The medical care provision system is in crisis

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medical care provision system is in crisis
medical care provision system is in crisis

A meeting of experts in Tokyo set the highest level of alertness regarding the infection status of the new coronavirus in Tokyo and the medical care provision system. In this article, the medical care provision system is in crisis detail Explain.

Experts expressed a strong sense of crisis, saying, “The medical care provision system is tight and we are facing a crisis situation. It is very likely that we will be in danger of bankruptcy if we continue in this situation.” He pointed out that it is most important to prevent the increase of positive and critically ill patients.

The last “monitoring meeting” of the Tokyo Metropolitan Government was held at the Tokyo Metropolitan Government Building on the 30th, and the infection situation and medical care provision system in Tokyo were both set to the highest alert level as last week.
Of these, experts pointed out that the 7-day average of new positives was “rapidly increasing for the third straight week.”
He added, “It will take a few weeks for the measures to take effect, so stronger measures need to be taken immediately.”
On the other hand, experts pointed out that the medical care provision system is “faced with a tight crisis.”

On top of that, if the rate of increase in new positives continues for two weeks, the number of confirmed infections will be 1136 per day, and if the proportion of patients requiring hospitalization does not change, the capital will not wait for two weeks. Analyzed that it could exceed 4000 beds, which is requesting medical institutions to prepare.

Then, he expressed a strong sense of crisis by saying, “It is very likely that we will be in danger of bankruptcy if we continue in this situation,” and immediately curb the increase in new positives and prevent the increase in critically ill patients. Pointed out that is the most important.

According to the Tokyo Metropolitan Government, in the analysis presented at the “monitoring meeting” on the 30th, the indicators used by the Tokyo Metropolitan Government to see the infection status of the new coronavirus and the medical care provision system are all seven for the first time in the previous week. It exceeded.

Of the seven, the indicators that show the infection status are the average number of new positives for seven days, the number of consultations such as fever sent to the telephone consultation desk of the Tokyo Fire Department, and the infection route among the new positives. For example, the number of people who do not know.

In addition, the index to see the medical care provision system is the 7-day average of the positive rate of PCR test and antigen test, but 5 medical institutions requested the acceptance of emergency patients, but the destination could not be found, or it took time to decide the destination. This is the 7-day average of the number of cases where the “Tokyo Rule” was applied, as well as the number of inpatients and the number of critically ill patients.

This is the analysis result of the infection situation and medical care provision system in Tokyo shown at the monitoring meeting on the 30th.

Infection status

Confirmation of new infections averaged about 751 for 7 days as of the 29th, an increase of about 134 from the previous week.
The rate of increase is about 123%, which is a very high level.

Experts said, “The number is increasing rapidly. It’s a situation I’ve never experienced before. Clusters are frequent in multiple regions and transmission routes, and the infection continues to spread. The situation where ordinary medical care is tight. Is becoming even more serious, and we must thoroughly defend against the increase in the number of new positives. “

On top of that, “If the current rate of increase continues for two weeks, 1136 new positives will occur daily, which is about 1.5 times the current rate, and if the ratio of inpatients does not change, it will be secured without waiting for two weeks. There is a possibility that the number of beds will be exceeded. We are in danger of bankruptcy. “

“It is necessary to pay close attention to the effects of mutated viruses originating from the highly infectious United Kingdom and South Africa.”

Looking at the 5007 people confirmed in the week up to the 28th by age group, the highest percentage was in their 20s at 26.9%. This was followed by 20.3% in their 30s, 15.9% in their 40s, 13.5% in their 50s, 6.5% in their 60s, 5.0% in their teens, 4.8% in their 70s, and 80s. 3.6% were in their teens, 2.5% were under 10 years old, and 1.0% were in their 90s or older.
It was analyzed that the percentage of people in their 20s and 30s has increased compared to about a month ago.
In addition, the number of elderly people aged 65 and over increased by 27 from the previous week to 599.

Experts said, “In order to prevent domestic infections in the elderly at high risk of aggravation, it is of utmost importance that families working outside are not infected. It should be noted that there is a risk of infection even if it is asymptomatic. There is. “
On the other hand, 49.3% of people whose infection route is known at home were infected, which was the highest for 22 consecutive weeks by infection route.

