JAAM Nationwide Survey on the response to the first wave of COVID-19 in Japan. Part I: How to set up a treatment system in each hospital

Jun Oda; Seizan Tanabe; Tetsuro Nishimura; Takashi Muguruma; Shigenari Matsuyama; Yoko Sugawara; Shinji Ogura

doi:10.1002/ams2.614

JAAM Nationwide Survey on the response to the first wave of COVID-19 in Japan. Part I: How to set up a treatment system in each hospital

Acute Med Surg. 2020 Dec 12;7(1):e614. doi: 10.1002/ams2.614. eCollection 2020 Jan-Dec.

Authors

Jun Oda^{1

2}, Seizan Tanabe^{1

3}, Tetsuro Nishimura^{1

4}, Takashi Muguruma^{1

5}, Shigenari Matsuyama^{1

6}, Yoko Sugawara^{1

7}, Shinji Ogura^{1

8}

Affiliations

¹ Labor Management Committee Japanese Association for Acute Medicine (JAAM) Tokyo Japan.
² Department of Emergency and Critical Care Medicine Tokyo Medical University Shinjuku Japan.
³ Foundation for Ambulance Service Development Emergency Life-Saving Technique Academy of Tokyo Tokyo Japan.
⁴ Department of Traumatology and Critical Care Medicine Graduate School of Medicine Osaka City University Osaka Japan.
⁵ Advanced Critical Care and Emergency Center Yokohama City University Medical Center Yokohama Japan.
⁶ Department of Emergency and Critical Care Medicine Hyogo Emergency Medical Center Kobe Japan.
⁷ Department of Emergency and Critical Care Medicine Tokyo Saiseikai Central Hospital Tokyo Japan.
⁸ Department of Emergency and Disaster Medicine Gifu University Graduate School of Medicine Gifu Japan.

Abstract

Aim: To clarify how the medical institutions overcame the first wave of coronavirus disease 2019 (COVID-19) in Japan and to discuss its impact on the medical labor force.

Methods: We analyzed questionnaire data from the end of May 2020 from 180 hospitals (102,578 beds) certified by the Japanese Association for Acute Medicine.

Results: Acute (emergency) medicine physicians treated severe COVID-19 patients in more than half of hospitals. Emergency medical teams consisted of acute medicine physicians and other specialists. Frontline acute care physicians were concerned about their risk of infection in 80% of hospitals, and experienced stress due to a lack of personal protective equipment. Twenty-six of the 143 hospitals that had a mental health check/consultation system in place indicated that there was a doctor who experienced mental health problems. Of the 37 hospitals without a system, only one hospital was aware of the presence of a doctor complaining of mental health problems.

Conclusion: Acute care physicians and physicians in other departments experienced high levels of stress as they fought to arrange COVID-19 treatment teams and inpatient COVID-19 wards for infected patients. Medical materials and equipment may be sufficient for a second or third wave; however, active support is needed for the physical and mental care of medical staff. Mental health problems may be missed in facilities without mental check and consultation system.

Keywords: COVID‐19; medical staff; mental care system; survey.