From the 2nd, four prefectures started to review the grasp of the total number of people infected with the new coronavirus and limit the target of detailed reports to the elderly.
In principle, the government plans to eventually shift to a uniform operation nationwide, and will determine the timing of the transition while assessing the future infection status.
How have operations changed in the four prefectures?
Four prefectures, Miyagi, Ibaraki, Tottori, and Saga, have started reviewing operations from the 2nd.
Of these, Chigashi Kusakari, director of an otolaryngology clinic in Miyagino Ward, Sendai City, welcomed the drastic reduction in the number of patient information reports and the reduction in input burden.
On the other hand, there is a risk that people who are not covered by the report may become unwell during home treatment, and it is necessary for the on-site doctor to carefully explain the future response.
Kusakari said, "In that sense, the amount of clerical work has been reduced. However, in an emergency, we must explain to the patient how to properly connect to a medical institution and prevent the patient from becoming seriously ill and dying. , the on-site responsibility has become heavy."
Understanding all numbers What will change?
The number of new coronavirus infections announced daily by prefecture.
The "total grasp" 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 by region, and public health centers and others are conducting health observations and adjusting hospitalizations based on "outbreak notifications."
"Reports of outbreaks" are submitted 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 difficult for medical institutions and public health centers. It was a business burden.
In this review, local governments will be able to limit the subjects for which "outbreak notification" is required at the discretion of the elderly and people with a high risk of becoming seriously ill, and the total number of infected people such as young people who are not eligible. And we are trying to figure out the number of people by age.
We will continue to count the number of infected people, so we can continue to understand the infection status.
On the other hand, there are also concerns that it will be difficult for people who are not covered by the "outbreak report" to notice if their physical condition worsens during home treatment.
Medical Institutions Evaluated for “Reduced Burden”
At a pediatrics clinic in Tottori City, where a review of the total number of cases began, children complaining of fever and other symptoms were seen one after another from the morning on the 2nd, and they were undergoing antigen tests for the new corona.
Until now, at this clinic, the clerks took about five minutes to enter each patient's information into HER-SYS based on the doctor's notes.
When it was busy, we were reporting about 10 patients a day, but with a review of the total number of patients, it is expected that there will be no need to input for most patients.
Hideyuki Otani, a doctor at the clinic, evaluates that "the burden on the overall medical system, including public health centers, will decrease."
On the other hand, Dr. Otani said, ``Even people who are at low risk of becoming seriously ill without follow-up from public health centers can suddenly become dehydrated or have convulsions. He pointed out that the clinic will take new measures such as checking the health condition of the family patients by phone every day.
The hospital in Saga, where I came home late at night,
At the Shida Internal Medicine Clinic in Saga City, fever outpatients are by appointment only, but at peak times, they see about 15 people a day.
Since regular medical examinations and vaccinations for the new coronavirus were being performed in parallel, even if the break time was cut, it was possible that he would return home after 11:00 pm.
At hospitals, we expect that the submission of outbreak notifications will decrease to about 20% as a result of the review of the total number of cases.
Masanori Shida, director of the Shida Internal Medicine Clinic, said, "With this review, the input work will be simplified and the time it will take will be shortened. In particular, it will have a great effect in reducing the burden on large-scale hospitals that submit many reports of outbreaks." Welcomed the review.
On the other hand, for those who are not subject to notification of outbreaks and have a low risk of becoming seriously ill, ``it will be difficult to deal with if their condition suddenly worsens. I would like to recommend that you register with the person registration center and receive health care."
Health center in the southern part of Ibaraki Input work reduced to 1/4
At the Ryugasaki Public Health Center, which has jurisdiction over nine municipalities in southern Ibaraki Prefecture, the number of "outbreak notifications" submitted by medical institutions rose from 200 to 900 per day in August.
In addition, one-third of these reported outbreaks by fax, and about 20 public health center staff members entered the patient's detailed information into the national "HER-SYS" system.
As of 4:00 pm on the 2nd, 110 reports of outbreaks had arrived at this public health center, of which only about 30 had been sent by fax.
It means that the input work can also be handled by five people, one-fourth of the previous work.
The public health center plans to use the reduced number of staff to care for people at high risk of becoming seriously ill, such as the elderly.
Kumiko Ishida, director of the Ryugasaki public health center, said, "The amount of manpower and time spent on inputting data was extremely large. There have been reports of clusters occurring every day from facilities for the elderly, etc., but we have not been able to take adequate measures. So, in the future, I think that we will be able to focus on those who are at high risk of becoming seriously ill."
Infected person not covered by outbreak report Contact point for handling
Along with the review of the total number of cases, Tottori Prefecture began operating the "Positive Person Contact Center" from the 2nd, which handles infected people who are not subject to the notification of outbreaks.
In Tottori Prefecture's new method, infected people who are not subject to the notification of outbreaks can register information such as their name, address, and date of onset in the system called "My HER-SYS" from a smartphone or computer, and then check their body temperature. You will be asked to enter your health and physical condition on a regular basis, and the contact center will monitor your health.
And when the symptoms worsen, we will guide you to a medical institution where you can consult.
The center has a total of about 100 people, and they are supposed to be distributed in the conference room of the prefectural office.
Koichi Nishio, head of the Tottori Prefectural Novel Corona Countermeasures Headquarters, said, ``In Tottori Prefecture, we will continue to follow up as before by keeping an eye on the medical conditions of people who are not subject to the notification of the outbreak, and will leave no one behind. I want to prepare a system that will not happen," he said.
Applications for review from outside the four prefectures
The second deadline for applications to review the total number of applications was on the 2nd.
According to NHK's summary, Mie Prefecture and Nagasaki Prefecture have newly applied.
Regarding the reasons for newly applying, Mie Prefecture said, "To reduce the burden on medical institutions," and Nagasaki Prefecture said, "To avoid medical pressures and concentrate more on medical care for severely ill patients."
The government plans to eventually shift to nationwide uniform operation, and is hastening to complete the necessary system renovations by the end of this month.
After the summer vacation ends and schools reopen, we will determine the timing of the transition based on the opinions of experts while assessing the infection status.
On the other hand, we are also considering permitting exceptions for local governments that wish to continue to monitor all populations even after the transition to a uniform operation.
In the future, we will also introduce a “fixed point grasp” test
Regarding the review of the grasp of the total number of new corona infected people, the Ministry of Health, Labor and Welfare will start a ``fixed point grasp'' in which only pre-designated medical institutions report on infected people in some local governments this fall. decided to introduce it.
The Ministry of Health, Labor and Welfare will continue to consider improving the accuracy of "fixed-point grasping" while verifying the results of trials by local governments.
A senior official of the Ministry of Health, Labor and Welfare said, "It's not the right time, but when the status of the novel coronavirus under the Infectious Diseases Control Law is lowered to the same level as the seasonal flu, we have to discuss whether to shift to a 'fixed-point grasp.' We have to do our own research."