Health centers around the country are at the frontlines of preventing the new coronavirus pandemic from spreading. Staff are extremely busy with tasks including handling phone consultations, transporting patients to medical institutions and tracking infection routes.
As they prepare for a protracted battle, centers around the country are trying to reduce their workloads and increase their workforces.
Osaka Prefecture, which has more than 1,700 infected cases, introduced in April a system that uses information and communications technology to help monitor the health of mild and asymptomatic patients who are recuperating at homes, hotels and other places.
"I'm able to listen to patients better than before," a public health nurse who works at a health center in the northern part of the prefecture said.
The system allows patients to input 13 items they need to pay attention to via smartphone or other device. These include body temperature, cough and shortness of breath.
Before, staff had to call patients recuperating at home or elsewhere every day and enter their responses into a computer.
Now, as soon as a patient enters information it is immediately available online to be viewed by public health nurses, relevant prefectural officials and others. This has eliminated the 20 to 30 minutes it took to interview and enter data on each patient.
Having mild and asymptomatic cases recuperate at home or elsewhere to ease the pressure in clinical settings has actually increased workloads at public health centers.
They are the ones to contact infected patients and their close contacts to check that their condition has not deteriorated to a state where hospitalization or other care is necessary.
The central government is planning to introduce a system similar to Osaka's nationwide. The system is slated to be operational at some public health centers as soon as the beginning of this week, and should be deployed nationwide by the next week.
These moves are aimed preventing public health centers from being overwhelmed.
Ota Ward, Tokyo, had a total of 197 confirmed infections as of Thursday. A consulting center for Japanese returning from overseas and people in close contact with infected people in the ward's public health center has been receiving as many as almost 300 calls per day.
The center's 10 public health nurses and other staff connect people with outpatient specialists if they may be infected. "There are times we're too busy to have lunch," a public health nurse in her 40s said.
Health centers take infected people to hospitals and bring samples for PCR tests to local hygienic science institutes. They also coordinate with the hospitals where people who are found to be infected will be admitted and ask patients about their behavior to determine infection routes and close contacts.
Some centers have started outsourcing telephone consultations. The Kanagawa prefectural government has outsourced consultations to its four public health centers to a private company since late April.
Previously, calls were handled by public health nurses and other staff at health centers on weekdays during the day and at the prefectural office building on weekday nights and weekends. Now calls are taken by 40 outside nurses and other staff during the day and by six workers at night.
In late March, Minato Ward, Tokyo introduced the an artificial intelligence "chatbot" that provides automated responses. A cartoon woman on the ward's website is available 24 hours a day to handle consultations about topics such as testing and how to avoid infections.
"It not only improves services for residents, but also reduces the burden on public health centers," a spokeswoman for the ward said.
New guidelines for consultations and examinations released Friday relaxed standards on body temperature and other items, which will probably lead to more consultations at public health centers.
However, to improve the PCR testing system, regional outpatient and testing centers are being set up around the country by local medical associations and others.
If a doctor at one of these centers determines a test is necessary, the person can be tested without going through a public health center. This is expected to reduce the burden on public health centers and increase the number of tests.
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