The medical site of the emergency declaration "Kanagawa model" is a new corona April 9 0:24
Based on the experience of accepting cruise ships, the municipalities in Kanagawa Prefecture, which was the subject of the “Emergency Declaration”, have taken the initiative in preparing for an infection explosion and preventing medical collapse.
On the 6th, at the prefectural office, a general meeting of the Coordinating Headquarters, which selects where to receive patients with the new coronavirus, more than 30 staff members from each department were considering medical measures.
The Coordination Headquarters will be led by Dr. Hideaki Anan of the Disaster Dispatch Medical Team, DMAT, who was responsible for accepting patients on the Diamond Princess, a cruise ship that had been affected by a mass outbreak. I became the Chief of Measures.
In Kanagawa Prefecture, Dr. Anan and others took the lead and used the experience and lessons learned from cruise ships, and on the 25th of last month, launched the “Kanagawa Model” to prevent the collapse of medical care, and have taken immediate measures.
In order to maintain a system to provide advanced medical care to severely ill patients, the Kanagawa Model has designated `` Priority Medical Institutions '' that will receive moderately ill patients in advance, securing 2500 beds, Asymptomatic infected people have stated earlier than in the country that they will accept them at accommodation or at home.
In the background, it is said that he did not need a ventilator when responding on a cruise ship, but had difficulty adjusting the transport destination for "moderate" patients who need oxygen inhalation.
Dr. Anan explained, “There are many patients with intermediate symptoms, and in many cases, the symptoms become lighter or more severe during hospitalization. I felt it was necessary. "
On the other hand, at the meeting on this day, it became apparent that there were various issues when trying to actually take measures. Despite having started to secure “Priority Medical Institutions”, securing hotels and other facilities for patients with mild illness did not proceed as expected.
Dr. Anan said, "The unknown world of securing a hotel for patients is the first mission, but I want you to do your best because it is a necessary part to operate the Kanagawa model."
When accepting mild cases at accommodations, the hotel staff will be divided into “zones” in accordance with the risk to prevent infection of hotel staff, and staff will immediately go to the site while securing more accommodation facilities to cooperate. The staff decided to go into "sales activities" to do so.
In addition, the necessity of a call center to respond to changes in the physical condition of suspected "positive" people before the test, and the need to establish multiple testing bases in the prefecture in preparation for a surge in tests were discussed.
The three hospitals have already been designated as "Priority Medical Institutions" and have started accepting moderately ill patients. The progress of securing beds was described, including the need for zoning guidance that separates certain areas from safe areas.
On the eighth day after the declaration of emergency, members of the Task Force at the Response Headquarters were busy with exchanges of necessary materials with "Priority Medical Institutions" and confirmation of the acceptance system.
Dr Anan stated, "At the same time, measures must be taken to prevent the spread of the new coronavirus, and at the same time, prevent the collapse of healthcare, or else this could lead to social collapse. The declaration of an emergency slows the spread of infection. If you can do that, you can quickly build a Kanagawa model in the meantime. I think there is only now a way to do it. "
"Employees break first"
Of the municipalities in Kanagawa Prefecture, Sagamihara City is expanding its inspection system, but as the number of inspections increases, the workplace is facing challenges.
At the Sagamihara Health Research Institute, in addition to samples from cruise ships, the number of tests for dense contacts increased sharply due to outbreaks at hospitals and other places in the city. From February, 1,500 suspected new coronavirus infections began. I have been inspected.
After receiving guidance on infection prevention, a clinical technologist and others took out the gene from the sample and checked the results on a device, but at this time, 3 out of 15 cases were “positive” was.
In the past, up to 40 inspections per day were performed using two dedicated devices, but since February, there have been days when 96 inspections were performed, up to twice the upper limit, until dawn.
The Institute of Health has 17 staff members, but only five have the experience and skills to test for new coronaviruses.
According to clinical technologist Satoko Kanazawa, `` The test requires concentration, and if fatigue and lack of sleep continue, there is a risk of making mistakes, but in order to obtain accurate results, there is a risk that the inspector will be exposed. I'm also nervous to avoid sex. "
Therefore, Sagamihara City spent about 8 million yen, introduced one new device, and improved the inspection method to shorten the time.
However, the number of staff does not change, and three are child care generations, so if nurseries are closed, there is a possibility that staff may not be able to be secured.
On the same day, infected people came out at a medical institution in the city, and many samples were sent immediately. The next day, there were some staff who were unable to attend the work, so they were busy trying to create a system.
Mr. Kanazawa, who entrusted her daughter with a feverish elementary school student to her husband, said, "I'm sorry for my child, but as long as I have this job, I have to do it, so I have to do my best. But over time, the inspecting staff may break first, and I think we can't catch up without increasing the number of people. "