In this article, the author discussed how to publish disaster medical studies from an ethical point of view. It points out that first the studies reported in the Japanese Association for Disaster Medicine should be based on science. Then, it should be in line with the ethical principle of the medical study such as “Declaration of Helsinki”. This declaration insists us researchers to follow its general principle in which it states “While the primary purpose of medical research is to generate new knowledge, this goal can never take precedence over the rights and interests of individual research subjects.” In other words, “ethics of the individual” is regarded as being superior to “ethics of the society”. However, in the scene of the large-scale disaster, “ethics of the society” were often looked down on “ethics of the individual”, e.g. the triage is carried out as the process of establishing the priority of patients’ treatment. Therefore, researchers who would participate in the disaster medical study should consider “ethics of the individual” more carefully. Finally, instructions about the publication were discussed. Researchers should pay the scrupulous attention how to publish the findings in order to keep the social trust.

【Purpose】Medical service continuity is essential for health emergency and disaster risk management. In Japan, the national government requires core disaster response medical hospitals to have business continuity plans (BCP). This paper describes the development of a business impact analysis method for medical facilities based on damage simulations of subsystems such as building structure, pipelines, medical equipment, and elevators. 【Method】Responses to a questionnaire about the business impacts of the 2018 North Osaka Earthquake at hospitals was used for analysis. 51 hospitals out of 217 hospitals responded to the questionnaire. The questions relate to physical damage, functional impact, and preparedness at each hospital. 【Results】The relationship between shaking, building seismic performance, and damage to physical components were analyzed. A prototype of a medical facility damage simulation system was developed and applied to the hospitals in Kyoto city. The possible damage to hospitals in Kyoto by a Nankai Trough Earthquake was simulated. 【Conclusion】Simulation results imply that damage to hospital facilities would be more severe than that caused by the 2018 North Osaka Earthquake. Such an event could have a serious impact on medical service continuity in Kyoto.

【Purpose】 To clarify the actual status of disaster countermeasures, focusing on earthquakes, at facilities handling delivery of babies in Miyagi Prefecture, and to clarify the relationship between these countermeasures and the assumption that mothers giving birth would be accepted if an earthquake equivalent to that of the Great East Japan Earthquake were to occur today. 【Method】 Data was provided by the prefectural government, and a survey of the situation under normal circumstances was conducted. Questionnaires were sent to 27 facilities handling delivery of babies, excluding base hospitals for disaster management. 【Results】 The number of deliveries, especially in the Sennan medical care area, was noticeably lower even compared to the number of births, and only two clinics were currently available for delivery of babies. The number of valid responses to the survey was 11 facilities. One clinic in the Sennan medical care area responded to the survey, but it was an existing nonconforming building. 【Discussion】 The results of the survey suggest that a response plan for patient care and lifeline disruption needs to be developed. Preventing beds and equipment from being moved was an issue. 【Conclusion】 Interdisciplinary research and two-way risk communication between the fields of architecture and medicine are required to ensure that delivery facilities can continue to receive deliveries in the event of a large-scale disaster.

【Objective】 The Great East Japan Earthquake led to a problematic increase in the percentage of elderly residents in disaster-stricken areas who have been certified as requiring long-term care (long-term care certification rate) due to poor physical and mental function. During two natural disasters in Kumamoto Prefecture, rehabilitation professionals were utilized to improve the living conditions of the elderly through early modifications made to newly-constructed emergency housing (early-phase home modifications). The purpose of this study is to examine the effectiveness of this initiative. 【Methods】 This retrospective study analyzed information from databases of administrative agencies and reports and various documents prepared by disaster support groups and other organizations. The study was also based on the responses of residents to a questionnaire on the newly-constructed emergency housing that underwent early-phase home modifications following the heavy downpours in July, 2020, as well as the responses of the personnel in charge of temporary housing in disaster-stricken municipalities. 【Results】 The areas affected by natural disasters in Kumamoto Prefecture saw no increase in the long-term care certification rate. The questionnaire revealed a high level of satisfaction overall among the respondents. 【Conclusion】 The study suggested that the early involvement of rehabilitation professionals in early-phase home modifications could be a contributing factor in preventing an increase in the long-term care certification rate in disaster-stricken areas.

