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Public health center workers in Tokyo exhausted as coronavirus cases keep rising

Workers at a public health center in Tokyo's Ota Ward field phone calls about novel coronavirus infections, on April 10, 2020. (Mainichi/Kazuya Shimura)

TOKYO -- Workers at public health centers in the Japanese capital have been left exhausted as they deal with a deluge of calls from residents about novel coronavirus infections and try to find hospitals to accept patients, amid concerns many workers could even end up crossing the line set for judging death from overwork.

In some cases, workers also risk infection by transporting infected people to hospitals themselves. They say they have never experienced such conditions before and can't keep up with their work as the number of people infected with the virus increases.

At a public health center in Tokyo's Ota Ward on the evening of April 10, workers scrambled to answer constantly ringing phones. One was from a female caller, who told a worker, "I've got a chill and I think I might have been infected." A center worker told her, "Rest at home, and if you feel anything is abnormal, then contact us again."

There is a constant stream of calls throughout the day, with as many as around 300 cases fielded at times. After putting down the receiver, one worker divulged, "We're physically and mentally exhausted."

About 20 workers at the public health center have been fielding calls. This includes those from other departments who have been providing support. Their overtime work continues until late at night, and they can rarely take breaks. After they get home, if they receive information of a new case of someone becoming infected with the virus, they rush to hospitals or other facilities, even in the middle of the night.

"If things continue like this, we'll see a succession of workers crossing the line for death from overwork (of 80 hours of overtime per month)," one official commented. From April 13, the private sector has been enlisted to field some of the calls, but no major improvements in working conditions have been seen.

In Tokyo's Minato Ward, where some 200 people have been infected with the novel coronavirus, one issue at hand at the local public health center is securing hospital beds for infected people. According to the Tokyo Metropolitan Government, the number of infected people in the ward stood at 39 as of the end of March, but as of April 18, the figure had surged to 208. The ward has been searching for places to accept patients in collaboration with the Tokyo Metropolitan Government's coordination headquarters, but there are not enough beds at hospitals in the ward or other surrounding wards, so it is taking time to find places that can accept patients. A center official commented, "Public health centers and medical institutions are barely managing. There's an increasing possibility that if a group infection were to occur in a busy shopping or entertainment area, we wouldn't be able to handle it."

A member of a public health center in the capital's Bunkyo Ward, meanwhile, commented, "There's been crowding of beds at hospitals where patients who test positive for the virus are taken. Sometimes patients are turned away, and we're facing difficulties in making arrangements for them."

Public health centers have a diverse range of tasks to fill in responding to the novel coronavirus. In addition to being inundated with consultations, they transport samples to testing organizations. If someone is confirmed to test positive for the virus, they put on protective clothing and drive the infected person to the hospital that will accept them, and ask them about the possible route of infection. As the number of patients increases, so does the number of people deemed to be in close contact with them.

"Sometimes when one person is infected, we investigate at least 100 people who have come in contact with them. But there are also infected people working in the night who don't want to talk, so investigations do not proceed as we have hoped, and those working on the scene have a very hard time," one senior Metropolitan Tokyo Government official commented.

Many public health centers are handling the response to the virus with staff ranging in numbers from around a dozen to about 20 people. In the Tokyo suburban city of Machida, where more than 30 people have been infected, a health center official expressed alarm over the situation. "We've doubled the regular number of people handling the situation, but we can see no end to it. We have an abnormal situation continuing."

(Japanese original by Kazuya Shimura and Kayo Mukuda, City News Department, and Lee Youngho, Machida Resident Bureau)

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