The Japan News by The Yomiuri Shimbun
Worker shortages affect patient care
Two of the “crucial three weeks” the government sees as an important period for curbing the spread of the novel coronavirus leading up to mid- December have now passed. The wave of infections is hitting not only urban areas but regional areas as well, with the number of new infections per day approaching 3,000.
The effort to prepare hospital beds has not kept up with the surge in severe cases, and securing accommodations for patients with milder cases to recuperate in is also becoming difficult.
ELDERLY PATIENTS RISE
“It’s becoming harder to balance coronavirus care with regular medical services in many places,” Shigeru Omi, who chairs the government’s subcommittee on the novel coronavirus, said at a press conference Friday where he expressed a strong sense of urgency.
An analysis by an advisory body to the Health, Labor and Welfare Ministry found that in addition to Hokkaido and the Tokyo, Kansai and Chubu metropolitan areas, infections have recently been spreading in a number of other regions, including Yamagata, Hiroshima and Kochi prefectures.
Nationwide, many of the new infections are in elderly people who are more likely to develop a severe case of the disease.
According to the ministry, 27% of the cases in the week that ended Wednesday were age 60 or older. During the second wave in early August, this figure was 17%.
While workers on the medical front lines are gradually getting more support, securing enough staff is still a challenge.
The Osaka prefectural government has set up a prefabricated facility called the Osaka Coronavirus Jusho Center (Osaka severe coronavirus case center) in Sumiyoshi Ward, Osaka. A training session was held Friday to confirm the procedures for accepting severe cases, scheduled to start Tuesday.
The prefectural government began work on the center in July to prepare for an increase in infections in winter. It was completed at the end of November. The center’s 30 beds are all equipped with ventilators and about 130 nurses are needed for the center to be fully operational.
At of the end of November, 80 nurses were still needed. Osaka Gov. Hirofumi Yoshimura sent out requests to the National Governor’s Association, the
Union of Kansai Governments and the Self-Defense Forces, which are expected to get the center the workers it needs.
However, nurses and other staff must still be trained, and thus it is unclear when all the beds will be available for use.
In Tokyo, the metropolitan government has a dedicated facility in Fuchu that will begin accepting mild and moderate patients Wednesday.
The facility has a total of 100 beds, but initially only 32 will be in use, using support from 14 hospitals, including metropolitan hospitals. It is unclear when all the beds will be available.
“Every hospital is struggling to secure medical staff,” a senior metropolitan government official said.
SPECIALIZED SKILLS
Medical workers with specialized skills are an important part of securing hospital beds for severe cases.
The Yomiuri Shimbun Nurses and others take part in training before the opening of the Osaka Coronavirus Jusho Center in Sumiyoshi Ward, Osaka.
Showa University Hospital in Shinagawa Ward, Tokyo, has reserved five beds in its 28- bed intensive care unit for severe coronavirus patients.
“Severe coronavirus cases take two or three times as many workers as regular ICU patients,” said the hospital’s director, Hironori Sagara.
For example, it requires at least three doctors to attach an extracorporeal membrane oxygenator, which involves tasks such as connecting blood vessels to equipment outside the body.
Even after the device is set up, doctors, nurses and other workers need to monitor the patient around the clock.
Normally in an ICU, one nurse is assigned to every two patients, but dealing with coronavirus patients has increased the burden.
“We are considering increasing staff levels, possibly by sending workers from other wards to help. If the number of severe patients increases any further, infection control measures such as separation of areas and disinfection will become much harder. We might have to cut back on normal medical care,” Sagara said.
The health ministry’s advisory body said on Thursday that an increase in severe cases in regions with fragile medical systems could create crises. “Preparing and securing medical care provision systems needs to be done immediately,” the body said.
On Friday, the government’s coronavirus subcommittee called on the government to dispatch specialists and help coordinate the accepting of patients across prefectural borders in cooperation with relevant academic societies and other entities in areas where infections are increasing or already high. (Dec. 13)