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Swine Fever (Err...Flu) Concerns Making Hospitals Paranoid About Foreigners?

Odd news from Japan and all things Japanese around the world.
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Swine Fever (Err...Flu) Concerns Making Hospitals Paranoid About Foreigners?

Postby Mulboyne » Wed May 06, 2009 12:16 am

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Mainichi: Paranoid hospitals turning away those with fever, or with a foreign friend
As hospitals step up their precautions against swine flu, those in the Tokyo area are starting to refuse examinations to those suffering from fever and other potential influenza symptoms, or even those with a foreign friend, it's been learned. Between Saturday morning and Monday morning, 63 people were turned away, according to the metropolitan government. All have no recent history of visiting countries where infections have been confirmed, and the new closed door policy could constitute a violation of the Medical Practitioners Law. Patients are now being referred to public health centers for preliminary diagnoses, and a worker at Narita International Airport was refused on the spot. One patient was denied an examination for mentioning that they had a foreign friend. Local governments are asking patients suffering from fever and who have recently traveled to Mexico, the U.S. or other high-risk countries to immediately contact their local Fever Consultation Center, rather than their local hospital. "If the number of hospitals refusing examinations increases, there's the danger of people believing it's better to report false symptoms," said the metropolitan government's Bureau of Social Welfare and Public Health.
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Postby Midwinter » Wed May 06, 2009 12:27 am

That's real fucking smart Japan. Shit, if I was sick and they refused to see me, I'd make a point of coughing, sweating, even ejaculating on them just to see them in the same boat as me.
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Postby wuchan » Wed May 06, 2009 12:35 am

fuck, if I think I have it and a hospital turns me away I will just camp out inside shinjuku station until I die.



It is time that Japan adopts the failure to treat law.... and establish a real medical training system.
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Postby omae mona » Wed May 06, 2009 12:50 am

I'm not particularly happy about what this would mean for my family members, in case they get sick. They have a foreign relative (me), which I assume is way worse than having a foreign friend. Let's hope that report, if true, was a very, very, very isolated case.
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Postby Samurai_Jerk » Wed May 06, 2009 2:28 am

Wow. That's fucked.
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Postby Mulboyne » Wed May 06, 2009 2:47 am

One way to nip this in the bud would be to name the damn institutions which are supposed to be turning people away just as they do when hospitals refuse to accept emergency cases.
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Postby Kaiju » Wed May 06, 2009 7:49 am

The Japanese really excel at xenophobia.
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Postby bolt_krank » Wed May 06, 2009 11:10 am

The whole hospital system there is rooted.
Many hospitals will turn down people due to the potential insurance money.
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Postby CrankyBastard » Wed May 06, 2009 1:14 pm

Just nitpicking, but nothing to worry about if it's swine "fever." Swine "flu" on the other hand............
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Postby Coligny » Wed May 06, 2009 1:20 pm

wuchan wrote:It is time that Japan adopts the failure to treat law.... and establish a real medical training system.



Amen...

Or introduce them to the Hippocratic Oath...
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Postby Behan » Wed May 06, 2009 2:43 pm

I had heard before that the staff in ambulances weren't either trained or allowed to give very much medical attention. I don't know if that was ever true or still true, but has anyone ever heard anything like that?
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Postby CrankyBastard » Wed May 06, 2009 4:05 pm

Behan wrote:I had heard before that the staff in ambulances weren't either trained or allowed to give very much medical attention. I don't know if that was ever true or still true, but has anyone ever heard anything like that?



Before 1991 Japanese ambulances didn't have paramedics.
Most people in Japan are unaware of just how limited the scope of its emergency medical technicians is by the 1948 Medical Practitioner Law under which they operate. Recruited, trained and employed by fire departments of local governments, most Japanese paramedics were previously firefighters their primary role being to provide an emergency transport service to hospital.
Until six years ago Japanese paramedics weren't even permitted to use defibrillators without doctors' supervision -- via the phone. New legislation has removed such restrictions on using semiautomatic defibrillators.
Insertion of a tube through the mouth of the patient is now allowed, without a doctor's approval -- but only when breathing stops, and not before. Resuscitation is all that emergency technicians are allowed to do. Anything more such as alleviating pain or discomfort or performing lifesaving preventive procedures is classified as "medical practice" under the 1948 law, and as such remains the exclusive domain of qualified doctors in Japan.

A good friend of mine, a paramedic here in Yokohama, was one of the first to get the qualification.
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Postby Behan » Wed May 06, 2009 5:24 pm

Thanks for that, Cranky. You know a lot on this subject.

