Regarding measures against the new corona, Prime Minister Kishida announced on the 24th that he would review the ``knowing of the total number'' of infected people.
The Ministry of Health, Labor and Welfare hopes to start operation as early as this month.
We have summarized why we are reviewing, what will be changed by the review, and the perception of medical sites and local governments that "the burden has increased."
[Why change]
The “total grasp” of newly infected people is based on the “outbreak report” of the patient created by the medical institution.
The Infectious Diseases Control Law requires the doctor who diagnosed the new coronavirus to submit information such as the name, age, and contact information of all patients to the public health center as an "outbreak report."
The national and local governments have aggregated "outbreak notifications" to understand the infection status nationwide and in each region, and public health centers and others are conducting health observations and adjusting hospitalizations based on "outbreak notifications."
The submission of "outbreak notification" is done using a system called "HER-SYS" introduced by the government, but the number of infected people has increased sharply in the "seventh wave", and the work of inputting and confirming has become a medical institution. and became a burden on public health centers.
From the medical field, there was a growing demand for a review, wanting to concentrate on dealing with corona patients.
[Changes]
In this review, it has been made possible to limit the targets for which an "outbreak notification" is required at the discretion of the local government to the elderly and those at high risk of becoming seriously ill.
We will also grasp the total number of infected people and the number by age group for those who are not targeted, such as young people.
Since the number of infected people will continue to be counted, we can continue to understand the infection status, but there are concerns that it will be difficult to notice if people who are not subject to "outbreak notification" become ill while recuperating at home. .
The Ministry of Health, Labor and Welfare says that in areas where fever outpatients and public health center operations are extremely urgent, measures to limit the target of "outbreak notification" will be gradually implemented if a notification is received from the prefecture.
On the other hand, the policy is to consider the "fixed-point grasp" that designates a fixed-point medical institution and requests regular reports after the seventh wave subsides, because it takes time to design a specific system.
[Details of the review]
The operation of the "HER-SYS" system began two years ago, and there were about 120 input items at the beginning.
The number of input items has been gradually reduced so far, and currently, for patients with the least number of input items and low risk of exacerbation, ◇ Name, ◇ Gender, ◇ Date of birth, ◇ Name of city, ◇ Phone number, ◇ Medical We narrowed it down to 7 items of diagnosis type, such as the date of reporting from the institution, and the presence or absence of symptoms.
However, as the spread of the infection continues in the so-called "seventh wave," there have been calls for further review from medical sites and local governments. Governor Hirai of Tottori Prefecture, who is the chairman of Tottori Prefecture, held an online meeting.
Governor Hirai said, "I understand the necessity, but I have to do input work until late at night at the site. I've been asked to ease the input items so far, but I want you to step further. The seventh wave is expected. I want you to work on it immediately, not after it's finished," and requested that it be reviewed immediately.
The Japan Medical Association also made a similar request.
In response to this, Minister Kato said during a parliamentary deliberation last week, ``While reducing the burden on medical institutions, we will consider how to retain the purpose and function of grasping all patients while listening to experts and medical practitioners. It's a situation," he said, showing his intention to respond promptly.
[Health, Labor and Welfare Minister ``Start accepting notifications promptly'']
At a press conference held at the Ministry of Health, Labor and Welfare on the night of the 24th, Minister of Health, Labor and Welfare Kato said, "On the premise that the prefectures that have reported will announce the total number of infected people by day and the total number by age group every day, the Minister of Health, Labor and Welfare From the date set by , we will limit the subjects of notification to ▽ 65 years old and over, those who require hospitalization, those who are at risk of serious illness and who are judged by doctors to need corona treatment drugs or oxygen administration, and pregnant women. said.
After that, if approval is obtained at the council of the Ministry of Health, Labor and Welfare on the 24th, regarding the revision of the related ministerial ordinance, the ministerial ordinance will be promulgated on the 25th. I was.
The Ministry of Health, Labor and Welfare will proceed with the administrative procedures after receiving the notification, and hopes to start operation as early as this month.
In addition, Minister Kato said, "I would like to consider a nationwide review after ascertaining future trends in the infection situation."
[Expectation from medical institutions to reduce burden]
Since mid-July, when the infection spread, the fever outpatient clinic in Setagaya Ward, Tokyo, which has been examining 70 to 100 patients every day, has had symptoms such as fever and sore throat on the 24th. The complaining patient was examined and prescribed medicine.
At this clinic, there are days when more than 50 outbreak reports are entered in a day, and on the 24th, nurses entered the names and phone numbers of those who tested positive, whether they had underlying diseases, etc. between examinations and during lunch breaks. I was working.
It takes about 5 minutes to enter each case, and the clinic spends about 3 hours a day working on it.
Director Kei Hase of "Clinic Plus Shimokitazawa" said, "Nurses and receptionists were always running around, and it took time and staff to report the outbreak, but if the burden was reduced even a little, it would be better for the site. I'm looking forward to it," he said.
On the other hand, ``Among the patients, there were more than zero who were young or had no underlying diseases and had mild symptoms but their condition worsened, so even those who are not subject to notification need care while observing their health. I want to find people," he said.
[Reaction of each governor after review]
Governor Hirai, who is the chairman of the National Governors' Association, said that he had a meeting with Minister Yamagiwa and decided to review the government's policy of reconsidering the grasp of the total number of infected people. I would like to publicize it well so that the public will not misunderstand that the response will loosen infection control measures."
In response, Minister Yamagiwa said, ``It is a difficult task to move forward without stopping socioeconomic activities while the infection is not contained, but how to take effective measures while discussing the impact of Obon and the reopening of schools. We would like to work even more closely with local governments.”
After the meeting, Governor Hirai told reporters, "Since the end of last month, the Governors' Association has been requesting that we 'review the total number of cases as soon as possible.' worth it,” he said.
Governor Koike of Tokyo responded to an interview with reporters at the Tokyo Metropolitan Government Office on the afternoon of the 24th, saying, "I heard that the Prime Minister made an announcement, but I have to confirm it a little more. We are not at the point of raising our hands as an emergency," he said, indicating that he would carefully check the government's policy before deciding on the city's response.
After that, he said, "The fundamental problem is a system problem such as the electronic medical record and 'HER-SYS' not being linked.
I think the country needs a strategy with a big perspective of preparing for infectious diseases that may continue."
Osaka Governor Yoshimura said, "There is no doubt that keeping track of all cases is a burden on public health centers and medical institutions, and we want to reduce the burden. It is important to protect people who are at high risk of becoming seriously ill. I agree,' he said.
On the other hand, he said, "We have decided that we do not know how public funds for medical expenses for people who are not covered by the report will be borne, and how to handle procedures for support such as admission to accommodation facilities and food delivery services. It is difficult to do, ”he said, and after confirming the details of the specific review, he indicated his intention to consider the response.