Over 70,000 home recuperators Timeline of home-visit doctors "There is danger" August 16, 21:04

The number of infection announcements per day exceeded 20,000, and more than 70,000 people were treated at home nationwide.

What is the situation we are facing now that it is said that "an infection spread that has never been experienced, which is a different dimension than before"?

I got close to the doctor's day visiting the home caregiver.

(Social Department reporter Kim Rin-i)

Yoichi Suzuki, Deputy Director of "Itabashi Ward Office Clinic", which provides home medical care in Itabashi Ward, Tokyo.

He responded to a close interview asking me to know the situation facing home caregivers and medical sites.

9:30 AM Doctor's day begins with a phone call to a home caregiver

One day in August.

The first thing Dr. Suzuki started with was the telephone.

Check the physical condition of the home recuperator who visited by the day before.

Dr. Suzuki

"I visited the doctor yesterday, but how are you doing today? How was the oxygen in your fingers? It's good that it's up."

The work of the public health center and the follow-up center in Tokyo is tight, so it is necessary to play a role close to that.

There was also a request for a new home visit from the public health center.

Dr. Suzuki

"Do you have a device to measure the oxygen value of your finger? Did you not receive it?"

AM10: 00 Departure for home visit

Depart from the clinic with a medical bag, protective clothing, antiseptic solution, etc.

After treating a woman in her 90s with dementia who is making regular visits, she will head to the home caregiver of the new Corona.

Wear protective clothing in front of the entrance.

To prevent infection, only one doctor has decided to enter the patient's room for the new Corona.

It takes about 5 minutes to prepare a medical mask, face shield, gloves, and all by one person.

The temperature is 33 degrees.

Dr. Suzuki's forehead was sweaty.

At each medical examination, the back of the bag and shoes is disinfected.

Including contacting the health center and prescribing medicine, each case takes more than twice as long as regular home visits.

As a result of the examination, the patient was mildly ill, but he was anxious because the pulse oximeter to measure the oxygen saturation in the blood did not arrive.

11:45 AM Home care request for home visits 5 cases already

Visited a man in his 70s who suffers from a chronic disease of respiratory failure who is undergoing regular medical care.

At this point, the public health center had already received five requests for home visits to the new Corona home caregivers.

As Dr. Suzuki couldn't see it alone, he decided to have another doctor at the same clinic take charge of the home visit of two out of five doctors.

PM0: 40 Home visit to the second home recuperator

Visited a home recuperator who was asking about the situation on the phone before departure.

At the front door again, put on new protective clothing before entering the room.

The patient is a man in his 40s.

He complained that he was coughing and couldn't eat.

Doctor: Can't you eat with cough?

Patient: I used to eat normally a few days ago, but I also eat with heat and dullness.

I want to take medicine as soon as possible.

But I can't eat it.

Doctor: Is it painful?

Patient: Let's get out (cough when trying to talk).

(Listen to heart sounds with a stethoscope)

Doctor: I have bronchial symptoms, but I haven't gone to the point of hypoxia.

Patient: Pneumonia, is it now?

Doctor: I can't say anything because I'm not taking X-rays, but I think it's a very limited and small range, if any.

Moderate I.

As a result of the medical examination, I decided that there was no problem even if I continued medical treatment at home.

Dr. Suzuki decided to prescribe an oral steroid.

PM1: 05 In some cases, you cannot be hospitalized

He continues to be a home recuperator of the new Corona.

All 6 family members infected.

I was informed that a man in his 60s had serious symptoms.

Patients with chronic diseases such as diabetes.

Doctor: Is the pain okay if you keep quiet?

Patient: That's right.

Doctor: Oxygen is 91 or a little low.

Doctor: Can I have you go up and down the stairs once and lie down?

As fast as possible.

(Check by applying load up and down the stairs)

Doctor: Is it painful?

Patient: A little bit painful.

Doctor:

Ah, not so good.

With a little load, it drops to 86.

Recovery is bad.

There is noise on the right back.

You probably have pneumonia in your right lung.

Even at rest, it's 92.

It's moderate II.

I have to breathe oxygen already.

Of course, hospitalization is desirable.

Knowing that he was most likely having pneumonia, Dr. Suzuki called the health center on the spot.

Physician: Hospitalization is desirable as it is a high-risk group with diabetes and moderate II and Phase 2.

Doctor: I'm sure there is pneumonia on the right side.

Doctor: Do you find it difficult (to be hospitalized today)?

Oh true.

The response from the public health center is that it is difficult to find a place to be hospitalized today.

Dr. Suzuki decided to outperform by arranging an oxygen concentrator to inhale oxygen at home.

PM2: 00 Arrange an oxygen concentrator for patients who cannot be hospitalized

After returning to the clinic, Dr. Suzuki immediately calls the oxygen concentrator dealer.

