"Although the burden is increasing, we would like to continue active epidemiological investigations of all infected persons, including close contacts."
This was said by Toru Nishizuka, director of the Sumida Ward Health Center in Tokyo.
We talked to Director Nishizuka, who has been communicating so far, about what is happening at the site in the third wave and new measures.
Infection spread to every corner
★ (P: Health Center Long)
Reporter About the
current status of infection spread.
Regarding the third wave of the
director,
there was an extremely steep rise from the second week of December.
It is characterized by family infections and a large absolute number of elderly people.
In the form that the infection has spread to every corner, it is safe to infect anytime and anywhere.
There are many cases in which pneumonia occurs about a week after an elderly person is infected.
About the reporter
"Medical collapse".
Director In
Tokyo, there is information that regional tertiary emergency departments such as metropolitan hospitals will stop accepting new first-visit patients.
If regular medical care such as stroke and myocardial infarction, which increases in winter, becomes tight, the lives that can be saved cannot be saved.
Fortunately, such cases have not occurred in the ward and have not reached a complete “medical collapse”.
However, there are cases where 20 or 30 cases are refused for hospitalization adjustment outside the ward.
The impression is that there are not enough beds for the severely ill and the situation is in crisis.
Eight-fold increase in the investigation system for close contacts ...
★
(P: Miscellaneous feelings in the health center @ 1/13 broadcast V)
Reporters
There is a movement to reduce the survey regarding the "active epidemiological survey" that investigates the infection route and close contacts.
Director
Sumida Ward has managed to conduct epidemiological surveys on all infected individuals so far.
We have increased the number of infectious disease officers from 10 to 80, centered on public health nurses who conduct epidemiological surveys called "tracers," but the reality is that it takes time to hear.
I am confused as to whether it is okay to stop the investigation because I recognize that it is meaningful to follow the infection route while there are some characteristics that the infection is caused by eating and spreading to other facilities.
Why is it still taking a long time to investigate even if the
reporter
system is strengthened?
Director
Now, even in a small clinic, there are several cases a day, and notifications may be sent together at 7:00 or 8:00 pm.
Since it will be a survey after that, I often cross the night.
It may take up to 3 hours to adjust the hospitalization of one person, and even those who cannot be contacted visit their homes to check, so it is becoming more common to carry over to the next day after all the surveys are completed.
There are also concerns that the health center will not contact you until the next day.
★ (P: Paper used for the survey) At
the countermeasures headquarters meeting on January 7, it was decided to increase the number of staff by 10 or more, and we will receive support from inexperienced staff, so we will make an easy-to-understand manual. I want to deal with it.
Active epidemiological survey Why continue?
★ (P: Health Center Director).
Reporters One
metropolitan area and three prefectures are asking the country to show standards such as simplification of surveys.
Director
This simply means "do not look for close contacts."
In Sumida Ward, I also found a group of year-end parties who were not wearing masks.
During the investigation, if you are a Sumida ward resident, you will be identified as a close contact and will be inspected immediately, but for example, if there is a Kanagawa citizen, you will not be able to inspect even if you say "I am a close contact". come.
In some cases, some people in the same group can and cannot be tested, creating confusion.
I think that it should be considered for each region according to the degree of tightness, but since it is actually happening that the correspondence is different within the same group, it becomes difficult to get the understanding of the inhabitants of the ward, the citizens of Tokyo, and the people. I feel that it is coming.
The investigation cannot be stopped due to the circumstances of the health center.
Even if we abandon the traditional Japanese way of crushing clusters, we have not been able to show the inhabitants what kind of strategy we have next.
With the help of each company and each organization, we have been doing business by turning the economy on the condition that even one case of infected person should be investigated.
Is it possible to continue the business if an infected person appears when it comes to "I will not inspect" or "I will not judge whether it is a close contact" just for the convenience of the staff of the health center.
I was wondering if it would be difficult to get an understanding of the people who were fighting Corona with the ward, and even if I was late, I managed to cope with it while strengthening my posture. The reality is that there is.
How to deal with the rapidly increasing number of home caregivers
★ (P pulse oximeter).
The
number of home recuperators is increasing rapidly due to the tightness of the
press
beds.
Director
There are actually cases where even patients in their 70s with underlying illness cannot be hospitalized immediately.
Ensuring the safety and security of home care recipients became an urgent issue at the countermeasures headquarters meeting on January 7.
Lend a pulse oximeter to measure the oxygen concentration in the blood to those who need it, or visit patients who are undergoing home medical treatment, mainly elderly people at high risk, to grasp the pulse, respiratory rate, oxygen saturation, etc. We have begun efforts to check daily signs of aggravation.
If there is a sign, we will proceed with the hospitalization procedure as soon as possible, so we can prepare so that we will not have to wait after it gets really bad.
It leads to the relief of the residents, and I feel that the relief is spreading a little to the fatigue and stress of the staff who are observing their health.
★ (P Home recuperation image * Photo of futon)
Long-term response
Reporter
The stress and burden of the staff due to the prolonged period.
The
staff responded without holidays during the year-end and New Year holidays.
The number of respondents is steadily increasing, and the number of people who are observing health is also increasing, so the reality is that the conventional way of thinking that we have to do it perfectly is becoming a dead end.
We will do it efficiently so that it will not be too late for the severely ill, and we will prioritize the triage of those who have to be hospitalized immediately for the outbreak report that comes out as many as 50 sheets a day. Public health nurses are worried about those who have no choice but to do so.
Even under such circumstances, in order to protect the health and lives of the residents, it is also the case that we do not overlook the seriously ill, and we do not always have a system to grasp the voices of people at home and fly if there is a sudden change. I am keenly aware of the weight of responsibility that I must do.
Expectations for vaccines
Reporter
What time is it now?
The preparation of the
director
vaccine is also in progress.
The vaccination venue has been decided in the ward, and the required number of vaccines and the number of people by when can be seen concretely.
It will start moving from February to March, so I think that now is the time to do our best while the bright news is coming into view.
★ (P vaccine image).
Cooperation to reduce patients intensively
★ (Face of Director P)
Reporter
Lastly, what do you want to tell the inhabitants of the ward?
Director Since
medical care is tight, we hear concerns about whether infected people who are being treated at home will be saved if they become seriously ill.
Even in Sumida Ward, doctors perform operations to search for hospitals 24 hours a day.
I think there will be a period of waiting at home for a while until hospitalization, but I would like to protect my health by using home-visit nursing care and a pulse oximeter.
We ask you to include 70% of telework so as not to increase the number of infected people any more, but you can save your life by reducing the number of infected people now.
I would like to ask for your cooperation.