In Tokyo, on the 5th and 1st, it was confirmed that more than 5,000 people were infected with the new coronavirus for the first time, and it is a record high every day.


Under these circumstances, a group of Professor Hiroshi Nishiura of Kyoto University conducted a simulation of the future infection status of the new coronavirus in Tokyo, and if the infection continues to spread, there is a risk that the serious beds in Tokyo will become full by the end of this month. We announced the result.

On the 12th of this month, it is estimated that more than 10,000 people will be infected in Tokyo.

Professor Nishiura's group at Kyoto University used data on how many new cases per day in Tokyo would be if the infection continued to spread, compared to the same day of the previous week. We made a trial calculation as of the 2nd of this month.



▽ As a result, if the pace of increase is set to "1.7 times" according to recent data, the number of infected people per day will exceed 10,000 on the 12th of this month and will exceed 30,000 on the 26th of this month. It became a calculation.

▽ In addition, if the pace was higher than this last week's "2.2 times", it was calculated to reach 30,000 on the 17th of this month, and


▽ On the contrary, the pace slowed down to "1.2 times". Even in that case, the number will exceed 10,000 on the 4th of next month.

Severely ill patients Estimated to exceed the beds secured by the city within this month

We also make a trial calculation for the tightness of the bed.



In the estimation, the effective reproduction number, which indicates how many people one person infects, is assumed to be "1.7", which is higher than now in consideration of the influence of the highly infectious Delta strain, and the number of severely ill people in Tokyo will change in the future. Was calculated.



As a result, assuming that the decrease in the number of effective reproductions is only 10%, the number of seriously ill patients will be about 399 on August 20, which is more than the 392 beds secured by the city.

In addition, even if the number of effective reproductions decreases by 30% as an effect equivalent to the state of emergency from April, the number of seriously ill patients will continue to increase, and in mid-August, the number of severely ill patients secured by the city will continue to increase. It reached 50% of the total, and on September 6, the number exceeded 400.



On the other hand, if the effective reproduction number could be reduced by 50%, the number of critically ill patients would not exceed 150.

Professor Nishiura "Situations that must be reduced at once"

Professor Nishiura said, "While the Olympic Games are being held, there is a contradiction in asking for self-restraint in action, and it is difficult to receive messages and the number of people is not sufficiently reduced. It's a situation we have to do. "

Medical field where severe situation continues

As the spread of the new coronavirus infection, which has never been experienced before, continues to spread, at hospitals in Tokyo, there are cases where patients who are in a dangerous state due to deterioration of their respiratory condition during medical treatment at home are transported by ambulance. It is one after another, and the severe situation continues in the medical field.

At Itabashi Hospital, Nihon University School of Medicine in Itabashi-ku, Tokyo, we have secured 56 beds in total, including 6 beds in the intensive care unit = ICU and 50 beds in "high care beds" that can provide advanced treatment, to treat patients with the new corona.

According to the hospital, as of 10 am on the 5th, 37 patients were hospitalized, and 20 of them had worsened symptoms during home medical treatment and were transported by ambulance.

A 61-year-old man who was transported last week had a positive PCR test on the 26th of last month and was receiving medical treatment at home. When the "meter" arrived and measured, it was found that hospitalization was necessary.



At this time, the man had difficulty breathing and called an ambulance himself and was taken to this hospital.



Currently, men are receiving a treatment called "Nasal High Flow", which administers a large amount of high-concentration oxygen through the nose, and because they do not have a ventilator, they are not seriously ill by Tokyo standards. , It means that it is a severe "moderate 2" condition among moderate illnesses.

The man said, "I was worried because I couldn't imagine how much oxygen was in my blood during my home recuperation. I'm really sorry that my wife who was with me at home also got a domestic infection." I was talking.

"There are a lot of patients waiting at home even though they need to be hospitalized."

Dr. Tsukasa Kuwana, director of the critical care center of Itabashi Hospital, Nihon University School of Medicine, said, "There are a lot of patients who are waiting at home even though they need to be hospitalized. The medical institution may not be ready for acceptance due to a sudden response, and in some cases it was transported in an ambulance after being refused by nearly 10 medical institutions, so treatment was delayed. Also, if the ambulance itself becomes tight, it may affect emergency transport other than the new Corona, and it may not be possible to save lives. "

ICU full bed Unable to accept new critically ill patients Chiba Matsudo

On the other hand, the number of confirmed infections on the 5th was 942, and Chiba Prefecture reached a record high following the previous day.


At the hospital in Matsudo City, which accepts critically ill patients in the northwestern part, the ICU = intensive care unit has been full since the end of last month, and it has been unable to accept new critically ill patients.



The Matsudo City General Hospital in Matsudo City accepts critically ill patients with the new coronavirus on six beds in the ICU.



At the beginning of last month, only about half of the ICU was used, but since the 26th of last month, all 6 beds have become full, making it difficult to accept new patients.

A man in his 60s who was hospitalized in the ICU was being treated hard because his family was infected and he was waiting at home and suddenly lost consciousness and was transported.



For four days, doctors and nurses wear protective clothing to check the condition of the patient's ventilator and perform "prone position therapy" to lie down the patient in order to reduce the burden on the lungs on the back side. I was busy dealing with such things.



Due to this situation, if a mild or moderately ill patient in the hospital becomes severely ill, he / she will have to be transferred to another hospital.



In fact, last month, three seriously ill patients were accepted by hospitals such as Asahi City and Kamogawa City, which take about two hours by car.

Deputy Chief Nurse "I'm exhausted because I can't see the future"

Minako Urai, Deputy Chief Nurse of Matsudo City General Hospital, said, "Even if one person leaves the ICU, he will soon come in and the situation will continue to be full. I'm exhausted. "

Doctor "I'm asking for other people who should be hospitalized."