Are current paramedics the equivalent of a nurse? A few years back I was teaching English to a male nurse who called himself a 'paramedic', but maybe it was just because he didn't want to use the term 'nurse'.

My Mrs. is in the process of upgrading her nursing license from junkangoshi to seikangoshi. She has told me that there are plans to phase out awarding junkangoshi licenses.
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Postby CrankyBastard » Wed May 06, 2009 7:09 pm

Behan wrote:Thanks for that, Cranky. You know a lot on this subject.



Nah, I only know what my friend, the paramedic has told me.
I do know, however, that he's really pissed off with the system.
:(

Some of the experiences this guy has had and told me about are truly remarkable.
He even floored a cop onetime for stopping him attending to a patient.
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Postby Mulboyne » Wed May 06, 2009 7:40 pm

CrankyBastard wrote:Just nitpicking, but nothing to worry about if it's swine "fever." Swine "flu" on the other hand............

Very true. My mind must have been elsewhere...

Meanwhile, here's another proportionate response:

DesMoinesRegister: Des Moines students' trip to Japan is postponed
The Des Moines schools' exchange trip to Kofu, Japan, has been postponed until October at the earliest amid concerns about the H1N1 flu virus, commonly known as swine flu. The Kofu school board canceled the trip after members there heard about a probable case in Des Moines County and thought it was the state's capital, said Luann Johnson, coordinator of the exchange program. Des Moines students were scheduled to travel to the sister city June 4-16, where they would have lived with a host family, learned about traditional Japanese activities and visited attractions. Des Moines district officials said they had had no intentions of canceling or postponing the trip because of flu concerns.
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Postby Taro Toporific » Wed May 06, 2009 9:33 pm

Mulboyne wrote:One way to nip this in the bud would be to name the damn institutions which are supposed to be turning people away just as they do when hospitals refuse to accept emergency cases.

Today, I was "refused" at two emergency rooms (a pin in my lower leg bone came loose).
It was not really a refusal, just an honest appraisal from the admitting/triage nurse that today (and tomorrow) that any ER treatment for me may take more 8 hours since day is Golden Week "U-Turn" and many emergency rooms are at 800% of capacity.
I suspect that Mainichi might be sensationalizing this non-news a bit. The Mainichi knows that every year at the end of GW emergency rooms (which are manned the lowest-ranking, green staff during the holidays) get over-crowded and all sorts of problems happen.
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Postby dimwit » Wed May 06, 2009 11:37 pm

CrankyBastard wrote:Before 1991 Japanese ambulances didn't have paramedics.
Most people in Japan are unaware of just how limited the scope of its emergency medical technicians is by the 1948 Medical Practitioner Law under which they operate. Recruited, trained and employed by fire departments of local governments, most Japanese paramedics were previously firefighters their primary role being to provide an emergency transport service to hospital.
Until six years ago Japanese paramedics weren't even permitted to use defibrillators without doctors' supervision -- via the phone. New legislation has removed such restrictions on using semiautomatic defibrillators.
Insertion of a tube through the mouth of the patient is now allowed, without a doctor's approval -- but only when breathing stops, and not before. Resuscitation is all that emergency technicians are allowed to do. Anything more such as alleviating pain or discomfort or performing lifesaving preventive procedures is classified as "medical practice" under the 1948 law, and as such remains the exclusive domain of qualified doctors in Japan.

A good friend of mine, a paramedic here in Yokohama, was one of the first to get the qualification.
:cool:


You can thank JMA for that. They have lobbied long and hard to prevent what they see as competition. Whether that is a good thing or a bad thing depends on how much of a social darwinian point of view you possess.
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Postby Cyka UchuuJin » Fri May 08, 2009 1:09 am

taro, i'm really sorry to hear about the non-refusal refusal. are you ok now?

come on, is anyone REALLY surprised at the hypochondria hysteria? or the hospitals lack of readiness to deal with it? (or anything else, really) or the 'foreigners are going to bring us down with swine flu' line?

emergency rooms can't give out anything stronger than aspirin really. and seeing specialists within the hospital are very limited in what they can prescribe.

i can't WAIT for the first case of swine flu to hit japan(and i hope it hits the owner of my former flat), the mass panic will give me at least an hour of amusement. my friend who works in a nursery told me that she's having to wear a mask at work, and the parents are wearing them too. and that anyone who went away for GW has not been allowed back at work. not that it's going to help anything since they all take the masks off to talk to each other, but hey! it makes them feel like they're actually doing something to prevent it.

