COVID-19 Cluster in a Psychiatric Institution in Tochigi Prefecture: Experience Report as a DMAT Commander

抄録

A cluster of COVID-19 outbreaks occurred at a psychiatric institution. The prefectural government ordered Disaster Medical Assistance Team to be dispatched. Patients with moderate disease cannot be transferred to other hospitals, which forces them to support themselves. Although the outside-of-hospital command supporters had zoned from the initial stage, private rooms were limited, and the ward was a mixture of those who had developed the disease and asymptomatic polymerase chain reaction-positive and -negative patients. Only two part-time internists were available to treat the patients, and treating the wards required much work. Unfortunately, no concrete support has been provided by the prefecture's medical association. Measures to support the hospital include adjustments to zoning on a case-by-case basis, reassignment of existing nurses, educational activities on how to wear personal protective equipment, and improving the environment. Additionally, several issues regarding slander existed. To address these various issues, prefectural health and medical coordination headquarters for emerging infectious diseases should be established. Furthermore, guidelines should be provided for ward management strategies, treatment protocols, and staff education in the event of an outbreak of emerging infectious diseases in psychiatric institutions.