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Response to the new coronavirus infection (COVID-19)

Japanese Association for Acute Medicine
2020.3.9

To members of the Japanese Association for Acute Medicine

We believe that many people are working to respond to the new coronavirus infection (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We have confirmed "person-to-person transmissions". As of March 8, 2020,107,000 people were confirmed to be infected worldwide and more than 3,600 people died. The increase rate in the number of infected people has not decreased. In Japan, as of March 8, 461 people were confirmed to have been diagnosed except for people quarantined in cruise ships at the Yokohama Port; we confirmed that a cluster occurred. As the situation changes, the "clinical characteristics" and "requirements of patients suspected of being infected" by the new coronavirus are updated regularly in documents issued by the Ministry of Health, Labor, and Welfare. As a characteristic of this virus infection, it has been reported that pneumonia is frequently associated with high infectivity (transmission). Although the mortality rate of COVID-19 is lower than that of SARS and MARS, it is higher than that of influenza. Complications of pneumonia in the elderly and those with underlying diseases are thought to be life-threatening. It has been reported that the number of mildly ill persons is around 80%, but the major problem is that it is not clear how many asymptomatic carriers are infected. On February 28, the Japan Society of Infectious Diseases and the Japan Society for Environmental Infectious Diseases released the document "Current Situation of New Coronavirus Infectious Diseases and Countermeasures Precautions When Shifting from Border Control to Infection Prevalence" on their websites. The main points for the control of the infection are as follows:

Points of Infection Control

  1. The basic measures against the infection are thorough standard request measures as well as measures to prevent droplets and contact.
  2. Infection can be transmitted even in close contact with people without symptoms such as coughing (for a certain time within reach).
  3. The virus is considered to produce more infectious than the normal influenza virus and therefore, it is necessary to consider the use of N95 masks and goggles depending on the situation (e.g. consultation of patients complaining of coughing or sneezing).
  4. Thoroughly perform hand hygiene and environmental disinfection because alcohol is effective for disinfection.
  5. Viruses may also be present in tears and eye secretions.
  6. New coronaviruses are found in feces. It is necessary to pay attention to the aerosolization of contaminated water after toilet drainage.
  7. It is necessary to pay attention to ventilation in waiting and consultation rooms.

In the context of the growing outbreak of the COVID-19, the role of emergency doctors in the community is important. In the future, the number of opportunities for emergency doctors to treat severely ill patients at various hospitals will increase. As part of the measures against the new coronavirus, the Japan Emergency Medical Association has established a telephone consultation service (Japan ECMO net for COVID19) to provide advice on critical care management centered on ECMO. "Clinical characteristics of COVID-19-Summary of ECMO net compatible cases for COVID-19 in Japan-(March 5)" has also been released, so please refer to it.

To reiterate, as a medical professional engaged in emergency medical care, please thoroughly implement standard precautions on a daily basis. As a member of the society, implement "hand hygiene and cough etiquette", and to prevent infection from patients, implement "hand hygiene and wearing a mask for respiratory infections that have not been diagnosed specifically". Protecting yourself can help protect patients, colleagues, their families, hospitals, and organizations. Please refer to the links below for highly reliable new coronavirus-related sites.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019
https://www.cdc.gov/coronavirus/2019-nCoV/index.html
https://www.ecdc.europa.eu/en/novel-coronavirus-china
https://www.chp.gov.hk/en/features/102465.html
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
https://www.cochranelibrary.com/collections/doi/SC000039/full