JAAM nationwide survey on the response to the first wave of COVID‐19 in Japan. Part II: how did medical institutions overcome the first wave and how should they prepare for the future?

Abstract

Aim To investigate and clarify the surge capacity of staff/equipment/space, and patient outcome in the first wave of COVID‐19 in Japan. Methods We analyzed questionnaire data from the end of May 2020 from 180 hospitals (total of 102,578 beds) with acute medical centers. Results A total of 4,938 hospitalized patients with COVID‐19 were confirmed. Of 1,100 severe COVID‐19 inpatients, 112 remained hospitalized and 138 died. There were 4,852 patients presumed to be severe COVID‐19 patients who were confirmed later to be not infected. Twenty‐seven hospitals (15% of 180 hospitals) converted their ICU to a unit for COVID‐19 patients only, and 107 (59%) had to manage both severe COVID‐19 patients and others in the same ICU. Restriction of ICU admission was occurred in one of the former 27 hospitals and 21 of later 107 hospitals. Shortage of N95 masks was the most serious concern regarding personal protective equipment (PPE). As for issues which raised ICU bed occupancy, difficulty performing or progressing rehabilitation for severe patients (42%), and the improved patients (28%), long lasting severely ill patients (36%) and unclear isolation criteria (34%) were mentioned. Many acute medicine physicians assisted regional governmental agencies functioning as advisors and volunteer coordinator. Conclusion The mortality rate of COVID‐19 in this study was 4.5% of all hospitalized patients and 14% (approximately one in 7) severe patients. The hospitals with dedicated COVID‐19 ICUs accepted more patients with severe COVID‐19 and had lower ICU admission restrictions, which may be helpful as a strategy in the next pandemic.

Effects of social support on mental health for critical care nurses during the coronavirus disease 2019 (COVID‐19) pandemic in Japan: A web‐based cross‐sectional study

“…It was reported that the mortality rate (among severe patients) of the first wave of COVID-19 in Japan was 12.5%. 1 The mental health of health-care professionals has been an important issue during the COVID-19 pandemic, as it influences the quality of care and patient turnover in a hospital. A meta-analysis including 55 sources examined the mental health of the health-care professionals who cared for COVID-19 patients, including their depression, anxiety, and post-traumatic stress disorder (PTSD), which were experienced by 15.9%, 15.1%, and 21.9%, respectively.…”

“…Coronavirus disease 2019 (COVID‐19) has spread across the world alarmingly quickly, including Japan. It was reported that the mortality rate (among severe patients) of the first wave of COVID‐19 in Japan was 12.5% 1 . The mental health of health‐care professionals has been an important issue during the COVID‐19 pandemic, as it influences the quality of care and patient turnover in a hospital.…”

Acute medical units during the first wave of the COVID-19 pandemic: a cross-national exploratory study of impact and responses

“…Two units described all COVID-19 suspected patients being routed to a dedicated COVID-19 hospital, rather than to any hospital. 9 There was agreement that point-ofcare testing for COVID-19 would be a priority. It was noted that non-COVID-19 activity was still a large proportion of daily work, and business continuity measures to ensure sustainability of these services remain important.…”

“…Acute care systems need to be able to regularly monitor basic indices to ensure that they have operational intelligence to be responsive to surges in patient need, but also to ensure no harm is being done with changes in processes. 9 We recommend that 7-and 30-day readmission rates, length of hospital stay, discharge before mid-day rates (or measure of delayed discharge), inpatient mortality rates and nosocomial infection rates should be included in a minimum dataset of what should be tracked on a regular basis, combined with measures of patient experience. Routine data collection and analysis must become a priority.…”

Infection prevention measures for patients undergoing hemodialysis during the COVID-19 pandemic in Japan: a nationwide questionnaire survey

“…In addition, the capacity of each facility to accept dialysis patients with COVID-19 is unknown. Furthermore, several facilities reportedly suffered from a shortage of personal protective equipment (PPE) such as masks and gloves [ 9 , 10 ]. However, the number of dialysis facilities in Japan that are in similar situations remains unknown.…”