Update on 2019 Novel Coronavirus Situation at Keio University Hospital

This is an update on information surrounding the 2019 novel coronavirus at the Keio University Hospital as of April 21, following our previous update on April 6, 2020.

1. Infections originating from patients transferred from Eiju General Hospital
As announced on March 26, 2020, hospital-acquired infections (4 patients) in a specific ward originated from patients transferred from Eiju General Hospital. A prompt screening that included PCR tests of the 113 hospital staff who had contact with these patients confirmed infections in one doctor and three medical workers (all were asymptomatic). There have been no new cases and the infection has not spread as of April 21, twenty-six days since self-quarantine was mandated for all individuals who had close contact with an infected person.

2. Infections related to doctors dispatched to Eiju General Hospital
Out of 99 doctors dispatched to Eiju General Hospital, five tested PCR positive for coronavirus. Subsequent screening of 35 people who had been in contact with the PCR-positive doctors revealed that an additional two doctors were asymptomatically infected. We were able to prevent any further cases and stop the spread of infection by requiring dispatched doctors and those who had contact with them to self-quarantine for two weeks, and by promptly conducting PCR tests on those who had contact with an infected person. All doctors have since recovered. There have been no new cases and the infection has not spread as of April 21, twenty days since the last contact with dispatched doctors.

3. Outbreak among junior clinical residents
18 of 99 junior clinical residents tested positive after receiving PCR tests on April 1. Subsequent screenings of 99 people who had been in contact with the 99 junior clinical residents confirmed that there were no further infections of hospital staff or patients. Later, during self-quarantine, two other residents developed symptoms and tested positive after receiving a PCR test. As a precaution, other residents who had initially tested negative were given another PCR test and again tested negative. There have been no new cases, and the infection has not spread as of April 21, twenty-one days since the hospitalization and self-quarantine for all junior clinical residents as well as twenty-one days since self-quarantine was implemented for hospital staff who had contact with these junior clinical residents.

【Outpatient Care】
We are continuing to provide outpatient care in a measured way for cancer chemotherapy and drug therapies for intractable immune disorders. For other outpatient services, we are doing all we can to prevent the interruption of treatment. These services include support by phone to confirm medical conditions, notifying patients of test results, and scheduling examinations as well as mailing prescriptions if necessary. Procedures with a high risk of infection have been rescheduled or canceled. These procedures include endoscopy, dental and oral surgery, ophthalmology, otolaryngology, and rehabilitation.

【Inpatient Care】
Inpatient treatments such as surgery have been limited to advanced cancer surgeries and urgent or emergency life-saving operations. We make patient safety our top priority, and since April 6 have performed pre-admission PCR tests and chest CT scans on patients scheduled for surgery under general anesthesia as well as pre-admission PCR tests on all other patients requiring inpatient treatment (including childbirth).
　
【Treating 2019 Novel Coronavirus Infections】
To save as many patients with severe infections and to prevent moderate cases for becoming severe, we have formed a COVID-19 life-saving team consisting of multiple clinical departments. We have created clearly designated zones within the hospital and, at the request of the Tokyo metropolitan government, are accepting patients with moderate and severe infections.

Preoperative and pre-admission PCR tests conducted between April 13 and April 19 confirmed that the coronavirus disease had infected 5.97 % of asymptomatic patients (4 out of 67) who were receiving non-coronavirus-related treatments. We think these infections happened in the community, outside of the hospital, and may reflect the state of coronavirus infection in the area. We also believe that it is necessary to take further measures to prevent further infections.

At Keio University Hospital, we are taking preventative measures against hospital-acquired infections. These include the zoning of the hospital and our efforts to treat patients with severe and critical coronavirus infections as we provide the advanced medical care that is part of our mission as a university and advanced treatment hospital.

As the situation continues to develop and cases of coronavirus infection increase, we hope to start accepting new patients around May 7. New patients will be limited, however, to those with cancer, intractable immune disorders, and other diseases that require advanced medical care.

Dates and other information will be announced on our website as it becomes available.

We will continue to bolster our medical readiness for coronavirus infections and create an environment in which everyone can receive treatment with peace of mind. Thank you very much for your continued understanding and cooperation.

*All PCR tests are currently carried out within Keio University Hospital, with all costs borne by the hospital (not covered by insurance).

Yuko Kitagawa
Director General, Keio University Hospital

Previous updates from the hospital regarding the 2019 novel coronavirus (April 6, March 27, March 26):https://www.hosp.keio.ac.jp/st/management/info/covid-19_info_0413.pdf(Japanese)