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By age group, domestic infections were the highest in all age groups except those in their 80s and above.
For those in their 80s and above, infections in hospitals and facilities for the elderly are the highest at 59.1%.
In addition, among those who know the infection route, 16.2% in the facility, 14.0% in the workplace, 7.2% for dinner, and 1.4% for restaurants with entertainment that are open at night. did.

Experts analyze that there is an increased risk of infection in daily life and that there are a wide variety of transmission routes.
On top of that, “As the risk of infection in the city increases, there are many cases of infection by staff, patients, and users in multiple hospitals and facilities for the elderly. It is necessary to take thorough measures in the hospital and facilities.” I pointed out.

In addition, it was revealed that cases of infection through trips with friends and family, camping with a large number of people, year-end parties, dinner without masks, and training camps of the university’s athletic club have been reported.
“At New Year’s, New Year’s parties, coming-of-age ceremonies, etc., people come into close contact with each other, take off their masks, eat and drink for a long time or late at night, and have a loud conversation, which significantly increases the risk of infection.” I pointed out.

In addition, the 7-day average of those who do not know the infection route, which is the “index that reflects the spread of infection,” is about 476 as of the 29th.
It’s about 113 more than the previous week, the highest ever.
The rate of increase has remained at a high level of approximately 134%.
Looking at the people who do not know the infection route by age group, those in their 30s exceeded 70%, those in their 20s, 40s, and 50s exceeded 60%, and those in their 60s exceeded 50%.

Experts said, “If the number of people who do not know the infection route continues to increase at the current rate, there will be 1537 people who do not know the infection route a day, which is about 3.2 times the current rate. Now is the brink. Immediately, we need to implement stronger infection control measures. “
In addition, 19.1% of the newly confirmed positives in the week leading up to the 28th were asymptomatic.

Experts point out that “the range of activities of asymptomatic and poorly symptomatic people is expanding. It is necessary to continue to strengthen the system such as intensive examinations including asymptomatic people who had a chance of infection.”
The Tokyo Metropolitan Government analyzes and evaluates saliva for PCR tests by people living outside of Tokyo, except for cases where saliva is sent to a medical institution in Tokyo and then positively reported to a health center in Tokyo. There were 214 such cases.

Medical care provision system

The “positive rate” of the test was 8.4% as of the 28th, up from the previous 7.3%.
It has been increasing continuously since the beginning of last month.
On the other hand, the number of inpatients was 2,274 as of the 29th, an increase of 171 from the 23rd of this month last week.
“Inpatients remain at a very high standard, the healthcare delivery system is tight, and we are facing a crisis,” said an expert.
He also revealed that the acceptance system for inpatients is tight and the adjustment of acceptance is difficult. “Especially, the adjustment of acceptance of dialysis patients and pediatric patients is difficult. There are many cases where waiting is forced. Therefore, the year-end and New Year holidays will be even tighter. Immediately, stronger infection prevention measures are needed to significantly reduce the number of new positives. “

In addition, as of the 29th, the number of people receiving medical treatment at home was 2,768, an increase of nearly 900 from the previous time, and experts said, “The rapid increase in the number of people receiving medical treatment at home has increased the work of health centers that perform health observations. I have. “
In addition, the number of seriously ill patients as of the 29th, which was calculated based on the Tokyo standard, was 84, an increase of 15 from the previous time.

By age group, 1 person was in his 30s, 4 people were in their 40s, 8 people were in his 50s, 24 people were in his 60s, 32 people were in his 70s, 14 people were in his 80s, and 1 person was being confirmed.
By gender, there were 65 males, 18 females, and 1 confirmed.

Experts said, “If the current situation where about 1% of new positives continue to become severe, the shortage of beds for severe cases will become more apparent. Medical institutions are forced to accept emergency services and limit scheduled surgery. After the year-end and New Year holidays, there is a strong concern about the impact on the resumption of regular medical care. “
In the week leading up to the 28th, the number of dead people reported to the city was 46, an increase of 17 from the previous week.
Of these, 42 were in their 70s or older.