Initiative to help Tokyo fight the Covid-19 wave

The number of Covid-19 cases this month is gradually decreasing in Tokyo and other urban centers, showing that the fifth and largest wave of infections since the outbreak in Japan has begun to be controlled. control. However, severe cases requiring the use of ventilators or ECMO machines remained unabated.

In order to support hospitals in the capital, a series of doctors and nurses, especially intensive care specialists, from all over the country have volunteered to come to Tokyo to help hospitals deal with the situation. increasing number of critically ill patients.

Doctors at Komagome Hospital are caring for a severe Covid-19 patient on September 8.  Photo: Kyodo.

Doctors at Komagome Hospital are caring for a severe Covid-19 patient on September 8. Photo: Kyodo.

Yu Onodera, 38, an expert at Yamagata University in Yamagata Prefecture, is one of them. On the evening of September 8, he was present at the Center for Cancer and Infectious Diseases of Komagome Hospital in Bunkyo Ward. Onodera is monitoring a patient on a ventilator.

The patient, over 60 years old, was intubated. He was barely awake because doctors injected him with sedatives to help ease the pain.

Onodera wanted to determine the patient’s pain level and find out if it was coming from the intubation or from respiratory failure.

“Severe patients recover unsettledly, their condition often gets better but then worsens,” he said. “The hardest decision critical care physicians have to make is when to wean a patient off the ventilator.”

Komagome Hospital, with 815 beds, is a famous cancer treatment facility in Japan, however, most of the hospital’s staff are not familiar with the use of ventilators.

Using ventilators for severe Covid-19 patients requires a high level of skill because they are not like other normal patients with healthy lungs. According to experts, if you operate a ventilator with a Covid-19 patient like a normal patient, medical staff risk further damaging the remaining healthy parts of the patient’s lungs.

Komagome Hospital has mainly treated Covid-19 patients with mild to moderate symptoms since the pandemic hit last year.

Last month, the number of hospitalized patients rose to 150 when the Delta variant sparked a new wave of infections in the Tokyo metropolitan area. By mid-August, the hospital had to switch to receiving severe patients that other hospitals could not handle.

According to data from the Tokyo government, at the beginning of July, there were about 50 cases requiring the use of ventilators or ECMO. By the end of August, the number of cases had increased to about 300. Komagome Hospital also occasionally accepts serious patients, but the most they have ever treated at the same time is only 4 people.

With the number of Covid-19 cases skyrocketing, the hospital had to urgently handle 12 severe cases, equal to the number of ventilators they had available and dispatched doctors from other departments to assist.

Komagome Hospital also had to reduce admissions by 40% of patients with other illnesses and postpone planned surgeries to help remedy what many doctors describe as “nothing different from a natural disaster.” “.

The Japan ECMO Network, a non-profit organization with members of intensive care professionals, has supported medical workers in Tokyo by mobilizing help from medical workers in other prefectures such as Hokkaido, Yamagata or Shimane, where the disease situation is not too serious and the health system has not reached the threshold of overload.

These specialists, including Onodera, have since August 23 been sent to a series of hospitals in Tokyo, where medical staff are not proficient in taking care of Covid-19 patients with ventilators.

“Our goal is to save as many lives as possible,” said Keiki Shimizu, senior member of ECMO Network Japan and leader of the Emergency Care and Critical Care Center at Tama Medical Center in Tokyo. good. “Many hospitals do not have the expertise and experience to care for critically ill patients because they have long treated only patients with moderate symptoms.”

From August 23 to September 13, Komagome Hospital welcomes 3-4 intensive care specialists every day to support. Doctors at the hospital say they now understand how to operate ventilators more effectively when caring for serious Covid-19 cases, after being guided by experts in professional exchanges.

Completing his special mission on September 13, Onodera said that working at Komagome hospital during the recent violent outbreak was an experience he had never had in his life.

“I have never had to take care of so many patients with severe respiratory failure at the same time,” he shared. “Really difficult”.

Vu Hoang (Follow Asahi Shimbun)

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