"We are facing a crisis."
Experts in Tokyo point out the usage rate of beds in Tokyo.
Now, the ratio is over 80%, which is tighter than the so-called "second wave" in summer.
However, there are circumstances in medical institutions where it is not easy to expand the bed.
Since May 12, last year, when the city began to accurately announce the number of inpatients, the largest number of patients in the so-called "first wave" was 1413 on May 12, at this time. The usage rate for 3300 beds was 42.8%.
After that, the number of inpatients decreased, and the usage rate dropped to the 20% level during June, but when the number of patients started to increase from around July, the usage rate of beds also increased.
The peak bed utilization in the so-called "second wave" was on August 11, with 1710 inpatients and 2400 beds secured at 71.3%.
After that, the number was around 1000 from late September to early November, but it will start to increase again after mid-November.
Last month, the city increased the number of beds from 2640 to 3500, but the number of patients did not stop, and the usage rate fell from the 60% range to the low 70% range.
Furthermore, on the 5th of this month (= 3025), when the number of hospitalized patients exceeded 3,000 for the first time, the usage rate for 3500 secured beds increased to 86.4%.
With the further increase in inpatients, the city increased 500 beds to 4000 beds on the 7th of this month, but as of the 12th, the number of inpatients was 3427, the highest number ever, and 85.7% was filled. Will be.
The severe situation has continued beyond the peak of the "second wave" in the summer, and experts in Tokyo said that if the current infection situation continues, the number of inpatients will greatly exceed the 4000 beds secured in the entire city. It has been pointed out that there is a possibility that
No waiting for bed expansion But ...
The expansion of beds has been a long-awaited challenge, but some medical institutions that have already accepted patients with the new corona say that it will not be easy to increase the number of beds any more.
The Tokyo North Medical Center in Kita-ku, Tokyo, which mainly treats patients with moderate illness, has been accepting patients with the new corona since February last year.
Initially it was 8 beds, but as the number of patients increased, it has increased to 40 beds.
However, it has been almost full since the middle of last month.
The number of patients accepted was 47 in a month in April last year, which was the peak of the first wave, but it has almost doubled to 93 in the last month.
The city has requested that the number of beds be increased to 50, but the hospital has decided that it will be difficult to accept more corona patients.
We are informing the staff that we will not increase the floor space.
Reasons for not increasing the floor space 1. Affects regular medical care
One of the reasons is that it has a great impact on regular medical care other than the new coronavirus.
During the winter months, the number of patients with myocardial infarction, stroke, and pneumonia not caused by the new coronavirus increases.
These patients also need to be hospitalized and have surgery, and must secure a bed to accept them.
The hospital has a total of 343 beds, including a dedicated bed for the new Corona, but currently 327 are occupied.
In particular, since last month, the occupancy rate of hospital beds has exceeded 100% one after another, and the burden on doctors and nurses is increasing.
Dr. Kunihisa Miyazaki of the Tokyo North Medical Center said, "Since the number of patients increases in winter, we cannot accept only corona patients. It has been almost a year since the spread of the infection, and no other surgery or treatment is necessary. I can't stop it. "
In addition, Mitsuri Mataki, the director of the nursing department who manages beds, said, "The number of hospitalizations for people who need long-term care and those with severe symptoms is increasing, and the burden on the site is increasing. The number of general inpatients is increasing, and they are in charge of internal medicine. Even nurses are looking at surgical patients, and the tension and stress are very high. "
Reasons for not increasing the floor 2. Dealing with critically ill patients
In addition, another reason why we cannot increase the number of dedicated beds for the new Corona is to deal with severely ill patients.
At this hospital, if a patient becomes severely ill, he / she was transferred to a designated medical institution for infectious diseases, but the beds are tight everywhere, and there is a risk that it will be difficult to adjust the transfer in the future.
In that case, it must be treated for critically ill patients, and more labor such as doctors and nurses is required.
If the number of dedicated beds is increased, there is a risk that manpower will not be enough.
Dr. Miyazaki said, "Recently, the adjustment of transfer of critically ill patients has been delayed. Furthermore, the number of people who are undergoing medical treatment at home or accommodation facilities or waiting for hospitalization has changed suddenly, and the number of people being transported by emergency has increased, so even a little sickbed. It needs to be free. The current situation is tough, but I just want to avoid situations where I can't save my life. "
Emergency transportation due to various illnesses
At the Tokyo North Medical Center, the number of patients being transported by emergency not only for the new corona but also for various illnesses is increasing rapidly this month.
Those who are
transported are
▽ people who have symptoms such as fever and are suspected of being infected with the new corona,
▽ people who need urgent treatment such as stroke, and on
many days 30 people, nearly double the normal number. ..
Many people have been refused acceptance by other medical institutions, and there are many cases where they are brought from outside Tokyo.
Furthermore, it is said that recently, people infected with the new corona are waiting for medical treatment at home or hospitalization, and their physical condition suddenly changes and they are transported by emergency.
Occasionally, there are times when we cannot accept emergency patients and have to decline, and it is said that if we accept more patients with the new corona, we will not be able to maintain emergency medical care.
Nobuyasu Kanai, the chief of the emergency department, said, "During the three consecutive holidays and the end of the consecutive holidays this month, there are constant calls, and if the number of patients continues to increase, the number of patients will disappear and the number of patients who have nowhere to go will increase. It is most worrisome that some patients will have to do it but will be put off. "
Medical Association "The real solution is to curb the increase in patients"
Regarding the expansion of the new corona bed, Masataka Inoguchi, Vice Chairman of the Tokyo Medical Association, said, "Accepting patients with the new corona is the same as creating another hospital in the hospital. In addition, staffing and equipment It is not easy to increase the number of beds due to maintenance. "
On top of that, "It is necessary to improve the efficiency of medical care, for example, make the entire hospital a specialized hospital. Then, the patient can move with only one flow line, the space for examining the patient will increase, and the hospitalization adjustment will be easier. So the effect is great. I have high expectations because the Tokyo Metropolitan Government will create some such hospitals. Also, individual hospitals are trying to increase the number of beds as much as possible. But the real solution is There is no choice but to curb the increase in patients. If the number continues to increase, the limits of medical care will be exceeded. "
National support for securing beds
This is the main content of the support measures that the government is providing to medical institutions to secure beds for accepting patients with the new coronavirus.
First, as a support measure when medical institutions newly increase the number of beds compatible with the new coronavirus by the end of next month, we will subsidize 15 million yen per bed for severely ill patients and 4.5 million yen for other beds. I am.
In addition to this, medical institutions in the prefectures where the state of emergency has been declared will be provided with an additional 4.5 million yen per bed.
With this
kind of
assistance,
we will cover
the labor costs of medical staff and the costs
of taking necessary measures to prevent nosocomial infections.
In addition, the treatment of the new coronavirus itself from that prospect is a patient that can not be discharged by, for example, is marked with although the physical strength to fall more, you pay plus 7500 yen a medical service fees in the case of these patients another medical institutions accept ..
Furthermore, if another medical institution dispatches a doctor or nurse to a medical institution that accepts patients with the new corona virus so that the necessary medical staff can be secured in the area, the maximum is the medical institution that sent the patient. ▽ Doctor will subsidize 15,100 yen per hour ▽ Nurse will subsidize 5520 yen.