What's happening in Osaka, the largest number of new corona dead in Japan?

I should have prepared ... May 24, 14:58

The sixth wave of infection with the new coronavirus.

The death toll in Osaka is the highest in Japan at 1934.

(Aggregated from December 17, 2021 to May 18, 2022)

Osaka should have taken various measures based on its experience so far.

Why did so many people die?

(Osaka Broadcasting Station reporter Daimu Shimizu Yuya Inagaki)

The construction of a 1000-bed reception facility is actually ...

At the end of May, the facility for accepting new corona patients, which was set up in the exhibition hall in Osaka City, was quietly closed.

"Use as a facility when an unexpected outbreak of infection occurs and you cannot enter a hospital or accommodation facility."

The facility where Governor Yoshimura of Osaka Prefecture said and showed confidence.

Last fall, the prefecture set up a 1,000-bed scale with a budget of about 7.8 billion yen, saying that it was necessary to prepare for the spread of disaster-grade infections.

Assuming the acceptance of mildly ill patients under the age of 40, who are not eligible for hospitalization or lodging treatment, doctors and nurses are stationed to create an environment where they can be treated with peace of mind.

However, this facility was rarely used in the 6th wave.

Only 303 people have used it in about 3 months since the start of operation.

While taking various new steps from past experiences, the number of people who died in the 6th wave was the highest in Osaka.

What on earth was happening?

In the background, the situation was significantly different from what the prefecture expected, and there was a gap between the measures taken in advance and the required measures.

Infection spread far beyond expectations

Last November, the prefecture announced an assumption that the maximum number of infected people per day in the 6th wave would be "3833".

Even if a new mutant virus spreads, it was expected that the rapid spread of infection could be suppressed to some extent by the progress of vaccination.

However, the number of new infections per day in the 6th wave was the highest, about four times the pre-estimated number in Osaka Prefecture, exceeding 15,000.

In addition to the fact that the infectivity of the Omicron strain was much stronger than expected, it is thought that many people had been vaccinated twice and the effect was diminishing.

The most serious of these was the rapid increase in cluster = outbreaks in nursing homes.

The number reached 716, which is about 14 times that of the 5th wave.

(December 17, 2021-May 15, 2022)

A facility for the elderly in a serious situation Not connected to a nursing home ...

One of the pay nursing homes that clustered in the sixth wave of infection responded to the interview on condition of anonymity.

A five-story building in Moriguchi City, Osaka.

Private rooms ranging in size from 14 square meters to 17 square meters are lined up on each floor, and long-term care staff go around each room to provide long-term care services such as meals and bathing assistance.

Due to thorough infection control measures such as wearing masks and installing acrylic plates in the cafeteria, no clusters occurred in the facility until the 5th wave.

The cluster will start on January 28th.

A man in his 80s had a fever.

The response within the facility stumbled from the beginning.

At that time, when an infected person appeared in a facility for the elderly, it was a general rule to contact the health center and be hospitalized.

The facility manager's man called many times to contact the health center, but he said he couldn't connect at all with a ringing tone.

The facility director's man also understood that it was necessary to reduce the chances of contact between residents in order to prevent the spread of the infection, but there are many people with dementia, and even with repeated caution, other residents' There was no end to the people who visited the room.

At this point, 41 people aged 63 to 99 were in the facility.

The "underlying illness" column of the resident list shown by the facility manager's man was filled with the names of various illnesses.

Lung cancer, brain tumor, diabetes, angina, dementia, and cerebral infarction.

Almost everyone had some kind of chronic illness.

The facility director's man said,

"If the infection is asymptomatic, we can handle it, but if the infection spreads and some people become seriously ill, we can only watch over. The health center cannot be reached, so where to consult? I didn't know what to do and I couldn't do anything about it. "

Doctors can't come right away and become isolated

In the end, the phone was called to the health center on January 31st, a day and a half after the man was found to be positive.

However, doctors cannot come immediately.

There are several types of paid nursing homes, such as "with long-term care" and "residential type", and while there are caregivers who provide long-term care services such as meal and bathing assistance, there are very few places where doctors are stationed. Is the reality.

There are no doctors in this elderly home, and when a resident feels sick, a doctor at a partner clinic called a "cooperating medical institution" visits the clinic.

Again, the facility manager's man turned to the clinic for help, but at the time, the clinic did not have a cure for the new corona, making specialized treatment difficult.

On this day (31st), 4 new residents who had symptoms such as fever were found to be positive.

The infection spread within the facility without outside support.

