More than a year has passed since COVID-19 (coronavirus disease 2019) was reclassified as a Category 5 infectious disease under the Infectious Diseases Control Law. Public health journals have published several special features on COVID-19. This paper outlines the responses of various public institutions to COVID-19 after the pandemic based on information from their official websites. In 2023, the Cabinet Agency for Infectious Disease Crisis Management was established within the Cabinet Secretariat to strengthen the leadership response to infectious disease crises and to develop a system that can respond promptly and appropriately. The Ministry of Health, Labour and Welfare continues to release information on COVID-19 outbreaks, vaccines, infection control measures, etc., on its website, while detailed information related to COVID-19 is available on the National Institute of Infectious Diseases website. The Tokyo Metropolitan Government provides residents with clear, easy-to-understand information related to COVID-19, either online or through leaflets and handbooks. Incidentally, the COVID-19 pandemic has highlighted not only the difficulties but also a range of other issues. The experience of restrictive situations widely felt by society should serve as both a resource and inspiration to find concrete solutions to various challenges.

The novel coronavirus infection spread rapidly. In response, meetings were convened at the Tokyo Women's Medical University Hospital, bringing together professionals from the medical, nursing, and medical technology departments. Various measures were implemented to curb the spread of the infection. Our Central Laboratory was tasked with promptly establishing a rapid polymerase chain reaction (PCR) testing scheme. They initiated operations using the manual from the National Institute of Infectious Diseases; however, problems quickly accumulated as the infection continued to spread. An increase in the number of PCR tests was requested to accommodate the growing number of patients as the infection spread.

Our laboratory aimed to establish a system for using PCR tests as a screening method for all patients prior to admission. Achieving this required increasing the number of technicians performing PCR tests, switching reagents, introducing new equipment, and extending testing to nights and holidays. Furthermore, new demands arose, such as distinguishing the virus from influenza in preparation for the winter season and detecting mutated virus strains. These demands led to further consideration of introducing additional equipment and reagents. During this time, the supply of provisions became unstable, prompting efforts to secure the necessary resources to prevent interruptions in testing. As clinical testing specialists, we are responsible for ensuring accuracy of testing and meeting clinical needs. We recognized the importance of responding appropriately by carefully analyzing information about testing reagents, monitoring trends in the spread of the novel coronavirus, and staying informed about the actions of the National Institute of Infectious Diseases and the Ministry of Health, Labor and Welfare.

The coronavirus disease 2019 (COVID-19) pandemic required pharmacists to respond rapidly and appropriately to various challenges, particularly regarding therapeutic drug management. This review describes the efforts of pharmacists at Tokyo Women's Medical University Hospital from the early stages of the pandemic and discusses current recommended therapeutic drugs. Initially, pharmacists played crucial roles in securing therapeutic drugs, evaluating off-label use of medications, managing disinfectants, and providing pharmaceutical care in COVID-19 dedicated wards. They also addressed COVID-19-associated pulmonary aspergillosis (CAPA) through antifungal stewardship initiatives, which showed improved compliance with treatment protocols over time. Currently approved therapeutic options include antiviral drugs such as remdesivir, nirmatrelvir/ritonavir, molnupiravir, and ensitrelvir fumarate, as well as immunomodulators like glucocorticoids, baricitinib, and tocilizumab. While the number of new COVID-19 cases has decreased, the experience gained during the pandemic highlights the importance of continuous professional development and preparedness among pharmacists. This review emphasizes the significant contributions of pharmacists in COVID-19 treatment and the need for sustained readiness in managing future infectious disease challenges.

In December 2019, the world's first coronavirus disease 2019 (COVID-19) case was reported, which subsequently resulted in a pandemic. In the early days, we witnessed a cluster occurred inside a cruise ship, the Diamond Princess, anchored at the port of Yokohama, and COVID-19 death cases. We experienced fear of its high infectivity and fatality rate even from the perspective of medical professionals.

The Tokyo Women's Medical University Hospital took countermeasures at early stage of the infection spread, and we have been diagnosing, treating, and nursing of patients with COVID-19 for approximately 5 years. Initially, the hospital staff had a strong fear and anxiety about COVID-19, which we have handled through careful discussions with the staff-in-charge. Furthermore, we were subjected to prejudice and false accusations from the public for dealing with the patients as healthcare professionals; however, we all had to perform our daily duties. Everyone cooperated to overcome the challenges across different positions because we had to treat one patient after another.

Looking back in the past five years, the Department of Infection Control has prepared an environment in which all hospital staff felt safe to perform their duties and aimed to respond to all the questions they had immediately by providing 24-h support in case the staff needed help. Nevertheless, we found out there were some important areas that were overlooked, in which each staff member took initiative using their expertise to aid in the intervention. Here, we elucidate our learnings in dealing with COVID-19 and our future challenges by summarizing our experience so far.

Co-detection of respiratory pathogens with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains poorly understood. This study aimed to assess the effect of interactions between different respiratory pathogens on clinical variables.

We retrospectively reviewed the results of comprehensive multiplex polymerase chain reaction (PCR) testing from November 2020 to March 2023 in Shinjuku, Tokyo, estimating co-detection rates and analyzing interactions between SARS-CoV-2 and other pathogens. A multiple logistic regression model adjusted for age, sex, and testing period was used to identify factors influencing co-detection.

Among 57,746 patients tested, 10,516 (18.2%) were positive for at least one of 22 pathogens, and 881 (1.5%) had co-detection. SARS-CoV-2 showed negative interactions with adenovirus, other coronaviruses, human metapneumovirus, parainfluenza virus, respiratory syncytial virus, and rhino/enterovirus. Co-detection with SARS-CoV-2 was most frequent in children aged 0-4 years. A multiple logistic regression indicated that younger age was the strongest factor associated with SARS-CoV-2 co-detection.

These findings highlight the prevalence of SARS-CoV-2 co-detection in young children, warranting further research on its clinical implications and severity.

This article is based on our study, first reported in the article "SARS-CoV-2 co-detection with other respiratory pathogens-descriptive epidemiological study," published in Respiratory Investigation (2024; 62 (5): 884-8).

Eight major epidemics of the novel coronavirus (SARS-CoV-2) infection (COVID-19) were observed between January 2020 and March 2023. Since the sixth wave (January 2022), when the Omicron strain became the mainstream of the epidemic, the number of pediatric patients with COVID-19 has increased rapidly, and the number of severe patients has also increased accordingly. As of November 2022, 103 patients with COVID-19-associated acute encephalopathy have been reported, with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) (27 cases, 26.2%) and clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) (9 cases, 8.7%) being the most frequent. There were 18 patients with cytokine storm encephalopathy (17.5%), including eight with hemorrhagic shock and encephalopathy syndrome (HSES), six with encephalopathy with acute fulminant cerebral edema (AFCE), and four with acute necrotizing encephalopathy (ANE). These frequencies were higher than those reported in 2017 for ANE (2.8%) and HSES (1.7%), before the COVID-19 outbreak. The prognosis of COVID-19-related acute encephalopathy was poor (11 deaths, 10.7%) owing to the high frequency of HSES and AFCE, which have a severe clinical course.