Dr. Masayuki Yagi, Deputy Director of the Emergency and Critical Care Center, said (39) "Since it is already full, there are no more requests for acceptance. Don't think it's okay if the number of patients increases because it doesn't change. "

Priority of hospitalization To a policy to make a strict judgment Chiba Prefecture

In order to deal with such a difficult situation, Chiba Prefecture switched to a policy of strictly determining the priority of hospitalization from 19th last month, and as of 4th this month, 4,100 people are receiving medical treatment at home. increase.



At the Matsudo City General Medical Center, there are many cases in which the condition suddenly changes during home medical treatment and ambulance is transported.

There is a risk that hospitalization will be delayed and transportation will increase at the last minute.

Regarding the risks of home care patients, Dr. Masayuki Yagi, Deputy Director of the Emergency and Critical Care Center, said, "Some people have no subjective symptoms even if they become severe. Without it, hospitalization could be delayed and more patients would be transported at the last minute. "



He added, "Although increasing the number of people receiving medical treatment at home can reduce the number of hospitalized patients, the beds for the severely ill are filling up, so I am worried that there will be a saucer when the condition becomes severe. We are in a situation where we cannot do it. "

Government policy

Due to growing concerns about the health care delivery system, the government will focus on hospitalization for critically ill patients and those at high risk of aggravation on the 2nd of this month in order to secure the necessary beds, while others. Has indicated a policy of strengthening health observation based on home medical treatment.

Ministry of Health, Labor and Welfare reviewing explanatory materials in response to withdrawal voice

However, both the ruling and opposition parties called for a polite explanation and withdrawal, and the Ministry of Health, Labor and Welfare reviewed the explanatory materials so far on the 5th.

He emphasizes that this policy is an urgent response to ensure that the necessary medical care is available according to the symptoms even in areas such as Tokyo where the number of infected people is increasing rapidly.



Then, after continuing to work on securing beds and accommodation facilities, there is a risk of hospitalization for severely ill patients, moderately ill patients who need oxygen administration, and even if administration is not necessary. The focus will be on one person, and the doctor will ultimately decide.

On the other hand, he explained that he would secure a certain number of beds so that he could be hospitalized promptly if the symptoms of the person being treated at home or at the accommodation facility worsened, and he will ask for his understanding again.

What do you do when your symptoms suddenly change during home care?

I asked the Tokyo Metropolitan Government what to do if my symptoms suddenly worsened while I was receiving medical treatment at home.

At the "Follow-up Center for Home Recuperators" in Tokyo, nurses and others receive consultations over the phone from people who recuperate at home 24 hours a day.

The phone number is not publicly available, but the health center will give it to those who are followed.



The city calls for calls if symptoms change suddenly, day or night, or if you have any concerns or doubts about your home care.



However, the telephone may be crowded, and the city wants you to call back several times if you cannot connect.



Depending on the city, there are more nurses who receive calls during the day from 10 am to 5 pm than at night, so it is easier to connect.



If you can't get it, if you have a family doctor in your area, we would like you to call us first to see if you can visit your home or have an online consultation.



We are calling on you not to go out to go to the hospital.

Also, if you cannot breathe unless you lie down and wake up, or if your lips are purple, the "oxygen saturation" that indicates how much oxygen is being taken into your body is the "pulse oximeter". If it is 90% or less, please call 119.

Home recuperation Tokyo's response

With the rapid spread of infection, the number of people receiving medical treatment at home is increasing at an unprecedented pace, and the Tokyo Metropolitan Government is working to strengthen its follow-up system.



Of these, several agreements were signed late last month to rent 500 "oxygen concentrators" that inhale oxygen at home in case of an emergency in which the patient suddenly worsens and needs to be hospitalized but cannot be hospitalized immediately. I tied up with the manufacturer.



Approximately 110 units have already been rented out to the company that visits the hospital or the local medical association, and in some cases they were actually used.

In addition, we have prepared about 40,000 "pulse oximeters" that measure the "oxygen saturation" that indicates how much oxygen is taken into the body, and send them directly from the city or rent them out through a health center.



The city is considering future measures with a view to purchasing additional "pulse oximeters" so that if the number of people receiving medical treatment at home increases further, there will be no shortage of "pulse oximeters".



The city says, "We would like to follow people who are receiving medical treatment at home, including health observations and medical consultations, and strengthen our response in various ways so that we can respond quickly to sudden changes in symptoms."

Points to be aware of during home medical treatment

Professor Satoshi Kutsuna of Osaka University School of Medicine, who specializes in infectious diseases, said, "In Tokyo, the number of home caregivers is increasing more rapidly than in the third wave, which was the highest ever. I was surprised, but as the number of infected people is increasing rapidly, there are some places where such measures have already been taken in order to prioritize the response to critically ill patients, so I think that the policy is tailored to the actual situation. " I pointed out.



On top of that, regarding measures such as health observations for home care recipients, "In some cases, people undergoing home care may suddenly become seriously ill, so it is necessary to ensure that they can be hospitalized at the right time. The number of infected people is increasing rapidly. , I think that the health center alone is in a difficult situation due to lack of manpower, so for example, we will not take a system to cover it, such as adding local government staff to strengthen the system or having a doctor at a local clinic perform medical treatment online. It will be difficult to find a person who becomes seriously ill at the right time and be hospitalized. "



As for the points to be noted during home medical treatment, "The new corona generally becomes severe around one week after the onset. Even young people may have rapid progress of symptoms, and they are short of breath. You need to be careful if you have any symptoms such as low oxygen levels or low oxygen levels. "