A surge in coronavirus cases in Japan is forcing exhausted medical workers to make “heartbreaking” decisions about treatment as healthcare services are close to being overwhelmed, medics have said.

In Osaka, at the centre of the country’s fourth wave of infections, hospital beds are almost at capacity and an estimated 17,000 people with virus symptoms are waiting for treatment at home. In recent weeks more than a dozen have died before they could be admitted to hospital.

There are fears the deepening crisis in the western prefecture could be repeated elsewhere in the country, including in Tokyo, which is due to host the summer Olympics in 10 weeks’ time. The last state of emergency was lifted in Osaka a week earlier than in the Tokyo region, where variants are accounting for a rising proportion of new infections.

Eighteen people with Covid-19 have died at home in Osaka, 17 of them since 1 March, while 96% of the prefecture’s critical care beds are full.

“Compared to the number of infections, the number of beds for severe cases is very limited in Japan,” said Yasutoshi Kido, a professor at Osaka City University’s graduate school of medicine, adding that hospitals were turning away people with cancer and heart disease to treat Covid-19 patients.

Osaka, along with Tokyo and two other prefectures, will remain under a state of emergency called in late April until at least the end of this month, and another three regions are due to join them from Sunday, Japanese media reported on Friday.

Pressure on medical services is expected to continue while Japan struggles to catch up with other developed economies in protecting its population against Covid-19. While it has almost finished giving at least one jab to more than 4 million frontline medical workers, the vaccine rollout for older people and other at-risk groups is only just picking up speed.

About 3% of the population of 126 million have been inoculated so far, amid reports of problems with the vaccination booking system, queue-jumping by local politicians and businesspeople, and millions of doses sitting in industrial freezers.

The country’s vaccine head, Taro Kono, blamed the delays on Japan’s rigid drug approval regime and said the government aimed to inoculate most of its 36 million people over the age of 65 by the end of July. That would mean administering 1m shots a day, about three times faster than the current pace.

While Covid patients are treated on ambulance stretchers in hospital corridors, the wait for vaccines is creating anxiety in the nursing care sector in Osaka, where 14 residents of a single nursing facility died recently following a large outbreak.

“At the moment the only tools we have to fight the virus are masks, hand-washing and sanitising,” said Kaori Akazawa, who works at a facility that provides daycare services for eight older people, most of whom live with dementia.

“We have to be careful when we’re not at work because no one has been vaccinated yet. We all want the jab as soon as possible. Everyone who works in this sector needs to be protected. We worry that we could become infected while commuting to and from work, or by someone at home. The thought that we might spread it to medically vulnerable people at the care facility is terrifying. The stress is getting to everyone, but we work in nursing care, so we have to be physically present.”

Staff at Osaka’s public health centres say they have been overwhelmed by consultations from people with Covid symptoms and often have no choice but to ask them to stay home and provide daily updates of their condition.

“It’s a community nurse’s job to help people and save lives, so this is heartbreaking for them,” said Yasunori Komatsu, the president of a union for community nurses in Osaka. “This pandemic has been going on for more than a year. The local government should have acted ages ago to solve the shortage of beds and staff, but nothing has changed.”

Japan’s doctors and nurses have emerged as outspoken opponents of the Tokyo 2020 Games, claiming the event risks spreading the virus and will divert medical resources that are desperately needed elsewhere.

The Japanese Nursing Association reacted angrily after organisers asked it to help find 500 volunteers for the Games, while this week a union of hospital doctors said it would be “impossible” to hold a safe Olympics as long as the pandemic continued.

On Tuesday, Osaka prefecture reported a record 55 deaths, bringing its total to 1,785. Japan has reported almost 670,000 cases and more than 11,300 deaths since the start of the pandemic – low compared with countries such as Britain and the US, but higher than other countries in the region.

“We are in desperate need of more beds and more staff now that we are in the middle of the fourth wave,” said Yoshihito Maehara, a senior official at the Osaka branch of the Japan Federation of Medical Worker’s Unions.

“Hospital staff are at the point where they can’t provide the personal care they were trained to give … only basic medical treatment. Lots of nurses want to quit, but they carry on because they don’t want to make their colleagues suffer even more.

“Other countries like Britain, the US and France all had terrible experiences last year, but they reached a turning point and the situation has improved. I’m sure people overseas are shocked to see what is happening in Japan. Headlines that describe the medical system here as on the verge of collapse are wrong. It has already collapsed.”

This content first appear on the guardian

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