personally, if i was health minister, i'd start ordering tamiflu in bulk...
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Postby Ol Dirty Gaijin » Fri May 08, 2009 8:07 am

Swine Flu Deaths - 44
est. Population of Mexico - 109,955,400

est. Population of Tokyo- 12,790,000
Average New Years Mochi deaths - 5
Never underestimate the power of very stupid people in large groups.
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Postby 2triky » Fri May 08, 2009 8:16 am

Ol Dirty Gaijin wrote:Swine Flu Deaths - 44
est. Population of Mexico - 109,955,400

est. Population of Tokyo- 12,790,000
Average New Years Mochi deaths - 5


Seriously, man. The exaggerated response to this swine flu outbreak is ridiculous and tiresome at the very least.
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Postby Mike Oxlong » Fri May 08, 2009 8:46 am

Surgical masks probably offer little to no protection against viruses anyway...
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Postby Mulboyne » Fri May 08, 2009 9:15 am

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Postby 2triky » Fri May 08, 2009 10:24 am

Mulboyne wrote:The problem lies on both sides because few people know how to interpret "risk". Take this opinion piece for instance:

Guardian: There is no known antidote for panic


That's the third article written recently by Simon Jenkins making essentially the same point. I think his attitude is just as much of a problem as the overreaction he condemns. He talks about needing "accurate risk assessments" but what he actually seems to want is to only be told there is a risk when something calamitous will definitely happen. That is a complete misunderstanding of "risk". Jenkins seems to see it in terms of the story of the boy who cried wolf but the situations aren't comparable. If a lookout says "there's a wolf coming" but nothing appears then he is wrong and unreliable. If the WHO issues an assessment saying something like "There's a 5% chance of a major pandemic" and nothing happens, that doesn't make their risk assessment wrong or unreliable. You couldn't even safely make that claim if the WHO thought there was a 90% chance of a pandemic and nothing happened. I've no doubt there is a cottage industry in scaring up government funds but I don't think we help ourselves by demanding certainty when a genuine risk assessment is framed in terms of probabilities. Certainly, we don't have the time and resources to guard against every risk that we might identify but dismissing risk assessments because a possible outcome doesn't occur seems to me to be a recipe for disaster.



Indeed certainty is not something one could expect in this situation, and perhaps it is best to err on the side of caution. But the hyperbole emanating from many international media outlets is quite over the top, one might say. Perception doesn't seem to be in line with the reality of the situation in many countries. Trust me I'm not saying we should throw the baby out with the bathwater as they say but some discretion is in order in certain instances.
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Postby Ol Dirty Gaijin » Fri May 08, 2009 12:55 pm

Never underestimate the power of very stupid people in large groups.
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Postby Mulboyne » Fri May 08, 2009 1:17 pm

Ol Dirty Gaijin wrote:The numbers I showed weren't to downplay the severity of the flu virus, just to show the local risk at the current time. Going Ogui on Mochi and running around Mexico city wrapped in bacon all carry risk.
I think some confusion comes from the language used in communicating the issue also. Pandemic seems to cause alarm bells but...
Times link


That's quite right. I don't have a problem with putting the risk assessments for swine flu into context. I do have a problem when a journalist like Jenkins writes:

...Health scares are like terrorist ones. Someone somewhere has an interest in it. We depend on others with specialist knowledge to advise and warn us and assume they offer advice on a dispassionate basis, using their expertise to assess danger and communicating it in measured English. Words such as possibly, potentially, could or might should be avoided. They are unspecific qualifiers and open to exaggeration...

The idea that you can have a decent risk assessment with no words expressing uncertainty is absurd. Everyone is correct to attack the media for the way this story has been framed but were are now seeing the other extreme where people with no technical training have decided it's open season on science. I'm always very wary of that trend because it gives the humanities graduates who dominate western media an excuse not to understand the nuances of important issues while leaving the door wide open for new age crackpots and anti-science religionists to promote their agendas.
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Postby Kuang_Grade » Fri May 08, 2009 1:30 pm

Image

It is also a 'good' story, in the sense there is no clear answer (so almost any answer could be the right one), could severely impact large numbers of people (although most people will likely not be impacted at all directly) and is something different that talking about the economy, which is a pretty slow and old story at this stage...and broadcast media always loves a story that they can do teasers along the lines of 'Will every one you know die in the next few days? tune in at 11 to find out.'

Seriously, last week I was starting to wonder when the US TV news was going to start talking about body disposal plans for the upcoming mass death event, given the dire predictions and tones they were using.
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Postby Samurai_Jerk » Fri May 08, 2009 4:56 pm

Mike Oxlong wrote:Surgical masks probably offer little to no protection against viruses anyway...