Typhoon No.15, called Faxai, hit Chiba Prefecture, caused devastating damage, and the Ministry of Japan designated it as an extremely severe disaster. Many patients who received home oxygen therapy (HOT) had difficulty in getting proper treatment. Because unusable of home oxygen concentrators due to power failure and telephone line distribution, the patient was not able to implement an emergency plan such as getting in touch with home oxygen supplier for oxygen tanks. We collected oxygen tanks in our hospital as much as possible from home oxygen suppliers and provided the patients with information about oxygen tanks through the city government emergency radio. Based on the previous disaster experiences in Japan, it has been pointed out that disaster response to patients who receive HOT therapy depends mainly on home oxygen suppliers. A new disaster manual for HOT therapy that focus on the cooperation system in the government, hospitals and home oxygen suppliers need to be made.

The accident at the Tokyo Electric Power Company’s (TEPCO’s) Fukushima Daiichi Nuclear Power Plant that accompanied the 2011 Great East Japan Earthquake threw relief efforts in disarray, which has led the Japanese Red Cross Society (JRCS) to reflect greatly on its practices. Based on these reflections, the JRCS has been working on various efforts including: preparing and maintaining the equipment and materials necessary to respond to nuclear disasters; developing activity policies and relief-team training based on these; the appointment of Japanese Red Cross Nuclear Disaster Medical Care Advisors to support the headquarters; establishing support systems for JRCS facilities located in areas stricken by nuclear disaster; and the better dissemination of information of nuclear disaster. Currently, 26 hospitals and the local JRCS Chapters throughout Japan have been designated and registered as either Nuclear Disaster Base Hospitals or Nuclear Disaster Medical Cooperative Institutions. These facilities can now play a part in the national response to nuclear disasters. But the issues remain to be addressed. There is a need to examine the appropriateness of JRCS’s activity policies and to address the declining interest in nuclear disasters within the JRCS. In addition, it is also necessary to further systematize the role of the JRCS in the overall nuclear disaster medical care system.

Japanese Red Cross Kitami Hospital is a core medical institution in the Okhotsk medical region of Hokkaido and provides complete regional medical care in cooperation with surrounding medical institutions. A COVID-19 infection control headquarters system was established by Japanese Red Cross Kitami Hospital by the director of Japanese Red Cross Kitami Hospital following the first Hokkaido COVID-19 cluster outbreak in Kitami City to share information with COVID-19 receiving hospitals, public health centers, and administrative agencies. During the fourth wave, worsening COVID-19 disease severity resulted in a series of increased patient transfers to Japanese Red Cross Kitami Hospital from surrounding institutions which resulted in a strain on our medical system. At that time, because it was found that regional COVID-19 treatment in surrounding institutions was not standardized, a web conference was initiated between seven regional referral hospitals and public health centers in order to share the standard treatment methods. Subsequently, the number of COVID-19 patient transferred to Japanese Red Cross Kitami Hospital decreased. We conclude that regional standardization of COVID-19 treatment based on daily collaboration may have been effective to prevent COVID-19 severe cases in our medical region where medical resources are limited.

The COVID-19 pandemic caused many healthcare workers to experience serious physical symptoms. At government request, The Disaster Support Acupuncture Masseur Joint Committee (DSAM) began to provide acupuncture treatment and massage to a group of healthcare professionals 11 days after a cluster of positive COVID-19 cases had been confirmed at their hospital. Most of the 63 recipients (cumulative total of 72 patients) of 7-day support were female (77.8%), in their 40s (30.2%), and worked as nurses (87.3%). Their chief complaints were neck and shoulder pain (54.7%). Thirty-four patients (39.5%), who had suffered from these symptoms until receiving treatment, showed an improvement in the Numeric Rating Scale (NRS): Although 16 patients (47.1%) had scored 7 or higher before the treatment, none did after the treatment indicating that early-stage intervention can effectively reduce pain.