However, this vendor was told that it would be night even if it could be delivered, with only a few of the 150 devices left.

Dr. Suzuki "It's bad. It's such a situation. It's bad ..."

I managed to secure it during the day by asking another company, but I will reiterate the reality that the number of home caregivers is increasing rapidly. It was an event.

The man was able to be hospitalized the next day.

PM2: 20 Eight-month-old baby also requested two more visits

Dr. Suzuki heads for home visits again.

You can get calls all the time while you are on the move.

When I arrived at my sixth visit on that day, I received two more requests for home visits to the new Corona home caregivers.

"I have regular medical examinations in the evening, but can I get around by then?"

Dr. Suzuki wears protective clothing.

Three family members were infected, and I was asked to check the condition of an eight-month-old baby.

Doctor: It's tiny.

Hello.

I was surprised.

Mother: At 38 degrees 8 minutes.

(I put on the pulse oximeter while struggling)

Doctor: I wonder if it's a finger or something difficult.

I'm sorry I don't like it.

It's hard, is not it.

Because my hands are different from adults.

Doctor: No,

Doctor: Hello.

Sound is okay, I'm glad.

Fortunately, the baby had stable breathing and then recovered.

PM2: 50 A woman who is anxious about home medical treatment

Home visits for home care recipients will continue.

A woman in her thirties living alone.

It was the 4th day after the onset, but he did not recover, and although he called an ambulance himself, he was not transported.

Doctor: What's the hardest thing right now?

Patient: Fever and

Doctor: How many times is it today?

Patient: Up to 9 degrees 3 minutes.

It's painful because I can't breathe from here (chest).

(Women stand up like that)

Doctor: Good luck.

It's tough.

I will lend you this (pulse oximeter), so please measure it 3 times a day.

It's important that you always exceed 95 at rest because you only have to put your finger in this way.

(Woman coughing)

He explained that although the patient was very anxious, his condition was not serious because his oxygen saturation was stable, and his symptoms would continue for a few more days.

After that, I lent out the pulse oximeter that Dr. Suzuki had and prescribed the medicine.

PM3: 30 Home recuperation that increases for young people

The next visit was to a woman in her thirties.

As a result of the medical examination, I was mildly ill, but I was worried because the pulse oximeter did not arrive and my cough suddenly became severe.

Dr. Suzuki:

"It seems that I was worried about how heavy I am now. I think that the new corona will have a longer fever and cough than a cold, so I think that anxiety will become stronger. It is difficult to contact the health center. It's understandable that I'm even more worried because there is increasing information that it's becoming more difficult to be hospitalized. "

PM5: 05 "Some people may spill from home medical treatment."

Finally, after visiting the homes of ALS patients in regular practice, Dr. Suzuki returned to the clinic.

The number of home recuperators for the new Corona visited by Dr. Suzuki was six on this day.

In the meantime, I talked to Dr. Suzuki, who says that he will continue to prepare documents after this.

Dr. Suzuki:

"Of course, I expected that the number of infected people would increase rapidly from the middle of July, and the number of home recuperators would increase, but when I actually got into that whirlpool, it was a bit tough. and feel you have "

" the beginning, and among his own, but I thought let's serving concurrently with a general medical examination, it was so even today, examine the home care person and a general medical examination does not somewhat limited I strongly believe that it will not be possible. "

He also finds it difficult to see patients with the new Corona at home.

Dr. Suzuki:

"It's difficult because I'm going to see you without a lung imaging, and if you're in the hospital, you'll check your pulse and breathing values ​​on a regular basis every day, but that's not always the case at home, so you're sick. I think there is a danger of who will notice it when it happens. "

" I have been doing home medical care for about 20 years, but it is difficult to distinguish the lung abnormality peculiar to the new corona just by auscultation, or it is in a sudden state. Given the changing nature of the disease, there is always concern that some people may spill in their home recuperation. "

Adhesion postscript

Dr. Suzuki didn't have time to have lunch that day, and the only break was a few minutes to go to the bathroom.

I found that I was sweating a lot even from a distance because I repeatedly put on and take off my protective clothing every time.

In addition, since the spread of the infection, there are increasing requests for home-visit medical care from patients other than the new corona.

Patients with terminal cancer who want to spend their time at home because they cannot meet due to infection control when they are hospitalized, or those whose surgery or hospitalization has been postponed to secure a dedicated bed for the new corona. is.

This spread is affecting many people seeking medical care.

And what I realized in this close contact interview was the rigor of home medical treatment.

Symptoms vary in severity and age, but the common denominator is the fear of "if there is a sudden change" and the anxiety of not being immediately connected to medical care.

There was a reality that the person and his family were being cornered.

Reporter of the Social Affairs Department

Kim Rin-i In

Yamaguchi Prefecture, where

he

first

joined the station in

2012, he

covered a wide range of themes such as incidents, administration, and emergency medical

care. responsible person