Masatoki Adachi comments

Posted in: Hospitals turning away sick people as coronavirus cases surge See in context

I am a family physician in Kobe. Here are my thoughts.

My points:

1) PCR test is not perfect

2) Hospitals and clinics are not safe

3) Take your time to consult by phone or online with trained professionals

PCR Testing is not perfect

Timing is the most important factor in conducting a test for coronavirus. If the timing is wrong, it will be said as a false negative and give a negative result, although one may later become positive. The test indications currently recommended by international agencies are mostly for those requiring hospitalization. For example, it is performed to judge the necessity of isolation for patients who need management such as oxygen administration and mechanical ventilation. The reason is that there is currently no cure for novel corona infections and no effective preventative measures have been established. If a novel corona infection is suspected, the first action we need take is isolation to prevent from spreading around.

Hospitals and clinics are not safe

Also, importantly, healthcare providers are concerned that people who visit the hospitals may catch new infections at medical facilities. To be honest, the medical facilities are already in an abnormal situation where basic infection protection equipment is not available as mentioned in this article. The number of beds left in medical centers equipped with infectious disease management is already at the limit. We are forced to take measures at secondary medical facilities where the prevention against infection such as novel coronavirus is insufficient. In this situation, healthcare workers are concerned that they may spread the infection around to the patients.

Take your time to consult by phone or online with trained professionals

This situation applies not only to hospitals but also to regional medical institutions such as clinics. Going directly to a clinic or a hospital is not a very safe method. Try to consult with trained healthcare professionals on the phone or online as much as possible. Spend your time to communicate. Governments and international organizations are recommending teleconsulting to primary care providers. This is to prevent the spread of novel corona infections spreading from clinics that do not have strict infection control measures. My clinic was lucky enough to be able to quickly switch to online and telephone consultations. However, there are only few medical institutions with such flexibility in Japan (less than 2%). The fact that the Japanese government opened telephone support centers at public health centers from an early stage was of great importance.

Language challenges exist. We need to expect the challenges and take time to communicate. Language barriers are one of the things that governments and healthcare professionals have been worried from the early days. It's not perfect, but the government is making language adaptations as fast as possible. One of them is the following multilingual inquiry center. The government is continuously expanding aid to such organizations. If you are reading this and want to take any action, please go to this NPO website. You can contribute in the form of donations.

Multilingual Hotline AMDA

We are in this together

I am grateful to the colleagues who are out in the field with such limited resources (including most of medical centers and institutions in Japan). They all know that many patients and healthcare workers have died from the virus. And they know that there are only provided with insufficient supplies to protect against the infection. They are doing the best with what they have. I am grateful to the people who are working at the stores and other services that is keeping us maintain our normal lives. They give us hope for normal days to come.

We are in this together.

Stay strong, stay safe.


Testing for COVID19

Telehealth guidelines:



1)         検査が全てではない

2)         医療現場は安全地帯ではない

3)         医療従事者と電話やオンラインでじっくり相談する。







Multilingual Hotline AMDA

We are in this together


We are in this together.

Stay strong. Stay safe.

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