bbc.co.uk/news/world-asia-52336388

Home energy use is up by up to 30% during the middle of the day, new analysis by energy firms reveals.

Much of the population is working from home and schools have closed, meaning home computers and televisions are busier than ever.

The highest peak is at lunchtime, when cooking is added to the power consumption of working from home.

But overall, the country is actually using less energy because of businesses being closed.

The National Grid reports that morning and afternoon electricity demand is down by nearly 20%. But most of that is due to lower demand from large, industrial users like factories.

At home, where individuals are paying, overall demand is up - and may reveal some details about our new habits.

Lie-ins

Many people are no longer commuting to the office - giving them longer to stay in bed before getting ready for work. Energy providers can see that, in a "delay" to early electricity demand.

"Households are consuming 21% less electricity than usual at 07:30, as fewer people commute to work, and are taking back the time to sleep later instead," a spokeswoman for Bulb Energy said, based on data from more than 2,000 smart meters.

Ovo Energy is seeing similar results from a sample of 230,000 customers.

"Morning routines are less structured and therefore the peak has reduced by up to 20%, as many people are working from home or not working at all," a spokeswoman said.

"We are seeing big changes in the way people consume energy during the lockdown period."

Any energy being saved in the morning is being consumed later. Ovo reports seeing up to a 30% increase in the midday period, and Bulb reports a 27% rise. EDF did not provide figures, but said it was seeing notably higher consumption in the middle of the day.

Bulb also says it is seeing a 7% drop in energy use between 21:00 and 23:00, "suggesting people are switching off earlier too".

Despite the midday surge, overall domestic demand has increased by only a few percentage points, rather than dramatically surging - partly due to weekend use remaining mostly the same.

Ovo says that "balancing out the ups and downs", it is only seeing a 6% overall increase in domestic consumption. EDF says it is only seeing a 3% rise.

Bulb said overall use across the week is flat. But it also calculated its weekday usage separately - and said use is up by 17% between 09:00 and 17:00 Monday-Friday. At the weekend, electricity use is actually down 3% - which it attributes to the warmer weather.

Gas use, too, is not showing any clear surge in demand, since many people use it for central heating, and the lockdown coincided with warmer weather.

Consumer help

Despite those small overall numbers, energy bills may rise for some more than others. Professionals who use power-hungry computing equipment, or shared households with many people, could see their bills increase.

In March, the government agreed a deal with energy providers to support those who may have difficulty paying their bills during the crisis, which has left many people out of work.

"With millions of people having to stay at home, our energy bills will likely rise as we use more gas and electricity," says Guy Anker, deputy editor of financial site MoneySavingExpert.com.

"So with money tight for so many, it makes it even more imperative to cut back on usage where you can, and also to cut back on your bills by ditching rip-off tariffs."

Switching from a standard tariff could save people up to £350 a year, he says - and using one of the many available price comparison sites should only take five minutes.

"Your supply isn't cut off as part of the process, while no one visits your home unless you want or need smart meters - though installations are paused for now, so it's not an issue during the lockdown."

https://www.bbc.co.uk/news/technology-52331534

Professor of global health at Imperial College, London warns we ‘may have to adapt’ to virus

Humanity will have to live with the threat of coronavirus “for the foreseeable future” and adapt accordingly because there is no guarantee that a vaccine can be successfully developed, one of the world’s leading experts on the disease has warned.

The stark message was delivered by David Nabarro, professor of global health at Imperial College, London, and an envoy for the World Health Organisation on Covid-19, as the number of UK hospital deaths from the virus passed 15,000.

A further 888 people were reported on Saturday to have lost their lives – a figure described by communities secretary Robert Jenrick as “extremely sobering” – while the total number who have been infected increased by 5,525 to 114,217.

The latest figures, which do not include deaths in care homes and in the community, put further pressure on the government amid continuing anger among NHS workers and unions over the lack personal protective equipment (PPE) for hospital and care home staff on the front line.

In late March the government’s health advisers said that if UK deaths from Coronavirus could be kept below 20,000 by the end of the pandemic, it would be a “good result” for country. But with an estimated 6,000 people having already died in care homes from Covid-19 – a figure not included in Saturday’s official tally – the 20,000 figure is likely already to have been exceeded.

In an interview with The Observer Nabarro said the public should not assume that a vaccine would definitely be developed soon – and would have to adapt to the ongoing threat.

“You don’t necessarily develop a vaccine that is safe and effective against every virus. Some viruses are very, very difficult when it comes to vaccine development - so for the foreseeable future, we are going to have to find ways to go about our lives with this virus as a constant threat.

“That means isolating those who show signs of the disease and also their contacts. Older people will have to be protected. In addition hospital capacity for dealing with cases will have to be ensured. That is going to be the new normal for us all.”

The comments came as the former UK health secretary Jeremy Hunt said the only way forward was for nations to support a new global health system that would mean far more international cooperation between governments on health issues. It would also require richer nations doing more to support the health systems of the world’s poorest countries.

“I think global health security is going to be on that small but critical list of topics like climate change that we can only solve in partnership with other countries,” Hunt told The Observer.

In a clear criticism of US President Donald Trump who announced last week he was putting on hold funding to the World Health Organisation (WHO) Hunt added: “Surely the lesson of coronavirus is cure not kill…It certainly does not mean cutting their funding (to the WHO).

“One of the big lessons from this will be that when it comes to health systems across the world, we are only as strong as the weakest link in the chain.

“Although China has rightly been criticised for covering up the virus in the early stages the situation would have been whole lot worse if this had started in Africa. International cooperation and supporting health care systems of the poorest countries has to be a top priority in terms of the lessons we need to learn.”

Nabarro’s message is the second grim warning to come from senior ranks of the WHO in the last three days. On Friday, Maria Van Kerkhove, head of WHO’s emerging diseases and zoonosis unit, warned that there was no evidence that antibody tests now being developed would show if a person has immunity or is no longer at risk of becoming reinfected by the Covid-19 virus.

On Saturday it emerged that doctors and nurses treating Covid-19 face shortages of protective full-length gowns for weeks to come, as anger mounts over failures to stockpile them. Gowns were not included in a stockpile list prepared for a potential flu pandemic.

After The Guardian revealed new guidance from Public Health England which instructs healthcare workers to re-use disposable equipment, the GMB, which represents NHS and ambulance staff, said support was “draining away” from Health Secretary, Matt Hancock.

Saffron Cordery, deputy chief executive of NHS Providers which represents many trusts, told the Observer: “We are in a situation where we think this [issue] will last a couple of weeks, which probably does just take us to May. There is a shortage of gowns which is affecting some trusts, but not all. Some have none, and are using the alternatives.”

The government will attempt to gain control of the mounting PPE concerns by appointing Paul Deighton, chief executive of the London Olympics organising committee, to lead efforts to produce equipment in Britain.

Ministers also announced another £1.6bn cash injection to local councils as they attempt to stem a spiralling crisis in social care that is pushing some care providers into the red. Some have been paying inflated prices for commercial protective equipment.

https://www.theguardian.com/world/2020/apr/18/dont-bet-on-vaccine-to-protect-us-from-covid-19-says-world-health-expert