Try telling that to Japanese people and they look at you like you're crazy. Even worse are gaijin who get into the habit of wearing a mask. Talk about fucking Stockholm Syndrome.
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Postby Mulboyne » Wed May 13, 2009 6:17 am

Mike Oxlong wrote:Surgical masks probably offer little to no protection against viruses anyway...


Image

ZakZak has a report (Japanese) that people travelling overseas during Golden Week were struck by the fact that foreigners weren't wearing masks. Some Japanese say they decided to give up wearing then because they felt embarrassed standing out.

Image

Tsuyoshoi Takashiro makes the same point on his blog (Japanese) which includes some pictures from Heathrow. He thinks Japanese people wearing masks are an unsettling sight for others because people thing they are infected.
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Postby Mulboyne » Wed May 13, 2009 11:59 am

Canadian Press: Japanese women's soccer team cancels North America tour due to swine flu
Less than two weeks before a scheduled game in Toronto, the Japanese women's soccer team has cancelled a tour to North America citing the swine flu outbreak. The Japan Football Association announced the decision Tuesday. The Japanese were scheduled to play Canada at BMO Field on May 25 after games against the United States in Frisco, Tex., on May 20 and in Sandy City, Utah, on May 23. "This is an unfortunate situation, but one that we had absolutely no control over," U.S. Soccer president Sunil Gulati said in a statement. "We have been assured that the risk to the participating teams is exceptionally low, but we accept the Japanese Federation's decision not to travel." The Canadian game was slated to be the home debut of women's coach Carolina Morace. Canada and the U.S. have previously scheduled games against each other July 19 in Rochester, N.Y., and July 22 in Charleston, S.C. The Japanese association acknowledged it may have to pay damages for breach of contract in calling of the tour. Japan's health ministry confirmed the fourth case of swine flu Sunday, a day after the country's first three were reported. The ministry said the fourth case is a teenager who recently returned from Canada on a high school trip with the three others.


Yomiuri: Schools postponing foreign trips
An increasing number of schools are postponing overseas trips for students in light of the emergence of a new strain of influenza, according to sources. As of May 1, 15 schools had decided to postpone such trips. However, the Education, Science and Technology Ministry expects this number to drastically increase. The ministry had instructed prefectural boards of education to report by Thursday on how many schools had decided to cancel or postpone trips. Kinki Nippon Tourist Co., a major travel agency based in Chiyoda Ward, Tokyo, said it had been contacted by schools that had been planning student trips to Canada, asking whether they could postpone the trips or change destination. However, the problem of cancellation charges has emerged as an important issue, the firm said. "Some airlines charge for cancellations, and we've already paid deposits to some hotels [connected with the school trips]," an employee of the firm said. "As each case differs, it's difficult to decide whether we should require the schools to pay a cancellation charge," the employee added.

Kakamihara High School in Kakamigahara, Gifu Prefecture, has abandoned a scheduled trip to British Colombia in Canada, canceling a one-week language training trip for 40 second-year students scheduled from Monday to next Monday. The school now plans an alternative, Japan-based holiday. Students of the only special English course offered at public high schools in the prefecture do not take a once-a-year trip as students on other courses do. However, the Canadian trip was to serve as an equivalent break for the English students. Principal Susumu Oya decided to cancel the trip after the World Health Organization raised its alert against the new strain of influenza to Phase 5 at the end of April. He reported his decision to parents at a meeting held May 1. Some students and parents said the school should change destinations to a different foreign country. "Even if we postpone the trip, we don't know whether the epidemic will be over [by that time]," Oya said. "I didn't want to see students go without a school trip because we failed to decide which country to choose." The school is now considering switching its holiday plans to British Hills, a British-themed accommodation facility in Teneimura, Fukushima Prefecture. About 30 native English speakers teach English at the facility, which features English-style gardens. According to the facility, it has received calls from several travel agencies about school trips. The ministry has received calls from schools asking if they are allowed to send students to foreign countries on school trips and if there are any stipulations under which they should cancel such trips after some students at Osaka prefectural high schools in Neyagawa were confirmed to have the new flu following their return from a school trip to Canada. "We foresee an increasing number of schools refraining from making such trips," a ministry official said.
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Postby Behan » Wed May 13, 2009 9:04 pm

People as healthy as soccer players should be shouldn't have to worry about Swine Flu that much, should they? I thought it was just the elderly, very young, or physically weak who had to worry about it being potentially fatal.
Seems a bit paranoid on their part.
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