Health workers at Risk of Karoshi 

 Makoto Iwahashi(POSSE)

SEP 30 2021 

Essential workers caring for coronavirus patients are at risk of death from overwork. A doctor working for a public hospital in Tokyo worked 327 hours of overtime in a month, well over the “karoshi threshold” of 80 hours of overtime per month (Tokyo doctor reported 1,180 hours of overtime over 4 months responding to COVID-19). It has been reported that public health center workers in essentially every prefecture have been working above the threshold since the coronavirus pandemic broke out in early 2020, with a worker in Nara prefecture reportedly worked 317 hours of overtime in May 2021. All 14 workers in a public health center in Akita prefecture recorded overtime more than the threshold in May 2021. 

We know that frontline health workers who conduct work that is essential in lessening the effects of the deadly virus are forced to shoulder enormous burden during the pandemic. But even though they are forced to work much longer in the pandemic, they have been overworked even during non-pandemic times. The government has been replacing public employees on permanent contracts with fixed term employees and aggressively privatizing to cut costs.

National Institute of Infectious Diseases, a national public health agency whose goal is to protect public health and safety through preventing and controlling disease, has reduced the number of researchers it employs from 312 in 2013 to 294 in 2019. The number of staff working for the institution compared to its counterpart in the US, the Center for Disease Control, would be 1 to 42 and the NIID’s annual budget is only 0.09% of what’s reserved for the CDC. In addition, the number of public health centers has been reduced dramatically. There were 852 centers in 1992 but now there are only 472 in 2019, a reduction of 45%. During this period, population has increased from 124 million to 126 million which means each health center (and thus public health workers) are responsible to take care of more people which much less resources.

This indicates that austerity and privatization measures that have been in place since the 90’s and 2000’s have severely weakened the society’s preparedness for pandemics like we are seeing right now. We are also seeing more essential workers being hired on temporary basis. A record shows that 53 percent of workers employed by the Ministry of Health, Labour and Welfare are on fixed term contracts. We cannot simply blame everything on the suddenness and the unexpectedness of the pandemic as it is obvious that had the government granted more resources, we would probably not see public health workers constantly forced to overwork like now. 

• Data is gathered from this article (in Japanese): 新型コロナ対応　厚労省の53％が「非正規公務員」の現実