Efforts of Hachioji City, Tokyo to support home medical treatment with "total war"

As the medical system becomes critical due to the spread of the new coronavirus infection, how can we bring together local medical care and respond in a “total war”?

In Hachioji City, Tokyo, we are building a system that allows home care recipients to be examined at a local clinic in a hurry even if they cannot be hospitalized immediately when their symptoms worsen.

In Hachioji City, there are a number of cases in which hospitals in the city cannot be hospitalized immediately, as the total number of beds for new Corona patients, which is more than 200, continues to be almost full, and the number of home care recipients is close to 1,500. ..

Under these circumstances, a week ago, we set up a "support base" in a corner of the city hall in an attempt to bring together Hachioji's medical care and deal with home recuperators in a "total war."

At the base, about 10 people, including full-time staff, public health nurses, and doctors, take care of the situation. Gather information.

Then, in addition to centrally collecting information when vacant beds appear at the six hospitals that handle corona patients and performing "hospitalization adjustment", even if there are no vacant beds and you cannot be hospitalized immediately, you can only have a quick consultation. In order to be able to do this, we are coordinating with more than 40 clinics and clinics in the city to sort out patients.

Once coordinated, the clinician's doctor will visit the patient's home or arrange a private emergency service at the patient's home to bring the patient to the clinic.

On the 24th, the health center was receiving information on patients whose condition had deteriorated one after another.

Of these, a man in his 50s who had been having a high fever for nearly a week began to have difficulty breathing, but he was not in a situation where he could be hospitalized immediately, so he was connected to a medical institution in the city and had a medical examination. bottom.

Dr. Kentaro Tokuoka, who is in charge of the support base, said, "It is important to get the patient to" touch "medical care as soon as possible in order to reduce the severity of the disease, such as the administration of therapeutic drugs. In the meantime, we have no choice but to do our best with "All Hachioji" to find out how to effectively use the limited medical resources. "

Although I continue to be suffocating, it is difficult to be hospitalized for home medical treatment

A man in his 50s who was examined by a doctor on the 24th was infected with the new coronavirus in the middle of this month and continued to receive medical treatment at home for nearly a week. Therefore, on the night of the 23rd, he requested an emergency transport by himself.

However, when the ambulance crew rushed in, the oxygen level in the blood was stable, and it was difficult to find a place to receive it at night, so the health center sent information to the support base.

Then, when a public health nurse who was in charge of dealing with the situation at the base heard from a man, he said, "I'm still suffocating. The antipyretic does not work." rice field.

Employees were to secure medical facilities and transportation, and to be seen one hour after talking to the man.

The medical examination revealed mild pneumonia, so she was prescribed a remedy and decided to continue her medical treatment at home.

The medical institution that provided the medical examination did not perform medical examinations for the new corona because elderly people with dementia are being treated, but due to the current infection situation, we decided to participate in the response. It means that.

The doctor who consulted said, "Since I can't be hospitalized now, I think that patients can feel relieved by connecting to medical treatment like this time even during home medical treatment. Although there is a need for hospitalization, the number of patients staying at home is steadily increasing. , I don't think home recuperators should die at home, so I think we have to hit this in a "total war". "

Governor of Tokyo and others emphasize "total war"

As the medical system becomes critical due to the fifth wave of the new coronavirus, the phrase "fight in total war" is heard one after another.

After exchanging opinions with Minister of Health and Welfare Tamura on the 23rd, Governor Koike of Tokyo said, "As the number of home caregivers and severely ill people increases, we strongly demand the cooperation of medical staff at necessary medical facilities. The biggest crisis. In order to overcome this, the national government, the capital, and medical institutions will work together to fight in a "total war". "

Shigeru Omi, chairman of the government subcommittee, said after the meeting on the 17th of this month, "It is not a message to the prime minister, ministers and governors that one thing can solve everything, such as vaccines and antibody cocktail therapy, but medical treatment. I want you to send a message that we must strengthen the system and inspection system, cooperate with people to restrict their actions, package all means, and use them as a "total war". "