Yomiuri Shimbun
The Health, Labor and Welfare Ministry will expand the list of infectious disease patients subject to legally binding measures, including hospitalization, to include people suspected of having severe acute respiratory syndrome, but who have not been diagnosed as having the disease.
A subpanel of the ministry's Health Sciences Council made the policy change and will authorize prefectural governors to issue orders for suspected SARS patients to be hospitalized.
The central government had instructed prefectural governments to ask potential SARS patients to agree to voluntary hospitalization.
But this measure was not legally binding, and if a patient refused hospitalization, it was feared the disease could spread.
Members of the ministry's council agreed Friday that it was important to take more concrete measures to prevent the risk of secondary infection and protect the nation from the disease.
The council decided that patients who were judged to be possible SARS carriers, as well as confirmed victims, will be compulsorily hospitalized for 10 days, with the entire expense to be covered out of public funds.
The government will retroactively reimburse the hospital costs of the 16 people who are suspected of having SARS.
If such patients disobey the instructions, prefectural governors can order their hospitalization.
The governors also can instruct those who have been in contact with suspected SARS patients to have medical examinations.
Reactions by prefectural governments to the ministry's decision were mixed. Some praised the initiative, saying it is an effective measure to prevent secondary infections, others voiced concern that the public may negatively react to the compulsory measures.
A Tokyo metropolitan government health official voiced doubt, saying, "I fear it may be a violation of the law."
But a ministry official called for understanding, saying, "The measures are necessary to prevent the spread of SARS in the nation."
A senior official of the metropolitan government's infectious disease prevention section said, "How can we interpret the law as stipulating that a person can be judged a SARS patient without the law being examined by the council?"
The ministry will soon issue formal letters of instruction on the compulsory measures to prefectural governments.
But the metropolitan government official suggested that the Tokyo government may not immediately accept the ministry's new policy.
"We'll consider actions to be taken after seeing the instruction letter. For the time being, we will just ask suspected SARS patients to agree to be hospitalized," he said.
A health official of the Toyama prefectural government said, "We have to be aware of violating patients' rights by restricting their freedom."
"The ministry must present its case on clear legal grounds in order for the patients to be convinced. I want the ministry to come up with a set of easy-to-understand judging standards for possible SARS carriers," he said.
But he welcomed the policy of full public funding, saying, "It'll be easier for us to obtain patients' agreement on voluntary hospitalization."
A senior official of the Shizuoka prefectural government praised the ministry's decision, saying "The decision is helpful to prevent secondary infections."
The prefectural government recently earmarked about 10 million yen for transporting possible SARS patients to hospitals and hospitalization costs, which previously were required to be shouldered by patients.
The official welcomed the central government's support saying, "There may be cases in which patients refuse to cooperate even if the prefectural government covers their costs."
A health official of the Niigata prefectural government said, "The central government judged that a step forward was required under the circumstances."
But another prefectural government official was not convinced, as there was a case in the prefecture in which a possible SARS patient was later confirmed not to have contracted the disease.
"I wonder whether the public funding will also cover those confirmed not to have been infected," the official said.
A health official of the Chiba prefectural government, the prefecture in which Narita Airport is located, said: "We are in a sense of crisis, as the flow of people to and from SARS regions is high. We praise the central government's decision as it provides us with another option."
But he expressed embarrassment regarding the advocated policy of forcibly hospitalizing suspected SARS victims saying, "Negative reactions toward forcible hospitalization are predicted."
"As a local government, we are obliged to protect as many prefectural residents as possible," he added. "It's difficult to keep the balance between patients' human rights and safety of residents."
Some prefectural governments voiced concern over the capability of hospitals to adequately cope with an influx of SARS patients.
In Tottori Prefecture, there are only 12 beds that can accommodate SARS patients. An official of the prefectural government said, "If the disease begins spreading, the number of beds will be insufficient."
In Nara Prefecture, which has no hospital designated by the Infectious Disease Control Law, a prefectural government official said, "We want the central government to extend fiscal assistance to ensure implementation of the measures."