"If you can treat early ..."

At the request of Osaka Prefecture, the visiting doctor visited the elderly home in Moriguchi City five days after the first fever.

Dr. Yasushi Nakamori of Kansai Medical University Medical Center, who visited the home visit, was carrying a drug called "sotrovimab".

The administration of a therapeutic drug, which is expected to have the effect of suppressing the aggravation, was finally carried out.

"How are you doing? Get well."

At that time, the video taken by the staff of the facility shows Dr. Nakamori going around the room of each resident and calling out to encourage him while administering an intravenous drip.

Infection at the facility eventually spread to 33 people, which is 80% of the residents.

Some people were weakened by the infection and their original illness worsened.

Dr. Nakamori diagnosed the two people with particularly severe symptoms as requiring hospitalization, but only one was able to be transported.

At that time, the medical care provision system was seriously affected by the rapid increase in infected people, and the bed operation rate for mild and moderate cases in the prefecture exceeded 80%, making it difficult to adjust hospitalization.

On the other hand, the medical treatment facility set up by the prefecture in the exhibition hall could not accept the elderly.

This is because there were not enough manpower and equipment to accommodate the elderly in need of long-term care.

After that, Dr. Nakamori went to the facility and was unable to be hospitalized, and continued to treat the men in their 80s who were left in the facility.

Dr. Yasushi Nakamori, Kansai Medical University Medical Center

"The condition of men was so bad that they needed to be hospitalized because they could not receive treatment at an early stage. It is important to be able to administer as soon as possible to prevent the aggravation. If the treatment is delayed and becomes severe like this man, it is impossible to deal with it at the facility, and the life that would normally be saved is lost. May be "

The remaining man in his 80s died in the facility without improving his symptoms.

The number of infected people who died in the facility in the 6th wave was 90, the highest number ever.

(December 17, 2021 to May 18, 2022)

The death toll reached 1,934, the highest number in Japan, and 90% of them were elderly people in their 70s or older.

The facility manager's man,

"The man in his 80s who died was popular among the residents, and many people were visiting his room. I'm full of disappointment if I could get treatment sooner."

"Situations that differ from wave to wave There are also mismatches in countermeasures"

The sixth wave that aimed at facilities for the elderly.

Osaka Prefecture, which saw the situation seriously, investigated the medical system such as facilities for the elderly.

As a result, only about 30% of the approximately 3,600 facilities answered that they were able to secure medical institutions that could handle corona treatment as of March in the middle of the sixth wave.

This was less than half the national average.

In response to this situation, Osaka Prefecture has begun to rebuild the medical support system for facilities for the elderly.

If the "cooperating medical institution" that is the family doctor of the facility cannot handle the situation, we have established a system to dispatch a visiting doctor by requesting from the prefecture or health center.

The number of medical institutions cooperating with home visits increased to 119 as of May 13.

Osaka Prefecture wants to take further steps to avoid delays in treatment for the elderly.

Mutsuko Fujii, General Manager, Health and Medical Department, Osaka Prefecture

"I take it very seriously that many people, especially the elderly, died in the 6th wave. I think I should have taken a step earlier. I have experienced six waves, and each time I have experienced a situation that exceeds expectations. Among them, there was a part where there was a mismatch in the countermeasures. The situation varies greatly from wave to wave, so it is as close to the infected person as possible. While having a big policy of early treatment, I think that we have no choice but to correct the course as quickly as possible to the problems that have occurred and to take measures every day, even one step. "

How to prepare for "unexpected" that may occur in the future

A new type of coronavirus that repeatedly mutates and continues to mess with the world.

Every time a wave of infection occurs, the local government has identified issues and has taken measures to prepare for the next.

Then, in the sixth wave of infection, there was a situation in Osaka where sufficient medical care could not be delivered to facilities for the elderly who spilled from "preliminary assumptions".

As "unexpected" may continue to occur, what is needed is the ability to provide appropriate medical care to the people who need it, no matter what wave comes.

Now, the infection situation has calmed down to some extent, and discussions on exit strategies such as under what circumstances the mask can be removed have begun.

However, because of this, it is necessary to drastically review the measures that have been accumulated like a patch every time a new wave of infection occurs, and to establish a system and system that can respond even if an unexpected infection spreads. Isn't there?

This is a question posed by Osaka, which has the highest number of deaths in the new Corona.

Osaka Broadcasting Station Reporter

Daimu Shimizu

Osaka Broadcasting Station Reporter

Yuya Inagaki