Due to the spread of infection called the "third wave" of the new coronavirus, the number of elderly patients at high risk of aggravation has increased rapidly since last month at general hospitals in Tokyo, and they are busy responding to sudden changes in their condition. ..
Saiseikai Central Hospital in Minato-ku, Tokyo has a ward dedicated to the new virus, which accepts patients with about 20 beds, and the dedicated ward and the general ward are separated from each other.
At this hospital, the proportion of elderly patients aged 65 and over was about 30% of the total as of April, but with the spread of infection called the "third wave", the proportion gradually increased, and last month it was 6 It means that it has exceeded the percentage and has increased rapidly.
Elderly patients have underlying illnesses such as heart disease and diabetes, and their physical condition often changes suddenly due to complications, and those with cognitive decline need careful care. In some cases, the burden on the medical field is increasing.
Dr. Koto Ito, a general practitioner and infectious disease internal medicine doctor, said, "Since elderly patients often have various diseases, it is necessary to manage sudden changes including the risk of unexpected complications. Only in the neighborhood. In addition, the number of elderly patients being transported from afar has increased, and in a situation that can be called a "disaster," the number of elderly people who have to make important decisions such as whether to attach a respirator has increased explosively. If you get infected, you will be hospitalized for a long time, so please be careful not to bring the virus into your home by reducing masks, disinfection, and eating out for the younger generation who live with you. "
Correspondence to elderly patients who have difficulty in sudden changes in physical condition
At Saiseikai Central Hospital in Tokyo, where the number of elderly patients is increasing rapidly, the condition of elderly patients, whose condition was relatively calming, suddenly changed even on the day we were interviewing in the hospital, and doctors and nurses I was busy responding.
Doctors and nurses wore gowns and special masks to prevent infection in the hospital rooms of elderly patients who had been infected with the new coronavirus and continued to receive treatment.
The patient has been in the hospital for several weeks and has recently been relatively calm, but his condition has changed abruptly.
Corona seemed to have exacerbated the illness that he had originally had, and doctors and nurses brought in the necessary equipment and took other measures in a hurry.
Carts containing medicines to be used when the condition suddenly changes are placed outside the hospital room to prevent the virus from adhering, and the medicines are handed over from the corridor to the nurses in the room while minimizing the opening and closing of the door. I did.
When I told the doctor in the hospital room a form with the results of the blood test that I hurriedly examined, I did not open the door and stuck it on the window glass.
Dr. Ito commented on the difficulty of dealing with elderly patients who are at high risk of becoming severe. "Elderly patients often have various diseases and are difficult to manage. Including unexpected complications. As my illness suddenly worsens, I have to go with the management of the corona at the same time. "
Discuss treatment policy over the phone without attending
As domestic infections increase, older patients are often transported unattended when their families become infected or become close contacts.
In the case of elderly patients with cognitive decline, it is difficult to confirm their intentions regarding the treatment policy, and when the family becomes a close contact, the doctor treats them by telephone for a short time without being able to meet with the family. It also means that we may have to discuss the policy.
In some situations, doctors feel the rigors of the current situation, as they have to make important life-threatening decisions over the phone, such as whether to wear a ventilator or heart-lung machine = ECMO. It's called.
Dr. Ito said, "If your family becomes a close contact, you will not be able to come to the hospital, so you cannot make face-to-face discussions about important decisions such as whether or not to use a ventilator. Even if you can survive, there are cases where you and your family do not get the shape you expected, such as being asleep. I don't think there are many things to talk about in case of emergency, so it's short. The number of people who have no choice but to decide the treatment policy in time is increasing in Corona. "
In some cases, you cannot be discharged even after treatment
Elderly patients often have weak legs and cannot be discharged immediately after being treated with the new coronavirus, even if they are ready to be discharged from the hospital.
At Saiseikai Central Hospital in Tokyo, when the symptoms of the new virus have subsided and it is time to leave the hospital, doctors, nurses, and physiotherapists in charge of rehabilitation will gather to discuss what to do with their future lives. We are.
Of these, a man in his 80s has weak legs due to hospitalization and needs assistance in living at home, but his wife who lives with him was also found to be infected and was just hospitalized, so he was nearby. The daughter who lives has also become a close contact, and there is no one in the family to help.
In addition, in order to have rehabilitation performed at another hospital, I was infected with the new virus even when I tried to adjust the transfer, so I was asked to confirm negative by PCR test twice, and the recipient was It means that it may be difficult to find it.
Dr. Ito said, "In the case of elderly patients, they are infected with corona and their activity is reduced, so even people who originally lived on foot may become wheelchairs or bedridden and cannot return home immediately. Even if I negotiate to be transferred to a rehabilitation hospital, I may not be able to receive it for more than a month due to negative confirmation, which is annoying. "