In Tokyo, with the rapid spread of the new coronavirus, the number of people who have not been adjusted whether to be hospitalized at a medical institution or to receive medical treatment at a hotel or home after the infection is confirmed has increased rapidly in the past month. It is about 13 times more than half.
On the other hand, in the Tokyo metropolitan area, we found that the usage rate of accommodations where mildly ill and asymptomatic people stay is only about 30%, according to interviews with local governments.
Rapid increase of 13.4 times in a month and a half
The Tokyo Metropolitan Government announces the status of patients who have been confirmed to be infected every day by dividing them into "in hospitalization," "accommodation treatment," "home treatment," and "adjusting hospitalization and medical treatment."
Of these, "under adjustment for hospitalization / medical treatment, etc.", which indicates those who are not adjusted whether to be hospitalized at a medical institution or to receive medical treatment at a hotel or home, was
▽ 577 on the 1st of last month,
▽ 1st of this month The number was 2447, an increase of 4.2 times in one month.
The pace of increase did not
stop
even this month, and on the
17th, the number reached 7,727, the highest number ever.
The number of people increased by 5280 from the 1st of this month to 3.2 times, and the number of people increased by 7150 from the 1st of last month, increasing rapidly to 13.4 times in the past month and a half.
Accommodation medical facility usage rate is only 30%
On the other hand, in the Tokyo metropolitan area, we found that the usage rate of accommodations where mildly ill and asymptomatic people stay is only about 30%, according to interviews with local governments.
Of these, in Tokyo, 11 facilities have been secured as accommodation treatment destinations, for a total of 2630 rooms, but as of the 17th, 831 people were actually receiving accommodation treatment, and the usage rate was only 32%. ..
Disinfection and cleaning waiting for all patients on the floor to leave
A major factor is the disinfection and cleaning of rooms, not for each room where the patient has completed medical treatment, but for all patients on one floor to wait for their discharge before disinfecting and cleaning. ..
Since it is used by people who are recuperating common areas of the building such as elevators and corridors, there are voices of anxiety about infection from linen exchange companies, so the city said, "For safety reasons, the operation has changed. It is difficult and there is no choice but to increase the number of facilities in order to accept more accommodation patients. "
Accommodation medical treatment is
recommended over home medical treatment because it can
reduce the risk of infecting family members and the
resident medical staff can grasp the physical condition of infected people.However, in
Tokyo,
home medical treatment is recommended for
more than 9,000 people. As many as 7,700 people are being hospitalized or adjusting their medical treatment destinations.
Similar issues are also in Saitama and Chiba prefectures, and Professor Tetsuya Matsumoto of the International University of Health and Welfare said, "If you replace people who have been confirmed to be infected, there should be no problem with simple cleaning. Some people die at home. We have to think of ways to efficiently operate the limited rooms so that they will not come out. "
Accommodation medical facility usage rate is about 30%
This is the usage rate of accommodation facilities as of the 17th in 1 metropolitan area and 3 prefectures.
▽ In Tokyo, we have secured a total of 2630 rooms as accommodation treatment destinations, but the number of people actually receiving medical treatment is 831 and the usage rate is 31.6%.
The number of people who are adjusting hospitalization destinations and medical treatment destinations is 7,727.
▽ Kanagawa Prefecture has secured 1592 rooms, but the number of people actually receiving medical treatment is 448, and the usage rate is 28.1%.
▽ Chiba Prefecture has 858 rooms, but the number of people actually receiving medical treatment is 289, and the usage rate is 33.7%.
The number of people who are adjusting hospitalization destinations and medical treatment destinations is 2,360.
▽ Saitama Prefecture has secured 967 rooms, but the number of people actually receiving medical treatment is 270, and the usage rate is 27.9%.
There are 433 people who are adjusting their hospitalization and medical treatment destinations.
Sorting patients at the "Hospitalization Coordination Headquarters" in Tokyo
The Tokyo Metropolitan Government has set up an "Inpatient Coordination Headquarters" in the government building to search for hospitalization destinations when the health center determines that it is difficult to adjust hospitalization destinations for patients with severe or moderate illness among those infected with the new coronavirus. ..
In early April of last year, when the infection began to spread, it became difficult for health centers to coordinate hospitalization individually, and hospitals were requested to be hospitalized by different health centers. It was raised.
About 10 to 15 staff members are available on Saturdays, Sundays, and holidays.
Based on the information sent from the health center, such as the presence or absence of underlying illness, the Coordinating Headquarters will sort out patients by observing what kind of symptom patients can be accepted at which hospital.
When making a decision, doctors belonging to the disaster medical assistance team "Tokyo DMAT" are also included, and prioritize the response according to the severity of the patient.
Bed tightness ... for various reasons
However, in the first place, the beds are tight, the number of patients that can be accepted changes every day depending on the posture of doctors and nurses, and the medical institutions that can accept are limited depending on the severity and the presence or absence of underlying diseases. That is.
According to the capital, the number of requests from the public health center to the Coordination Headquarters has exceeded 400 every day since the 6th of this month, and there are many cases where they are carried over or have to wait after the next day.
According to people familiar with the matter, there are not enough beds in the beds these days, and it has become very difficult to accept especially critically ill patients.
Corona characteristics are difficult to adjust even for sudden changes in prioritized medical conditions
According to Dr. Kunihisa Miura, a doctor at Tokyo DMAT who is involved in the actual coordination at the hospitalization coordination headquarters in Tokyo and the deputy director of Tokyo Hikifune Hospital, recently, patients with severe symptoms and high urgency are the so-called first wave and second wave. It has increased significantly compared to the time, and there are situations where adjustments have to be made the next day or later.
Dr. Miura said, "The capacity of medical institutions that can be hospitalized has been exceeded. The number of requests has increased far beyond imagination, and the current situation is that we cannot adjust everything on the same day. I am making adjustments for this. "
He also said, "I am doing this with the concern that patients who could not make adjustments will become more serious. I am making adjustments with priority, but the number of requests is so large that it is difficult to make adjustments. No one can foresee the fact that even mildly ill patients who have no symptoms have progressed and become severely ill. Even if they are prioritized, they may change suddenly and it is difficult to identify them. " The characteristics of the new coronavirus, which can be exacerbated, are also one of the reasons why it is difficult to adjust hospitalization.
Furthermore, Dr. Miura said that in order to overcome this situation, "it is difficult for the field to reduce the number of infected people and increase the number of hospitals that accept them."
The target of accommodation medical treatment
The Ministry of Health, Labor and Welfare has decided that for mild or asymptomatic people, in areas where sufficient accommodation facilities can be secured,
▽ prevent domestic infections
▽ can respond when symptoms suddenly change,
so each local government should respond based on accommodation treatment rather than at home. I am asking for.
In addition, the Tokyo Metropolitan Government summarized the criteria for determining hospitalization for people who have been confirmed to be infected by inspection in November last year, and in principle, those who do not fall under hospitalization are treated as accommodation.
Specifically, the subjects of hospitalization are:
▽ severe symptoms such as fever and cough,
▽ have underlying illness such as diabetes,
▽ over 65 years old,
▽ pregnant,
▽ unable to do personal things alone
Any one
of them
is applicable.
However, due to the tight beds, the age item was raised to 70 years or older last month in order to narrow down the number of hospitalization targets, and the number of people eligible for medical treatment is expanding accordingly.
In addition, according to the health centers in Tokyo, there are a number of cases in which even people who meet the criteria for hospitalization are forced to take medical treatment at home because there are no beds or accommodations available as the infection spreads rapidly. is.